Thursday, November 08, 2007

Vindicated

Sorry, but after all the trash-talk I received from members of a certain financial board regarding my decision not to purchase Cambridge Heart's T-wave alternans test previously, I'm feeling a bit vindicated right now.

4 comments:

Mani said...

Hello Dr. Wes,
You blog was displayed on the google finance page for CAMH and I thought I would check it out.

MTWA seems interesting. I need to read a bit more about it. However after reading your blog and also a couple of message boards dedicated to CAMH, I have a question. Are the ICD manufacturers really against MTWA as most people claim on the message boards. I'm confused because in one your blogs you say "the increased screening using this test might actually INCREASE the number of implanted devices" which kind of explains why STJ may buy a stake in the company. Why haven't other ICD companies wholeheartedly embraced the technology then? I think i am missing something here.

regds

Mani

Anonymous said...

wow, i don't know how i missed the mtwa comments. kudos to you for keeping your cool despite inflammatory comments, dr wes.
fwiw, my practice and the 3 practices i keep in close contact with (representing a total of 18 ep physicians) in the last year voted pretty unanimously to wait for more data before purchasing/recommending its use.

DrWes said...

Mani-

Most tests give results that are considered either "positive" or "negative." Depending on the quality of the test, they will either correctly determine the disease is present ("true positive") or think the disease is present when it is not ("false positive"). Likewise, the test could correctly determine the disease is absent ("true negative") or think the disease is not there when, in fact, it is present ("false negative").

A positive test, then, will represent a certain number of "true positives" and "false positives." If the population screened in large, these "positive" tests would mount and would imply an therapy should be rendered, but if the number of false positives is large, then MORE tests might be applied to the population than would be without the test.

In the case of MTWA testing, "positive" patients would be recommended to have ICD implants. If you screen enough people, there will certainly be lots of "true positives" but also many "false positives" as well and this number might actually be larger than the number of patients being implanted presently. This is why St. Jude and Medtronic were hoping this would jump-start their ICD implant volume.

Hope that helps.

Anony 09:23 -
Thanks for your kind words.

Anonymous said...

What do you think of Dr Chows new statement concerning his endorsement of MTWA?