It’s been a while since I’ve pointed to any of Richard Lehman’s witticisms as he pores through medical journals each week, trying to make sense of what he reads, and trying to help us do so as well.
On Twitter today, somebody tweeted today that Lehman’s brain needs to be preserved in a jar so he can blog for the next 100 years. Someone else wrote “I find it almost impossible not to quote him.” I quote him as he lances The Lancet today:
Lancet 7 Dec 2013 Vol 382
The Lancet is a very odd journal, in case you hadnt noticed. Some weeks it contains pharma-funded phase 2 trials of astounding clinical irrelevance; occasionally it contains important papers heralding major breakthroughs, or reporting massive RCTs; then there are some issues entirely devoted to health in a particular part of the globe you are unlikely to visit; last week the journal was all about sex and the British, in case you are thinking of having sex in Britain; and this week the entire research section is taken up with this analysis the safety and efficacy of drug-eluting stents in women, based on patient-level results from 26 randomised trials; plus a paper on risk stratification at diagnosis for children with hypertrophic cardiomyopathy. We seem to have wandered into the pages of Circulation rather than The Lancet. Anyway, the message from the stents-for-women analysis is that drug-eluting stents are safer than bare metal stents, and that second-generation drug-eluters are better than first generation. This is very much what pharma would like you to believe, so I am inclined to disbelieve it. But then neither I nor you, dear reader, are in a position to re-interrogate the data and the methods of 26 major trials. We must believe what we read, and buy the latest products.
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