A reaction to ORBITA: Keep on stenting, judiciously

Physicians’ reactions to ORBITA — a blinded, randomized controlled trial (RCT) from Britain with a sham arm comparing percutaneous coronary intervention (PCI) to placebo in patients with stable angina — are as fascinating as the cardiac cycle. There were murmurs, kicks and pulsating jugulars. Though many claimed to be surprised and many unsurprised by the null results of the trial, the responses were predictably predictable. Some basked in playful schadenfreude, and some became defensive and bisferious. No shame in sham The coverage of the trial in the The New York Times was predictably jejune and hyperbolic. Predictably, the most nuanced and divergent viewpoints were curated by Larry Husten. Predictably, medical Twitter was set alight. The trial vindicated Vinay Prasad and Adam Cifu who predicted that PCI for stable angina will get placeboed in their popular book, “Ending Medical Reversal”. Prasad and Cifu are tireless advocates for using sham control trials to judge the true efficacy of procedures, such as PCI in relieving symptoms and reject the notion that invasive placebos are unethical. There’s no shame in sham, they say. They were right. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Cardiology Source Type: blogs