Visions of a Cure: Visualization, Clinical Trials, and Controversies in Cardiac Therapeutics, 1968-1998
In the early 1970s physicians engaged in fierce debates over the most appropriate method of evaluating the efficacy of coronary artery bypass grafting (CABG). With millions of patients and billions of dollars at stake, CABG sparked fierce controversy. Skeptics demanded that randomized controlled...
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| Other Authors: | |
| Format: | Article |
| Language: | en_US |
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History of Science Society
2011
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| Online Access: | http://hdl.handle.net/1721.1/61724 |
| _version_ | 1826200423469416448 |
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| author | Jones, David Shumway |
| author2 | Massachusetts Institute of Technology. Program in Science, Technology and Society |
| author_facet | Massachusetts Institute of Technology. Program in Science, Technology and Society Jones, David Shumway |
| author_sort | Jones, David Shumway |
| collection | MIT |
| description | In the early 1970s physicians engaged in fierce debates over the most appropriate method
of evaluating the efficacy of coronary artery bypass grafting (CABG). With millions of
patients and billions of dollars at stake, CABG sparked fierce controversy. Skeptics demanded
that randomized controlled trials (RCTs) be performed, while enthusiasts argued
that they already had visual proof of CABG's efficacy. When RCTs appeared, they did
not settle the controversy. Participants simply reasserted their preconceptions, defending
a trial's strengths or exploiting its flaws. The debate centered on standards of knowledge
for the evaluation of therapeutic efficacy. Specifically, cardiologists and cardiac surgeons
struggled to assess the relevance of different measures of therapeutic success: physiological
or clinical, visual or statistical. Many factors contributed to participants' decisions, including
disciplinary affiliation, traditions of research, personal experience with angiography,
and assessments of the history of cardiac therapeutics. Physicians had to decide
whether angiography provided a meaningful representation of the disease and its treatment
or whether demonstrations of therapeutic success could come only from long-term statistical
evaluation of mortality data. |
| first_indexed | 2024-09-23T11:36:10Z |
| format | Article |
| id | mit-1721.1/61724 |
| institution | Massachusetts Institute of Technology |
| language | en_US |
| last_indexed | 2024-09-23T11:36:10Z |
| publishDate | 2011 |
| publisher | History of Science Society |
| record_format | dspace |
| spelling | mit-1721.1/617242022-09-27T20:39:16Z Visions of a Cure: Visualization, Clinical Trials, and Controversies in Cardiac Therapeutics, 1968-1998 Jones, David Shumway Massachusetts Institute of Technology. Program in Science, Technology and Society Jones, David Shumway Jones, David Shumway In the early 1970s physicians engaged in fierce debates over the most appropriate method of evaluating the efficacy of coronary artery bypass grafting (CABG). With millions of patients and billions of dollars at stake, CABG sparked fierce controversy. Skeptics demanded that randomized controlled trials (RCTs) be performed, while enthusiasts argued that they already had visual proof of CABG's efficacy. When RCTs appeared, they did not settle the controversy. Participants simply reasserted their preconceptions, defending a trial's strengths or exploiting its flaws. The debate centered on standards of knowledge for the evaluation of therapeutic efficacy. Specifically, cardiologists and cardiac surgeons struggled to assess the relevance of different measures of therapeutic success: physiological or clinical, visual or statistical. Many factors contributed to participants' decisions, including disciplinary affiliation, traditions of research, personal experience with angiography, and assessments of the history of cardiac therapeutics. Physicians had to decide whether angiography provided a meaningful representation of the disease and its treatment or whether demonstrations of therapeutic success could come only from long-term statistical evaluation of mortality data. 2011-03-18T14:24:52Z 2011-03-18T14:24:52Z 2000-09 Article http://purl.org/eprint/type/JournalArticle 0021-1753 http://hdl.handle.net/1721.1/61724 Jones, David S. “Visions of a Cure: Visualization, Clinical Trials, and Controversies in Cardiac Therapeutics, 1968-1998.” Isis 91.3 (2000): 504-541. ©2000 The History of Science Society. en_US http://dx.doi.org/10.1086/384853 Isis Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use. application/pdf History of Science Society David S. Jones |
| spellingShingle | Jones, David Shumway Visions of a Cure: Visualization, Clinical Trials, and Controversies in Cardiac Therapeutics, 1968-1998 |
| title | Visions of a Cure: Visualization, Clinical Trials, and Controversies in Cardiac Therapeutics, 1968-1998 |
| title_full | Visions of a Cure: Visualization, Clinical Trials, and Controversies in Cardiac Therapeutics, 1968-1998 |
| title_fullStr | Visions of a Cure: Visualization, Clinical Trials, and Controversies in Cardiac Therapeutics, 1968-1998 |
| title_full_unstemmed | Visions of a Cure: Visualization, Clinical Trials, and Controversies in Cardiac Therapeutics, 1968-1998 |
| title_short | Visions of a Cure: Visualization, Clinical Trials, and Controversies in Cardiac Therapeutics, 1968-1998 |
| title_sort | visions of a cure visualization clinical trials and controversies in cardiac therapeutics 1968 1998 |
| url | http://hdl.handle.net/1721.1/61724 |
| work_keys_str_mv | AT jonesdavidshumway visionsofacurevisualizationclinicaltrialsandcontroversiesincardiactherapeutics19681998 |