Evidence based medicine is first and foremost at the Preventing Overdiagnosis Conference in Dartmouth this week. The importance of data, research, and careful analysis has been repeatedly hammered home, with talks catchily entitled such as, “Does inclusion of total cholesterol in mortality risk algorithims lead to overestimation of risk?” “Ten years prospective data from the […]
Category: US healthcare
Tessa Richards: Lifting the lid on information and learning from it
Progress. The march towards giving patients online access to their medical records is accelerating. The Society of Participatory Medicine has put out the bunting in welcome to the announcement by the OpenNotes initiative that 1.8 million more US patients can see and share full versions of their doctor’s notes; and that big US providers, including […]
Richard Smith: Is the pharmaceutical industry like the mafia?
The piece that follows is my foreword to a new and fascinating book by Peter Gøtzsche, the head of the Nordic Cochrane Centre, entitled Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare. I hope that this piece might prompt you to read the book. I was not paid for my foreword and […]
Richard Smith: Time for science to be about truth rather than careers
Most scientific studies are wrong, and they are wrong because scientists are interested in funding and careers rather than truth. That was the chilling message delivered by the smiling, brilliant, erudite, and cuddly John Ioannidis at the Seventh Peer Review Congress in Chicago this week. Listening to somebody as brilliant as Ioannidis is like listening […]
Richard Smith: A gamechanger for the polypill?
It is now some 15 years since the emergence of the idea and supporting evidence that combining antihypertensives and a statin into a single polypill and giving it to people daily could dramatically reduce morbidity and premature mortality from heart disease and stroke. Yet polypills are still not licensed in any high income country, although […]
Desmond O’Neill: Elysium—an effective Trojan horse for Obamacare and the social gradient
“Just enjoy the film, dad, you don’t always have to write about it!” is a familiar refrain from my family on our sporadic outings to the movies. Yet cinema was the great art form of the 20th century and this century is continuing the same way, according to Philip French, the masterly film critic of […]
Siddhartha Yadav: A foreign medical graduate’s path to US residency
On 15 September 2013, thousands of doctors and doctors-to-be will flock to the Electronic Residency Application Service (ERAS) website to apply for a residency position in the United States. As this date is approaching, I can see both excitement and apprehension on the faces of prospective candidates. Most of the candidates that I know are […]
Paul J Rosch: Cholesterol, cancer, and statins
Numerous studies of healthy people show that a low cholesterol concentration that has persisted for a decade or more is associated with an increased risk of cancer, and that elevated cholesterol has the reverse effect. This has raised concerns that statins might result in an increase in malignancies, especially since all statins are cardinogenic in doses that […]
Jonathan Leo and Jeffrey R Lacasse: A troubling definition of cognitive enhancement
Whenever studies documenting the rising use of stimulants for children in the Western world make headlines, the medical community goes through a significant amount of word twisting to address the public reaction. The latest bit of semantic juggling involves the definition of “cognitive enhancement.” Webster’s Dictionary describes cognitive enhancement (CE) as, “Any drug, supplement, nutraceutical, […]
William Cayley: Resistance is futile (?)
Recent years have seen a lot of optimistic talk and writing about the “Patient Centered Medical Home”, the promise of population registries and electronic health records for preventing and managing chronic disease, and the ideals of training the personal physician for the 21st century. The goal of integrating personal care with the best that technology […]