I don't just rant about methods and evidence -- in my work life I also rant about health economics and outcomes! This is why I was so interested in this post by the health economist Ulf Staginnus called"New Models for Market Access." I want to give a hat tip to Healtheconomics.com for pointing me here. The thesis of the article is that we need to refocus our discussion from market access to true innovation in the biopharma sector. There are some...
Thursday, 22 December 2011
Tuesday, 13 December 2011
When end of life is not
Twenty years ago, I helped save a man's life.So begins this New York Times essay by Peter Bach, MD, where he talks about the inadequacy of resource use at the end of life as a policy metric. Now, I am not very fond of policy metrics, as most of you know. So, imagine my surprise when I found myself disagreeing vehemently with Peter's argument. Well, to be fair, I did not disagree with him completely. I only disagreed with the thesis that he constructed,...
Tuesday, 22 November 2011
Lessons from Xigris
I have been wanting to write for a while about the demise of Xigris, but work and other commitments have stalled my progress. But it is time.Here is my disclosure: I have received research funding from BioCritica, a daughter company of Eli Lilly, the manufacturer of Xigris. I also happen to know well and hold in high esteem the depth of knowledge and integrity of several colleagues who worked on Xigris internally at Lilly.But on to the story. Xigris...
Monday, 21 November 2011
Massachusetts' unwinnable gamble
It is ironic how, just a few days following the startling (?) confirmation by the Robert Wood Johnson Foundation-funded research that an ounce of prevention is indeed worth a pound of cure, the Massachusetts legislature with reckless abandon ushered in yet another mechanism for the erosion of public health: legalized gambling. Really, I have nothing against a little gambling. The issue is that this legislative move does not just open the door to...
Thursday, 13 October 2011
ONLY kills cancer cells ?
SUPPOSED TO BE BETTER THAN CHEMO!!! PLEASE READ BELOW THEN SHARE AROUND.Just cut 2-3 thin slices of lemon in a cup/container and add drinking water will become "alkaline water", drink for the whole day, just by adding drinking water. Take it as drinking water everyday is good for everybody.The surprising benefits of lemon!I remain perplexed!================================Institute...
Saturday, 1 October 2011
Thursday, 29 September 2011
An open letter to my past and future students
As most of my readers know, I teach Public Health graduate students and the University of Massachusetts, sometimes on campus, and sometimes online. This is an open letter to all of my past and future students. First, I want to thank everyone in my June course who took the time to complete the evaluation -- the feedback is very helpful to me. I also want to thank the whole class (and all my previous and future classes) for the privilege of learning...
Friday, 23 September 2011
Clinician as the Politbureau of medicine?
Do you think that medicine in the US is centralized? I do, but not in the way that we generally understand centralization. And furthermore, it is this centralization that I believe is making the idea of shared decision making so intimidating to some. Here is what I mean.If you read management texts, centralization refers to an organization that is run predominantly top-down. In other words, a couple of oligarchs at the top of the ladder make all...
Wednesday, 21 September 2011
Why patient lab data should be liberated, with a few caveats
I am admittedly not an expert on health IT, but I am a firm believer in the empowerment of patients to be the driver of her/his health decision making. So this whole discussion about lab data being available directly to the patient is of great interest to me. But it does seem like yet another instance of the two sides coming together not to listen to each other but to be heard by the other side. And as well know, this works so well for any relationship!Each...
Tuesday, 20 September 2011
Eminence or evidence, or how not to look like a fool when reporting your own data
A study presented a the ICAAC meeting was reported by the Family Practice News that piqued my interest. Firstly, it is a study on C. difficile infection treatment, and secondly it is counter to the evidence that has accumulated to date. So, I read the story very carefully, as, alas, the actual study presentation does not appear to be available.Before...
Monday, 19 September 2011
Adventures with American or Flying, American Style
So, we all know that the time for a doctor's appointment is merely a suggestion, not a mandate, as the doctor is hardly ever on time. We have even started of necessity to apply this theory to air travel. But to end up arriving 5 hours late and... to the wrong city? Well, this was a new one on me. Here is what happened.I went to ICAAC for the day yesterday to present some of our data on predictors of a mixed skin and soft tissues infection. If it...
Wednesday, 14 September 2011
So I got my son a tracfone...
Wanted to post some follow up to my absurd interaction with AT&T, the beginning of which can be found here. Briefly, all I wanted to do was add one more line to my family plan for $9.99 per month. Instead of making it simple, the web site demanded personal information (including my social security number) for the purpose of doing a credit check....
Tuesday, 6 September 2011
Supersize me, the AT&T way
File this under "etc."I had one simple goal -- add a line to my AT&T family wireless plan for my son. I know, I know, I did check other carriers' plans and deals, since my contract with AT&T ran out long ago. But for various reasons I decided to stay with them. Why trade a known headache for an unknown one? Anyway, I went online with every intention of being finished in the space of 10 minutes. How naïve...I wanted to get a basic plan, with...
Thursday, 1 September 2011
You want to know #6?
Actually, it should really be #1. I am referring to the list I blogged yesterday of my top 5 reasons for rejecting a manuscript. The most important reason, which I failed to mention is...... drum roll, please...6. No "Limitations" paragraphThis is something that no manuscript should neglect, as every study, even the most well designed and executed randomized controlled trial, has limitations. So, in every paper that I write, my third paragraph from...
Wednesday, 31 August 2011
My top 5 reasons for rejecting a manuscript
Here are five manuscript transgressions that make me hit "Reject" faster that you can blink. The first four in particular do not instill confidence in what you actually did in the study.1. Matched cohort masquerading as a case-controlThis happens quite a bit with papers submitted to third and fourth tier journals, but watch out for it anywhere. The authors claim to have done a matched case-control study, where there is indeed matching. However, the...
Friday, 26 August 2011
Botox and empathy: Less is more
I am kind of stuck on this whole Botox-empathy thing. A recent study from researchers at Duke and UCLA implied that people who get Botox to attenuate their wrinkles also seem to attenuate their empathic ability. Somehow their inability to mimic others' facial expressions impairs the firing of their mirror neurons and they top feeling empathy. Wow!But think of it -- Botulinum toxin, arguably one of the most potent poisons known to humans, is being...
Thursday, 25 August 2011
Side effects: The subject must become the scientist
A few weeks ago someone I know, a normally robust and energetic woman, began to feel fatigued and listless, and had some strange sensations in her chest. She presented to her primary care MD, who obtained an EKG and a full panel of blood tests. The former showed some non-specific changes, while the latter was entirely normal. Although reassured, she continued to experience malaise. When she fetched her EKG, she received a copy with the computer interpretation...
