CHEST Guidelines-Rebuttal-From-Dr-Maron

Rebuttal-From-Dr-Maron_chest

Pdf Summary

The document discusses the debate surrounding the revised definition of pulmonary hypertension (PH) from a clinical perspective. Dr. Maron argues in favor of adopting the revised hemodynamic definition of PH, emphasizing that accurate disease identification should not necessarily be accompanied by a defined clinical care strategy. He suggests that understanding the clinical phenotype of diseases like PH can improve care over time even if specific treatments are not yet available.<br /><br />Dr. Maron highlights that accurate diagnosis is a cornerstone of medicine, serving to enhance the risk spectrum for better management and future treatments of PH, invoking examples of other medical conditions which initially lacked treatments. He also points out that while incorporating the revision should present a tangible benefit and minimal harm, there are currently insufficient data to warrant medical therapies for patients with mildly elevated pulmonary artery pressure. He stresses that understanding and defining clinical risk accurately is important and is part of effective medical practice, despite the absence of immediate therapeutic applications.<br /><br />In his counterpoint, Dr. Frantz opposes the revision, viewing the potential for patient misclassification as significant, which may lead to psychological and physical harm. He recommends a period of cautious clinical research before implementing such changes into routine practice. Dr. Frantz's view leans towards a more conservative approach, underscoring the need for substantial evidence before adopting new definitions in medical practice.<br /><br />The document also makes brief mention of funding and disclosures, noting that Dr. Maron has consultancy affiliations and reports no involvement of sponsors in the study's design or data analysis. The discussion contextualizes the ongoing debate regarding evolving medical definitions and their implications on patient care and clinical practice standards.

Keywords

pulmonary hypertension

hemodynamic definition

clinical phenotype

accurate diagnosis

patient misclassification

clinical research

medical practice

disease identification

risk spectrum

medical definitions