John Mandrola
Cardiac electrophysiologist in Louisville, Kentucky. Co-writes the Sensible Medicine newsletter, where he reviews cardiology and other clinical trials, and blogs at drjohnm.org.
John Mandrola did not write this page. ppll compiled it from their own words, each linked to the source. Is this you? · Report a mistake
What they believe
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The NHS-Galleri trial did not show a reduction in late-stage cancers.
Yet there was no reduction in late-stage cancers, the primary endpoint.
sensible-med.comSaid 19 Oct 2026This on korrents
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The TRIC-I-HF trial results may be influenced by bias due to its open-label design and the nature of the hospitalization endpoint.
The endpoint that drove the results were open to bias in this open label trial. In the win ratio, the HF hospitalization endpoint did the work: 9,280 vs 2,871 wins. Death rates were close (4,366 vs 3,166), and 74% of pairs were tied on death. Hospitalization, of course, is a clinician decision. Since everyone knows the treatment assignment, it's easy to give an increase in oral diuretics to a patient with a device while admitting a patient without one.
sensible-med.comSaid 12 Oct 2026This on korrents
The bold line is korrents’ wording; the quote is theirs. These 2: what they wrote before what they said aloud, one per source, newest first.
Beliefs
Korrents What they believe 15 beliefs — each backed by an exact quote.
Each is a — compiled by korrents.com, not by them: the one-line wordings are korrents', the quotes are theirs.
Recent
The NHS-Galleri trial did not show a reduction in late-stage cancers.
Yet there was no reduction in late-stage cancers, the primary endpoint.
Sensible Medicine Said 19 Oct 2026
The Grail multicancer blood test has poor sensitivity and test characteristics.
But it had a terrible sensitivity of only 30%, meaning it missed a lot of cancers.
Sensible Medicine Said 19 Oct 2026
The Grail test results are not reassuring because a positive test is often a false positive and a negative test does little to reduce baseline risk.
A positive test leads to as many false positives as true positives, and a negative test is not at all reassuring.
Sensible Medicine Said 19 Oct 2026
Show 12 more
The TRIC-I-HF trial results may be influenced by bias due to its open-label design and the nature of the hospitalization endpoint.
The endpoint that drove the results were open to bias in this open label trial. In the win ratio, the HF hospitalization endpoint did the work: 9,280 vs 2,871 wins. Death rates were close (4,366 vs 3,166), and 74% of pairs were tied on death. Hospitalization, of course, is a clinician decision. Since everyone knows the treatment assignment, it's easy to give an increase in oral diuretics to a patient with a device while admitting a patient without one.
Sensible Medicine Said 12 Oct 2026
The reduction in tricuspid regurgitation achieved by the repair procedure was modest.
The fourth issue was that the amount of TR reduction was modest. Only 70% of repair patients had moderate or less TR at 30 days, versus 30% of controls. That is less complete than reported in TRILUMINATE.
Sensible Medicine Said 12 Oct 2026
More compelling data is needed before embracing the tricuspid valve repair approach.
Before embracing the tricuspid valve repair approach, I feel we need more compelling data.
Sensible Medicine Said 12 Oct 2026
The POET II trial authors chose their primary and secondary endpoints incorrectly.
My issue is the author's choice of primary and secondary endpoints. A rule of evidence is that you choose as the primary endpoint the most important outcome. Secondary outcomes are chosen to bolster or support the primary. POET II authors got this backward; but readers of the trial can still make conclusions from the evidence-it's just different from what the authors conclude.
Sensible Medicine Said 5 Oct 2026
The shorter antibiotic course in the POET II trial is a worse strategy than the standard course.
The bottom line is that you don't need to be an academic or infectious disease specialist to take from this trial data that the shorter course is clearly the worse strategy.
Sensible Medicine Said 5 Oct 2026
For serious infections, the recurrence of infection or death is a more important endpoint than days without antibiotics.
When we treat infections, especially serious ones in the heart and bloodstream, there are a couple of important endpoints-and one is not days without antibiotics, but recurrence of infection or death.
Sensible Medicine Said 5 Oct 2026
Mechanical CPR devices do not show a signal of benefit in survival or survival with neurologic recovery.
While there were limitations of this data, including the lack of granular data on both patients and agencies, there was not any signal of benefit in the outcome of interest. Note here that the outcome of interest was not the quality of CPR, which may have been better, but survival and survival with neurologic recovery. Here, there was no signal of benefit.
Sensible Medicine Said 17 Aug 2026
A Cochrane Systematic review of 11 trials found no evidence of benefit and a small signal of harm for mechanical CPR devices.
A Cochrane Systematic review of 11 trials also found no evidence of benefit and a small signal of harm.
Sensible Medicine Said 17 Aug 2026
Mechanical CPR devices should be abandoned if the treatment of out-of-hospital cardiac arrest is to remain an evidence-based intervention.
Given the aggressiveness of these devices and their costs (approximately $20,000 plus disposables x many ambulances), I would think we would abandon them. That is, if the treatment of patients with out of hospital cardiac arrest is to remain an evidence-based intervention.
Sensible Medicine Said 17 Aug 2026
A polypill may reduce the work of being a patient and may increase adherence to beneficial drugs.
Enter the polypill: what if you could take one tablet that had multiple drugs in it? This reduces the work of being a patient and it may even increase adherence to beneficial drugs.
Sensible Medicine Said 6 Jul 2026
The difference in ejection fraction in the Poly HF trial was not clinically significant despite reaching statistical significance.
What's more. the difference in EF in this trial was only 3%-a number that reached statistical significance, but it's not clinically significant.
Sensible Medicine Said 6 Jul 2026
The Poly HF trial results may be limited by the highly selected nature of the patient group.
This, I think, is one of the major limitations of polypill data: namely, that you have to be highly selected to be eligible for a polypill.
Sensible Medicine Said 6 Jul 2026
What is a korrent?
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Nobody here wrote their own korrents. They are compiled from public statements, and a person can change their mind, which is recorded too.
Where they publish
Blog Dr John M His blog on cardiology and evidence; active through 2022, archive remains
Link verified 24 Oct 2026.
Newsletter Sensible Medicine Weekly trial reviews under his byline, alongside co-founders Adam Cifu and Vinay Prasad
Link verified 24 Oct 2026.
x.com @drjohnm Posts on cardiology trials and evidence
Link verified 24 Oct 2026.
About the English under a post
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