The Bob Harrington Show
By theheart.org
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Podcast Description
Produced by theheart.org, The Bob Harrington Show brings education and news from the world of cardiology to listeners all around the world. It is hosted by Dr Robert A Harrington professor of Medicine at Duke University, Director of the Duke Clinical Research Institute, and a practicing interventional cardiologist. He shares his thoughts and opinions on the latest clinical trials. He invites special guests to comment on news stories and asks listeners to share their opinions as well. The show is available every two weeks.
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The Bob Harrington Show - Episode 47: Rebooting the medical system with Dr Eric Topol | Technology is the key to a radical transformation of medicine, which is shifting from a population-based model to one of individualization. Will cardiologists and medical practitioners be left behind? Dr Eric Topol discusses his recent book, The Creative Destruction of Medicine, and his thoughts on the future of health and care. | 4/11/12 | Free | View In iTunes |
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The Bob Harrington Show - Episode 46: Healthcare reform and cardiovascular practice in the election year with Dr Kevin Schulman | Where do things stand with healthcare reform? What is the status of CMS innovation centers, accountable care models (ACOs), and new models for reimbursement? Dr Kevin Schulman, professor of medicine and business administration, joins the show to discuss healthcare reform and its implications on cardiology—and society at-large—in 2012. What are the implications of the trend toward hospital employment vs private practice? Does it make a difference whom we vote for? Beyond the election, what can medical schools do to prepare physicians for the reality of practice in increasingly difficult financial circumstances? | 3/15/12 | Free | View In iTunes |
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The Bob Harrington Show - Episode 45: Clopidogrel pharmacogenomics: Challenges, controversies, and clinical implications with D | The issue of clopidogrel genomics and CYP2C19 genotyping came to a head with the recent JAMA meta-analysis that questioned the use of clopidogrel loss-of-function gene testing—controversially stating that there is no link between genotype and cardiovascular events. Dr Jessica Mega joins the show to shine light on the rapidly evolving field of clopidogrel pharmacogenomics, examine the scientific data—and the controversy—and share her recommendations for practitioners. | 2/10/12 | Free | View In iTunes |
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The Bob Harrington Show - Episode 44: Improving patient adherence to medication with Dr Eric Peterson | Patient adherence to medication has long defied quantification, with many physicians assuming that the cost of medications is the primary factor explaining poor rates of compliance. The MI FREEE trial conducted by Dr Niteesh Choudry, and presented during AHA 2011 offers stunning proof that compliance is a more complicated issue than cost alone and raises numerous issues that our guest Dr Eric Peterson discusses. How do we explain abysmal rates of patient adherence to medication? Should the physician be held responsible for adherence? | 1/9/12 | Free | View In iTunes |
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The Bob Harrington Show - Episode 43: Same-day discharge from the hospital after elective PCI | What is the best way to care for patients following PCI? Is same-day discharge a viable - or even desirable - option? Dr Sunil Rao joins the show to discuss his recent paper in JAMA, including the background for the study, source of data, and methodology. Discussion focuses on the thorny issues of cost savings and policy implications as well as technical issues to consider when evaluating whether to discharge a patient (or not) | 12/7/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 42: Statins - Cardiovascular benefit vs diabetes risk | Statins have become a cornerstone therapy in the prevention of cardiovascular disease by helping to modify the risk profile of millions of people. But what about a possible connection between statin use and diabetes? Lipidologist and preventive expert Dr Michael Cobble joins the show to relate his examination of the data and clinical experience and share his thoughts on the advantages of statin use relative to the risk of diabetes. | 10/31/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 41: The ISCHEMIA trial on optimal care for patients with stable coronary disease with Dr Judi | Both cardiologists and patients grapple with the concept that fixing a blockage may not prolong life, as indicated by the results of the landmark COURAGE and BARI 2D trials and reflected by the limited effect these trials seem to have had on clinical practice. The large ISCHEMIA trial, led by Dr Judith Hochman, seeks to build on the results of COURAGE and BARI 2D to answer the important question: what is the best treatment for patients with stable coronary disease? Dr Hochman joins the show to discuss rationale and trial design and give information on how to become involved in the study issues that contribute to professional discourse and why it's important to remain optimistic. | 10/5/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 40: The civility of professional discourse with Dr Clyde Yancy | With the multiplication of methods of communication, the democratization of access to information, and the fast pace of today's technology it's hard not to feel that professional discourse has taken a bashing and that civility in discourse is a lost art. Dr Clyde Yancy joins the show to talk about manners, anonymity, and broader societal issues that contribute to professional discourse and why it's important to remain optimistic. | 9/12/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 39: The uptake of clinical trial findings: Focus on OAT | Recent reports indicate that the Occluded Arteries Trial (OAT)—while continuing to stir debate—has made little impact on clinical practice among US physicians. What explains this situation? Dr David Kandzari joins the show to take a broad look at the design, implementation, and uptake of clinical trials, with focus on strategy bias, how to follow evidence-based medicine, and why physicians are quick to act on certain trial results (but not others). | 8/9/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 38: HDL cholesterol, niacin, and AIM-HIGH with Dr Jim Stein | Is the concept of raising HDL cholesterol still pertinent in an era of well-controlled LDL levels via statin therapy? To address this question, our guest Dr Jim Stein reviews what evidence exists to indicate low HDL cholesterol may predict heart disease, how the drug niacin fits into the equation, and what the results of the AIM-HIGH trial might mean for this hypothesis. | 7/6/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 37: Reversible anticoagulation in RADAR with Dr Thomas Povsic | Reversible anticoagulation may open the door to more efficacious treatment and better outcomes in settings such as PCI and valve replacement, as well as bypass surgery. But how does the risk of bleeding fit into the equation? Dr Thomas Povsic joins the show to discuss reversible anticoagulation: the clinical imperative of the RADAR trial, background on aptamer technology, and a discussion of trial results and implications for future research. | 6/1/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 36: Antiplatelet responsiveness and personalized medicine: Lessons from GRAVITAS and TRIGGER- | The key to improved efficacy of antiplatelet regimens—in theory, at least—appears to be a personalized approach to therapy. But based on the TRIGGER-PCI and GRAVITAS trials, how productive is routine testing for platelet responsiveness in clinical practice? Dr Gregg Stone discusses his expertise in this field, why the hypothesis for TRIGGER-PCI did not work, his thoughts on the current role of genotype/phenotype testing, and why we should be optimistic about future research in this arena. | 5/9/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 35: Oral antithrombotic agents: An update for the clinical practitioner with Dr Jonathan Halp | After decades of reliance on warfarin, there are finally new options for oral anticoagulation, with exciting results from the RE-LY, ROCKET, and AVERROES trials paving the way for dabigatran, rivaroxaban, and apixaban. With over 20 years of experience in the development of antithrombotic therapies, our guest, Dr Jonathan Halperin, discusses the road to approval of these drugs and shares practical insights for the healthcare professionals for finding their way. | 4/14/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 34: Healthcare reform update: Clinical and business implications for cardiologists | Where does healthcare reform stand, and what are the implications for cardiologists? Physician and business leader Dr Kevin Schulman joins the show to help clarify the healthcare debate and shine light on how the new Congress and future presidential elections influence reform. How does the deficit shape the debate? What are the implications for the current reimbursement system and private practice partnerships with hospitals? Are there any grounds for optimism? | 3/30/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 33: Quality assurance in cardiology with Dr John Rumsfeld | Quality assurance—or appropriate use of cardiology procedures—is a hot topic that defies simple quantification and has important ramifications for patients, healthcare professionals, and society at-large. Dr John Rumsfeld joins the show to share his thoughts on QA—how to measure it, who should assume responsibility for the process, the role of professional societies, and how reliable feedback can affect quality. | 2/10/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 32: Advances in heart-failure research with Dr Clyde Yancy | Heart-failure is estimated to account for two million hospital admissions per year in the US, based on primary and secondary diagnosis. Despite the amplitude of this burden, there is reason for cautious optimism, with encouraging results from clinical trials in 2010 that point to better treatment options and outcomes. In this comprehensive review, Dr Clyde Yancy discusses important recent research and how trials such as RAFT, EMPHASIS-HF, ASCEND-HF, and ADVANCE will help ambulatory, decompensated, and advance heart-failure patients. | 1/10/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 31: Atkins, diet, obesity, and cardiovascular disease risk with Dr Eric Westman | Hotly debated among healthcare professionals, "low-carb" diets—such as Atkins—have soared in popularity, offering easy-to-follow approaches and rapid results. But are they safe? Dr Eric Westman joins the show to discuss safety, his research in lifestyle intervention, and thoughts on how curbing the intake of carbohydrates can help tackle the obesity pandemic. | 1/10/11 | Free | View In iTunes |
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The Bob Harrington Show - Episode 30: Canadian antiplatelet guidelines with Dr Alan Bell | Notable for their therapy-based approach, rigor, and clarity, the Canadian Cardiovascular Society (CCS) antiplatelet guidelines were recently presented by coauthors Drs Alan Bell and Jean-François Tanguay at the CCS annual meeting in Montreal. Dr Bell joins the show to discuss the raison d’être, methodology, and aspirations of the new guidelines, while addressing specific line items, including aspirin dosing, duration of dual antiplatelet therapy poststenting, primary prevention, and interaction with proton-pump inhibitors. | 12/16/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 28: AVERROES: Apixaban as a future alternative to warfarin with Dr Stuart Connolly | The findings of the AVERROES trial foretell a future with appropriate treatment for patients with atrial fibrillation who are not candidates for anticoagulation with oral vitamin-K antagonists. In this discussion, Dr Stuart Connolly describes the design and findings of this important trial, the safety and efficacy data for apixaban, and shares his predictions for better anticoagulation options for this patient set. What are your thoughts on apixaban as a future alternative to warfarin? | 11/9/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 29: Obesity in America with Dr Thad Waites | According to the Center of Disease Control, 72.5 million Americans are obese (with a body-mass index [BMI] >30), and 27% of the increase in healthcare costs is related to the treatment of obesity. Dr Thad Waites joins the show to discuss these sobering statistics, the cardiovascular implications of obesity, what we can do to reverse the pandemic and the implications of the controversial obesity paradox in outcomes for CV disease. | 10/29/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 27: Elinogrel and INNOVATE PCI with Dr Sunil Rao | From the convention hall at the European Society of Cardiology 2010 Congress, Dr Sunil Rao joins the show to give an overview of the field of antiplatelet therapy, review the key features of elinogrel, and discuss the design, features, and findings of INNOVATE PCI while mapping out the next steps for this new antiplatelet agent. | 9/7/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 26: Dissecting the controversy around JUPITER with Dr Paul Ridker | Hailed as a landmark trial by many, JUPITER has spawned a vociferous cadre of detractors whose assertions have stirred debate and some controversy throughout the cardiovascular community. Dr Paul Ridker joins the show to review key areas of criticism pertaining to the design and execution of the trial, putatively skewed results from halting the trial early, data inconsistency, and the involvement of industry in JUPITER. | 8/20/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 25: Platelet responsiveness to antiplatelet therapy with Dr Paul Gurbel | There has been much research, press, and some controversy in the rapidly evolving sphere of antiplatelet therapy—culminating in the FDA's black-box warning on clopidogrel. Dr Paul Gurbel joins the show to clarify the core issues; review key terms such as hypo- and hyper-responsiveness and resistance and nonresponsiveness; discuss the roles and relative importance of genotyping vs phenotyping; and ponder how the GRAVITAS and TRIGGER PCI trials may help to lead the way forward for antiplatelet therapy. What are your thoughts on the FDA's black-box warning on clopidogrel? What roles do you see for genotyping and phenotyping for platelet responsiveness? | 8/2/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 24: When is a test appropriate to identify obstructive CAD? Dr Manesh Patel discusses his res | How many patients going to the cath lab with chest pain but without known disease—in the absence of acute MI—have obstructive coronary artery disease? Manesh Patel's latest paper sought to address this seemingly simple question. His research has had far-reaching implications for healthcare policy and reform, touching raw nerves and provoking debate across the cardiovascular community while raising a number of fundamental issues such as the notion of "acceptable" risk in an age of exploding healthcare costs. What are your thoughts on noninvasive testing to detect obstructive CAD? When is a test appropriate? Join in the discussion by commenting below. See: Patel MR, Peterson ED, Dai D, et al. Low diagnostic yield of elective coronary angiography. N Engl J Med. 2010 Mar 11;362(10):886-95. | 7/21/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 23: FDA advisory committee meetings and the drug-approval process with Dr Sanjay Kaul | New drugs that are brought to market in the US must face the FDA approval process, which frequently includes a public discussion or advisory committee meeting. With an extraordinary knowledge of drug approval and fresh from his experience on the FDA advisory committee that examined dronedarone, Dr Sanjay Kaul joins the show to address: - How a drug moves from the realm of research to clinical practice. - The role of the FDA in the approval process. - How the FDA influences clinical research and the way research is reported. - The thorny issue of industry-academic relationships. See: ATHENA scrutinized in media: Questions raised about access to raw data and clinical end points Avandia and FDA both subject of severe criticism at Congressional hearing Experts hash over new review challenging dronedarone's value in AF FDA approves dronedarone for atrial fibrillation | 6/30/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 22: Business and practice implications of healthcare reform with physician and business schoo | Do you fully understand the healthcare reform bill, how it will be enacted, and the implications for the business of medicine and your practice? Physician and business school leader Dr Kevin Schulman joins the show to discuss the fundamentals of reform, offer unique insight into what it could mean for practice, and challenge us to ponder two fundamental questions: Do finances allow medical care in the US to continue "as is"? How can physicians leverage a better position at the decision-making table? See: House and Senate vote to delay Medicare pay cut to June 1 Delaware cardiologists clash with insurers on nuclear stress test preauthorization requirement Heart groups applaud passing of US health reform bill but say: Real work now begins Medicare will delay paying claims for two weeks Medicare pay cut of 21.2% to take effect Monday What are your thoughts on healthcare reform and the implications for your practice? Join in the discussion by commenting below. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 21: Global chronic disease research: Learning from India and Kenya with Drs Jerry Bloomfield | Chronic diseases do not respect geographical and political boundaries, and as our world becomes a smaller place, it's appropriate that our approach to disease become more global. Drs Jerry Bloomfield and Mark Huffman join the show to share their experiences with the US National Institutes of Health (NIH) Fogarty International Clinical Research Fellows' (FICR-F) program and highlight why global chronic disease research is an enriching bidirectional flow of knowledge and expertise. See: Bloomfield GS, Huffman MD. Global chronic disease research training for fellows: perspectives, challenges, and opportunities. Circulation 2010 Mar 23;121(11):1365-70. Available at: http://www.ncbi.nlm.nih.gov/sites/entrez?orig_db=PubMed&db=pubmed&cmd=Search&TransSchema=title&term=global%20chronic%20research%20training%20for%20fellows NHLBI Global Health Initiative: Collaborating Centers of Excellence Set to Combat Chronic Diseases in Developing Countries. Available at: http://www.nhlbi.nih.gov/about/globalhealth/ NHLBI Global Health Initiative: Collaborating Centers of Excellence Set to Combat Chronic Diseases in Developing Countries | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 20: Clopidogrel and proton-pump inhibitors with Deepak Bhatt | While there appears to be a biological rationale for the adverse interaction between proton-pump inhibitors (PPIs) and clopidogrel, observational studies—for what they are worth—have shown mixed results. The partial results from the COGENT randomized clinical trial—although it was halted early and gathered just four months of data—appear to show no adverse interaction. Dr Deepak Bhatt joins the show to discuss this complicated issue and offer practical guidance for the clinical practitioner. What are your thoughts? Join in by commenting below. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 19: Managing acute coronary syndromes in NSTEMI patients with Shamir Mehta | Patients with non-ST-elevation-myocardial-infarction outnumber their STEMI counterparts by a ratio that is estimated at between 5 and 8 to 1 and hence constitute a large public-health concern. Dr Shamir Mehta, a leader in NSTEMI research, joins the show to discuss the TIMACS study and share his opinions on the use of the cath lab in invasive strategies as well as the use of antithrombotic agents in NSTEMI patients. What are your thoughts? Join in by commenting below. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 18: Get With The Guidelines with Ileana Piña | "Get With the Guidelines" is a striking example of a successful nationwide initiative that addresses the gap between guidelines and performance by providing tools for healthcare providers and hospitals to improve care in both the in-patient and out-patient setting. In an era of budget cuts and heightened accountability, GWTG shows the viability of tackling quality gaps while fostering improved care across a variety of barriers such as location, age, sex, and ethnicity. Dr Ileana Piña joins the show to share her extensive experience work with the "Get With the Guidelines-Heart Failure" initiative and with information on how you can get involved. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 17: Diabetes and cardiovascular disease with Darren McGuire | Diabetics account for up to 25% of the patients seen in the chronic ambulatory setting and for as much as 40% of patients enrolled in clinical trials of patients with ischemic heart disease. To shine light on these disturbing statistics and chart a path forward for the care of diabetic patients with cardiovascular disease Dr Darren McGuire joins the show for an informative discussion that focuses on: Diabetes: The problem in general and background on a growing epidemic Medical treatment of diabetics, FDA guidelines for the development of drugs to treat diabetes, and cardiovascular safety issues Specificity of diabetes in cardiovascular disease: What's different about diabetics undergoing revascularization? What are your thoughts? Join in by commenting below. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 16: PLATO, ticagrelor, and platelet inhibition: Insight from Lars Wallentin | With two months perspective since the simultaneous publication of PLATO trial results at ESC 2009 and in NEJM, Lars Wallentin joins the show for an insightful review of the results, context, and importance of PLATO, specifically: § An explanation of why ticagrelor is a different type of platelet inhibitor § Top line results of PLATO § Insight into the mortality finding § A review of the invasively managed cohort data presented by Chris Cannon at TCT 2009 § Discussion of the effect on stent thrombosis § The "North American issue" and what might explain the anomalous North American results compared to those of the rest of the world § Background on the late-breaker—addressing patients with STEMI—at AHA 2009 that will be presented by Gabriel Steg What are your thoughts? Join in by commenting below. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 15: Care of advanced heart failure patients with Joe Rogers | The burden of caring for patients with heart failure in the US is measured in the tens of billions of dollars annually and is one of the largest problems for a healthcare system facing skyrocketing costs and an aging population. Heart failure specialist, Dr Joe Rogers joins the show to share his thoughts and top picks from the HFSA conference and his insights on the upcoming scientific sessions of the AHA, with particular focus on "mechanical support". What are your thoughts? Join in by commenting below or calling 1-866-996-5440 to leave an audio response. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 14: International collaboration and mentorship with Paul Armstrong | Dr Paul Armstrong joins the show to discuss the related subjects of international collaboration in research and mentorship amongst physicians. As the world continues to shrink with new opportunities to network and communicate there are numerous occasions to learn from international collaboration and improve standards of care globally. But what are the challenges of collaborating on an international basis? How do we tackle the obstacles and continue to improve research and care? Along with collaboration comes mentorship. What role does mentorship play in the development of first rate, effective, and balanced researchers? Drs Armstrong and Harrington discuss their experience and visions of this informal yet essential institution. What are your thoughts? Join in by commenting below or calling 1-866-996-5440 to leave an audio response. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 13: RE-LY and PLATO: Direct from ESC Congress 2009 with Ph Gabriel Steg | The RE-LY and PLATO trials have electrified the ESC Congress 2009 with results that are both practice changing and paradigm shifting. Direct from the conference floor, Professor Ph Gabriel Steg joins the show to take a close look at trial findings and their monumental implications for clinical practice and standard of care. What are your thoughts? Join in by commenting below or calling 1-866-996-5440 to leave an audio response. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 12: Relationships with industry and conflict of interest with Dr Rob Califf | It's one of the hottest issues in medical policy today and has excited the interest of wide swathes of society. Beyond the hyperbole and simplistic rhetoric, how do we go about addressing conflicts of interest—be they financial or intellectual—to promote meaningful, fair, and productive relationships with industry? Dr Rob Califf joins the show to address these thorny subjects, notably: § What are the challenges of relationships with industry and how do they "go wrong"? § Is clinical research possible without industry support? § How do we improve on the status quo? What are your thoughts? Join in by commenting below or calling 1-866-996-5440 to leave an audio response. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 11: Contemporary approaches to coronary revascularization with Dr Gregg Stone | ur mechanistic understanding of revascularization issues in ischemic heart disease patients has improved tremendously thanks to OAT, COURAGE, SYNTAX, BARI 2D, and countless smaller studies. What about the broader picture? Dr Gregg Stone joins me to address fundamental issues that are essential for a truly contemporary approach to revascularization: (1) Is the "anatomy-driven" cardiology model flawed? (2) What are the true advantages of coronary revascularization over vastly improved medical therapy? (3) What do we need to learn about optimal patient selection? (4) How can cardiologists and surgeons work better together to improve patient outcomes? (5) What advances does the future have in store? What are your thoughts? Join in by commenting below or calling 1-866-996-5440 to leave an audio response. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 10: Comparative effectiveness with Dr Harlan Krumholz | Clinicians, politicians, policy makers and payers are talking about comparative effectiveness with catch phrases as varied as "focusing on what works", "rationing care", and "limiting choices". But what does "comparative effectiveness" really mean? To help answer this question and unravel the implications for practitioners, cardiovascular research and patient care, Dr Harlan Krumholz joins the show with thoughts and expertise to tackle this controversial and timely issue. What are your thoughts? Join in by commenting below or calling 1-866-996-5440 to leave an audio response. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 9: Dr Melissa Walton-Shirley on delivering primary angioplasty without onsite surgery | Science, politics, economics, ego, and turf war--all the possible subplots for a spy novel lurk in the background of this timely discussion on access to PCI. Sharing her thoughts on this debate, Dr Melissa Walton-Shirley describes her battle to provide primary PCI at her hospital in rural Kentucky, lagging guidelines, the stark comparison with realities in parts of Europe, and how best to save lives--whether in rural, suburban, or urban locations--throughout the US. This is a passionate episode that you won't want to miss! What are your thoughts? Join in the discussion by commenting below or calling 1-866-996-5440 to leave an audio response. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 8: Antithrombotic drugs for cardiovascular medicine with Dr Magnus Ohman | We all agree that antithrombotic therapy is the cornerstone in the care of patients with ACS and vascular disease as well as for preventing complications from PCI. In terms of long term therapy, we have been largely limited to antiplatelet therapy (aspirin +/- clopidogrel) which has been the standard therapy in the chronic setting and often part of a larger armamentarium of therapies in the acute setting. But with the success of clopidogrel, a new era was ushered in marked by tremendous excitement and a push to develop a wide range of new therapies. It’s been a productive period! With the prasugrel story as a backdrop, what lessons can we learn from the world of antithrombotic drug development? Dr Magnus Ohman, one of the lead investigators in antithrombotic research, joins me today to examine the following questions pertaining to the development of antithrobotics and their use: (1) What populations do we study? Why? (2) What is the comparator? (3) What constitutes a meaningful effect? (4) How do we address safety issues? (5) How do we enroll and get the trials done? | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 7: Appropriateness criteria with Dr John Spertus | The AHA, ACC and other professional societies have done a tremendous job creating various documents to guide clinical practice. These include ACC/AHA guidelines covering numerous topics, performance measures, and clinical expert consensus documents. However there is no body of evidence that provides clear recommendations to cover all of the scenarios that we face in clinical practice. With this in mind ACC/AHA has been working on appropriateness or “appropriate use” criteria to address the issues of variability of practice from one location to another by documenting what experts deem to be the appropriate use of a particular technology. What are the implications of these new criteria? How will the information be interpreted by the public, by payers, by professional bodies? Join my discussion with Dr John Spertus from Mid America Heart Institute, an outcome investigator, clinical cardiologist, and senior author of the 2009 Appropriateness Criteria for Coronary Revascularizaton. What are your thoughts? Join in the discussion by commenting below or calling 1-866-996-5440 to leave an audio response. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 6: CORE 64 with Dr Julie Miller | Use of CT coronary angiography in the diagnostic assessment of patients with proven or suspected coronary disease is currently provoking intense discussion amongst cardiologists and radiologists. In this program, Dr Julie Miller provides background to the observational CORE 64 study for which she was co-principal investigator and discusses the results and their far reaching implications. In the ensuing discussion, Julie and I tackle some of the broader issues that are brought up by CORE 64 including: - How do we develop new technology and successfully adopt it into clinical practice? - How do we decide which patients should benefit from the new technology? - How do we deal with “turf wars” as the different specialists maneuver to administer the new technology? - What are the risks of new the new technology? | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 5: ATLAS ACS-TIMI 46 trial and antithrombotic therapy with Dr Mike Gibson | Over the past 15-18 years, research in the field of antithrombotic therapy has been stunning, fueled by an explosion of interest and breakthroughs. In this episode I discuss this exciting field with Dr Mike Gibson focusing specifically on the ATLAS trial: What was learned? What do the results mean? What challenges will the coming decade hold? More generally, how are phase II trials changing? Join in the discussion by listening to our exchange and then sharing your thoughts by commenting in the space below or by calling 1-866-996-5440 to leave an audio response. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 4: Testing behavioral intervention, the tyranny of the p-value, and all you need to know abou | HF-ACTION is a bold step into the realm of behavioral intervention and its role in altering clinical practice. In this episode, Dr O’Connor provides background on why he wanted to undertake the trial and how it came to life while discussing the goals of the trial, the major concerns from the outset and the ways to interpret the results. On a more philosophical level, what can we learn from “negative” trials? What are your thoughts? Join in the discussion by commenting below or calling 1-866-996-5440 to leave an audio response. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 3: The JUPITER trial - a home run for the science and the public health | The high point of the 2008 American Heart Association (AHA) meeting was the release of the results of the JUPITER trial, a home run for the science and for the public health. I’m joined by Dr Paul Ridker from Brigham and Women's Hospital in Boston, who was the principal investigator on the JUPITER trial, to give us his insights on the results. Please join me by sending in your comments, questions and feedback. Write a comment (heartradio@theheart.org) or call 1-866-996-5440 to leave an audio comment. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 2: SYNTAX and TRITON-TIMI 38 trials and what they mean for practitioners | The European Society of Cardiology (ESC) meeting continues to grow in scope. The breadth of educational offerings and the quality of the science presented greatly impressed me. The ESC has become a fantastic meeting for people who want to learn the latest in cardiovascular medicine and research. Two big things that I thought I would share with you: the SYNTAX and TRITON-TIMI 38 trials, and what they mean for practitioners. Please join me by sending in comments, questions and feedback. Write a comment (heartradio@theheart.org) or call 1-866-996-5440 to leave an audio comment. | 5/18/10 | Free | View In iTunes |
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The Bob Harrington Show - Episode 1: Embracing podcasting with radio at theheart.org | Welcome to episode #1 of The Bob Harrington Show. Dr Robert A Harrington is explaining why he is taking on podcasting with theheart.org and what his show format will be. As professor of Medicine at Duke University, Director of the Duke Clinical Research Institute, and a practicing interventional cardiologist, Dr Harrington is bringing a unique perspective in this podcast about cardiology and clinical trials. Please join him by sending in comments, questions and feedback. Write a comment (radio@theheart.org) or call 1-866-996-5440 to leave an audio comment. | 5/18/10 | Free | View In iTunes |
| Total: 47 Episodes |
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