A Public Letter to ASE

Raymond Stainback, MD, FASE

Texas Heart Institute

Stephen H. Little, MD, FASE

DeBakey Heart & Vascular Center

Benjamin W. Eidem, MD, FASE

Mayo Clinic

Dear Mr. president,

 

On behalf of a group of Tau enthusiasts, we request an investigation into research misconduct with many connections to ASE.

 

Tau, the left ventricular diastolic time constant, is widely accepted as the most established index used to describe diastolic function. Unfortunately, it is not measured in daily clinics due to this research misconduct.

 

A distinguished ASE member, Dr. James Thomas, invented a Tau formula that is logically flawed. Both its experimental and clinical "verification" must have been motivated reasoning. No one can obtain good data with unintentional mistakes. Anyone can tell it is not working by simply checking it on a random patient. The results will be inconclusive. Nevertheless, this incorrect theory has been recommended in both ASE's textbooks and diastolic function guidelines to this day.

 

It is fair to say that motivated reasoning is not uncommon in researchers. If an influential researcher uses it to justify a wrong method or tool, it is like putting the lighthouse in the wrong place. Traumatic events could follow as a result of reckless behaviour.

 

Not only is the incorrect theory misleading, but it also has a negative effect on genuine Tau research and development. Yet the measurement of Tau thrived on the other side of the planet. Mindray launched the first Tau-measurable Echo machine in 2017.

 

Tau is the only index directly related to the power of the cardiac muscle. Once it is excluded, all the approaches from the ASE diastolic function guidelines have to be indirect descriptions. Compared with Tau, routine assessments of diastolic function could be inaccurate up to 30% of the time. We can elaborate on this upon request.

Tens of thousands of diastolic dysfunction diagnoses are made every day worldwide. Imagine that up to 30% of them could be inaccurate! Imagine that some patients receive treatment based on those diagnoses! Sometimes the treatment is invasive, like IASD...

 

Please investigate and give Tau a chance, which is consistent with the mission of "advancing cardiovascular ultrasound and improving lives through excellence in education, research, innovation, advocacy, and service to the profession and the public."

 

Please do not hesitate to let us know if further explanation is needed.

 

Xufang Bai, MD, PhD20MD%2C%20PhD