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Specific guide to this web site for:
1. Medical
School
Educators
in
Statistics
2. Medical Students
3. Science media writers
4. High School & College
Statistic Teachers
Misadventures:
1. Harvard led MI study
2. JACC
study
(J. of Amer. Coll.
Cardio.)
3. NEJM
cath study
4. Amer. J. of Cardio.
review of literature
5. ALLHAT
controversy
6. Oat bran study
7. Pregnancy & Alcohol
8. Are Geminis
really
different?
9. Columbia 'Miracle' Study
Additional
Topics:
Celebrex
Limitations of Meta-Analyses
Large Randomized Clinical
Trials
Tale of Two Large
Trials
Advocate
meta-analyses
Network
meta-analyses
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Angioplasty vs. Medication and Adequate Aspirin dose for unstable
angina-
"10 years later"
Eventually, there were several studies in the scientific literature showing the benefit of angioplasty over medication for patients presenting with high risk unstable angina. The technique of angioplasty improved in subsequent trials (including the introduction of stents) and an appropriate dose of aspirin was subsequently used in subsequent studies. In addition, there are multiple medications that are now available that have similar or more potent effects than aspirin in inhibiting platelets which is crucial for a good outcome.
The trial critiqued in this web site concerned a trial comparing angioplasty (balloon dilatation of an artery of the heart) to clot dissolving medicines. The trial was unintentionally constructed in a way that inappropriately biased against the angioplasty group. (An inadequate, single low dose of aspirin was initially specified by trial protocol). Though the cumulative effects of low dose aspirin are potent, a single initial dose does not give the full effects of the platelet inhibition of aspirin. The full effects of aspirin are needed in order to avoid unnecessary heart attacks or
complications with the use of angioplasty or stenting of the arteries of the heart.
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