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LOS ANGELES TIMES positive review by Sheri Linden

27/2/2015

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http://www.latimes.com/entertainment/movies/la-et-mn-widowmaker-movie-review-20150227-story.html

Delivering something of a shock to the system, the documentary "The Widowmaker" follows the money in the treatment of heart disease, revealing how the profit factor has adversely affected millions of people.

A few dramatic fillips — a model of a toiling heart, audio of 911 calls — underscore the urgency of the message, but for the most part Patrick Forbes' film is a straightforward reckoning, exposing a system that promotes costly intervention tactics rather than affordable preventive measures.

Narrator Gillian Anderson intones the grim statistics about Americans' No. 1 killer. She traces the recent history of the metal stent, a once-revolutionary way of opening blocked arteries. Over 30-odd years, stenting has gone from oddity to industry: With a price tag in the tens of thousands of dollars, the procedure has enriched doctors and, according to the film, rescued at least one hospital from the financial brink.

As to its role in saving lives, Forbes and many of his interviewees aren't convinced. They point to a $100 test, the coronary calcium scan, as a truly proactive approach, albeit one that has been scorned by the medical establishment, insurers included, in what one physician calls a "deadly double standard."

Despite confusing information about the role of diet and lifestyle, "The Widowmaker" is a lucid and important work of advocacy journalism. It illuminates yet another way that mainstream medicine thrives on crisis rather than health.

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ROGER EBERT.COM positive review by Sheila O'Malley

27/2/2015

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There's a reason why people say someone "drops dead" of a heart attack. How many times have we heard stories of a perfectly healthy individual, who doesn't smoke or drink, "dropping dead" in the driveway, on a treadmill, during a walk? Often people don't make it to the hospital, and die on the spot, as panicked loved ones call 911. "The Widowmaker," Patrick Forbes' engrossing new documentary, tells the story of the often-contentious development of both preventionist and interventionist technology in the cardiology world over the last 60 years, highlighting the ongoing battles between insurance companies, the American Heart Association, groups of doctors, inventors, and financiers, all who have a vested sometimes-financial interest in their pet technology gaining the most traction. "The Widowmaker", narrated by Gillian Anderson, is a disheartening portrait of blatant greed, as well as a fascinating examination of the trial and error process used in the scientific method. It does what good documentaries should do: it shines a very focused light on a very specific problem, a problem that affects millions of people and their families.


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New York Times review/ The Widowmaker NEW YORK TIMES positive review by Neil Genzlinger

27/2/2015

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Review: 'The Widowmaker,' a Heart Care Documentary By NEIL GENZLINGER

By now the average health care consumer perhaps understands that treatment recommendations from a doctor may be influenced by research grants, financial interests and other personal entanglements. "The Widowmaker<http://www.widowmakerthemovie.com/>," a documentary by Patrick Forbes, takes a lengthy look at that phenomenon as it relates to heart attacks, promoting the coronary calcium scan, a noninvasive procedure that faced years of resistance because the medical establishment preferred the surgically implanted stent. The film's only problem is that it may leave you so skeptical that you're not sure you're getting the unbiased story on the scan, either.

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Implementing NICE guidance, ct calcium scoring factsheet - chest pain of recent onset.

27/2/2015

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Recommendations include: The use of Coronary Artery Calcification assessment for people with chest pain who do not have confirmed coronary artery disease. The use of Coronary Artery Calcification assessment for people with chest pain in whom stable angina cannot be diagnosed or excluded by clinical assessment alone.
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Diagnosis of stable ischemic heart disease: summary of a clinical practice guideline from the american college of physicians/american college of cardiology foundation/american heart association/american association for thoracic surgery/preventive cardiov

27/2/2015

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This guideline presents the available evidence on the diagnosis of stable known or suspected ischemic heart disease (IHD). The guideline includes 48 specific recommendations that address the following issues: patient education, management of proven risk factors (dyslipidemia, hypertension, diabetes, physical activity body weight, and smoking), risk factor reduction strategies of unproven benefit, medical therapy to prevent myocardial infarction and death and to relieve symptoms, alternative therapy, revascularization to improve survival and symptoms, and patient follow-up.
AUTHOR
Qaseem, A., Fihn, S.D., Williams, S., Dallas, P., Owens, D.K., Shekelle, P. and for the Clinical Guidelines Committee of the American College of Physicians (2012)
REFERENCE
Ann Intern Med. 20 November 2012;157 (10):729-734
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European guidelines on cardiovascular disease prevention in clinical practice (version 2012).

27/2/2015

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Recommendations include: Class IIa CT for coronary calcium should be considered for cardiovascular risk assessment in asymptomatic adults at moderate risk.
AUTHOR
The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR).
REFERENCE
Eur Heart J (2012) 33 (13): 1635-1701.
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2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults.

27/2/2015

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Recommendations include: Class IIa Measurement of Coronary Artery calcification is reasonable for cardiovascular risk assessment in asymptomatic adults at intermediate risk (10% to 20% 10-year risk). Class IIb Measurement of Coronary Artery calcification may be reasonable for cardiovascular risk assessment in persons at low to intermediate risk (6% to 10% 10-year risk). Class IIb Measurement of Coronary Artery calcification is reasonable for cardiovascular risk assessment in asymptomatic adults with diabetes, 40 years and older.
AUTHOR
A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance.
REFERENCE
J Am Coll Cardiol 2010 56(25): e50-103.
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ACCF/AHA 2007 Clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain.

27/2/2015

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The writing committee of this document consisted of acknowledged experts in the field of coronary artery disease. This is a very large document and should be considered in detail - of particular note is the meta-analysis on Page 385 and the summary and final conclusions on page 396, which include: ‘The Committee judged that it may be reasonable to consider use of CAC measurement in such patients based on available evidence that demonstrates incremental risk prediction information in this selected (intermediate risk) patient group. This conclusion is based on the possibility that such patients might be reclassified to a higher risk status based on high CAC score, and subsequent patient management may be modified’.
AUTHOR
A Report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography) Developed in Collaboration With the Society of Atherosclerosis Imaging and Prevention and the Society of Cardiovascular Computed Tomography.
REFERENCE
J Am Coll Cardiol. 2007;49(3):378-402.
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Associations between c-reactive protein, coronary artery Calcium, and cardiovascular events: implications for the Jupiter population from mesa, a population-based cohort study

27/2/2015

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This study sought to establish whether Coronary Calcification assessment could identify a subgroup of patients eligible for JUPITER who would be expected to derive the most or the least benefit from statin treatment. It found that Coronary Calcification assessment seems to further stratify risk in patients who meet eligibility criteria for JUPITER, and might be used to target a subgroup of patients expected to derive the most and the least absolute benefit from treatment. Focusing of treatment on the subset of individuals with low LDL cholesterol with measurable atherosclerosis might represent a more appropriate allocation of resources, reduce overall health-care cost, and prevent the occurrence of a similar number of events.
AUTHOR
Blaha, M.J., Budoff, M.J., DeFilippis, A.P., Blankstein, R., Rivera, J.J., Agatston, A., O’Leary, D.H., Lima, J., Blumenthal, R.S., Nasir, K. (2011)
REFERENCE
Lancet 2011; 378: 684–92
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Coronary risk stratification, discrimination, and reclassification improvement based on quantification of subclinical coronary atherosclerosis - the heinz nixdorf recall study

27/2/2015

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This study sought to determine the net reclassification improvement (NRI) and improved risk prediction based on coronary artery calcification (CAC) scoring in comparison with traditional risk factors. It found that Coronary Calcification assessment results in a high reclassification rate in the intermediate-risk cohort, demonstrating the benefit of imaging of subclinical coronary atherosclerosis. Our study supports its application, especially in carefully selected individuals with intermediate risk.
AUTHOR
Erbel, R., Möhlenkamp, S., Moebus, S., Schmermund, A., Lehmann, N., Stang, A., Dragano, N., Grönemeyer, D., Seibel, R., Kälsch, H., Bröcker-Preuss, M., Mann, K., Siegrist, J., Jöckel, K-H (2010)
REFERENCE
J Am Coll Cardiol. 56(17):1397-1406.
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About the IHDA

The Irish Heart Disease Awareness charity has been established to raise awareness of heart disease as a progressive, measurable and treatable disease that can be detected by a simple calcification test.The charity's founder, David Bobbett, is the CEO and majority shareholder of H&K International, one of the world's largest equipment suppliers to the Quick Service Restaurant (QSR) industry. 

Irish Heart Disease Awareness

Contact Information

Irish Heart Disease Awareness, a Company Limited by Guarantee

Directors
David Bobbett;
Dr. Jerry Clifford
Eric Wallace
Pat Caslin
Caroline O'Sullivan
​

Registered Number – 518296
Registered as a Charity under reference:
CHY 20387
Tel: 01 605 5421


Registered Address:
Knockmitten House,
Knockmitten Lane,
Dublin 12

Email: info@ihda.ie

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