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Nimura lecture: “Three EBMs”

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Abstract

The three EBMs in the title refer to the following concepts: evidence-based medicine, experience-based medicine, and echo-based medicine. Evidence-based medicine: I have carried out the following clinical research using transthoracic Doppler echocardiography: (1) noninvasive pulsed-wave Doppler echocardiographic detection of the direction of shunt flow in patients with atrial septal defect: usefulness of the right parasternal approach (1985), (2) significance of laminar systolic regurgitant flow in patients with tricuspid regurgitation: a combined pulsed-wave, continuous-wave, and two-dimensional echocardiography (1990), (3) obstruction of the inferior vena caval orifice by the giant left atrium in patients with mitral stenosis: a Doppler echocardiographic study from the right parasternal approach (1992), and (4) demonstration of a localized acceleration flow signal in the transmural penetrating coronary artery using transthoracic color and pulsed-wave Doppler echocardiography in patients with hypertrophic cardiomyopathy (1996–2017). Experience-based medicine: Dr. Eugene Braunwald says “The best book of cardiology is the patient itself.” I have conducted my modest research activities gleaning hints through day-to-day routine work and sometimes investigating experimentally using the Doppler echocardiographic method. I have also learned from the Japanese Society of Echocardiography that a physician should stand between evidence-based medicine and experience-based medicine. Echo-based medicine: This term is intended to express my personal determination. I believe that echocardiography is the stethoscope of the 21st century. It is a safe, painless, low-cost, and repeatable tool at the bedside. I expect that echocardiography can reduce unnecessary healthcare costs and appropriately select reasonable examinations for patients. I would like to devote the time left in my career to the study of cardiovascular medicine, believing in the power of echocardiography and the Doppler method to provide a link between evidence-based medicine and experience-based medicine.

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Authors and Affiliations

  1. Department of Cardiovascular Internal Medicine, National Hospital Organization, Kagoshima Medical Center, 8-1 Shiroyama-cho, Kagoshima, 892-0853, Japan

    Shinichi Minagoe

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  1. Shinichi Minagoe
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Correspondence to Shinichi Minagoe.

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Shinichi Minagoe declares that he has no conflicts of interest.

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Minagoe, S. Nimura lecture: “Three EBMs”. J Echocardiogr 16, 6–19 (2018). https://doi.org/10.1007/s12574-017-0369-x

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  • DOI: https://doi.org/10.1007/s12574-017-0369-x

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