Neurosis is the inability to tolerate ambiguity.

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As the father of psychology Sigmund Freud points out, the undulations of our daily professional and personal lives require us to evaluate and absorb the various shades of gray. And this week’s cardiovascular news perpetuates the necessity.

A JACC study was released questioning randomized controlled trials, which have served as the gold standard for evidence-based management policies. The researchers found they often have flaws that can lead to suboptimal practice recommendations.

In an accompanying editorial, Dr. Gregg W. Stone concurred, adding that randomized controlled clinical trials are often poorly designed, hold inadequate quality control and are often subject to unsuitable interpretation.

While many policy and regulatory decisions are based on these types of trials, the various practices and individual practitioners should, therefore, be expected to look past the headlines from trials, and sift through the design and outcomes for its true value.

In the financial realm, Pfizer reported a net income jump of 7 percent in year-over-year results and a 188 percent increase in the fourth quarter income. However, media reports suggested that Wall Street was lamenting that Pfizer produced lower results than expected.

Often, government agencies make far-reaching decisions that leave the healthcare industry to scrambling to assess their value. For instance, CMS recently designated three organizations as accrediting bodies for non-hospital providers of advanced medical imaging. Dr. Stephen Green, chief of cardiology at North Shore University Hospital helps to discern the accreditation standardization process, and how this affect practices.

Finally, in order to help clear up a controversial and ambiguous issue that has plagued cardiovascular imaging for years, the NIH is incorporating radiation dose exposure reports into the EMR at their Clinical Center. The agency hopes this effort will lead to an accurate assessment of whether any cancer risk is associated with the radiation exposure from medical imaging tests.
While we all must tolerate ambiguity, hopefully our sanity allows us to uncover—with some clarity—the proper procedures and methods to approach the field. Yet, Freud also suggests: Man should not strive to eliminate his complexes, but to get into accord with them.

On these topics, or any others, please feel to contact me.

Justine Cadet, managing editor