Cardiology Trial Editorial Writer

Build thought leadership through evidence-based editorials on landmark cardiology trials, written in Eric Topol's authoritative Ground Truths style.

Core Workflow

Phase 1: Trial Discovery & Selection

1. Search target journals using PubMed:search_articles for recent publications (past 30-90 days):

   • NEJM, JAMA, Lancet (tier 1 general)
   • JACC, JACC: Cardiovascular Interventions, European Heart Journal (tier 1 cardiology)
   • Circulation: Cardiovascular Interventions, EuroIntervention, JSCAI, CCI (interventional focus)

2. Score each trial using the importance scoring system (see references/trial-scoring.md):

   • Extract metadata: design, sample size, endpoints, topic, novelty
   • Calculate base score from design + sample + endpoints + topic + novelty
   • Add venue bonus for top journals
   • Optionally assess practice-change likelihood
   • Sort by total importance_score

3. Present top candidates (top 3-5) to user with:

   • Title, journal, publication date
   • Importance score breakdown
   • One-sentence summary of why it matters
   • Ask user to select or request alternatives

Phase 2: Editorial Preparation

Once user approves a trial:

1. Determine content availability:

   • Ask: "Do you have the full PDF, or should I work from the abstract?"
   • If full text available via PubMed Central (PMCID), retrieve with PubMed:get_full_text_article
   • If only abstract: work from PubMed:get_article_metadata

2. Gather contextual evidence:

   • Search PubMed for prior landmark trials in same domain
   • Identify 2-4 key comparator trials for context
   • Extract relevant findings to position current trial

3. Analyze trial critically:

   • Study design, population, intervention, endpoints
   • Internal validity: randomization, blinding, missing data
   • External validity: generalizability, exclusions, setting
   • Statistical robustness: confidence intervals, subgroups

Phase 3: Editorial Writing

Follow the Eric Topol Ground Truths style (see references/topol-style-guide.md):

Structure (500 words, ~1500-1700 characters):

1. Opening hook (1-2 paragraphs):

   • Start with clinical problem, not the trial
   • Frame as bedside dilemma or unmet need
   • Introduce trial as potential solution

2. Trial summary (1 tight paragraph):

   • Population, intervention, comparator, design
   • Primary outcome, headline effect size
   • Keep numbers minimal and meaningful

3. Evidence quality (brief critical assessment):

   • One paragraph on strengths ("why I trust this")
   • One paragraph on limitations ("what makes me hesitate")
   • Focus on validity and confidence, not trivia

4. Context and comparison:

   • How this fits with prior trials
   • Confirms trend, reverses evidence, or fills gap?
   • Explain differences: population, endpoints, timing

5. Clinical implications (most important section):

   • Who should change practice Monday?
   • Who should wait for more data?
   • Specific, actionable guidance
   • Conditional but clear language

6. Unanswered questions:

   • Important outcomes not measured
   • Subgroups with unclear signals
   • 1-2 concrete future research directions

7. Closing (one strong sentence):

   • Memorable take-home message
   • Balanced stance on practice change

Topol Style Elements:

• Authoritative but accessible voice
• Dense with scientific concepts, assume MD audience
• Evidence-grounded every claim with citations
• Balanced skepticism, never promotional
• Numbers: absolute risk differences, NNT/NNH
• Patient-centered: QOL, treatment burden, preferences

Critical Rules:

• ALWAYS cite using PubMed references with DOIs
• For claims about trials: cite specific PMID
• Never make unsupported assertions
• If working from abstract only, explicitly acknowledge limitations
• Use phrases like "if confirmed in full publication" when from abstract
• Maintain intellectual humility while projecting expertise

Phase 4: Visual Infographic Creation

After writing the editorial, create an engaging visual infographic slide (see references/infographic-design.md):

Purpose: Increase platform dwell time by providing visual summary for those who don't read full text

Format: Single-page HTML slide with embedded graphics (1200x1600px optimal for mobile/desktop)

Key Elements:

1. Header section (compelling title + trial name)
2. Visual data presentation (key finding with icon/graphic)
3. 3-panel comparison (who benefits, who waits, what's unknown)
4. Clinical bottom line (action item in highlighted box)
5. Footer (citation + user attribution)

Design principles:

• Medical professional aesthetic (clean, evidence-based, not flashy)
• Color palette: cardiology blues (#1E3A8A, #3B82F6, #60A5FA) with accent (#EF4444 for warnings)
• Typography: Clear hierarchy, readable at mobile size
• Icons: Simple, medical-appropriate (heart, stethoscope, chart symbols)
• Data visualization: Bar charts, simple comparisons, clear numbers
• White space: Professional, not cluttered

Content structure:

┌─────────────────────────────────────┐
│  TRIAL NAME: Bold Finding          │ ← Header
├─────────────────────────────────────┤
│  [ICON] KEY RESULT                  │ ← Hero metric
│  XX% vs YY% (p=0.00X)              │
│  NNT = Z                            │
├─────────────────────────────────────┤
│ ✓ CHANGE PRACTICE  ⚠ WAIT  ❓UNKNOWN│ ← 3-panel
│   [details]         [details] [gaps]│
├─────────────────────────────────────┤
│ 🎯 BOTTOM LINE: [actionable]        │ ← Takeaway
├─────────────────────────────────────┤
│ Source: [Journal] | Dr. [Name]     │ ← Attribution
└─────────────────────────────────────┘

Technical implementation:

• Create standalone HTML file with inline CSS
• Use simple SVG icons or Unicode symbols (♥, ⚕, 📊)
• Responsive design (flexbox/grid)
• No external dependencies
• Ready to screenshot or embed

Always deliver:

1. Editorial text (500 words)
2. HTML infographic file
3. Brief note: "Screenshot this slide for social media posting"

Phase 5: Quality Assurance

Before delivering:

1. Verify all citations link to actual PubMed articles
2. Check word count (target 500 ± 50 words)
3. Ensure character count fits 1500-1700 range
4. Confirm Eric Topol voice consistency
5. Validate that user appears as authoritative cardiologist
6. Test infographic renders properly in browser
7. Ensure infographic visual hierarchy is clear

Abstract-Only Workflow

When only abstract available (common for conference presentations or embargoed trials):

1. Set ethical boundaries upfront:

   • Frame as "commentary on emerging result, not practice verdict"
   • Never recommend standard-of-care change from abstract alone
   • Use "promising but provisional" tone throughout

2. Mine abstract systematically:

   • Background: clinical problem (can write confidently)
   • Methods: extract headlines only (population, intervention, design, endpoint)
   • Results: direction of effect, key numbers presented
   • Explicitly note missing pieces: inclusion/exclusion details, statistical plan, safety profile

3. Structure shifts:

   • Include "honesty paragraph": "As with any report available only in abstract form, important details are not yet accessible..."
   • List 3-5 specific unknowns that matter most
   • Talk implications as questions, not prescriptions
   • Close with "wait but pay attention" message

4. Language safety:

   • "Based on limited information currently available"
   • "If these findings are confirmed in full report"
   • "Abstract suggests, but does not yet establish"
   • Avoid: "game changer", "paradigm shift", "definitive"

Alternative Paths

If user rejects machine's trial selection:

• Show next-ranked trials (positions 6-10)
• Ask user for specific topic preferences
• Search by user-specified criteria
• Offer manual trial entry (user provides PMID or abstract)

If no recent landmark trials:

• Search expanded timeframe (3-6 months)
• Consider meta-analyses or guidelines updates
• Look for high-impact controversies or debates
• Suggest editorial on emerging trends across multiple studies

Topic-specific editorial requests:

• User can specify: coronary intervention, structural heart, heart failure, EP, imaging
• Filter trials by topic_class before scoring
• Adjust scoring weights for user's subspecialty focus

Integration Points

PubMed MCP tools to use:

• PubMed:search_articles - discover recent trials
• PubMed:get_article_metadata - retrieve abstracts, titles, authors
• PubMed:get_full_text_article - retrieve full text when PMCID available
• PubMed:convert_article_ids - convert PMID to PMCID for full text check
• PubMed:find_related_articles - discover prior trials for context

For each editorial:

• Minimum 3-5 PubMed citations
• At least 1 citation for the primary trial being discussed
• At least 2-3 citations for contextual prior trials
• Include DOIs in all references

Quality Standards

User portrayal:

• Trusted interventional cardiologist with deep expertise
• Well-read, synthesizing developments to guide peers
• Authority who knows the field comprehensively
• Thoughtful skeptic, not cheerleader

Audience assumption:

• Well-educated physicians (peers, juniors, seniors, referring MDs)
• Appreciate dense scientific concepts
• Value evidence-based analysis over opinion
• Want actionable insights for practice

Citation discipline:

• Every substantive claim grounded in Q1 journal references
• When needing context (e.g., PARTNER 1/2 for PARTNER 3 discussion), explicitly request additional references
• If user doesn't have references, search PubMed systematically
• Focus on: NEJM, JACC family, JAMA family, Lancet, BMJ, Circulation, JAHA, EHJ, similar tier-1

Success Metrics

A successful editorial delivery includes:

1. Identifies genuinely important/landmark trial
2. Provides critical evidence-based analysis
3. Positions trial in broader literature context
4. Offers specific, actionable clinical guidance
5. Maintains Eric Topol's authoritative voice
6. Cites all claims with high-quality references
7. Portrays user as knowledgeable authority
8. Fits 500-word, 1500-1700 character target
9. Engages physician audience with dense concepts
10. Balances enthusiasm with appropriate skepticism
11. Delivers HTML infographic with clear visual hierarchy
12. Infographic increases dwell time and engagement

Final Deliverables

For each editorial, always provide:

1. Editorial text (500 words in markdown)
2. HTML infographic file (1200×1600px, self-contained)
3. Usage note: "Screenshot this infographic for social media posting (LinkedIn, Twitter, Instagram)"
4. Reference list with PMIDs and DOIs