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Infectious Disease: Hepatitis C
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This physician won ’t practice parachute-based medicine
I try my best to practice evidence-based medicine on a daily basis. When I know that the test or intervention that I am recommending for my patient is based on expert opinion rather than reliable data on patient-oriented outcomes that matter, I invariably make a point of saying so. It has been my position for several years that despite the impressive effectiveness of newer antiviral medications for hepatitis C at producing a sustained virologic response (SVR), there are still not enough data to be certain that SVR always represents a “cure,” and therefore not enough data to warrant age cohort-based screen...
Source: Kevin, M.D. - Medical Weblog - January 29, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/kenneth-lin" rel="tag" > Kenneth Lin, MD < /a > Tags: Physician Cardiology Source Type: blogs
Why “ Precision Health ” May Not Be the Precise Word
By DAVID SHAYWITZ, MD
The appeal of precision medicine is the promise that we can understand disease with greater specificity and fashion treatments that are more individualized and more effective.
A core tenet (or “central dogma,” as I wrote in 2015) of precision medicine is the idea that large disease categories – like type 2 diabetes – actually consist of multiple discernable subtypes, each with its own distinct characteristics and genetic drivers. As genetic and phenotypic research advances, the argument goes, diseases like “type 2 diabetes” will go the way of quaint descriptive diagnoses like “dropsy”...
Source: The Health Care Blog - November 28, 2017 Category: Consumer Health News Authors: John Irvine Tags: OP-ED Uncategorized Broad Institute CAD Circulation Disease Categories Gimish Model of Disease Kathiresan Khera Massachussetts General Hospital Source Type: blogs
A New Gimish Model of Complex Disease?
By DAVID SHAYWITZ, MD
The appeal of precision medicine is the promise that we can understand disease with greater specificity and fashion treatments that are more individualized and more effective.
A core tenet (or “central dogma,” as I wrote in 2015) of precision medicine is the idea that large disease categories – like type 2 diabetes – actually consist of multiple discernable subtypes, each with its own distinct characteristics and genetic drivers. As genetic and phenotypic research advances, the argument goes, diseases like “type 2 diabetes” will go the way of quaint descriptive diagnoses like “dropsy”...
Source: The Health Care Blog - November 28, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Broad Institute CAD Circulation Disease Categories Gimish Model of Disease Kathiresan Khera Massachussetts General Hospital Source Type: blogs
A More Precise Definition of Precision Medicine?
By DAVID SHAYWITZ, MD
The appeal of precision medicine is the promise that we can understand disease with greater specificity and fashion treatments that are more individualized and more effective.
A core tenet (or “central dogma,” as I wrote in 2015) of precision medicine is the idea that large disease categories – like type 2 diabetes – actually consist of multiple discernable subtypes, each with its own distinct characteristics and genetic drivers. As genetic and phenotypic research advances, the argument goes, diseases like “type 2 diabetes” will go the way of quaint descriptive diagnoses like “dropsy”...
Source: The Health Care Blog - November 28, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Broad Institute CAD Circulation Disease Categories Gimish Model of Disease Kathiresan Khera Massachussetts General Hospital Source Type: blogs
The Cost of Public Reporting
ANISH KOKA MD
In an age where big data is king and doctors are urged to treat populations, the journey of one man still has much to tell us. This is a tale of a man named Joe.
Joseph Carrigan was a bear of a man – though his wife would say he was more teddy than bear. He loved guitar playing, and camp horror movies. Those who knew him well said he had a kind heart, a quick wit and loved cats.
I knew none of these things when I met Joe in the Emergency Department on a Sunday afternoon. I had been called because of an abnormal electrocardiogram – the ER team was worried he could be having a heart attack. ...
Source: The Health Care Blog - September 18, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs
The High Cost of Public Reporting
ANISH KOKA MD
In an age where big data is king and doctors are urged to treat populations, the journey of one man still has much to tell us. This is a tale of a man named Joe.
Joseph Carrigan was a bear of a man – though his wife would say he was more teddy than bear. He loved guitar playing, and camp horror movies. Those who knew him well said he had a kind heart, a quick wit and loved cats.
I knew none of these things when I met Joe in the Emergency Department on a Sunday afternoon. I had been called because of an abnormal electrocardiogram – the ER team was worried he could be having a heart attack. ...
Source: The Health Care Blog - September 18, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Cardiac surgery High-risk Quality Reporting Source Type: blogs
Which Is More Efficient: Employer-Sponsored Insurance or Medicaid?
By SAURABH JHA, MD
An old disagreement between Uwe Reinhardt and Sally Pipes in Forbes is a teachable moment. There’s a dearth of confrontational debates in health policy and education is worse off for it.
Crux of the issue is the more efficient system: employer-sponsored insurance (ESI) or Medicaid. Sally Pipes, president of the market-leaning Pacific Research Institute, believes it is ESI. Employers spend 60% less than the government, per person: $3,430 versus $9,130, per person (according to the American Health Policy Institute). Seems like a no brainer.
Pipes credits “consumerist and market-friendly approaches t...
Source: The Health Care Blog - July 13, 2017 Category: Consumer Health News Authors: at RogueRad Tags: Economics OP-ED employer-sponsored insurance Medicaid Sally Pipes Uwe Reinhardt Source Type: blogs
Welcome to my World: Perpetual Alarm Fatigue
By HANS DUVEFELT, MD
Part of a series on primary care challenges and their solutions.
I missed a drug interaction warning the other day when I prescribed a sulfa antibiotic to Barton, a COPD patient who is also taking dofetilide, an uncommon antiarrhythmic.
The pharmacy called me to question the prescription, and I quickly changed it to a cephalosporin.
The big red warning had popped up on my computer screen, but I x-ed it away with my right thumb on the trackball without reading the warning. Quite honestly, I am so used to getting irrelevant warnings that it has become a reflex to bring the cursor to the spot where I can ...
Source: The Health Care Blog - August 15, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Quality Measure Core Set Implementation Plan
Discussion on Medicare Part B Drug Payment Model DemonstrationMedPAC Votes for Sweeping Revisions to Medicare Part DMedPAC Meeting on Part B Drug Payment Policy
Source: Policy and Medicine - April 17, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
CBO Releases Report On Private Health Insurance Premiums And Federal Policy (Updated)
Implementing Health Reform (February 16 update on quality measures). On February 16, 2016, the Centers for Medicare and Medicaid Services (CMS) released a set of core quality measures developed by The Core Quality Measure Collaborative. The Collaborative includes representatives from CMS, America’s Health Insurance Plans, the National Quality Forum, national physician groups, employers, and consumers. The core quality measures apply to accountable care organizations, patient centered medical homes, and primary care (21 measures); cardiology (30 measures), gastroenterology (eight measures), HIV and Hepatitis C (eight mea...
Source: Health Affairs Blog - February 12, 2016 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage Affordable Care Act Physicians premiums Private Health Insurance quality measures Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 15
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Source: Cardiophile MD - February 9, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
The Value And Limits Of Economic Evaluation In Policy Analysis
Health care resources, no matter how represented, are ultimately finite. Trade-offs occur as spending in one area means that those same resources are unavailable to fund another program. In spite of this, U.S. policymakers remain reluctant to engage in conversations that even hint at “rationing.” This reluctance is evidenced by the fact that the Patient-Centered Outcomes Research Initiative (PCORI) is legislatively forbidden to include cost-effectiveness ratios in its comparative effectiveness evaluations.
Diametrically opposed to the U.S. system, most other countries embrace cost-effectiveness, whereby competing progr...
Source: Health Affairs Blog - September 1, 2015 Category: Health Management Authors: Victoria Phillips Tags: Costs and Spending Drugs and Medical Technology Equity and Disparities Global Health Health Policy Lab Medicaid and CHIP Payment Policy Population Health Quality Comparative Effectiveness cost-effectiveness health economics heart d Source Type: blogs
Praluent, the Next Expensive "Game Changer," Blockbuster," "New Hope," - But Not Yet Shown to Benefit Patients
ConclusionsThe NEJM study was accompanied by an editorial by Stone and Lloyd-Jones(2) which documented that drugs previously shown to lower cholesterol were never proved to do any good for patients, and concluded,it would be premature to endorse these drugs for widespread use before the ongoing randomized trials, appropriately powered for primary end-point analysis and safety assessment, are available. After an FDA advisory committee recommended approval of aliromucab and another PCSK9 inhibitor in June, 2015, John Mandrola entitled a Medscape article,Dear FDA: Resist the Urge on PCSK9 DrugsHis reasons included lack o...
Source: Health Care Renewal - August 5, 2015 Category: Health Management Tags: aliromucab evidence-based medicine health care prices manipulating clinical research PCSK9 inhibitor Praluent Regeneron Sanofi-Aventis Source Type: blogs
Entresto: Blockbuster, or Just Over Hyped? - Whatever, It Will Cost $4500 a Year
The newest drug for congestive heart failure, Entresto, a fixed combination of valsartan and sacubitril, has just hit the market at an elevated price. Like other drugs recently introduced as blockbusters, the high price does not seem clearly justified by clinical evidence about the drug's benefits and harms. Questions Raised by the One Big Published Controlled Trial Last year, we discussed the hoopla around a study of a new drug for congestive heart failure (CHF),(1) a fixed combination of valsartan and sacubitril. Also, on the now defunct CardioExchange blog, Dr Vinay Prasad discussed the same study (look her...
Source: Health Care Renewal - July 30, 2015 Category: Health Management Tags: CHF clinical trials Entresto evidence-based medicine manipulating clinical research Novartis sacubitril Source Type: blogs
An update on cycling and writing and video (gulp)
Hi all,
Things have changed for me. I have taken on a larger role at theheart.org | Medscape Cardiology. This means I have less time for original posts here.
I write and read a lot more, though. Almost every day. Writing has morphed into what cycling was: a source of contentment. It used to be that if I had a good workout, I felt good during that day. Now I get those same sensations from writing.
I still exercise but its place in my self-esteem bucket is smaller. Except last Tuesday night during the local “ride,” I was dropped out of a break because of an asthma attack. That sucked. But I redeemed myself last n...
Source: Dr John M - April 8, 2015 Category: Cardiology Authors: Dr John Source Type: blogs
