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July 18, 1966

Exhibit Wins Billings Gold Medal

JAMA. 1966;197(3):29. doi:10.1001/jama.1966.03110030027016

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A clinical investigation with 49 "authors" at hospitals nation-wide received the Billings Gold Medal at the AMA annual meeting.

The broad-based effort is continuing its attempt to evaluate portocaval shunts in treating cirrhosis and hemorrhagic esophagogastric varices, according to Francis C. Jackson, MD, Pittsburgh.

It took more than four years to establish protocol for the study, in which 12 Veteran's Administration hospitals, 42 clinicians and seven consultants, biometricians and others participated.

From 3,700 patients screened, 157 "good risk" cases were admitted to the study. Seventy-nine were randomly assigned to medical treatment as determined by attending physicians. The remaining 78 received a portocaval shunt, either after hemorrhage or prophylactically.

Results, now evaluated at the two and one-half year follow-up point, include:

  • Liver failure was the primary cause of death in both groups.

  • Medically-treated subjects had a better survival than those treated with prophylactic shunts; that is, operation before hemorrhage.

  • The survival

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