This is a really exciting day for the ORBITA family! The last of 301 patients randomised in the ORBITA-2 trial. Smiles all round!! Well done to
@rajkumar_chris
for driving this trial and thanks to all our incredible collaborators all over the UK who really made this happen
With many Tube stations closed now, staff are having great difficulties getting to work at our London hospitals. Uber drivers declining hospital pick ups. Black cab drivers the NHS needs you! Can you volunteer your services?
#BlackCabs4NHS
@alibendertv
@SCatlingAuthor
@SukhNijjer
There is an unsung hero in the ORBITA family and we don’t do forgotten heroes.
@mshunshin
is the cleverest man I know and responsible for all the statistics and beautiful figures in ORBITA-2 (with a little help from my RAL chart). Give this man a round of applause!
Today we have to say thank you to the wonderful
@teegee217
who picked up one of our nurses to make her journey into work that little bit easier and transferred PPE equipment from one hospital to another because our NHS delivery teams are overwhelmed. What a hero!
Friday night...
My son: “Mummy I don’t like it when you wear red lipstick”
Me: “Why?”
My son: “Because it makes you look like a mummy who goes to parties, not a mummy that fixes hearts”
Me: “That’s why mummies are special- they can do both!”
#bringingupboys
@ShrillaB
@dr_manisty
Thank you to Paul and all our black cabbies who have been delivering food to our NHS staff in self isolation all over London. We really appreciate it!
@HpTaxi
Six years on, the ORBITA family has grown. We can’t wait to show you the results of ORBITA-2. Coming to you soon from a broom cupboard in West London and 14 amazing centres in the UK!
Couldn’t be prouder of
@MikeFoley89
and the ORBITA team today. What are the chances that ORBITA-COSMIC would be published on the same day as a solar eclipse?!
Dear fellow NHS workers, we are a team, we will get through this. Please stop stealing all the masks in the cath labs. It’s not fair to those of us who will end up operating without masks. Best wishes an on call cardiologist
@rallamee
who led the most scientifically disruptive trials in modern history of PCI sits with an innocent smile in the middle of a school of old PCI sharks… i cant love anything more than this!
@CRT_meeting
@aymanka
So I think cardiology has taught me the art of improvisation. Spent all day in the baking heat attempting to make a World Cup trophy cake for my son’s bday. Nearly burst into tears as the whole thing spectacularly fell down. Then I realised I could turn it into something else...
Just in case you thought the ORBITA team had gone on summer vacation… The first ORBITA-MOON case was completed yesterday. Another n-of-1 trial that might have some interesting results. Well done
@ShaynaChotai
on achieving the first of many big milestones during your PhD!
First day of key worker school for my son today and he was pretty happy. Him: “Mummy I think the teachers are going to be really nice to us because we’re the special kids of key workers. Thank you Mummy, you make me so proud.” Tear in my eye. That’s a special COVID moment
Another great day for the ORBITA team.
@MikeFoley89
has finished recruiting for his MRC-funded ORBITA-COSMIC trial of the CSR in refractory angina. Expect the results in 2024. Well done Mike and thanks to all the brilliant teams that worked so hard to make this happen
Of course a placebo-controlled trial of TriClip is possible. It is time for these trials to become entry standard for interventional procedures aimed at improving subjective endpoints. We should not accept substandard evidence of efficacy for procedures with both risk and cost
There is nothing wrong with QOL benefits. It is at the core of what we do as doctors.
But gosh you can only show QOL benefits when a treatment is studied against a proper control arm.
It's why drug trials have placebos. It's no different for procedures. Ask
@rallamee
In ORBITA-STAR, angina verification with an ischaemic stimulus powerfully predicted response to PCI.
#EuroPCR2024
Perhaps we have been too focused on treatment when the problem always lay in the diagnosis! Published today in
#JACC
@rallamee
I’m incredibly proud to have played a part in ORBITA2, presented brilliantly today by Chris Rajkumar at
#AHA23
. Rasha Al-Lamee has shown not only that PCI works, but so too does academic mentorship, authentic leadership and empowering her fellows. Can’t wait for the next one
@DrAseemMalhotra
@NHSEngland
No
@DrAseemMalhotra
these deaths were caused by the global spread of a virus not by nurses and doctors having a treat in the middle of a long shift. Also I might have a mum tum but I am not overweight and obese.
ORBITA-STAR at
#EuroPCR
is a fascinating & successful study of type of chest pain as a predictor of PCI success. Very difficult to ascertain if angina caused by ischemia is what patients felt. This was a concern of Gruentzig's 40 yrs ago!
@rajkumar_chris
@rallamee
#AngioHistory
Well done
@neilruparelia
@AlexNowbar
@rajkumar_chris
and the team at Royal Berkshire NHS Trust on the first ORBITA-2 randomisation in Reading today. Fabulous work- welcome to the ORBITA-2 team!
No rest for the ORBITA team! Recruitment is going strong for ORBITA-FIRE which is being led by
@fiyyazAJ
. Thank you to
@kliokon
and the Essex CTC a fantastic case this week
@Drkeeble
@dizzledavies73
Hands up if you really could have used the help of grandparents for childcare over the last 2 months. Why didn’t you tell us that was an acceptable option
@MattHancock
and
@BorisJohnson
?
Thanks
@jcspratt
and all the team
@StGeorgesTrust
for randomising your first 3 patients in
@MikeFoley89
’s ORBITA-COSMIC trial testing the placebo-controlled mechanism of action of the coronary sinus reducer. Great to work with you all today!
I can’t lie I’ve been a bit low recently - it’s been a tough few days in the UK. However today I got the
#CovidVaccine
and now I’m smiling again. There is light at the end of this tunnel. We have better days ahead thanks to the amazing scientists who got us here
Just boarded my flight for
#CRT2019
and something very pleasing has happened.... Found my seat all the way in the back in economy only to find I am sat all alone on my row.
#smallpleasures
#smileonmyface
Thanks to all the incredible cabbies who’ve responded.
@rajkumar_chris
doing an incredible job of coordinating. Some offered amazing discounts, others free rides. You are all heroes! All staff who can pay will pay full price. Please help those who can’t as much you can. Amazing!
@rwyeh
@boback
@DavidLBrownMD
@ProfDFrancis
When unblinded and returned to routine clinical care, the majority in the placebo arm chose to have PCI. Not necessarily because of symptoms but because they wanted the treatment they were offered pre-trial and they did not want to continue 3 anti-anginals for life.
The moment when you are really proud of your child... when you accidentally walk past a facist right wing march in central London and your 7 yr old suddenly starts shouting “Booooooooo you are all idiots”!
If anyone feels hopeless and sad about the world at the moment I urge you to watch Becoming on Netflix. After 90min you will feel energised and hopeful again. Future President of the USA
@MichelleObama
- we need you!
I hope the terminology around placebo-controlled trials of procedures will now finally start to change. In the the main manuscript of ORBITA-2 the only mention of “sham” is in the surname of one our fab investigators - Clesham!
@DrKeeble
@drjasondungu
Amazing work from
@DrPeterOKane
@rajkumar_chris
@AlexNowbar
and all the team at Royal Bournemouth Hospital! Welcome to the ORBITA-2 trial. Three randomisations in one day. A new ORBITA record!
Have you already metabolized the outcomes of ORBITA 2? Next stop in the ORBITA program is called ORBITA-COSMIC. The coronary sinus Reducer (CSR) is an hourglass-shaped device which creates an artificial stenosis in the coronary sinus. The ORBITA-COSMIC trial is a randomized,
Our PJs are on, the nachos are made and we are ready to stay up for as long as we can... Come on our American friends - please make 2020 great again!
#BidenHarris2020
Two placebo-controlled studies with a synergistic outcome both published in JACC by two fabulous fellows from the ORBITA team
@rajkumar_chris
@FloSimader
The best part of my job is working with amazing people. We missed lots of key players last night but here are some of the members of the fabulous
#ORBITA
team plus some of the partners who support them!
As always my team make me very proud. Today we launched our newest ORBITA fellow
@FloSimader
who did the most fabulous job of explaining how symptoms predict outcomes from ORBITA-2
@JACCJournals
@mshunshin
As an “outlier” pupil from an under-performing state school in Liverpool, my whole life would have been very different if my A levels had been downgraded by a poorly thought out computerised algorithm. Urgent action please
@BorisJohnson
Football is back and my 8 year old is happier than ever. He’s even enjoying watching his team lose to Man City. “Mummy it means life is going back to normal” he says
Well done
@pajhaworth
@AlexNowbar
@rajkumar_chris
and the Queen Alexandra team for randomising the first of many ORBITA-2 patients in Portsmouth. Thank you for your energy and enthusiasm as we get back to normal - welcome to the team!
Merry Christmas one and all! Hope you are having a wonderful day with your loved ones. To those of you hard at work today like my wonderful sister
@HannanAllamee
, we are thinking of you and thank you for working to keep us safe and healthy all year round
Well done
@DrKeeble
, John Davies and the team at Essex CTC for randomising their first two patients in
@MikeFoley89
’s ORBITA-COSMIC study, investigating the efficacy of the coronary sinus reducer. So pleased to be working with you on yet another clinical trial!
Stressful Sunday night for a working mother. Just realised my son needs to take 2 toilet rolls, 1 big rectangular box, 1 small square box and 1 egg carton into school tomorrow so he can make a WW2 tank. Currently unravelling toilet paper into a plastic bag...
Remember reading about Russian soldiers being sent out to fight in the trenches without boots in WW1? This is what this feels like. Someone MUST listen. We are the NHS, we are dedicated and we will do it but we have families that need us too. Think of them
@DrPeterOKane
This is what we are being told will “protect us”. What a joke. A plastic bag and a mask less sophisticated than what is worn during building construction.
@SkyNews
reporter has better kit because his employer values his life. Shame
@NHSuk
hasn’t done same for
#doctors
#nurses
@drjohnm
@escardio
@theheartorg
Thank you to the guideline writers for selectively quoting me and inferring that I agree with their assessment of the limitations our trial. For the record, I don’t. Luckily soon we will have ISCHEMIA and one day ORBITA-2 so maybe then we can “inform” the guidelines
@rwyeh
@boback
@DavidLBrownMD
@ProfDFrancis
Now the world seems ready to engage in balanced educated debate on ORBITA I am happy to be involved. Thanks to you
@rwyeh
for being the voice of reason! If the trolling starts again I may have to go back into hiding under my rock....
Getting ready for the long days ahead for our team. Thanks to my son for preparing the overnight provisions for our staff and to my husband for collecting endless supplies on his travels over the years!
@SadiqKhan
we key workers need your help! Please can you wave the congestion charge and any parking restrictions for us in London? We need to be able to drive across the city. Some of us doctors will cross cover 3 hospital sites very soon
@LCC_DrMalik
@SukhNijjer
#keyworkers
There are so many parts of my job that I love but what I absolutely hate is the horror show that is the vintage NHS computers. So much time is wasted trying to find one that works. I guess the upside is that it gives me time to check my phone!
Thank you
#EuroPCR
for a wonderful meeting in a wonderful city! Sorry I had to leave early but had to get home to my other role - to watch my son sing in his school concert tonight!
This is a cause that is very close to my heart. One year on one of our wonderful
#ORBITA
patients is still living in a hotel after losing her home in this tragic event. I am ashamed of how our system has let so many people down. We should never forget
#GreenForGrenfell
@drjohnm
Now you’re talking my language! It’s time we made placebo controlled trials of interventional procedures an entry standard. If we are to do that it starts with standardising the language we use for trials of drugs and procedures
With
#AHA23
on the horizon and the presentation of
#ORBITA2
, we need to grapple with syntax
Re the word placebo vs sham
ORBITA tests subjective symptoms of PCI vs placebo-control
Because of course you could NEVER assess subjective endpoints without a proper control arm (wink
Tonight, in Washington, D.C. and across the nation, we came together to honor the over 400,000 Americans we’ve lost to COVID-19. The last year has tested us in unimaginable ways, but now it’s time we begin to heal and overcome — together.
A big thank you to
@SarahTheDuchess
, Princess Eugenie and their team for sending the most incredible amount of fruit and vegetables to Hammersmith Hospital today. Lots of smiling faces all round! Thank you for thinking of us
@rkhamis
Has anyone else woken up feeling a bit low this morning? We’re going to the cinema and out for lunch and dinner in a bid to cheer ourselves up and support our local businesses!
A proud mothering moment. I got home to find my son had done this to The Brexit Party leaflets posted through our door today. Me: nice work my love. My son: Mummy now all the King’s horses and all the King’s men couldn’t put Farage back to together again!
So we can testify that this promise from
@Benaresofficial
is true! Thank you for delivering lunch to all our cardiology staff at Hammersmith Hospital today. It’s lovely moments like this that seriously cheer us all up!
How intravascular imaging may change outcomes in stable CAD. Do you agree that the ISCHEMIA results would have been different with mandated intravascular imaging?
@MaeharaAkiko
#AHA21