Here is the UK's British National Formulary (equivalent in role, I believe, to the US Physician's Desk Reference) regarding standard short-acting metoprolol.
A question that I thought was simple, has had enormous pushback from respondents. 50:50 are ardently espousing an answer I consider to be obviously wrong.
Suppose there is a shop which only lets you in if you bring exactly ONE child.
Each person going shopping has two children, and chooses one child to go with them, but ALWAYS takes a boy if they have a boy.
For a randomly chosen customer in the shop, if their accompanying child is a boy, what is the probability that the child at home is a girl?
Let's give it a few days to see how people vote.
Please don't give the answer away, as it will spoil the experience.
A picture tells a thousand words. And if you use a thousand colours, it tells a million words.
Here we are! The bestest trial in all the world!
Today I am happy to say I am something to do with it!!! No longer am I saying I had nothing to do with it and it was just something @rallamee was doing without my knowledge.
The cleaner could tell the people in NYHA 1: they are basically feeling normal.
The cleaner could also tell people in NYHA 4. They are slumped in a chair or bed, breathless at rest.
Everyone else is in 2 or 3.
Therefore the entire purpose of the 10 years of medical school, cardiology training, PhD and whatnot, is to be more skilled than the cleaner, i.e. to be able to distinguish NYHA 2 from 3.
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.
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.
However take no notice of this. I am an interventionist and it shows a reduction in some sort of events, when interventionists do our thing, so I am bound to like it.