Recommended Readings

(1). Simpkin AL, et al. Communicating Uncertainty: a Narrative Review and Framework for Future Research. J Gen Int Med 2019;34:2586-2591.

Discussing the uncertainty associated with a clinical decision is thought to be a critical element of shared decision-making. Yet, empirical evidence suggests that clinicians rarely communicate clinical uncertainty to patients, and indeed the culture within healthcare environments is often to equate uncertainty with ignorance or failure. Understanding the rationale for discussion of uncertainty along with the current evidence about approaches to communicating and managing uncertainty can advance shared decision-making as well as highlight gaps in evidence. With an increasing focus on personalized healthcare, and advances in genomics and new disease biomarkers, a more sophisticated understanding of how to communicate the limitations and errors that come from applying population-based, epidemiologic findings to predict individuals’ futures is going to be essential. This article provides a narrative review of studies relating to the communication of uncertainty, highlighting current strategies together with challenges and barriers, and outlining a framework for future research.

(2) Greenhalgh T. Effectiveness and Efficiency: Random Reflections on Health Services. BMJ. 2004;328(7438):529.

Archie Cochrane was an epidemiologist with a maverick streak. In 1935, as a lone medical student, he marched through London carrying a home made placard that read, “All effective treatments must be free.” According to him, nobody noticed. In this seminal book, first published in 1972 by the Nuffield Provincial Hospitals Trust and issued in this imprint in 1999, he called for an international register of randomised controlled trials, and for explicit quality criteria for appraising published research, but neither goal was achieved in his lifetime. Today, the Cochrane Controlled Trials Register has more than 400 000 entries, and an international movement to improve the methodology of research synthesis also bears his name.

(3). The disease that lurks for decades. 2022.

Chagas disease causes misery in poor communities around the world, and may lead to 10,000 deaths a year. Health workers are trying new methods to ease suffering.

But for all the technical and scientific progress against Chagas, the disease will persist as long as there is poverty and challenging living conditions


(4). Branswell. With usual suspects ruled out, disease detectives try to crack mystery of viral hepatitis cases in kids


When medical professionals think they’re seeing something new, or an unusual spike in cases of something known, disease detectives – epidemiologists – are generally tasked with solving the mysteries of the case. Some of these seeming events turn out to be nothing more than coincidence. Some, however, are very real and teach us more about what a known disease agent can do or introduce us to a new bug that poses a hitherto unrecognized threat.

Increasingly, it appears that the mounting reports of unusual pediatric hepatitis cases will turn out to be the latter type of event. As of May 1, at least 20 countries reported 228 cases of pediatric hepatitis of unknown etiology or origin, with more than 50 suspected cases still under investigation. At least 18 of the children have required liver transplants and at least one has died, the World Health Organization said Wednesday. The question is no longer “Is this real?” but “What is triggering severe liver inflammation in previously healthy little kids?”

The usual suspects – the hepatitis viruses labeled A through E – were quickly ruled out. But that leaves a number of options on the table. The good news is there are hypotheses and there are clues and there are public health experts and scientists in a number of countries trying hard to crack the case. But solid answers will take time.

(5). David Vearrier. 10 Cases of Food Poisoning: Find the Pathogen Responsible. 2022.


(6). Vincent Richeux. ACC Recognizes Alain Cribier, MD, PhD, for Developing TAVR. 2022.

A tribute to the pioneer of TAVR.

Hope this would be read by our first residents who join our Dr.NB Cardiology program.

That would hopefully instil in them a taste for Basic and Applied Clinical Research.

“It is by standing on the shoulders of giants that we see very far”-Sir Isaac Newton

(7). Ashley Lyles. Takotsubo Syndrome Also Linked to Happy Life Events. 2022.

Takotsubo syndrome, a condition that’s also been called “broken heart syndrome,” can be triggered by both positive and negative life stressors, especially in men, a new study suggests.

The findings show that although Takotsubo syndrome, a type of acute heart failure related to atypical patterns of transient left ventricular contraction abnormalities, is often triggered by negative emotional stressors, it can also stem from positive life events, something the researchers are calling “happy heart syndrome.”

In this registry study, males were more likely to experience Takotsubo syndrome from a positive life event, as were those with atypical, nonapical ballooning, report Thomas Stiermaier, MD, of the University Hospital Schleswig-Holstein in Lübeck, Germany, and colleagues (continue reading)….

(8). Jaya Mallidi. Adieu, Interventional Cardiology: My Spiritual Journey to a New Ikigai. 2022.

The plain white walls in my new windowless office looked sterile. After months of procrastination, I decided to decorate them with the cards I had received over the years from patients from my interventional cardiology practice. These thank-you cards had been stored in a large box in my car trunk for months. I carried the box to my office and slowly started reading one card at a time, reminiscing about that patient before pinning it to the wall (continue reading)….