Project ECHO: Enthusiasm Overtakes Evidence
Project ECHO (Extension for Community Healthcare Outcomes) is a popular model for improving patient outcomes through provider education, which has grown rapidly since its initial success in the treatment of Hepatitis C. Recently, the U.S. Senate passed the ECHO Act, calling for the Secretary of Health and Human Services to examine the model and implicitly to spread it through existing programming. Unfortunately, the evidence of the benefits of ECHO appear to be far more limited than is generally understood and we are in substantial danger of making public policy decisions without adequate clinical results, much less cost-e...
Source: Health Affairs Blog - January 3, 2017 Category: Health Management Authors: Christopher Langston Tags: Featured Health Professionals hepatitis C Physicians Primary Care Project ECHO Source Type: blogs
The Perils of Precision Medicine
By MERCEDITAS VILLANUEVA , MD
When The White House announced their Precision Medicine Initiative last year, they referred to precision medicine as “a new era of medicine,” signaling a shift in focus from a “one-size-fits-all-approach” to individualized care based on the specific characteristics that distinguish one patient from another. While there continues to be immense excitement about its game-changing impact in terms of early diagnoses and targeting specific treatment options, the advancements in technology, which underlie this approach, may not always yield the best medical results. In some cases, low cost ap...
Source: The Health Care Blog - December 26, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
A medical student rediscovers a love for writing
Over the past month, I’ve slowly rediscovered my love for writing. Though I have never considered myself a strong writer, I have fond memories of it providing an outlet for my thoughts. The history essays that everyone dreaded writing in high school were some of my favorite assignments. I spent days wording and rewording my sentences while my classmates wrote them quickly the night before they were due. It felt exciting to produce a piece of work that I could read over and over again. Sometimes I wish I could go back to having writing assignments. With the hectic schedule of undergrad and medical school, I have abandoned...
Source: Kevin, M.D. - Medical Weblog - November 9, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Education Medical school Source Type: blogs
Common Myths About Marijuana Legalization
This coming Tuesday, nine states will consider ballot initiatives that legalize marijuana for medical or recreational purposes under state law. Twenty-five states have already legalized marijuana for medical use, and four have legalized fully, and polls suggest many or most of the new initiatives will pass. Opponents nevertheless make strong claims about adverse consequences from existing and proposed legalizations. We argue, based on the evidence, that such claims are exaggerated, misleading, or outright false.Legalizing marijuana dramatically increases use: Several countries (Portugal, the Netherlands, Australia, and p...
Source: Cato-at-liberty - November 4, 2016 Category: American Health Authors: Jeffrey Miron, Angela Dills, Sietse Goffard Source Type: blogs
Not So Wondrous Drugs? - New Warnings about Severe Adverse Effects of New, Heavily Marketed Drugs for Hepatits C,
In conclusion, evidence-based medicine rigorously applied suggests that individual health care and health policy decisions should be driven by the best available evidence, mostly from clinical research, about the benefits and harms of tests, treatments, programs, and so on, in the context of what outcomes matter to patients. The skepticism EBM should engender could lead to health care that is more about patients and their outcomes, and less about ideology, hype, and hucksterism. If only such skepticism were easier to find........APPENDIX - Clinical Research about Hepatitis C TreatmentsStarting in March, 2014, we havep...
Source: Health Care Renewal - October 6, 2016 Category: Health Management Tags: adverse effects clinical trials deception evidence-based medicine Gilead hepatitis C marketing Sovaldi Source Type: blogs
Treatment of Patients with Cirrhosis via Now@NEJM
Posted oninfosnack. (Source: Kidney Notes)
Source: Kidney Notes - August 24, 2016 Category: Urology & Nephrology Authors: Joshua Schwimmer Source Type: blogs
Heart disease and cancer are responsible for nearly half of all deaths in the U.S., report says - LA Times
http://www.latimes.com/science/sciencenow/la-sci-sn-causes-of-death-20160629-snap-story.htmlHeart disease and cancer are responsible for nearly half of all deaths in the U.S., report saysWhat are the most common ways to die in America? The answer depends on how old you are, whether you ' re a man or a woman, and your racial and ethnic background, a new report shows.Alzheimer ' s disease accounted for 5% of deaths among U.S. women, for instance, but only 2.1% of deaths among men. Accidents and unintentional injuries caused 39.7% of deaths among people between the ages of 10 and 24, but only 7.4% of deaths for adults between...
Source: Dr Portnay - August 14, 2016 Category: Cardiology Authors: Dr Portnay Source Type: blogs
LITFL Review 244
Welcome to the 244th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
A gold, silver, and bronze performance in one week. An epic non-clinical focus three-for from Don’t Forget the Bubbles: The impacts of bullying on kids; A call for action against asylum seeker abuse on Nauru; and the effect of adults bullying i...
Source: Life in the Fast Lane - August 14, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
How the System is Rigged - Johnson and Johnson Board Member Pretends to be Independent Brookings Institution Scholar
DiscussionIt is hardly news that US health care is broadly dysfunctional, that it suffers from ever rising costs, and questionable quality, while access has only somewhat improved after the 2009 Affordable Care Act. The big question is why these problems seem so intractable.Our latest case illustrates that the problem may be that health policy making is dominated by people withconflicts of interest. In the current case, one of the more influential voices on health care policy turns out not to have just a garden variety conflict of interest. He actually has a duty to uphold the corporate interests of one o...
Source: Health Care Renewal - August 10, 2016 Category: Health Management Tags: boards of directors Brookings Institution hepatitis C Johnson and Johnson revolving doors You heard it here first Source Type: blogs
Abort, Retry, Fail - Billionaire Bill Gates Opines, Sans Evidence, on ... the Efficacy of Hepatitis C Treatment?
Conclusions So maybe Bill Gates' seemingly ill-informed apologia for the extremely high drug prices charged in the US, and his lack of understanding of the evidence about the efficacy, or lack thereof, of some of these high priced drugs is a small humorous story that indicates just the tip of the iceberg. It appears that in our current market fundamentalist, neoliberal world, foundations may be more about promoting the commercial interests of their board members and officers than about improving the lot of humanity. Yet for the most part they may succeed in obfuscating what they are doing through the haze of ma...
Source: Health Care Renewal - July 14, 2016 Category: Health Management Tags: conflicts of interest Gates Foundation Genentech Gilead global health health care foundations hepatitis C Sovaldi Source Type: blogs
Hyponatremia in cirrhosis
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - July 1, 2016 Category: Internal Medicine Tags: gastroenterology nephrology Source Type: blogs
A patient dies during live video surgery. Who’s to blame?
“Was the delay in deciding to open influenced by the presence of an audience of 100 surgeons expecting to see a laparoscopic liver resection?”
“In addition to his tumor, the patient had hepatitis and cirrhosis. Was he a good candidate? A major complication was inevitably to occur during a live broadcast.”
As I predicted last year, it had to happen sooner or later.
In that post, I wrote, “A major complication will inevitably occur during a live broadcast. No matter the reason, it will be blamed on the live video surgery.” Of the many stories in the Indian media about this tragic case, most brought up the...
Source: Kevin, M.D. - Medical Weblog - June 23, 2016 Category: Journals (General) Authors: Skeptical Scalpel, MD Tags: Physician Surgery Source Type: blogs
The Mischief and the Good In Precision Medicine
By MERCEDITAS VILLANUEVA, MD
When The White House announced their Precision Medicine Initiative last year, they referred to precision medicine as “a new era of medicine,” signaling a shift in focus from a “one-size-fits-all-approach” to individualized care based on the specific characteristics that distinguish one patient from another. While there continues to be immense excitement about its game-changing impact in terms of early diagnoses and targeting specific treatment options, the advancements in technology, which underlie this approach, may not always yield the best medical results. In some cases, low cost ap...
Source: The Health Care Blog - June 22, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Gene Expert Precision Medicine Initiative tuberculosis Source Type: blogs
Making Hepatitis C A Rare Disease In The United States
New breakthrough medicines for Hepatitis C present an important choice about setting goals and taking systemic action to achieve public health advances in the United States. Despite appearing to offer cure rates greater than 90 percent, high-priced Hepatitis C drugs have driven treatment rationing since their approval over two years ago. Gaps in the screening, diagnosis, and treatment of Hepatitis C pose significant public health consequences.
In May, the Centers for Disease Control and Prevention (CDC) identified Hepatitis C as the leading infectious killer in the United States in 2014—the first year in which new me...
Source: Health Affairs Blog - June 15, 2016 Category: Health Management Authors: Victor Roy, Dave Chokshi, Stephen Kissler and Prabhjot Singh Tags: Costs and Spending Drugs and Medical Technology Equity and Disparities Featured Global Health Population Health Public Health Gilead hepatitis C Sovaldi Source Type: blogs
Recognizing Emotion
By: John Ragsdale, MD, MS, assistant professor, Division of Hospital Medicine, Department of Medicine, University of Kentucky College of Medicine
You can learn a lot just by observing. As clinicians, we frequently diagnose and assess just by paying careful attention to our patients. We see the signs of impending respiratory failure in the patient with asthma who’s not improving. We note subtle signs of developing encephalopathy in the patient with cirrhosis. We learn to differentiate the critically ill patients from the stable ones. In some way, this is all part of the physical examination, and we hone these skills with ...
Source: Academic Medicine Blog - June 7, 2016 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective emotional diagnosis facial expressions patient centered care physical exam Source Type: blogs
