Published in:
01-04-2017 | Original Article
What is the evidence? A call for scientific rigor
Fourteenth Annual Mario S. Verani, MD, Memorial Lecture
Published in: Journal of Nuclear Cardiology | Issue 2/2017
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Thank you Ami for those kind words of introduction. During the 1980s, I interfaced extensively with Mario Verani. I can recall when he first told me that he was going to start working on adenosine for pharmacologic stress, which led to this landmark paper in Circulation.1 (Figure 1) Subsequently he, Frans Wackers, and I collaborated on the development of Tc-99m sestamibi for acute infarction imaging, which led to this paper on planar imaging2 (Figure 2) and this paper on SPECT imaging3 (Figure 3). My most extensive contact with Mario was when we both served on an ACCF/AHA Guidelines Committee on Radionuclide Imaging, which was chaired by Jim Ritchie and included Tim Bateman and Bob Bonow4 (Figure 4). Mario believed in scientific rigor. I believe that he would approve of my focus today on the need for scientific rigor in our field. In the first half of this lecture, I will focus on past lessons from these five areas (Table 1); in the second half of this lecture, I will apply these lessons to two promising new applications in our field.
Figure 1
Landmark article on the use of adenosine with thallium stress imaging. Reproduced with permission from Verani, Circulation 1990;82
Figure 2
Landmark article on the use of planar technetium 99m sestamibi imaging in acute myocardial infarction. Reproduced with permission from Wackers, J Am Coll Cardiol 1989;14
Figure 3
Landmark article reporting the use of SPECT imaging with technetium 99m sestamibi in acute myocardial infarction. Reproduced with permission from Gibbons, Circulation 1989;80
Figure 4
Initial AHA/ACC Guidelines for cardiac radionuclide imaging. Reproduced with permission from Ritchie, Circulation 1995;91
Table 1
Past lessons regarding scientific rigor
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Incremental value
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Reclassification
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Clinical action
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Test variability
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“Read the paper”
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