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Food for Afterthought
Reflections From 2 Implantable Cardioverter Defibrillator Trials
Arch Intern Med. 2004;164:1835-1839.
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INTRODUCTION
The prime goal is to alleviate suffering and to prolong life, and if your treatment does not alleviate suffering but only prolongs life, that should be stopped.—Christian Barnard1 (1922-2002), cardiac surgeon
Two valuable trials, Antiarrhythmics Versus Implantable Defibrillators (AVID)2 and Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II),3 have compared the survival of patients with an implantable cardioverter defibrillator (ICD) with that of patients treated with antiarrhythmic drug therapy. The importance of their findings demands a careful and detailed analysis of these trials. It is the purpose of this article to review these trials for (1) entry and exclusion criteria and the number of patients who entered the trial in relation to those screened and to those who met entry criteria; (2) baseline characteristics of the patients; and (3) the number of patients who were actually benefited and those who were not benefited. And from this review, it is my . . . [Full Text of this Article]
THE AVID TRIAL
Patient Characteristics Cost Analyses Cost of the Initial ICD
THE MADIT-II
ANALYSIS OF FINDINGS FROM THE 2 TRIALS
CRITIQUE
CONCLUSIONS
Shahbudin H. Rahimtoola, MB, FRCP, MACP, MACC, DSc(Hon)
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