drsclafani wrote:
Cece wrote:
http://www2.macleans.ca/2012/09/30/finally-ccsvi-clinical-trials-so-why-is-everyone-so-pissed-off/
Quote:
But he also raises a big concern: that doctors performing CCSVI treatment in the Canadian clinical trial won’t have prior hands-on experience. Interventional radiologists say it takes upwards of 60 procedures to achieve proficiency; Salvatore Scalfani, a veteran interventional radiologist in Brooklyn NY, has reported it took him 200 procedures to feel comfortable. Traloubsee told Maclean’s the technologist and radiologist involved in the trial spent a week with Zamboni and his team in Italy. The vascular team has had “extensive conversations with many international colleagues who’ve performed the procedure,” he says, including Dr. Gary Siskin who’s running the Albany trials.
I don't consider conversations about a procedure to be a substitute for experience performing the procedure.
With the stakes as high as they are, I would want this to be research done by experienced providers.
I spent a week with Dr Zamboni too. I asked Dr Galleoti how many cases it took for him to be comfortable and he said fifty.
I then showed Galleoti and Zamboni a case study and they both got it wrong and missed the stenosis.
I can tell you that a trial done by inexperienced physicians will lead to the following results:
1.It is dangerous. many patients thrombose their jugular veins
2. many patients will have benefits that last a couple of weeks to a couple of months
A group of us offered our help and advice. No one ever contacted me.
it is a situation that makes me angry
There are two locations for this trial as announced. Dr. Sclafani cannot himself be in both at once. I expect the other doctors who had made this offer with him would be world-class as well, though he is undoubtedly the best they could ask for. If they do not contact him or the group, it is an egregious error, which shows that due diligence and reasonable prudence cannot be among their concerns. If I were a patient involved in this trial, and became aware of this fact, I would have grave concerns about the care of these researchers, and would have a hard time giving my informed consent.
That being said, if I knew they had taken advantage of this offer of help and advice from the most experienced people in the world in this procedure, I would have a much easier job giving my consent to the trial.
Let's be realistic:
people have died, and quite a few Canadian and American doctors have expressed their reservations about this procedure, forcefully, and in public, with all the fanfare the media could muster. We have to hope, with the government's oversight, they are willing to take the best advice and assistance when it is offered. There can be no excuse for not doing so.
I'm sure others, even in this forum, have a good awareness of what is required for such a trial. Canadian doctors, with all their training and expertise, should know as well.
These doctors are not infallible, and these people who are willing to take such risks on behalf of all Canadians, all their fellow sufferers, and the inevitable future ones, deserve
the best they can be given. Not the most convenient, the cheapest, or the least challenging, but
the best.