Ethics of Obesity Trials

JAMA Network | JAMA | Effect of Weight Reduction and Cardiometabolic Risk Factor Management on Symptom Burden and Severity in Patients With Atrial Fibrillation: A Randomized Clinical Trial

Good randomised trials in medicine are like good wines - rare and their published account should be savoured slowly and carefully - there are nuggets of useful information that may not feature in the headline statements.

BIOLOGICAL OR MECHANICAL , WHO KNOWS ?

Aortic Valve Replacement: A Prospective Randomized Evaluation of Mechanical Versus Biological Valves in Patients Ages 55 to 70 Years -- Stassano et al. 54 (20): 1862 -- Journal of the American College of Cardiology

A surgical randomized controlled study is always welcome and worth commenting on - they are difficult to organise and expensive and consequently they are rare.

EVIDENCE

JAMA -- Mediastinoscopy vs Endosonography for Mediastinal Nodal Staging of Lung Cancer: A Randomized Trial, November 24, 2010, Annema et al. 304 (20): 2245

I used to practice both cardiac and thoracic surgery until August 2007. After the appointment of 2 purely thoracic surgeons to our department, 2 of us who practiced both disciplines had to give up thoracic surgery. For various reasons that I won't go into now, I decided to give up thoracic surgery and stick to cardiac. Although this paper will not affect my practice, it still gives me great pleasure to see a well conducted surgical trial that produces good evidence that surgeons can use in their everyday practice - even though the results of the study means less surgery. We need more of these.