Thursday, July 19, 2007

Classes, Mock IRB Session, Grand Rounds, and More Cardiac Surgery

Yesterday's biostats class was on how to build databases in a computer program called JMP. So far, the program hasn't been as scary as I was expecting it to be. After the class, we had a mock IRB session where several of the CCF IRB members discussed some real protocols that had been submitted to them from CCF researchers. We were able to also ask questions of the IRB members, and there were some interesting issues that came up. One was whether it is ethical to conduct a clinical trial with a placebo arm if there is a known treatment (the standard of care) that is already proven to be superior to placebo. In this specific case, there was one. So some of the IRB members (and I as well) had concerns about this.

The mock IRB session tied in well to today's epidemiology class, which was about clinical equipoise. Equipoise means that there is a real uncertainty about which of two treatments is superior to the other (including a treatment versus placebo if no treatment for that disease is currently known). We read an article for today where the researchers had performed a sham surgery in the placebo arm of the trial. In that case though, I think it was appropriate to do the sham surgery because the purpose of the study was to decide whether the standard treatment really was superior to placebo. It turned out that it wasn't.

Before class this morning, I went to the Internal Medicine Grand Rounds. It was about the General Clinical Research Center (GCRC) here at CCF. The speaker talked about some of the clinical experiments going on at CCF and the services that the GCRC provides. She was also talking about CCF setting up future clinical research collaboration with Case, University Hospital and Metro Hospital, including training opportunities in clinical research. It will be too late for me of course, but it sounds like there will be a lot of opportunities for clinical research training here in Cleveland in the future.

I spent all of this afternoon in the OR watching cardiac surgeries. One was being done because the outside covering (called the pericardium) of the patient's heart was sticking to the heart itself so that there wasn't enough room for his heart to contract and expand properly. Another surgery was for a patient whose aorta (the big artery coming out of the heart) was partially blocked. There was a third patient who was having a coronary artery bypass graft, but I had already been in the OR for five hours at this point, and I didn't want to stay longer just to see another bypass graft. It's really interesting to see all of these surgeries, but I have to say that I'm completely exhausted now.

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