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Ann Thorac Surg 1997;63:1381-1382
© 1997 The Society of Thoracic Surgeons

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 1374.

Dr Thomas R. J. Todd (Toronto, Ont, Canada): I congratulate Dr Amar for a great study and a great presentation, and thank him for sending me the manuscript ahead of time.

This is a trial comparing one drug with another. And whenever you are looking at a trial, you not only have to look at the results that they got, you also have to look at how valid the trial was in its construction. And when you do that, there are a number of questions that you have to ask, and the answer to each of the questions should be a resounding "Yes."

Is the trial randomized? Yes, it was.

Was there a sample size calculation and a power calculation to enable you to determine how powerful this trial was? Unfortunately, the answer to that is no.

Was it controlled? Yes, it was. The control patients were not part of the randomization sequence, but it was controlled for the reasons that Dr Amar pointed out to you.

Is the population representative of the standard practice? Here I have to put a question mark. Half the patients throughout the trial had either an extrapleural pneumonectomy or an intrapericardial pneumonectomy. By my standards that is a high incidence of both of those, and I think it reflects the kind of difficult patient who frequently gets referred to Memorial.

To put this in perspective, I went back and looked at the same number of patients consecutively operated on in the last . . . [Full Text of this Article]


Related Article

Effects of Diltiazem Versus Digoxin on Dysrhythmias and Cardiac Function After Pneumonectomy
David Amar, Nancy Roistacher, Michael E. Burt, Valerie W. Rusch, Manjit S. Bains, Denis H. Y. Leung, Robert J. Downey, and Robert J. Ginsberg
Ann. Thorac. Surg. 1997 63: 1374-1381. [Abstract] [Full Text]





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Copyright © 1997 by The Society of Thoracic Surgeons.