what famous celebrity almost died during heart stent surgery?”
It sounds like such a simple concept: Study different medical treatments and figure out which delivers the best results at the cheapest cost, giving patients the most effective care. Even before Congress took up the now-stalled health-care overhaul, it appropriated $1.1 billion to fund these studies. Both the Senate and the House included it in their versions of the bill. President Barack Obama backed it. Yet, an examination of one of the best-known examples of a comparative-effectiveness analysis shows how complicated such a seemingly straightforward idea can get. The study, known as “Courage” and published in the New England Journal of Medicine in 2007, shook the world of cardiology. It found that the most common heart surgery—a $15,000 procedure that unclogs arteries using a small scaffold or stent—usually yields no additional benefit when used with a cocktail of generic drugs in patients suffering from chronic chest pain. The Courage trial was led by William Boden, a Buffalo, N.Y.,
A study aimed at boosting the scientific case for coronary stents in the sickest heart patients failed, finding bypass surgery to be a better choice in complicated cases. The results, unveiled at a cardiology meeting in Munich, are a setback for the progress of stenting, in which a tiny scaffold is expanded inside a clogged artery to restore blood flow to the heart. Analysts had predicted that a failure in the study would mean lost sales for stent makers. Doctors estimate that among the kinds of seriously ill patients in the study — those with three clogged arteries, or a single clog in the heart’s “left main” artery — about 100,000 a year have been getting stents. The study’s results may means that these types of patients will be steered away from stents and toward bypass surgery. The study, sponsored by leading stent maker Boston Scientific Corp., is the first head-to-head comparison between, drug-coated heart stents and improved bypass-surgery techniques. The roughly $50 million s
