CAMH....worth watching

[jblaze71]

NBB,

I looked on a map and picked 6 places that I wanted to live. I then just called hospitlas to see if they had an ED physician job. Based on job, cost of living, weather, and outdoor recreational activities, Greenville won out. Although I do work 3 days a month in Branson, MO so that I can fund my trading account. Did you go to Bob Jones or Furman?

[Websman]

if camh drops below $2.60, I'll be out and will likely never buy it again.....I am not sure what VTP stands for but I am not finding it very helpful or interesting frankly

Why so negative Jim? The VTP inner circle is the most elite group of traders in the world. One important requirement is that inner circle members must exhibit a positive attitude.

Stick with me Jim. I could teach you the ways of the Vulcan, but you must be willing to cooperate.

[Jim Smith]

jblaze,,,,,could you evaluate the following

i believe as i have said before, that there will be a 3 way deal between icd guys, cms, and mtwa..cms will raise lf to at least 40 maybe 45, and icd guys accept mtwa negative result as ...,..NEGATIVE, and patients finally get healthcare they deserve..Its obsurd to continue using soley lf below 30 when IF I KNOW THAT CRITERIA IS BOGUS, THAT THESE EDUCATED SCIENTISTS CERTAINLY MUST KNOW IT BY NOW...SO CMS KNOWS IT...IT DOESNT MATTER WHAT YOUR LF IS...THATS WHY I BELIEVE THE MOST IMPORTANT PART OF THE ABCD TRIAL WILL NOT BE THE COMPARISON TO EP STUDIES, BUT THE FACT THEY USED PATIENTS BELOW 40..SO THEY AGREE TO LOSE PEOPLE WITH NEGATIVE MTWA RESULTS, AND GAIN PEOPLE ABOVE LF30, THAT THEY OTHERWISE WOULD HAVE NOT GOTTEN, THEN ITS AT LEAST A PUSH...IF YOU DO THE MATH, ITS A NET POSITIVE TO EVERYONE...THE MATH IN THIS SENTENCE IS THE NUMBER ONE SUBJECT MATTER DISCUSSED AT ICD BOARD MEETINGS FOR THE PAST SEVERAL YEARS..i GUARANTEE IT,,,,,THERE ARE MANY MORE POTENTIAL PEOPLE ABOVE LF30 WITH POSITIVE MTWA THAT NEED ICDS, THEN THERE ARE PEOPLE BELOW 30 WITH NEGATIVE MTWA RESULTS. BUT in order for it to work, MTWA MUST BE EVERYWHERE AND ANYWHERE TO FIND ALL THOSE PEOPLE, IN A GLOBAL SCREENING PROCESS..IF ITS NOT EVERYWHERE AND YET IS THE ACCEPTED CRITERIA, THEN ICD GUYS LOSE.THAT IS WHY THEY MUST TOTALLY EMBRACE FOR IT TO WORK FOR THEM....IF THEY LET IT "TRICKLE OUT", THEY WILL NOT GAIN FROM ITS POSITIVE VALUE..THE ONLY WAY TO GET THE MATH RIGHT, IS TO TEST A WHOLE LOT OF PEOPLE...THERE IS NO HALFWAY...
This is a guy from ragingbull.com applying the mosaic theorey to make some interesting inferences.

[jblaze71]

Jim,

I do agree with his statement, but that does not mean that widespread testing will happen even if the STJ and CAMH research proves the effectiveness of MTWA. Unfortunately in medicine, most things are about the bottom line with minimal altruism mixed in. I will equate this test to doing an ultrasound on every high school athlete to rule out hypertrophic obstructive cardiomyopathy (The heart disease that causes sudden death in sed athletes), they have effectively rule out this scenario because detection rates are so low that it is not cost effective to do this on every athlete. I think that this is probably how the testing will work. Sorry that I am rambling but there are a lot of ideas and different scenarios that could play out. Most likely this will be adopted, many people will get the test but not everyone who needs it. The other scenario is that after widespread use if the detection rate is something around 1/1000, CMS (Medicare) will cut reimbursement and the test will go on the shelf.



BTW I do think this would be a coup for the cardiologists because they could do exercise stress tests and MTWA at the same time and could double bill. I think this will be a good push for the test because more money for the physician means more implementation

[New-born baby]

NBB,

I looked on a map and picked 6 places that I wanted to live. I then just called hospitlas to see if they had an ED physician job. Based on job, cost of living, weather, and outdoor recreational activities, Greenville won out. Although I do work 3 days a month in Branson, MO so that I can fund my trading account. Did you go to Bob Jones or Furman?

BJU. I pastor a church in Monroe, WI.

Greenville was an excellent choice, although it has one negative. The way those people drive . . . any 80 year old woman from Greenville can hold her own against any NY cabbie. No question about it.

[Jim Smith]

Keep an eye on CAMH

Big week coming up....I believe Blue Cross of California said they will cover MTWA as a test they deem medically necessary......Those last two words are key.....Update was Saturday.

[IIC]

I saw the question about Bob Jones...I won't go there....However, I will read the responses...I actually knew someone who went there in the early '70's...WHOA!!!...Where is the REAL World???

Jim...I have no idea about CAMH...But what about your bash on me for getting out of ELN?

We can all find fault w/ other's trades...Doug(IIC)


PS...I made 40% on HANS in 2004...Sold WAY too early thanks to...Hey...Can't blame anyone but myself...IIC

[Jim Smith]

CAMH....Wellpoint hmo announces coverage

announced this morning in a press release......CAMH shares up slightly preopen....I think only UNH has yet to announce coverage....

[Jim Smith]

Iic

this is about CAMH, not eln or hans.....

[IIC]

this is about CAMH, not eln or hans.....

You're right...sorry...Doug

[Jim Smith]

CAMH rolling up

third pullback in the last 5 weeks that ended when it reached 10%.....The shares act well.....I like it when WLP used the term "medically necessary"......booyaaaa

[Websman]

third pullback in the last 5 weeks that ended when it reached 10%.....The shares act well.....I like it when WLP used the term "medically necessary"......booyaaaa

Go CAMH!

Nice job Jim... The VTP has failed me on this one. Then again, this is the first time the VTP has ever failed to predict a move. I must now hang my head in shame.........

So.....Jim. Are you willing to cooperate with me now? I could teach you the ways of the Vulcan.

[Jim Smith]

jblaze, could you look at this?

Presentation Abstract

Monday, November 13, 2006 10:45am - 11:00am. 2113 T-Wave Alternans SCD HeFT Study: Primary Endpoint Analysis
Michael R. Gold, MUSC, Charleston, SC
Gust Bardy, Seattle Institute for Clinical Research, Seattle, WA

Abstract: The Sudden Cardiac Death in Heart Failure Trial (SCD HeFT) demonstrated that implantable defibrillators (ICD) decrease mortality compared with amiodarone or placebo, among patients (pts) with heart failure (NYHA II-III) and a reduced ejection fraction (< 35%). There is increasing interest in more refined risk stratification of SCD. In this regard, T-wave alternans (TWA) has emerged as a promising new measure of arrhythmia vulnerability.

Methods: This was a prospective study of 490 pts enrolled in SCD HeFT at 37 sites. Exercise TWA was interpreted by 2 blinded readers. The composite primary endpoint was SCD, sustained VT/VF or appropriate ICD discharge. All cause mortality was a secondary endpoint. Median follow-up was 35 months.

Results: This cohort was 76% male with median age of 59.6 yrs and EF of 25%. NYHA II CHF was present in 71% and 49% had ischemic heart disease. TWA was classified as positive (+) in 37%, Negative (-) in 22% and Indeterminate (Ind) in 41% of pts. Among ICD and placebo pts, there was no significant difference between event free survival among TWA + and - pts (HR=1.24, p=0.56, Figure). Similarly, TWA non - (+ or Ind) did not differ from TWA - (HR=1.28, p=0.46). Finally, mortality did not differ significantly between TWA groups.

Conclusions: Indeterminate TWA results (41%) were frequently observed in this population, which may limit the utility of this test. In addition, TWA was not useful for risk stratifying arrhythmia vulnerability in SCD HeFT, regardless of test outcome.

Does this in any way hurt the validity of MTWA? Thanks.

[Websman]

Oh well...I guess Jim doesn't have time to waste on an amateur such as myself. Maybe I should go play with the kiddies on the playground...Sssssjejejeje

Seriously though Jim!

Congratulations!!!

Your friend,
The Vulcan

[Jim Smith]

Thanks Websman

I am just so wrapped up in this CAMH thing I can hardly think straight.....Did I drink four beers or six?