Surgery Nightmare -- Yikes!

[Vikram]

"...Ten-year follow-up of survival and myocardial infarction in the randomized Coronary Artery Surgery Study. Alderman EL, Bourassa MG, Cohen LS, Davis KB, Kaiser GG, Killip T, Mock MB, Pettinger M, Robertson TL, Stanford University, California.
The Coronary Artery Surgery Study (CASS) randomized 780 patients to an initial strategy of coronary surgery or medical therapy. Of medically randomized patients, 6% had surgery within 6 months and a total of 40% had surgery by 10 years. At 10 years, there was no difference in cumulative survival"

Comment: In other words "unnecessary surgery."

The fact that an angioplasty does not significantly increase cumulative survival is well-documented in all medical textbooks. Harrison's textbook of Internal Medicine states it clearly and unambiguously. I advise you to read it.

Before my mother underwent an angioplasty earlier this year, the cardiologist had very clearly informed her that the angioplasty would NOT eventually increase her survival. What it would do (and has been documented as doing) is produce "marked improvement or complete resolution of the presenting symptoms". After the angioplasty, my mother felt a great degree of relief from the nagging chest pains that she felt everytime she walked a small distance. This allowed her to resume her daily activities, something she was incapable of doing previously.

Medicine does not claim that angioplasties increase survival. It only states that angioplasties considerably alleviate the symptoms of a narrowed coronary artery. Every patient is made aware of this fact. And the patient is asked to decide whether the decrease in suffering is worth the risks of the procedure. If the patient feels that it is, then the surgeons proceed with the surgery.

Angioplasties are certainly NOT unnecessary surgeries. They do not decrease mortality but they documentedly decrease morbidity. That is the purpose for which they are performed.

By the way, the link you posted in your previous post does not work.

2) Demonstrate that the actual number of surgeries performed is more than two standard deviations in excess of the number of surgeries indicated.

The number of surgeries "indicated" in the above example was shown to be zero.

Wrong again. To penalise a surgery for not being able to do something that it does not claim to is just ridiculous. Angioplasty is certainly indicated in symptomatic patients of coronary artery disease - their quality of life would be considerably improved by the procedure. It will not significantly postpone the age at which they will eventually die, but it will allow them to be physically and socially active for a much longer duration of time. Sounds like a indication enough for me.

>>3) Demonstrate that this excess is a result of a plot to train interns/residents.

>>That's science.

No, that is not science. Science does not measure motivation for mal-practice.

Of course it does. Science measures all knowledge. In any case, what I meant was that science uses documentation and statistics. Please use that.



You have not provided any evidence for your libellous claim. Therefore, I would request you to either:

1) Admit that you simply made a defamatory statement without having any evidence whatsoever for it, or

2) Please provide evidence for your claim that unneeded surgeries are routinely being performed FOR THE PURPOSE OF training interns/residents.

 

[Vikram]

"...Ten-year follow-up of survival and myocardial infarction in the randomized Coronary Artery Surgery Study. Alderman EL, Bourassa MG, Cohen LS, Davis KB, Kaiser GG, Killip T, Mock MB, Pettinger M, Robertson TL, Stanford University, California.
The Coronary Artery Surgery Study (CASS) randomized 780 patients to an initial strategy of coronary surgery or medical therapy. Of medically randomized patients, 6% had surgery within 6 months and a total of 40% had surgery by 10 years. At 10 years, there was no difference in cumulative survival"

Comment: In other words "unnecessary

 

[Vikram]

"...Ten-year follow-up of survival and myocardial infarction in the randomized Coronary Artery Surgery Study. Alderman EL, Bourassa MG, Cohen LS, Davis KB, Kaiser GG, Killip T, Mock MB, Pettinger M, Robertson TL, Stanford University, California.
The Coronary Artery Surgery Study (CASS) randomized 780 patients to an initial strategy of coronary surgery or medical therapy. Of medically randomized patients, 6% had surgery within 6 months and a total of 40% had surgery by 10 years. At 10 years, there was no difference in cumulative survival"

Comment: In other words "unnecessary surgery."

The fact that an angioplasty does not significantly increase cumulative survival is well-documented in all medical textbooks. Harrison's textbook of Internal Medicine states it clearly and unambiguously. I advise you to read it.

Before my mother underwent an angioplasty earlier this year, the cardiologist had very clearly informed her that the angioplasty would NOT eventually increase her survival. What it would do (and has been documented as doing) is produce "marked improvement or complete resolution of the presenting symptoms". After the angioplasty, my mother felt a great degree of relief from the nagging chest pains that she felt everytime she walked a small distance. This allowed her to resume her daily activities, something she was incapable of doing previously.

Medicine does not claim that angioplasties increase survival. It only states that angioplasties considerably alleviate the symptoms of a narrowed coronary artery. Every patient is made aware of this fact. And the patient is asked to decide whether the decrease in suffering is worth the risks of the procedure. If the patient feels that it is, then the surgeons proceed with the surgery.

Angioplasties are certainly NOT unnecessary surgeries. They do not decrease mortality but they documentedly decrease morbidity. That is the purpose for which they are performed.

By the way, the link you posted in your previous post does not wo

 

[Rouser2]

Originally posted by Vikram [/i]

>>Science measures all knowledge. In any case, what I meant was that science uses documentation and statistics. Please use that.

Science does not measure "motivation" for mal practice. If it does, please provide an example.

>>You have not provided any evidence for your libellous claim. Therefore, I would request you to either:

1) Admit that you simply made a defamatory statement without having any evidence whatsoever for it, or

2) Please provide evidence for your claim that unneeded surgeries are routinely being performed FOR THE PURPOSE OF training interns/residents.

Comment: There is no such a thing as "libel' when a specific person or persons are not named. Casting aspersions on a specific hospital's practice is not libel. And there is plenty of evidence for unnecesary surgeries of which I have offered one example.




__________________

 

[Rouser2]

Originally posted by Vikram [/i]

>>Angioplasties are certainly NOT unnecessary surgeries. They do not decrease mortality but they documentedly decrease morbidity. That is the purpose for which they are performed.

That does not seem to be the purpose of the study nor its conclusions.

>>By the way, the link you posted in your previous post does not work.

As I wrote, you need to type in Cass Study in the space provided after being transported by the link.

 

[Benguin]

Originally posted by Vikram [/i]


Science does not measure "motivation" for mal practice. If it does, please provide an example.

And yet you still are in need of evidence to support an assertion ... spooky eh?

Mal practice has many causes ranging from incompetence to greed.

In any case, you've just introduced malpractice. Concentrate on proving unnecessary operations are performed for the purposes of training before moving your goalposts on.

 

[Vikram]

>>Angioplasties are certainly NOT unnecessary surgeries. They do not decrease mortality but they documentedly decrease morbidity. That is the purpose for which they are performed.

That does not seem to be the purpose of the study nor its conclusions.

Rouser2,

The title of the study was "Ten-year follow-up of survival and myocardial infarction in the randomized Coronary Artery Surgery Study."

The purpose of this study was to ONLY evaluated the survival and probability of myocardial infarction. And it's conclusion was that there is no change in mortality. Which is a finding that you can observe documented in all medical texts.

It did not evaluate relief of symptoms. There are other studies that have done for that.

What's your point?

 

[Rouser2]

Rouser2,

The title of the study was "Ten-year follow-up of survival and myocardial infarction in the randomized Coronary Artery Surgery Study."

The purpose of this study was to ONLY evaluated the survival and probability of myocardial infarction. And it's conclusion was that there is no change in mortality. Which is a finding that you can observe documented in all medical texts.

It did not evaluate relief of symptoms. There are other studies that have done for that.

What's your point?

The entire point of the study in question is the summary conclusion that none of these surgeries were necessary. The relief of symtoms was not even taken into account as irrelevent to the larger question of risk versus life saving benefit.