Lots of headlines @escardio re CT-FFR. 1 of most prominent is ADVANCE multicenter registry from @manesh_patelMD & colleagues using @HeartFlow. I'd like to dissect this a bit to see how excitement in a field combined with lots of industry funding can blind us to basic problems.
Team worked across 38 international sites over >2 years to collect data from N=5083 patients w/ “symptoms concerning for CAD”. They had primary endpoint of change in management plan from coronary CTA. That happened in 67% of patients. Most impressive.
Is this a valid endpoint? I contend that this is a measurement of physician psychology rather than of anything objective.
If you want to kill people, the most effective way to do this in the modern era (since gun laws and annoying people like the Police will make things awkward) is to persuade people to stop (or never start) a statin.
Over the long term, 1 in 10 will be killed by that choice.
You can even write books about it and make money.
And be seen as a crusader against a crooked medicogovernmental conspiracy.
The internet is a good place to operate, because most lay people can't distinguish scientific reasoning from pseudoscience, and because ...
Heh heh, the Amazing Yuripridio, world-conquering hypnotist
But we must be careful on this. I have a PhD student at #ORBITA hq called Frances Wood. I met her first as a manager in a research unit a few years ago. She was the nicest, kindest person there, who would always make me tea when I visited anyone in the unit.
By and by, she wrote a PhD proposal with me. She was a trained nurse, as many of that unit's staff are. But when we submitted the grant, I discovered in her CV that she was also secretly a trained psychologist.