{"id":4952,"date":"2010-11-17T11:42:17","date_gmt":"2010-11-17T16:42:17","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=4952"},"modified":"2011-07-19T17:44:10","modified_gmt":"2011-07-19T21:44:10","slug":"negative-trials-positive-impact","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2010\/11\/17\/negative-trials-positive-impact\/","title":{"rendered":"Negative Trials, Positive Impact"},"content":{"rendered":"

Several Cardiology Fellows who are attending this week\u2019s AHA\u00a0meeting are blogging together on CardioExchange. The Fellows include Susan Cheng<\/a>, Madhavi Reddy<\/a>, John Ryan<\/a>, and Amit Shah<\/a>. Check back often to learn about the biggest buzz in Chicago this week \u2014 whether it\u2019s a poster, a presentation, or the word in the hallways. You can read the preceding post here<\/a>.<\/em><\/p>\n

After the sessions today, I grabbed a cup of coffee with a few friends before they flew out of town. After going through many of the results of the studies presented at the meeting, we recognized a common theme: there were a lot of negative studies. PFO closure is no different from medical therapy (CLOSURE 1<\/a>), there is no benefit of clopidogrel dosing based on platelet function testing (GRAVITAS<\/a>), Omega 3 is not effective for A Fib<\/a>, and N-acetylcysteine NAC) makes \u201cabsolutely no difference\u201d in contrast-induced nephropathy (ACT<\/a>). However, in this setting, these negative (or, perhaps more appropriately, \u201cneutral\u201d) studies are likely to have a substantial effect on patient care. Or, at least one would expect that they should. Each of the studies was well designed and well executed. Will physicians now feel comfortable with not<\/em> closing PFOs in patients with cryptogenic stroke? Defensive medicine has long generated concern among physicians and has been shown to significantly influence practice<\/a>. So, over the next few months, it will be interesting to see whether these studies are sufficiently powerful to reassure physicians not to <\/em>give NAC before coronary angiogram in patients with mild renal insufficiency. Because, after, all NAC does not have any adverse side effects. One of my colleagues commented that this is because \u201cit also has no positive effects\u2026you know what else has no side effects? Placebo.\u201d What are people\u2019s thoughts?<\/p>\n

After the excitement surrounding my inaugural talk yesterday, today was more relaxing. The Chicago-land AHA had invited 187 high school students to the scientific sessions, and 11 fellows from the city volunteered to show them around the exhibition hall and talk to them about careers in science. I had a group of twelve students from north of the city. I did not know exactly how to tell them about the things we do. I was going to try and identify with them by talking about iCarly<\/a> and Justin Bieber<\/a>, but I suspected that it might not go over very well. So, instead I decided to give them an inspiring talk about all the great things that have been discovered and presented at AHA, such as Paul Dudley White<\/a>, Goldstein and Brown<\/a>, and Mason Sones<\/a>. It was a lot of fun trying to engage these high school seniors in cardiology and telling them tales to inspire them. However, at the same time it was also a challenge to explain our everyday issues, such as MIs, arrhythmias, or heart failure, and break them down to a basic level. What do people normally do to try and inspire high schoolers to consider a career in medicine? Or would you even recommend a career in medicine, with the current changes that we are going through? I told them about the 8 years of training that follow medical school, and their eyes opened wide as they considered that it would take them almost twice as many years as the age they are right now to become cardiologists. I tried to put it in context by saying that master chef apprenticeships are just as long, hoping that they were Iron Chef fans. Needless to say, they were not. Nonetheless, I hope that I still made a positive impression on these students.<\/p>\n

Thanks to all who have commented on our blogs over the last few days. This has been a fun venture, and I hope you have enjoyed it as much as we have.<\/p>\n","protected":false},"excerpt":{"rendered":"

Several Cardiology Fellows who are attending this week\u2019s AHA\u00a0meeting are blogging together on CardioExchange. The Fellows include Susan Cheng, Madhavi Reddy, John Ryan, and Amit Shah. Check back often to learn about the biggest buzz in Chicago this week \u2014 whether it\u2019s a poster, a presentation, or the word in the hallways. You can read […]<\/p>\n","protected":false},"author":280,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[476,195],"class_list":["post-4952","post","type-post","status-publish","format-standard","hentry","category-general","tag-aha","tag-fellowship-training-2"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/4952","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\/280"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=4952"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/4952\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=4952"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=4952"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=4952"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}