At this moment in time the pre-pandemic cardiology research agenda needs to be completely reprioritized. There are two broad areas that now take precedence over all existing research concerns. On the one hand, researchers need to achieve a better understanding of the staggering incidence of deferred or delayed treatment of cardiovascular events and conditions as a result of the pandemic. Of course there will be important adverse consequences when serious events go untreated (but there also may be important insights that can be achieved about overdiagnosis and overtreatment).
On the other hand are urgent questions about the role of cardiovascular disease in patients with COVID-19. This includes both the increased risk from the virus in people with existing cardiovascular conditions or risk factors as well as the frightening possibility that COVID-19 itself may have serious short- and long-term adverse effects on the cardiovascular system. To date there have been no really good scientifically rigorous studies that provide useful and actionable information about this last truly urgent question. This represents a catastrophic failure of the cardiology research establishment.
The middle of a raging pandemic is no time for business-as-usual research studies, especially when the studies falsely purport to shed light on that pandemic. Such papers have all the appearance of high quality science. They have a ton of data and a lot of big words but they’re incapable of providing reliable or useful information that can aid in our understanding and control of the health emergency.
The problem is that academic medicine in general, and academic cardiology in particular, have become factories for the assembly-line production of low quality studies that either don’t add to our understanding of important questions in any significant way or, worse, influence the scientific discussion with hype, fear, or confusion. Even when such research is relatively harmless– for instance, if it doesn’t promote a drug or procedure that doesn’t work or is dangerous– it represents a wasted opportunity, effort that would better have been directed toward higher quality research. Low quality research is never desirable; now, in the time of the coronavirus, it is inexcusable.
A new study published in the Journal of the American College of Cardiology illustrates this problem.