Translating Medical Research - Preventing Sudden
Heart Death
SAN FRANCISCO, An issue of the renowned
New England Journal of Medicine (December 16, 1999) contains an original research article
entitled "A Randomized Study of the Prevention of Sudden Death in
Patients with Coronary Artery Disease."
The research reported in this article will, we believe, influence
health care. However, can someone who is not an MD or a PhD
biomedical scientist understand this article? Our purpose will be
to "translate" four sentences as a sampler from the report.
The Opening Sentence
Article: The body of the article opens with this
sentence: "Despite recent decreases in the rates of death from
cardiovascular disease, mortality after discharge from the hospital
remains high among survivors of acute myocardial infarction who have
substantial left ventricular dysfunction."
Translation: When they leave the hospital after a heart
attack that has impaired the function of the left ventricle of their
heart, people still face a high risk of death from heart disease.
The Design of the Trial
Article The Methods section of the abstract of the article
begins: "We conducted a randomized, controlled trial to test the
hypothesis that electrophysiologically guided antiarrhythmic therapy
would reduce the risk of sudden death among patients with coronary
artery disease, a left ventricular ejection fraction of 40 percent or
less, and asymptomatic, unsustained ventricular tachycardia."
Translation: To test the idea that an implantable
defibrillator (which shocks a quivering heart back into a normal
rhythm) might prevent sudden death among people who have survived a
bad heart attack, we did a trial comparing the device with standard
drug treatment.
The Results
Article: The Results section of the abstract of the article
begins: "A total of 704 patients with inducible, sustained
ventricular tachyarrhythmias were randomly assigned to treatment
groups."
Translation: A total of 704 people were by chance alone
assigned one or another treatment for a
fast irregular ventricular heart rhythm.
The Last Sentence
Article: The conclusion of the abstract of the article
reads as follows: "Electrophysiologically guided antiarrhythmic
therapy with implantable defibrillators, but not with antiarrhythmic
drugs, reduces the risk of sudden death in high-risk patients with
coronary disease."
Translation: Implantable defibrillators prevent death after
a bad heart attack, but drugs do not.
The Language of Medicine
The point of this exercise is not to denigrate The New England
Journal of Medicine. Far from it. The New England Journal is arguably
the finest medical periodical in the world.
The point is to illustrate the fact that medicine has a language
of its own, a lingo that is not always easily fathomed by the
majority of people not in medicine. The language of medicine is not
getting any closer to our everyday tongue.
Reference
Alfred E. Buxton, Kerry L. Lee, John D. Fisher,
Mark E. Josephson, Eric N. Prystowsky, Gail Hafley, for the
Multicenter Unsustained Tachycardia Trial Investigators. A Randomized
Study of the Prevention of Sudden Death in Patients with Coronary
Artery Disease. The New England Journal of Medicine -- December 16,
1999 -- Vol. 341, No. 25, Pages 1882-1890.
Last Editorial Review: 2/1/2005
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