JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study Comparative Study
Effect of Bempedoic Acid vs Placebo Added to Maximally Tolerated Statins on Low-Density Lipoprotein Cholesterol in Patients at High Risk for Cardiovascular Disease: The CLEAR Wisdom Randomized Clinical Trial.
Additional treatment options are needed for patients who do not achieve sufficient reduction in low-density lipoprotein cholesterol (LDL-C) level with available lipid-lowering therapies. ⋯ Among patients at high risk for cardiovascular disease receiving maximally tolerated statins, the addition of bempedoic acid compared with placebo resulted in a significant lowering of LDL-C level over 12 weeks. Further research is needed to assess the durability and clinical effect as well as long-term safety.
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Multicenter Study
Association of Cardiac Resynchronization Therapy With Change in Left Ventricular Ejection Fraction in Patients With Chemotherapy-Induced Cardiomyopathy.
The incidence of chemotherapy-induced cardiomyopathy is increasing and is associated with poor clinical outcomes. ⋯ In this preliminary study of patients with chemotherapy-induced cardiomyopathy, CRT was associated with improvement in LVEF after 6 months. The findings are limited by the small sample size, short follow-up, and absence of a control group.
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In recent years, many new clinical diagnostic tools have been developed using complicated machine learning methods. Irrespective of how a diagnostic tool is derived, it must be evaluated using a 3-step process of deriving, validating, and establishing the clinical effectiveness of the tool. ⋯ On the validation set, the outcome against which the model is evaluated is termed the reference standard. The rigor of the reference standard must be assessed, such as against a universally accepted gold standard or expert grading.