Healthy Skepticism Library item: 12364

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Chester MR.
Consider palliative coronary intervention.
BMJ 2008 Jan 12; 336:(7635):59
http://www.bmj.com/cgi/content/full/336/7635/59-a

Abstract:

The recommendation by Yank et al, that pharma sponsored drug trials should be interpreted with caution, is well made.1 Most percutaneous coronary intervention (PCI) procedures entail the implantation of a coronary stent. Most stent studies are funded by equipment manufacturers and are designed and conducted by researchers who believe in coronary intervention despite the lack of hard evidence of cost effectiveness or clinical superiority over optimal medical therapy.2 3

Therapists’ irrational faith in intuitive based practice adds an extra dimension to the “positive spin” effect described in the paper. Given the paucity of independently funded coronary stent studies and the total lack of a placebo controlled study of this palliative therapy, healthcare commissioners have a hard time unravelling spin, especially when professional bodies weigh in with their spin on the evidence.

The RITA-2 study showed that, although palliative PCI was associated with a small and transient improvement in symptoms, it increased