BMJ 1995;310:1471 (3 June)

Letters

Carotid endarterectomy

Author's reply

EDITOR,--Many of those who commented in the debate on carotid endarterectomy suggested that the use of non-invasive tests for carotid stenosis can transform the balance of risks and benefits to patients of a service for carotid endarterectomy.1 2 This may overstate the case.

These tests should firstly be exposed to a more comprehensive formal evaluation; it should not stop at small case series assessing only accuracy, as this represents an inadequate assessment of these technologies. The acceptability, reproducibility, and economics of these investigative techniques requires more examination.

We should not be surprised that some centres with considerable expertise are able to achieve high levels of accuracy, but this may be unrepresentative of what happens in many centres carrying out investigation and surgery. This process of evaluation should therefore extend to a local level, with each service carrying out an audit of the investigation pathways used locally, and should examine . . . [Full text of this article]


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

Controversies in Management: Should carotid endarterectomy be purchased? Treatment avoids much morbidity
Roger N Baird
BMJ 1995 310: 316-317. [Extract] [Full Text]

Access jobs at BMJ Careers
Whats new online at Student BMJ