Following a feature on CCSVI this spring, Dr. Bradley Diddle, a Barrie Ontario Cardiologist wrote a letter to the editor of Maclean’s magazine. Dr. Diddle’s comments raise an interesting argument of double standards and equal access to care in Canada.
“The resistance to CCSVI treatment for MS from the neurological community surprises me because they aren’t even consistent when it comes to this kind of problem. As a cardiologist I am asked by neurologists on a daily basis to investigate patients with unexplained strokes to see if they have a small hole in their heart called the patent foramen ovale, PFO, and if I find one to have it closed with an invasive procedure. This is despite the fact that there are no clinical trials to show us that this is the right thing to do for these patients. There does appear to be a slightly higher incidence of PFO in unexplained strokes although they are present in about 25% of everyone on the planet and some observational information showing that this reasonably safe and not too costly invasive procedure appears helpful. To me, this sounds a lot like CCSVI, an association that has identified the procedure that can address the abnormality and some early observations that suggest a benefit. My neurology colleagues need to start moving forward and offer this procedure to MS patients and see how they respond”.
Clearly there is a precedent set in Canada that allows our medical professionals to perform invasive procedures based on ‘observational information showing that this reasonably safe and not too costly invasive procedure appears helpful’. So what’s all the debate about?