[HN Gopher] Heart doctors 'held back stent death data' ___________________________________________________________________ Heart doctors 'held back stent death data' Author : olvy0 Score : 54 points Date : 2020-02-18 20:53 UTC (2 hours ago) (HTM) web link (www.bbc.com) (TXT) w3m dump (www.bbc.com) | mgarfias wrote: | Any mention of these things and death is pretty frightening. I've | got two of the damn things in me. However, the article is | baffling in the extreme. It sure appears to be written to alarm, | and doesn't provide enough detail. I will definitely bring it up | with the cardiologist in a few weeks and see what he says. | scrozier wrote: | This strikes me as a) not very well written, and b) not | presenting all the relevant information. For example, if the | study was designed to gather data for three years after each | procedure, then taking into account data beyond that period would | possibly taint the analysis. (Of course, if people were dying in | year four, there could/should be another study.) | | I had to read the article twice to understand the main point. | Sentences like this make me scratch my head: "The data suggested | more people fitted with stents were dying after three years." | satya71 wrote: | Exactly, the last two year survival of control group may be | artificially enhanced because the ones that were going to die | were already dead in the first three. | James_Henry wrote: | Why would they compare the death rate in just the fourth year | between the two groups instead of doing a normal survival | analysis? | mohammad_ali85 wrote: | Agreed. It isn't clear what the issue is here. If the research | protocol states 3 years of data collection it's technically | unethical, without submitting an amendment, to collect data | beyond 3 years as the patient hasn't agreed to this. Sure, in | hindsight the data should have been collected for longer but at | the time of study design 3 years probably seemed appropriate. | It's really difficult to say how long to follow up - forever? | Sure, but would be financially unfeasible. We do have a yellow | carding system in the UK - the medicine and health regulatory | authority (MHRA) run this and it's for submission of adverse | drug reactions as well device issues. But again, not sure how | helpful it would have been for the instances of participant | death after 3 years. Seems harsh on the doctors who carried out | the research, unless I'm not reading this correctly. | James_Henry wrote: | They were already collecting data past 3 years. | | The doctors who carried out this research are, it sounds, | blatantly in the wrong, for they withheld the data that | appears to make clear that stents have worse outcomes past | year 3 until after the guidelines were written while they had | already gathered this data before the guidelines were | written. | | Sure they cannot openly share all their data because it is | private, but it is very suspect that they do not share the | external review that found them at fault | | As Prof John Ioannadis points out in the article, there are | wide systemic issues in the trials and guidelines process. | dontdoitpls wrote: | Physicians claim they should be the only ones with the power to | give antibiotics, but then they created the opioid epidemic. | | The physician cartel in the US is awful. | | I only see them being more powerful in the future. They've | bribed/lobbied $400,000,000 in my lifetime. | pcj-github wrote: | This is pretty well-known phenomenon to vascular practitioners... | | Interventional cardiologists chronically low-ball the dangers of | stents and gloss-over their well-known short-term performance. | Who'd a thunk that jamming a foreign body in a small artery ends | up making it worse in the long-term? | | Patients with coronary bypass often have a better long-term | outlook, but in many cases the cardiologists simply don't refer | to cardiac surgeons to line their own pockets (and admit | "defeat"). ___________________________________________________________________ (page generated 2020-02-18 23:00 UTC)