Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions.
Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
The ESC Councils' goal is to share knowledge among medical professionals practising in specific cardiology domains.
OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
Prof. Michel Bertrand
Firstly, Dr LM Ruilope (Madrid) addressed the matter of fallacies in hypertension clinical trials and underlined once more the impact of high blood pressure on CV risk. Most of the fallacies in hypertension trials stem from the fact that none have been pure hypertension trials, and almost no trials achieved equal level of blood pressure. Next, Dr K Swedberg listed a number of fallacies in heart failure trials. • Too much hope on surrogate markers • Incorrect interpretation of sub group analysis • Lack of awareness of benefits in small studies revealed by meta-analysis • Inadequate translation of mechanisms to results • Lack of awareness of symptoms, for example importance of breathlessness and fatigue . In his presentation, Dr P.J. Barter pointed out several fallacies in Dyslipidemia trials: • Based on the assumption that associations equate with causality (CRP for example) • Based on the assumption that surrogate markers equate with clinical outcome • Based on the belief that p value < 0.05 demonstrates efficacy whilst p> 0.05 equates with lack of proof • Based on post hoc subgroup analysis which can only generate hypothesis. Lastly, Dr R. Califf described several fallacies in PCI clinical trials. In terms of trial methods, registries suffer from a lack of a true anchor comparison but randomized clinical trials select simple, low risk cases performed by the best operators. Fallacies in trial interpretation arise, depending on the endpoints and the duration of the trial, and finally, there are fallacies related to the quality of the treatment after discharge.
In conclusion, these excellent presentations showed that there are many fallacies in clinical trials.
Webcasts of Presentations available: LM Ruilope, K Swedberg , PJ Barter, RM Califf
Fallacies from Clinical trials
This congress report accompanies a presentation given at the ESC Congress 2008. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.
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