CardioExchange Archive

September 13th, 2011

Is Most Research Done Today a Waste?

Harlan M. Krumholz, MD, SM

Richard Smith (@Richard56), the former editor of BMJ, sent out a tweet earlier today that is worth some reflection. Here it is: 85% of clinical research is waste because the question is unimportant, the design is not right, nothing is published, or the paper is biased What do you think? Is most research done today a waste? Are […]

---

August 7th, 2011

Help Cover ESC for CardioExchange

Harlan M. Krumholz, MD, SM

Ever dream of being a writer living in Paris? Here’s your chance.

---

August 1st, 2011

A Set of Calculators for Estimating Readmission Risk

Harlan M. Krumholz, MD, SM

If you are interested in a tool that estimates the readmission risk of a patient who has been hospitalized for acute myocardial infarction, heart failure, or pneumonia, you can find one at www.readmissionscore.org. Readmission rates are increasingly a focus of quality-of-care efforts in the U.S., including those initiated by the Centers for Medicare and Medicaid […]

---

May 1st, 2011

Don’t Miss the New AHA Recommendations on Triglycerides

Harlan M. Krumholz, MD, SM

I’ve been surprised at the lack of fanfare surrounding the American Heart Association’s recently published scientific statement on triglycerides and cardiovascular disease (CVD). The attention it did receive focused on the lower fasting triglyceride level that is now considered optimal: <100 mg/dL. In my opinion, the real headline was the committee’s important statements in support of […]

---

March 2nd, 2011

A DOSE of Reality: The Challenges of Comparing Effectiveness

Harlan M. Krumholz, MD, SM

An ideal paper for your next journal club — “Diuretic Strategies in Patients with Acute Decompensated Heart Failure” — was just published in NEJM, by the NHLBI Heart Failure Clinical Research Network.  In this study (called DOSE), patients hospitalized with heart failure were randomized to receive different diuretic regimens based on dose and mode of […]

---

February 27th, 2011

Examining an Ad for a Platelet-Inhibition Test

Harlan M. Krumholz, MD, SM

I’ve recently seen in medical journals an advertisement that features an image of a clot within a stent and this headline in all capital letters: “Low Levels of Platelet Inhibition May Have Significant Consequences.” The final two words, “Significant Consequences,” are in a very large font, and the entire ad has an ominous black background. Below […]

---

February 3rd, 2011

How to Question the Research Question

Harlan M. Krumholz, MD, SM

Another good paper for a journal club recently appeared in JAMA. What makes this one worth discussing is the research question the investigators posed and how they addressed it. Although this is not focused on cardiac care, the issues are germane to literature in our field and cardiac care certification is also spreading. The article, titled “Association […]

---

January 24th, 2011

Poor Justification for Compulsory Angiography Before Vascular Surgery

Harlan M. Krumholz, MD, SM

I recently heard a physician quote a paper from JACC to justify pursuing revascularization in an asymptomatic patient who was scheduled for major vascular surgery. This article is worth a close look in your journal club, even though it was published in 2009. In their discussion, the authors summarize their findings as follows: “For patients in […]

---

January 11th, 2011

How Are We Doing?

Harlan M. Krumholz, MD, SM

Dear Colleagues, We launched CardioExchange in an effort to build a non-partisan venue for the exchange of information and views about the world of cardiology. Our presumption is that there is wisdom in our community and that we can learn from each other. It was a bit of an experiment and we had no idea whether […]

---

January 10th, 2011

Have the COURAGE to Critique a Substudy

Harlan M. Krumholz, MD, SM

In this journal club, I compare the published data from an original trial with the authors’ conclusions in a substudy from that trial. Often, a substudy provides valuable insights that complement the initial trial findings. Sometimes, however, you need to look closely to identify the additional insight. Case in point: COURAGE. The Original COURAGE Trial As reported […]

---