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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