(Posted on behalf of Neil Gibson)
As a related but interesting side note, this discussion could also include the differences seen between single trials and metanalyses.
Differences seen between Single Trials and Metanalyses
Reply
Category Archives: Session 1
Points to Ponder: Spironolactone versus Eplerenone
(Posted on behalf of Chester Morris)
The results also don’t address the question of spironolactone versus eplerenone and whether one is superior/equivalent to the other and whether those with NYHA class II symptoms and higher ejection fractions could benefit. In addition as with any subjective classification NYHA could be seen as bias in stratification.
Can you share your views on the superior/equivalent nature of spironolactone versus eplerenone?
From my experience in our community there is a lack of clarity on the use of these agents especially among family physicians and guidelines are not yet updated so there is a need for education in this area.
Points to Ponder: Obtaining Representative Samples in Trials
(Posted on behalf of Chester Morris)
I have included two points to ponder to start the discussion. Please feel free to add to the discussion.
In terms of the trial there are always problems here getting representative samples as certain ethnicities and female gender are both underrepresented in the sample. Does anyone have anything to add or any strategies that might deal with the issue of representative samples?
Welcome to Session One
Hi all,
Thanks for following us on the specialist journal club.
Hope you all had a nice weekend and are ready for our first journal club session.
We are going to start with a publication on the use of mineralocorticoid antagonists and mild heart failure addressing one of your topic suggestions. This is the report of the EMPHASIS-HF trial in the NEJM last year.
This paper reported on the study of mineralocorticoid antagonists and heart failure in a group of patients who had not been covered in earlier studies such as EPHESUS (eplerenone in acute myocardial infarction complicated by left ventricular
systolic dysfunction and heart failure) and RALES (spironolactone for NYHA functional class III or IV symptoms).
Specifically those with NYHA II functional class and either an LVEF ?30 percent or LVEF >30 and ?35 percent and QRS duration >130 msec.
This paper is interesting as it will change guidelines on the management of this group of patients which we all see in our offices and hospitals.
The learning objectives for this session will involve:
1) Understanding the indications for the use of these agents in heart failure
2) Commenting on the use of these agents in your practice
3) Discussing the validity and applicability of the study
ARTICLE:
Krum H, Pitt B, Pocock S.J, et al. Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms. N Engl J Med. 2011. 364(1): 1-11. (NEJM Free Full Text) or click the image of the article.
Regards,
Chester
Journal Club Session Topics Selected
Hi all,
Thanks for signing up to the Club. We have gone through the results of the Topics Survey and the 5 sessions of the club will be based on the following topics:
Review of internal medicine issues;
Inflammatory bowel disease;
Cardiovascular disease in the elderly;
Abnormal liver tests; and
New therapies for cardiac diseases
Please let me know if you have specific papers in mind for the sessions. Suggestions are welcome. We would prefer open access papers but any source is fine as long as you think it is relevant.
Look forward to your responses.
Chester
Session One – Coming Soon!
Session 1 will begin on Monday, October 15th. The UBC Admin team will send you a reminder to log in and download the first journal article that day. The article will be selected by the club moderator, Dr. Chester Morris, and will be a new, practice-changing article on one of the “Top 5” topics identified in the Introductory Session.
You will have six weeks to read the article, and you will receive CME credits for posting a minimum of two (2) replies or new threads per session.
If you have not yet introduced yourself to the group, please feel free to do so now by visiting the Meet Your Colleagues section of the website.
If you would like to start a new post, please click here