In recent years defenders of commercially-supported continuing medical education (CME) have claimed that the industry has cleaned up its act and that CME programs today are largely free of the abuses that were so common not so long ago. Perhaps. But there are still plenty of examples of programs that violate the fundamental principle that medical education should be completely separate from commercial interests.
A striking example is a recent email I received from TCTMD, the online arm of the Cardiovascular Research Foundation (CRF), which is basically the equivalent of the Vatican for interventional cardiologists. The subject line of the email was nothing out of the ordinary:
Sponsored Message from Volcano: ADAPT-DES Webcast and Investigator Interview
I get lots of these sort of messages from different medical organizations. I’m not crazy about them but I understand that these groups have to pay their bills. But it’s vitally important that these groups maintain a clear separation between commercial messages like these and genuine educational content.
The text of the email makes some astonishing claims. It makes the case– not surprising in a promotional message– that interventional cardiologists should use IVUS more often during their procedures. But the text fails to mention that the numbers mentioned in the text come not from a randomized controlled trial but from an observational study. The findings thus should be considered hypothesis generating. In addition, as is so often the case when medical results are being hyped, the relative differences sound quite impressive– 50% reduction in stent thrombosis and 33% reduction in MI– but the absolute differences are much less impressive: at one year stent thrombosis was reduced from 1.04% to 0.52% and MI was reduced from 3.7% to 2.5%. And remember, since these differences are not the result of a randomized comparison they may be completely illusory.