Controversies in Cardiovascular Medicine Revisited
Over the last decade, the Controversies in Cardiovascular Medicine section has established a position as a popular and frequently downloaded section of Circulation. Controversy is inherent to medicine and other disciplines when a course of action must be taken on the basis of insufficient evidence. Like debates at scientific meetings, published controversies generate considerable interest because of the purposefully polarized positions taken by experts on topics in which clinical uncertainty or equipoise exists. In fact, a fundamental requisite for selecting a suitable topic for a debate or controversy is the absence of conclusive evidence clarifying the correct course of action. In this context, the opinions of experts are highly valued by those seeking guidance on decisions in the setting of gaps in knowledge. Circulation’s Controversies, published in debate format and including rebuttals, support the notion that the passion with which an opinion is represented is inversely proportional to the amount of evidence available. Since 2005, the Controversies in Cardiovascular Medicine section has included 106 articles with thoughtful and informed opinions on 53 clinically important issues that remained unresolved at the time of publication.
Recognizing the particular significance of new clinical evidence in bridging the knowledge gaps related to previously published controversial topics, this issue of Circulation contains the inaugural contribution to Controversies in Clinical Medicine Revisited. The article titled “Surgical Septal Versus Alcohol Septal Ablation: Assessing the Status of the Controversy in 2014,” contributed by Drs Maron and Nishimura, represents an update on evidence published since 2007.1–3 This inaugural contribution, like subsequent contributions to this section, has the objective of updating the readership with a single article written jointly by the previous “protagonist” and “antagonist.” Previous controversies were written as separate articles advancing the strongest possible arguments. With this new section, the original contributors to the controversy provide a collaborative update that is evidence based and balanced in a single article. Areas of consensus and areas of continued disagreement are summarized. Studies that are in progress or are needed to fill gaps in knowledge are noted. It is evident that this new section, Controversies Revisited, should be of considerable value to the readership by providing the best available contemporary evidence and expert guidance on important controversial topics previously published in Circulation.
- © 2014 American Heart Association, Inc.
- Maron BJ,
- Nishimura RA
- Fifer MA
- Maron BJ