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Posts Tagged ‘medical ethics’

Simplest way, to find fake news in medical science

Posted in Uncategorized, tagged , , , , , , , , , , , on November 18, 2025|

Link : Same quote with a heading

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Trust deficit in medical research and Journals : Need for an unprecedented transparency in declaring conflicts of Interest. 

Posted in Uncategorized, tagged , , , , , , on July 25, 2025|

An Awakening Call to the Guardians of Medical Science

Dr. Venkatesan Sangareddi MD, Former professor of cardiology, Madras medical college,Chennai .India

Medical science remains a cornerstone of human progress, and what we have achieved in the last 100 years is unprecedented. Every one of us is aware that the trust placed in medical research is sacred. Also, the medical profession is expected to remain noble as long as human beings exist. However, as in all walks of life, there must be trade-offs to any positives. Yes, this trust has increasingly become vulnerable, threatened by the pervasive and often subtle influence of conflicts of interest (COI). This is especially explicit in the current medical research landscape.

While the scientific community has made strides in acknowledging and requiring disclosure of COIs, particularly from authors , the measures are proving insufficient. There is a big irony sitting right across us. It is made to look, as if conflicts of Interest (COI) exist only with the authors.

The following article written by the author (Ref 1) calls for an  awakening to every medical journal publishers, regardless of their prestige or impact factor, to recognize their vulnerability . We are expected to adopt a new paradigm of transparency in declaring COI, that extends to every participant in the publication process, including the scientific or ethical committies that approve the study ,the peer reviewers, the publishers and finally to the industries that fund the research.

Reference

1,Click here to download the full paper: A caution: It is a fairly lengthy article. (15 minutes read) Hope the suggestions made in the article are not labeled as unrealistic and possibly crazy as well.

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Management of ACS : The eleven new commandments

Posted in acute coroanry syndrome, acute coronary syndrome, Medcal research, Medical education, Medical ethics, Primary -PCI, Primary PCI, Thrombolysis, tagged , , , , , , , , , , , , , , , , , , , , on June 8, 2025|

How can we use AI as a tool of knowledge distillation ?

Here is a deep discussion with Grok 3, on the merits, limitations & validity of DANAMI 2 and PRAGUE 2 , the two old studies on pPCI. Curiously , we don’t have any other studies to quote. As on 2025 , superiority of pPCI hangs precariously on these two decade old studies, which has some serious omissions in the primary end point and its Interpretation. To get into the facts , please go through the following link.

https://grok.com/Is primary PCI really superior to lysis in a global perspective /

It is a long chat, I am sure most of you can’t spare your vital time. But, the truth comes out only at the fag end of the conversation.

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Be proud to be  a new generation cardiologist.

Posted in Uncategorized, tagged , , , , on March 27, 2025|

Yes, It’s not a humiliation, to get branded as a new generation cardiologist. In fact, the opposite is true. Sorry, no-blaming any one. We can’t avoid it as well. It is the wages, we are foreced to pay for sensationalised technological sins , that is Imploding in the world of medical science.

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Journal club debates : Can “Aim of a study” be wrong ?

Posted in Uncategorized, tagged , , , , , , , , , , on December 18, 2024|

Absolutely yes. The number of studies with such wrong aims is staggeringly higher than we could imagine. “Wrong aim” is probably not the right word to describe them. Rather, we can call them obsolete, duplicate, illogical, unproductive, intentionally fraudulent studies, or studies with a prefixed conclusion.

There is an estimate, that says 95% of papers in nearly 5,000 medical journals, is either junk or written for the sake of publication related to mandatory academic positions or promotions as a budding scholar or faculty. Science has to survive on the shoulders of those rare & genuine 5% souls.

Final message

What is the true “Aim for your study” , I want a very honest answer ?

Yes sir, I agree ,the primary aim is to publish my damn paper and get that promotion !

A related post

There was a brief post about this in the year 2008, 15 years ago. Is it still relevant? Find out for yourself.

Journal club debates : Can a “Aim of a study” be wrong ?

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A MCQ, that can change the way you practice cardiology

Posted in Uncategorized, tagged , , on November 14, 2024|

A right answer to this MCQ will check , how realistically we have understood modern medical decision making .It could change the way we practice cardiology, provided you choose the right response.

Which of the following correctly describe about the disease specific popular guidelines by various scientific committees like AHA, ESC, and other by global expert forums ?

A. They are absolutely scientific and evidence based. Tremendously helping us and our patients. We must follow it strictly day in and day out.

B. These guidelines are very tricky , but still useful .However , if strictly followed, it may not be in the interest of patients. Still, I am compelled to follow it because of peer pressure and perceived sanctity of science.

C. I know ,most guidelines are too elaborate and complex and trying to confuse me, but glad to say I am able to tackle it.

D. Read, understand and use them as an adjunct, but always form your own guidelines in the best interest and care for our patients.

Answer

Did you find the correct(rather pragmatic) answer? I am not going to reveal mine , instead will tell the response which could be explicitly wrong . (Yes, it is the first letter of the English alphabet)

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Will meta-analysis really come under an original scientific research ?

Posted in Uncategorized, tagged , , , , , , , , , , , , , , , , , on October 10, 2024|

“In one sense, meta-analysis would come closer to a milder form of ethical plagiarism”

Can meta-analysis really be called as original scientific research ?

No it is not, but some may say yes. It is very difficult to dispute either. But, the fact of the matter is, meta-analyses are not a true science of innovation. It is using some others’ work( sort of intellectual steal ?) done by a group of scientists interested in the same research topic, trying to squeeze more info from these studies. It is a glorified group journal club activity.

Image source & Courtesy http://www.inquasar.com

At best, meta-analysis can be referred to as knowledge and evidence aggregation. Surprisingly, mostof the academia seems to give more weight to meta-analysis, disproportionately more than the original researchers. This is because meta-analytic scientists backed by big journals claim, they can bring out more info out of the original. The assumed scientific superiority of meta-analysis is expected to be downgraded soon, as these sort of evidence aggregation can be done easily by any AI-powered engines. Network meta analysis, by dedicated medical scholastic AI networks can do this in a fraction of a second.

Meta analyses as of now is sitting proudly as crowning glory at the top of evidence pyramid. This is one of the reasons for the false glory surrounding anyone (or anything ) associated with meta-analyses. I doubt whether it really deserve the top slot. (An excellent debate between RCT vs metanalysis) Wish, the meta-analysis taste its own medicine at least once. We need to have a meta-analysis to show it is really superior to other forms of evidence. I cant find one as yet.

What about systematic review ? This looks better, as it has less statistical content , and the researcher is at least compelled to go deep and get enlightened on the topic as they spend months together on the topic.

How is meta analysis different from original research?

There is no new data collection ,no primary hypothesis testing . It primarily focus on summarizing existing evidence. To do it properly, there are certain standards.

  1. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)
  2. Cochrane Handbook for Systematic Reviews of Interventions
  3. MOOSE (Meta-analysis of Observational Studies in Epidemiology)

Ref :Finckh A, Tramèr MR. Primer: strengths and weaknesses of meta-analysis. Nat Clin Pract Rheumatol. 2008 Mar;4(3):146-52.

Positive side of metanalysis

While meta-analyses aren’t original research, it’s a crucial tool for evidence synthesis, research translation informed decision-making.

Flaws of metanalysis

It is a academic business with done studies. So it is 100% retrospective. It might come with irreversible errors. Unless every error in the past studies is accounted for and curated the result of meta-analysis, it can never be foolproof.

Should we get permission from all the authors who did their original studies before doing a meta-analysis?

As long as fair use criteria applies there is no need , but a moral obligation is definitely there . Other wise metanalyses will come closer to a milder form of academic plagiarism of others’ work. (Of course legally and scientifically approved)

Final message

In the world of true scientific research, meta-analyses can not be considered as great scientific work. It is just evidence aggregation, which of course could be meaningful if and only if the studies taken were done properly.

However, meta-analysis has undisputed value in aggregating rare cases, scenarios, diseases, and problems where there are very few published studies. Collecting them together in an organized fashion serves a real good purpose.

Reference

1.Pearson K. Report on certain enteric fever inoculation statistics. Br Med J. 1904;3:1243–6.

2 Smith, Mary L.; Glass, Gene V. (1977). “Meta-analysis of psychotherapy outcome studies”. American Psychologist. 32 (9): 752–760. doi:10.1037/0003-066X.32.9.752.

3. Eysenck, H. J. (1978). “An exercise in mega-silliness”. American Psychologist. 33 (5): 517. doi:10.1037/0003-066X.33.5.517.a.

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Two troubling medical quotes in tandem …

Posted in Uncategorized, tagged , , , , , on July 28, 2024|

One

Two

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Forbidden quotes in medicine

Posted in Uncategorized, tagged , , , , , , , , , , , , on April 22, 2024|

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Lancet : A 200 year old Idea and a process towards righteousness

Posted in Medical ethics, Uncategorized, tagged , , , , on January 4, 2024|

It was 1823, a genesis of a new thought process in medical publication began. The man who started it all, Dr.Thomas Wakley the founder of the most famous medical journal (Ref 1)

One of his peers described him what sort of an Image he had. “Thomas Wakley the editor as we find him—a courageous challenger of the medical establishment who was usually right and whose language, however tasteless it might seem today, was well suited to the rough and tumble of the time in which he wrote and spoke”

Lancet celebrates 200 year anniversary

On this 200th anniversary Lancet , looks back ,introspects and redefine the agenda of medical profession. We need more and more people like Wakley in the current era.

The Lancet editorial team has come out with two clips one podcast and other a brief video for a total of 28 minutes . If you have enough patience to hear to this , you are probably in the right direction to understand what exactly is the purpose being a Doctor.

After going through the history of medicine through the lens of Lancet, and understanding its original motto, one thing is very clear. Science and research are vital for progression medical science . But, the least important enemy to handle for a healthy planet and mankind is not diseases and afflictions as such, but the unkind behaviour of biased power centres, skewed knowledge, and unhealthy & unequal practices of health care invention and delivery.

Final message

Doctors are primarily healers, all right; more importantly, they are guardians of goodness and justice in healthcare. For this, we need to “Wakleyse the medical education“, meaning, keep a watch always on the true aim and action of medical establishment under which you work . I know, this post might sound pessimistic for many of you, … but that’s where optimistic goals are hidden deep .

Reference

Thomas Wakley (1795–1862): a biographical sketch

sharp2012Download

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