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Helping Doctors Choose Wisely: Three Innovative Principles For Health Care Organizations
Achieving higher value, cost-conscious care that eliminates waste and optimizes quality is a crucial priority. Recent professional and policy initiatives aiming to spur individual physicians to achieve that priority include the American Board of Internal Medicine’s Choosing Wisely Campaign, the High Value Cost-Conscious Care Initiative from the American College of Physicians, and new content in the American Medical Association Code of Medical Ethics.
Although professional organizations can be influential, physicians work in organizations, and evidence suggests health care organizations influence individual physician beh...
Source: Health Affairs Blog - April 30, 2015 Category: Health Management Authors: Jon Tilburt Tags: Costs and Spending Featured Health Professionals Hospitals Payment Policy Public Health ABIM ACOs ACP AMA Choosing Wisely delivery High-Value Care Innovation Physicians Source Type: blogs
Women Who Serve: Who We Are
The concept of women as the gentler sex is hard to square with the military warrior culture. Husband hunter, lesbian, s., whore, manipulator, or too dumb to do anything else are the historical characterizations of women who serve and are changing far too slowly. No one is more surprised with this rancor than the young, naïve and innocent women who join the military with an eye on what the future may bring.
I wanted a chance at a better life. I wanted to be more than my surroundings dictated to me. I felt a duty to my country; to protect and preserve all the things I loved.
My time in the Army was one of the best exp...
Source: Disruptive Women in Health Care - February 18, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Advocacy Women Veterans Women's Health Source Type: blogs
Cancer Treatment Centers of BS
If you share my vice of sometimes watching sports on TV, you have been afflicted with advertisements for Cancer Treatment Centers of America. I was inspired to write this post just by looking at the ads. I can't evaluate the quality of whatever actual cancer treatment they provide, but they do not inspire confidence by aggressively promoting quackery and fraud.One of their ads features a naturopathic "doctor" describing all the wonderful things she does for her patients. Naturopathic "training" consists of exposure to every form of nonsense known to humanity, from homeopathy to acupuncture to ayurvedic and traditional chin...
Source: Stayin' Alive - February 10, 2015 Category: American Health Source Type: blogs
Old wine in a new skin: The Society for Integrative Oncology issues guidelines for breast cancer
It should come as a surprise to no one that I’m not exactly a fan of “integrative oncology”—or integrative medicine, or “complementary and alternative medicine” (CAM), or whatever its proponents want to call it these days. After all, I’ve spent nearly ten years writing this blog and nearly seven years running another blog dedicated to…
Source: Respectful Insolence - December 1, 2014 Category: Surgery Authors: Orac Tags: Cancer Clinical trials Complementary and alternative medicine Naturopathy Quackery Science Skepticism/critical thinking acupuncture American Cancer Society Chiropractic clinical guidelines Consortium of Academic Health Centers for In Source Type: blogs
Unwanted interrogations
I really despise this. You reveal an ailment and get an interrogation in return. It doesn't matter how well you know the person, you just want to shut them up.Recently, when asked about my wrist brace, I said my usual 'its a combination of tendinitis, tennis elbow, RA and more'. These questions ensued:Have you had a cortisone injection? Yes, two.Do you take anti-inflammatories? YesDo go to PT? No but I go to a gym which is run by physical therapists. Do you take vitamin B6? Yes to shut them up (and then I went home and checked my vitamin bottle).Do you meditate? No but I knit and crochet and it has been shown to have the s...
Source: Caroline's Breast Cancer Blog - August 3, 2014 Category: Cancer Tags: ailments questions rudeness Source Type: blogs
On the hazards of significance testing. Part 2: the false discovery rate, or how not to make a fool of yourself with P values
What follows is a simplified version of part of a paper that will shortly be submitted. If you find anything wrong, or obscure, please email me. Be vicious: it will improve the eventual paper.
It’s a follow-up to my very first paper, which was written in 1959 – 60, while I was a fourth year undergraduate.(the history is in a recent blog). I hope this one is better.
‘". . . before anything was known of Lydgate’s skill, the judgements on it had naturally been divided, depending on a sense of likelihood, situated perhaps in the pit of the stomach, or in the pineal gland, and differing in its ver...
Source: DC's goodscience - March 24, 2014 Category: Professors and Educators Authors: David Colquhoun Tags: false discovery rate statistics Bayesian P values significance Source Type: blogs
From routine dental visit to oral cancer…
CALIFORNIA MOM OF TWO HAS HALF OF HER TONGUE REMOVED AND A NEW ONE RECONSTRUCTED WITH FOREARMSomeone dies from oral cancer every hour of every day in the United States aloneEarly DETECTION – early cure: Oral Cancer Awareness Month in AprilLos Angeles, CA, February 11, 2014… A routine trip to the dentist saved the life of a California mom of two. The American Dental Association estimates that “60% of the US population visits a dentist every year, however less than 15% of them report having received an oral cancer screening.” Although the number of deaths each year from oral cancer is astoundingly large, it is highly...
Source: Dental Technology Blog - February 17, 2014 Category: Dentists Source Type: blogs
From routine dental visit to oral cancer… california mom of two has half of her tongue removed and a new one reconstructed with forearm
Someone dies from oral cancer every hour of every day in the United States aloneEarly DETECTION – early cure: Oral Cancer Awareness Month in AprilLos Angeles, CA, February 26, 2014… A routine trip to the dentist saved the life of a California mom of two. The American Dental Association estimates that “60% of the US population visits a dentist every year, however less than 15% of them report having received an oral cancer screening.” Although the number of deaths each year from oral cancer is astoundingly large, it is highly curable if diagnosed early. Early detection is a key factor in oral cancer care and a 90-sec...
Source: Dental Technology Blog - February 3, 2014 Category: Dentists Source Type: blogs
Why you should ignore altmetrics and other bibliometric nightmares
Conclusions about bibliometrics
Bibliometricians spend much time correlating one surrogate outcome with another, from which they learn little. What they don’t do is take the time to examine individual papers. Doing that makes it obvious that most metrics, and especially altmetrics, are indeed an ill-conceived and meretricious idea. Universities should know better than to subscribe to them.
Although altmetrics may be the silliest bibliometric idea yet, much this criticism applies equally to all such metrics. Even the most plausible metric, counting citations, is easily shown to be nonsense by simply...
Source: DC's goodscience - January 16, 2014 Category: Professors and Educators Authors: David Colquhoun Tags: Academia altmetrics bibliometrics open access peer review Public relations publishing acupuncture badscience bibliobollocks publication regulation Source Type: blogs
We know little about the effect of diet on health. That’s why so much is written about it
One of my scientific heroes is Bernard Katz. The closing words of his inaugural lecture, as professor of biophysics at UCL, hang on the wall of my office as a salutory reminder to refrain from talking about ‘how the brain works’. After speaking about his discoveries about synaptic transmission, he ended thus.
"My time is up and very glad I am, because I have been leading myself right up to a domain on which I should not dare to trespass, not even in an Inaugural Lecture. This domain contains the awkward problems of mind and matter about which so much has been talked and so little can be said, and havi...
Source: DC's goodscience - November 18, 2013 Category: Professors and Educators Authors: David Colquhoun Tags: badscience Bernard Katz nutribollocks nutrition nutritional therapy randomisation randomization RCT regulation Academia causality quackery Source Type: blogs
Addendum to stigmas
As Lesley commented yesterday, the same can be true about chronic problems. People just don't understand. Then they forget you still have a problem or ask why it isn't better. Chronic problems do not go away.A good example of this is that I have lymphedema in my left arm. I used to go for acupuncture. When I started I had to fill out a big long form with all my health issues on it. We talked about all my ailments and including lymphedema and how there could be no needles on that arm.The acupuncturist would 'forget' sometimes and go to put a needle in my left arm. The last straw for me was when she said to me 'this hasn't r...
Source: Caroline's Breast Cancer Blog - November 8, 2013 Category: Cancer Tags: ailments chronic loneliness Source Type: blogs
Yet another incompetent regulator. The General Pharmaceutical Council is criminally negligent
Conclusions
The main conclusion from all of this is that the General Pharmaceutical Council is almost criminally negligent. It continues to allow pharmacists, Anthony Pinkus among them, to endanger lives. It fails to apply its own declared principles. The members of its Council, and Duncan Rudkin (its chief executive and registrar), are not doing their job.
Individual pharmacists vary a lot, from the superb to those who believe in quackery. Some, perhaps many, are embarrassed by the fact that their employer compels them to sell rubbish. It’s too much to expect that they’ll endanger their mortgage payments by sp...
Source: DC's goodscience - November 4, 2013 Category: Professors and Educators Authors: David Colquhoun Tags: Ainsworths Alliance Boots Anthony Pinkus Avogadro CAM General Chiropractic Council General Pharmaceutical Council homeopathy Royal Pharmaceutical Society Ainsworth's malaria meningitis pertussis pharmacists Pharmacy regulator Source Type: blogs
How Does Acute Pain Become Chronic? | NIH Director's Blog
Chronic pain is a major medical problem, affecting as many as 100 million Americans, robbing them of a full sense of well-being, disrupting their ability to work and earn a living, and causing untold suffering for the patient and family. This condition costs the country an estimated $560-635 billion annually—a staggering economic burden [1]. Worst of all, chronic pain is often resistant to treatment. NIH launched the Grand Challenge on Chronic Pain [2] to investigate how acute pain (which is part of daily experience) evolves into a chronic condition and what biological factors contribute to this transition.But you m...
Source: Psychology of Pain - September 26, 2013 Category: Psychiatrists and Psychologists Source Type: blogs
