When expert opinion does matter...

Abstract

The Roland Hetzer International Cardiothoracic and Vascular Surgery Society (RHICS), held its 2nd Expert Forum on February 11th 2012 in Freiburg, Germany, just three months after the 1st Expert Forum which took place in Lisbon, Portugal, in pursuit of its goals and objectives, which are to provide a forum for expert discussion on relevant cardiothoracic issues, to set up guidelines based on conclusions derived from this expert opinion forum, to promote cardiothoracic surgical education skills from beyond standardized and statistical medicine to a patient-based medicine wherein treatment approaches are individualized and personalized, and specific high-quality treatment tailored to the patient’s unique pathology so as to give them an optimal quality of life, after surgery, to promote continuing medical education through the holding of regular symposia and meetings and the continuance of clinical and experimental research efforts and the publication of the results in scientific journals, and to foster international collaboration and cooperation in clinical practice and scientific research in cardiothoracic and vascular surgery and associated fields. With numerous annual meetings, symposia, and conferences taking place in the field of cardiothoracic surgery, notwithstanding the hundreds of published expertise papers on new developments, ongoing researches, new technologies and techniques, surgical outcomes and its implications on clinical practice, when does an expert opinion matter? We are constantly bombarded with controversies in surgical options to manage cardiovascular diseases. What strategies to offer, which to repair, when to replace, for what disease, and for whom, seem to be eternal questions. Then again, which option gives the most acceptable, if not the most excellent, outcome, is of course, ever a matter of controversy. Most, if not all, published literature on a specific field in cardiothoracic surgery, would claim having the best outcome using the best technique for a certain subset of patients. The readers are left muddled up, whether their patients belong to those categorized in the published reports. We surf the internet but as we are all aware much of this material can be partially reliable and indeed often pitched at the wrong entry level and even far too complex for those new in the field. There are various editorials and commentaries we can search in Pubmed, but they may seem rather half-hearted to match what we are searching for covering some areas in great depth and others with less than a couple of bullet points. Surgical journals may sometimes let us down in our search for what we need. There is nothing quite like the mad pilgrimage to Black Hole followed by the terrible sinking feeling as you open pages after pages of journals, only to realise we do not understand a single word of concepts being discussed, or worst, we get even more confused. There must be a way to sum all these up, in a very concise manner, and from the mouths of the experts themselves. This is where an expert forum comes in. Expert opinions concentrate on driving back the boundaries of debates and controversies. It gives the audience or the readers an opportunity to take a fresh look at key issues through the eyes of people who know them best - masters and virtuosos, who are on the front line - to promote ideas and guidelines based on best practice from experts in their relevant fields. If we are to dramatically improve practice in our chosen fields, expert opinions from renowned surgeons, who put forward their Best Practice first-hand experience and suggestions, are priceless and much desired. Expert opinion aims to stimulate intellectual debate in key topics, whilst also offering a flagship for driving forward a truly logical and reproducible agenda. Hence, an expert opinion provides systematic and authoritative analysis to support every stage in our search for the best patient-based medicine. What makes expert forum really stand out is each paper presented concludes not with the “Conclusion” but with an “Expert Opinion”.  This is where our speakers, all internationally recognised experts in their field and key opinion leaders within the cardiothoracic field, give their own personal view. They put their knowledge, expertise and experience to the test, stating where the research is now, where it should go next, and how it should get there. And, because we recognise that there are two sides to every argument, participants and audience feedback is always welcome. In this issue of the Journal we publish five expert opinions [1,2,3,4,5] and three original articles [6,7,8] presented at the 2nd RHICS Expert Forum. We are certain that the readers (40% from North America, 50% from Europe and 10% from Asia and Australia in the last issue) will appreciate them as much as those who personally attended the Freiburg meeting.