Monday, March 01, 2010


I wrote about heart surgery not long ago. The issue was whether health authorities should be restricting access to the use of stents in treating clogged and weakened arteries.
It used to be that doctors treated abdominal artery problems by cutting open the patient's chest and using a plastic tube to patch weak points.
Stents are newish. Instead of prying open your chest, surgeons make a small slit in your groin, slide the stents up into the right place and then use a balloon to expand the little metal mesh tube. The artery is kept open. Drugs built into the stent keep the cells from growing back around.
Is it worth the big money? Read this, a link from a knowledgeable reader


Anonymous said...

I had a stent placed about 6 months ago at VGH. The whole process at VGH was a very well run process. I had a stress test prior to my appointment.

The Keith J. Winstein / WSJ article (don't forget to read the comments after the article) relies entirely on one study that although seemingly well done, doesn't appear to take into account costs over the long term or the full Canadian experience - $15,000 procedure? What does a BC surgeon get paid for this procedure?

The malpractice implications are huge.

American health insurers find all conceivable ways to cut costs; I cannot see them paying for ineffective treatment.

The study is "Optimal Medical Therapy with or without PCI for Stable Coronary Disease"

Anonymous said...

American health insurers find all conceivable ways to cut costs;

You've got to be kidding. Apart from working hard to deny payments to policy holders whenever they can, the American health insurers work hand in glove with the AMA and big Pharma at the expense of patients.

Anonymous said...

While we're on the subject of medical studies...

We're so good at medical studies that most of them are wrong

It's possible to get the mental equivalent of whiplash from the latest medical findings, as risk factors are identified one year and exonerated the next. According to a panel at the American Association for the Advancement of Science, this isn't a failure of medical research; it's a failure of statistics, and one that is becoming more common in fields ranging from genomics to astronomy.

The problem is that our statistical tools for evaluating the probability of error haven't kept pace with our own successes, in the form of our ability to obtain massive data sets and perform multiple tests on them. Even given a low tolerance for error, the sheer number of tests performed ensures that some of them will produce erroneous results at random.

Read the rest by John Timmer at Ars Technica.

Anonymous said...

Another view: Health Care Spending v. Life Expectancy