Thread by @ProfDFrancis

Yes but this is not because they are evil.

It is because they feel that they are responsible for being advocates for their craft. That is why we congratulate people who broaden the indications for an intervention, and shun those who narrow it.

https://twitter.com/AllenFrancesMD/status/1382307096436252686

The Echo CRT trialists did an excellent job discovering that CRT given to people with only mechanical dyssynchrony, killed you progressively over time. In the same way that CRT for LBBB saved your life progressively over time.

In other words they showed that it was not a procedural complication problem (that happens soon after the implant) but a progressive result of the pacing itself.

They rarely get credit for this exquisite insight.

In an ordinary science, i.e. not clinical trials, people don't have an ace to grind on whether the speed of light is 300 or 400 million m/s, so we get to the right answer quickly.

But in medicine everyone wants to quote the fastest speed of light and there is competition to find the highest estimate.

"In the right hands, the speed of light can be up to 600 million m/s"

"With careful patient selection, it can reach 900 million m/s"

"With good training, speeds of around 1200 million m/s can be expected"

"Some studies report lower values, as low as 300 million m/s, but they are small, did not include solely purple light which we recommend as the fastest, and only measured travel over 6 weeks. In practice it takes light longer to reach its full speed."