Further information about the medical activities of Dr. Eric Roehm:
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1. Preventing inadequate dosages of aspirin being used with patients undergoing balloon angioplasty and patients presenting with unstable angina.
Dr. Roehm became involved in preventing inadequate antiplatelet drug administration in patients undergoing balloon angioplasty (dilatation of the arteries of the heart) in patients presenting with a heart attack. Inadequate treatment with antiplatelet drugs such as aspirin will result in increased death and additional heart attacks. published article
Dr. Roehm was concerned about preventing the increased death and additional heart attacks, as well as skewed trial outcomes, that can result from inadequate treatment with antiplatelet agents. This became an issue when a national trial named the TIMI (Thrombolysis in Myocardial Infarction) IIIb Trial announced through the release of a trial protocol the intention of randomizing patients to treatment with balloon angioplasty where the only antiplatelet agent was a single 81 mg dose (“baby dose”) of aspirin. Though not widely appreciated at that time, this dose of aspirin as a single acute dose, does not give the full antiplatelet effects of aspirin, which leads to an increased risk of death and further heart attacks at the time of balloon dilation of the arteries of the heart.
Dr. Roehm wrote a letter to the leaders of the trial. The trial leaders, however, did not appear initially responsive. The TIMI IIIb trial investigators did later change the dose of aspirin to a single, regular strength, enteric coated aspirin which, unfortunately, is also suboptimal. At that point, Dr. Roehm went on to publish a critique of the trial prior to the trial’s completion.
Dr. Roehm was subsequently active in trying to prevent the use of a single low dose aspirin as the sole antiplatelet drug in patients undergoing coronary intervention (letter) as well as avoiding an overestimation of the effect of a single dose of low dose aspirin in the literature (published letter- American Journal of Cardiology). Of note, the standard of care in the modern day patient, in order to reduce heart attacks and complications in patients undergoing intervention, is the use of multiple antiplatelet drugs in order to achieve an effect greater than that obtained with full dose aspirin alone.
2. Journal of American College of Cardiology and statistical review of submitted papers
Dr. Roehm has a long standing interest in the proper interpretation of medical studies and the proper use of statistics in the medical literature. The Journal of American College of Cardiology is the official publication of the American College of Cardiology, of which all board certified cardiologists in the United States are members.
When the Journal of American Cardiology (JACC) published a study where the most elementary principles of proper statistical analysis were completely missed, Dr. Roehm made a detailed critique of the study which was then sent to every member of the JACC editorial board. The cover letter strongly urged that the JACC editorial board institute a policy where every paper published in JACC undergo a formal review of statistical issues.
(This presumably represented one voice in a chorus of many advocating this type of change.) The JACC editorial board later announced a change with the institution of the policy that every manuscript returned to an author for revisions is first reviewed for statistical issues.
3. Creation of ImprovingMedicalStatistics.com
Because of a continued concern with the misuse of statistics and the misinterpretation of clinical trials in the medical field Dr. Roehm created a website dedicated to improving the use of statistics in medical studies. (www.ImprovingMedicalStatistics.com)
4. Formulation of hypertension treatment protocols for the treatment of high blood pressure in Haitian patients in areas where no laboratory monitoring testing is available.
In 2010, Dr. Roehm volunteered for a week in Haiti, two months after the earthquake, when the tremendous amount of trauma occurring with the earthquake had primarily been addressed medically. The medical issues present subsequently concerned caring for a displaced poor population. This involved many chronic care issues, including how to treat high blood pressure when no laboratory monitoring facilities were available. Dr. Roehm developed and published on www.HypertensionRxHaiti.com blood pressure treatment protocols which were low in cost (total cost for 3 medications: 10 cents per day) that could be used by patients without any available laboratory monitoring facilities.
5. In 2015, wrote an article for the medical literature about estrogen use and clinical outcomes: Reappraisal of Women’s Health Initiative Estrogen-Alone Trial: Long-Term Outcomes in Women 50–59 Years of Age
6. Current interests
Dr. Roehm’s current interest and focus has been in making information available relating to cardiology issues, as well as nutrition, and making a website to present this information- www.nutritionheart.com .
