Thomas F Heston MD


November 30, 2023

Coronary calcium scores in patients with normal myocardial perfusion

This study examined coronary calcium scores (CCS) in patients with normal myocardial perfusion imaging to assess cardiac risk factors. 2351 patients were evaluated. 55% had a CCS of 0, 36% had a CCS of 1-400, and 9% had a CCS over 400. Older age and hyperlipidemia were the strongest risk factors for higher CCS among…


November 29, 2023

The Ethical Significance of Statistics in Medical Research

A new review article examines statistics’s pivotal role in upholding research integrity and patient safety. It scrutinizes common statistical errors in medical studies, like p-hacking and neglecting limitations. Using historical examples, it demonstrates how such errors have resulted in flawed conclusions causing public harm, including hormone therapy research. Recommendations encompass more statistical rigor by ethical…


November 27, 2023

Statistical Significance Versus Clinical Relevance

This study investigated how often statistically significant results in nuclear medicine clinical trials actually translate into clinically meaningful differences for individual patients. The authors analyzed 32 test results reported as statistically significant and found that the cutoff between normal and abnormal values averaged just 0.66 standard deviations from the mean. This means that for a…


November 13, 2023

The Efficacy of Smoking Cessation Strategies: A Meta-Analysis

A 1993 meta-analysis reviewed research on the efficacy of different smoking cessation strategies. The analysis found that office-based approaches were more effective than community-based approaches. Effective strategies included brief counseling, nicotine replacement, workplace bans, and increasing the excise tax. More research is still needed to understand the long-term outcomes of different approaches. The analysis highlights…


November 10, 2023

Gender Bias in the Treatment of Acute Myocardial Infarction

More evidence back in 1997 that gender bias in the management of acute coronary syndrome existed. Women experienced delays in ECG and physician evaluation in emergency departments. Women were also less likely to be admitted to intensive care units compared to men. More needs to be done to eliminate this gender gap in heart attack…


November 7, 2023

Predictors of Weight Loss in Hypertension Prevention

This study highlights the significance of food records as predictors of weight loss in a hypertension prevention program. Thirty-two individuals, overweight by 10-60%, participated in a 14-week intervention involving diet and exercise modifications. The program, led by health professionals, recommended a daily caloric reduction and regular walking. Results showed an average weight loss, with initial…


November 3, 2023

Comparing Statistical Significance with Clinical Relevance: The Fragility Index vs. The Relative Risk Index

A recent study compared different metrics for evaluating the fragility and clinical relevance of research findings. The fragility index, which measures how easily p-values flip from significant to nonsignificant, strongly correlated with p-values in simulated 2×2 contingency tables. This suggests the fragility index provides minimal insight beyond p-values alone. In contrast, the relative risk index,…


November 1, 2023

The Cost of Living Index as the Main Driver of Homelessness

This study analyzed data across all 50 US states to identify factors associated with homelessness rates. It found the cost of living index, mainly driven by housing costs, was the primary driver of homelessness. Unemployment, poverty, alcohol use, and taxes were also contributors. Surprisingly, more restrictive opioid prescribing policies were linked to increased homelessness, implying…