{"id":43218,"date":"2014-05-12T12:03:51","date_gmt":"2014-05-12T16:03:51","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=voices&#038;p=43218"},"modified":"2014-05-12T12:03:51","modified_gmt":"2014-05-12T16:03:51","slug":"selections-from-richard-lehmans-literature-review-may-12th","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2014\/05\/12\/selections-from-richard-lehmans-literature-review-may-12th\/","title":{"rendered":"Selections from Richard Lehman\u2019s Literature Review: May 12th"},"content":{"rendered":"<p><em>CardioExchange is pleased to reprint this selection from Dr. Richard Lehman\u2019s\u00a0<a href=\"http:\/\/blogs.bmj.com\/bmj\/category\/richard-lehmans-weekly-review-of-medical-journals\/\" target=\"_blank\">weekly journal review blog<\/a>\u00a0at\u00a0<a href=\"http:\/\/www.bmj.com\/\">BMJ.com<\/a>. Selected summaries are relevant to our audience, but we encourage members to engage with the\u00a0<a title=\"Lehman_8282012\" href=\"http:\/\/blogs.bmj.com\/bmj\/2014\/05\/12\/richard-lehmans-journal-review-12-may-2014\/\" target=\"_blank\">entire blog<\/a>.<\/em><\/p>\n<p><strong>BMJ\u00a0 10 May 2014\u00a0 Vol 348<\/strong><\/p>\n<p><strong>Influence of Healthy Candidate Bias in Assessing Clinical Effectiveness for ICDs:<\/strong> I was taught English in a northern British grammar school in the 1960s. This makes a me a bit curmudgeonly about much medical prose, especially from America. Consider this <a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g2866\">latest BMJ submission from Harvard<\/a>: \u201d Lower risks of measured outcomes likely reflect unmeasured differences in comorbidity and frailty. The findings highlight potential pitfalls of observational comparative effectiveness research and support physician consideration of general health status in selecting patients for ICD therapy.\u201d By spending a year in New England I\u2019ve grown used to listening attentively to this kind of stuff and translating it as I go. \u201cLikely\u201d means \u201cprobably.\u201d\u00a0 \u201cMeasured outcomes\u201d means \u201crecorded adverse outcomes.\u201d The second sentence jumbles unrelated concepts. \u201cFindings highlight potential pitfalls\u201d is the sort of phrase that would have led to corporal punishment in my day. We were taught that writing was the organization of thoughts and words so that they followed a logical order and rhythm that would make them understandable. I can\u2019t find any connection between the first and second parts of this sentence. If the findings show that important data about comorbidity and frailty are (likely) missing or unrecorded, how does that help physicians take them into account when selecting patients for ICD? And what is this \u201cwhen selecting patients\u201d about: shouldn\u2019t that read \u201cwhen discussing ICD implantation with patients?\u201d This is paternalistic shared decision making at its traditional worst: the physician makes the decision on the basis of lousy evidence and the patient shares it.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This week&#8217;s topic is the influence of healthy candidate bias when assessing clinical effectiveness for ICDs.<\/p>\n","protected":false},"author":475,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[448,2251],"class_list":["post-43218","post","type-post","status-publish","format-standard","hentry","category-general","tag-icds","tag-shared-decision-making"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/43218","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/475"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=43218"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/43218\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=43218"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=43218"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=43218"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}