Comparative Effectiveness in Cardiovascular Disease | Cardiology Grand Rounds (RECORDING)

Thursday, September 12, 2024, 12:00 AM - Sunday, September 12, 2027, 11:59 PM, On Demand

In this recorded Cardiology Grand Rounds presentation, Dr. David Cohen, an interventional and structural cardiologist, discusses the role of observational studies in comparative effectiveness research. Dr. Cohen discusses the strengths and limitations of randomized controlled trials (RCTs) and observational studies, highlighting the importance of matching study design to the research question. He provides examples of instrumental variable analysis, regression discontinuity, and other quasi-experimental designs to address confounding and selection bias in observational studies. Dr. Cohen emphasizes the importance of pre-registration, falsification endpoints, and careful validation of assumptions in observational studies. In addition, he explores the potential for registry-based randomized trials to address some limitations of traditional RCTs and observational studies. Overall, the presentation calls attention to the value of observational studies, when properly designed and analyzed, in supplementing evidence from RCTs and addressing gaps in the evidence base.

  Release Date: September 12, 2024
  Expiration Date: September 11, 2027
  Estimated Time to Complete: 0.75 hours
  Registration Fee: FREE
 *Originally recorded 02/01/2024

AMA PRA Category 1 Credits™ (0.75 hours), Non-Physician Participation Credit (0.75 hours)

1. Recognize the limitations of randomized controlled trials (RCTs), such as high costs, narrow inclusion criteria, protocol-driven care, addressing only one question, and potential obsolescence due to rapidly changing technologies or practices.
2. Realize the strengths and weaknesses of observational studies, including the ability to rapidly enroll large numbers of patients, accommodate changes over time, and have broad inclusion criteria, as well as potential data quality issues, lack of a unique time zero, and the challenge of addressing confounding.
3. Explore the use of instrumental variable analysis, regression discontinuity design, and other quasi-experimental designs to address confounding and selection bias in observational studies.
4. Implement pre-registration, falsification endpoints, and careful validation of assumptions in observational studies to address potential biases and unmeasured confounding.
5. Consider the potential for registry-based randomized trials to address some limitations of traditional RCTs and observational studies.
6. Develop expertise in both clinical knowledge and methodological training to conduct high-quality observational research.
7. Perceive the value of observational studies, when properly designed and analyzed, in supplementing evidence from RCTs and addressing gaps in the evidence base.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 0.75 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

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Cultural and Linguistic Competency
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Mitigation of Relevant Financial Relationships

 

Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education.

 

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity, except those listed in the table below. All of the relevant financial relationships listed for these individuals have been mitigated.

Faculty Member Information	Role in activity	Name of commercial interest/Nature of relationship
David Joel Maron, MD	Course Director	Membership on Advisory Committees or Review Panels, Board Membership, etc.-Abiomed, Inc.|Consulting Fee-Scilex (Relationship has ended)
Yaanik Desai, MD	Planner	Consulting Fee-Sandbox AQ (Relationship has ended)
Sneha S. Jain, MD, MBA	Planner and Reviewer	Nothing to Disclose
David J. Cohen, MD, MSc	Faculty	Grant or research support - Edwards Lifesciences LLC, Grant or research support - Boston Scientific Corporation, Grant or research support - Abbott Vascular, Grant or research support - Cathworks, Grant or research support - Philips Medical Systems Inc., Grant or research support - Zoll Medical, Consulting Fee - Edwards Lifesciences LLC, Consulting Fee - Abbott Vascular, Consulting Fee - Elixir Medical