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This Is Not A Disruptive Blog Post
By MICHEL ACCAD, MD Frank Knight, risk and uncertainty In this article, I wish to introduce the reader to the theory of entrepreneurship advanced by Frank Knight (1885-1972), and show that the common, everyday work of the physician could be considered a form of entrepreneurial activity in the Knightian sense. Knight was an influential American economist. He is best known for his book Risk, Uncertainty, and Profit in which he proposed to distinguish risk and uncertainty as follows: Risk pertains to situations where outcomes occur with a frequency that is quantifiable according to probability distributions. Risk may b...
Source: The Health Care Blog - December 8, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB MICHEL ACCAD Source Type: blogs

An Attempt to Quantify the Degree to Which Alzheimer's is a Lifestyle Disease
To what degree is Alzheimer's disease a consequence of poor lifestyle choices such as being sedentary and overweight, as is largely the case for type 2 diabetes, versus a consequence of the unavoidable accumulation of cell and tissue damage that causes degenerative aging? Researchers here run the numbers to obtain a partial answer. You'll note a couple of interesting associations such as with low body mass index (BMI) in later life, as considerable loss of weight in old age is usually a sign of systematic health issues, and the fact that people with cancer tend not to get Alzheimer's, an phenomenon noted in recent years, b...
Source: Fight Aging! - November 2, 2015 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

The End of the NHS?
By SAURABH JHA, MD Britain’s health secretary wants to uncharm his way to a revolution. To galvanize support for a seven-day National Health Service (NHS), which the NHS was before Jeremy Hunt’s radical plans, and still is, he asserted that thousands die because there is a shortage of senior doctors during weekends. This is an expedient interpretation of a study which showed that mortality was higher in patients admitted on weekends. Hunt ignored the fact that patients admitted on Friday night are actually sicker than those admitted on Wednesday morning. When logos failed, and after briefly dabbling with pathos, ...
Source: The Health Care Blog - October 30, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Saurabh Jha Source Type: blogs

Right Care Action Week — rational care
I wrote yesterday about how a broken healthcare system favors overuse of procedures. Today I will discuss rational care. Remember the goals of the Lown Institute: We think healthcare should be affordable, effective, rational and available to all. Rational means in accordance with reason or logic. Hardly a day goes by that I don’t see irrational care. Why it happens is complicated. Patients may expect irrational care. Doctors and nurses can get pushed into delivering it. Then, insidiously, unreasonable and illogical care become normal; and rational care stands out as an outlier. Some examples: It’s not rational ...
Source: Dr John M - October 19, 2015 Category: Cardiology Authors: Dr John Source Type: blogs

Marcia Angell writes
By Marcia AngellIn 1953, a new drug was released by Burroughs Wellcome, a pharmaceutical company based in London. Pyrimethamine, as the compound was named, was originally intended to fight malaria after the microorganisms that cause the disease developed resistance to earlier therapies. The drug was used against malaria for several decades, often in combination with other compounds. It ’s mostly used now to treat toxoplasmosis, a parasitic infection that can be life-threatening in people whose immune systems are suppressed, for example, by HIV/​AIDS or cancer.More than 40 years later, Burroughs Wellcome merged with the...
Source: PharmaGossip - October 4, 2015 Category: Pharmaceuticals Authors: insider Source Type: blogs

Health Information Technology: A Guide to Study Design For the Perplexed
This study, which was widely reported in the news media and influenced policy, found significant differences in the rate of flu-related deaths and hospitalizations among the vaccinated elderly compared with their unvaccinated peers. Although it controlled for certain easy-to-measure differences between the 2 groups, such as age, sex, and diabetes, it did not account for other more difficult-to-measure “healthy user” factors that affect the well-being of the elderly, such as their socioeconomic status, diet, exercise, and adherence to medical treatments and advice. The cohort design has long been a staple in studies of...
Source: The Health Care Blog - September 13, 2015 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Rising Cost Of Drugs: Where Do We Go From Here?
The trends are clear: patients and institutions across the nation are concerned about skyrocketing drug prices. This post offers some information about drug pricing, explores the notion of market intervention, and proposes a series of responses to high pharmaceutical costs. A few jaw-dropping facts quickly illustrate the pattern of rising drug costs. The average annual cost of cancer drugs increased from roughly $10,000 before 2000 to over $100,000 by 2012, according to a recent study in Mayo Clinic Proceedings. Several breakthrough specialty medications and orphan drugs recently approved by the Food and Drug Administratio...
Source: Health Affairs Blog - August 31, 2015 Category: Health Management Authors: Ifrad Islam Tags: Costs and Spending Drugs and Medical Technology Featured Medicaid and CHIP Payment Policy Public Health Big Pharma CMS FDA Gilead Sciences hepatitis C Pricewaterhouse Coopers Source Type: blogs

A Rapid-Learning Initiative For Cholesterol-Lowering Drugs
In late July, the Food and Drug Administration (FDA) approved selective use of Praluent, the first of a new class of cholesterol-lowering drugs (PCSK9 inhibitors). A similar drug, Repatha, is expected to be approved this month. The reported results so far for Praluent, e.g. 50-70 percent lowering of cholesterol levels, are very promising — particularly for patients who are unable to control their cholesterol with statins. The new drugs may be uniquely valuable for a million or more persons with genetic conditions that cause high cholesterol. However, there is considerable uncertainty and debate about how broadly Pral...
Source: Health Affairs Blog - August 25, 2015 Category: Health Management Authors: Lynn Etheredge Tags: Costs and Spending Drugs and Medical Technology Featured Population Health Public Health Quality cholesterol-lowering drugs FDA genetic conditions Praluent rapid learning regulation Repatha Source Type: blogs

Blow your HDL through the roof
The HDL cholesterol value is one of the four values on any conventional lipid/cholesterol panel, along with total cholesterol, triglycerides, and calculated LDL cholesterol (what I call “fictitious” LDL because of its incredible inaccuracy when compared to superior measures). The HDL cholesterol value has some unique characteristics not shared by the others, however, and can serve as an index of overall health. Very high HDL values, for instance, are associated with extreme longevity. Centenarians typically have values of 90 mg/dl or higher. Higher HDLs are also associated with less risk for diabetes, hypertens...
Source: Wheat Belly Blog - June 29, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle fish oil HDL longevity omega-3 saturated fat vitamin D Source Type: blogs

Top stories in health and medicine, May 4, 2015
From MedPage Today: Statins Linked to Improved Lung Cancer Survival. Sustained statin use was associated with modestly better survival in lung cancer, an observational study in Great Britain showed. MRI-Detected Bone Marrow Changes Linked to Low Back Pain. Vertebral subchondral bone marrow changes visible on magnetic resonance imaging (MRI), known as modic changes, of the M1 type are positively correlated with low back symptoms. Slow Medicine: MOC in the Middle. The American Board of Internal Medicine (ABIM) has received a fair amount of criticism from U.S. internists and subspecialists because of its imposition of antiq...
Source: Kevin, M.D. - Medical Weblog - May 4, 2015 Category: Journals (General) Authors: Tags: News Cancer Source Type: blogs

New Cures Require New Pricing Policies
One critical incentive for ongoing drug discovery and development is the temporary monopoly pricing that manufacturers can command for novel drugs. Yet this incentive, embedded in current patent and regulatory policy, does not guarantee that manufacturers will deliver novel products with clinically meaningful benefits. Indeed there are many diseases---including Alzheimer’s disease and Amyotrophic lateral sclerosis (ALS)---that pose significant patient, family, and societal burden but have not benefited from meaningful treatment advances. Meanwhile, the American public appears increasingly wary of the unintended conseque...
Source: Health Affairs Blog - April 16, 2015 Category: Health Management Authors: Rena Conti Tags: Health Policy Lab costs drugs Pharma pricing Source Type: blogs

Doctor's Article Counters The "Myths That Undermine Medical Research"
Thomas Stossel, American Cancer Society Professor of Medicine at Harvard Medical School and a visiting scholar at the American Enterprise Institute, recently wrote an article entitled “Myths that undermine medical research.” Stossel raises important points to counter three prevailing myths about the drug and device industry.  View the article, as published in the hill.com If you or a loved one suffers from a serious and debilitating disease and hope for improved treatment or—even better—a cure, the recent history of medical progress should be encouraging. Over the years I have practiced medicine, U.S. longevi...
Source: Policy and Medicine - April 14, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Rob lost about 1/3 his body weight on the Wheat Belly lifestyle
Rob shared his Wheat Belly lifestyle experience, demonstrating a dramatic transformation in body appearance and composition: I’m a fervent proponent of the wheat-free lifestyle, which I adopted full time in 2011 (except for an odd pizza or cupcake a few times a year). To date, I’ve lost 104 pounds. My challenge now is to transition my children from wheat to this healthful and sustainable lifestyle! Though he doesn’t mention it, you can be sure that Rob also experienced dramatic improvements in multiple aspects of health. Among the more prominent effects that people experience over time, especially a sust...
Source: Wheat Belly Blog - February 24, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories gluten-free grain Weight Loss Source Type: blogs

Top stories in health and medicine, January 12, 2015
From MedPage Today: Statins and RA: No Joint Benefit. The use of statins does not reduce onset of new joint pain or stiffness in middle-age or older women but their use is associated with poor physical functioning and poor self-rated health. Expert Groups Clarify HPV Testing Recommendations. Primary cervical cancer screening with a test for human papillomavirus (HPV) DNA represents a reasonable and effective alternative to cytology or co-testing with cytology and the HPV assay. Is ESRD Finally on the Decline? New cases of end-stage renal disease in the U.S. have declined for the third year in a row, potentially signaling...
Source: Kevin, M.D. - Medical Weblog - January 12, 2015 Category: Journals (General) Authors: Tags: News Heart Infectious disease Nephrology Rheumatology Source Type: blogs