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Heart. 2007 July; 93(7): 785.
PMCID: PMC1994444

Heart: technology and guidelines


See articles on pages 862 and 864

The greatest task before civilization at present is to make machines what they ought to be, the slaves, instead of the masters of men. —Havelock Ellis

Havelock Ellis never practised as a doctor, preferring to devote himself to the scientific study of sex. However, as a Victorian, he understood the need for us to master our machines, a sentiment that most cardiologists would readily subscribe to. Yet the task is daunting, and it is often difficult for us to keep abreast of the technologies that are now the major drivers of our specialty. Subspecialisation has, to some extent, protected us by reducing “need‐to‐know” to groups largely defined by tools of trade. However, subspecialties do not act in isolation and, as we have emphasised elsewhere, properly integrated care demands that we understand the clinical applications of these tools rather than rely on the hearsay of enthusiasts or those with conflicting interests.

In this issue of Heart appears the first in an occasional series of articles devoted to technology and guidelines. The guideline component was a late addition that emerged from editorial discussion partly because, like technology, it is an important driver of cardiological practice and also because we wanted to include within the series reports and commentaries of the technology appraisals by the National Institute for Health and Clinical Excellence (NICE). These appraisals are based on a detailed assessment of the evidence base and include cost‐effectiveness calculations. NICE is also a major agency for guideline development and it was but a small step to collaborate with the BMJ by including these influential guidelines within our new series of articles.

The first article summarising the recently presented NICE guideline on management after the acute phase of myocardial infarction1 (see page 862) appears with a commentary from representatives of the guideline development group (see page 864).2 It will be the model for future guideline summaries from NICE. Next month a technological review of virtual histology as applied to the heart will appear,3 with further reviews of multislice CT angiography, cardiac MRI, gene therapy and molecular imaging in the pipeline. Interspersed amongst all the activity will be additional summaries of NICE technology assessment, which, like the guideline summaries, will be accompanied by expert commentary.

We believe the Technology and Guidelines series will be a valuable adjunct to the educational content of the journal and will help us enslave our cardiological machines in the manner of which Havelock Ellis would approve.


1. Skinner J S, Cooper A, Feder G S. et al Secondary prevention for patients following a myocardial infarction: summary of NICE guidance. Heart 2007. 93862–864.864 [PMC free article] [PubMed]
2. Skinner J S, Minhas R. Commentary on NICE guidance for secondary prevention for patients following a myocardial infarction. Heart 2007. 93864–866.866 [PMC free article] [PubMed]
3. König A, Klauss V. Virtual histology. Heart. Published Online First: 13 May 2007. doi: 10.1136/hrt.2007.116384

Articles from Heart are provided here courtesy of BMJ Group