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......................m......................... Specific guide to this web site for:
Additional Topics: Large Randomized Clinical Trials
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"Subsequent developments" regarding article in the New England Journal of Medicine This example critiqued a very poor article in the New England Journal of Medicine which had conclusions that were not supported by their data. The article had to do with outpatient cardiac catheterization. The conclusion of this study, that outpatient cardiac catheterization is safe has actually been documented to be correct by hundreds of thousands of outpatient cardiac catheterizations. The New England Journal of Medicine article was a relatively small study that found 3 heart attacks occurring for 200 patients that had outpatient heart catheterization and 1 out of 100 heart attacks occurring in patients with inpatient catheterization. The article unbelievably said this study proved that outpatient catheterization was safe. (This was despite the fact that elective heart catheterization is usually associated with only a risk of 1 out of 1,000 for a myocardial infarction.) In answering a follow-up letter, the authors of this study admitted making the major error of miscounting their primary end point regarding the number of myocardial infarctions that occurred, as well as including patients that were not appropriate for the study.
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