Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Physician Learns A Lot Doing AFib Research With No Funding

I learned a lot from putting together an abstract for a national heart meeting.

  • More than just learning how to e-submit, e-upload and e-print a large poster;
  • More than what t-tests and chi-squares measure;
  • More than learning that females respond differently to AF ablation;
  • And surely more than which coffee shop offers the best work place.

Putting this thing together showed me stuff: the process of discovery, it’s role in helping us be better doctors and the difficulties inherent in doing this kind of valuable research in our current system.

So of course…bloggers blog.

First: Many have asked why we bothered doing research? What’s the motivation? Money? Fame? A greater purpose?

It was none of these. Read more »

*This blog post was originally published at Dr John M*

Government Grants Support Meta-Analyses That Can Spawn Mega-Misinformation

It was another headline busting study this week: Pfizer Drug Tied to Heart Risks – a provocative title no doubt fed to the media from the publisher: the Canadian Medical Association Journal. The study was yet another meta-analysis that culled the world’s literature in an attempt to determine if a trend could be found that might implicate Chantix as a causative agent for and increased incidence of heart disease in smokers.

On its surface, the study sounds authoratative, analyzing “14-double-blind randomized controlled trials involving 8216 participants” ranging in duration from “7 to 52 weeks.”

Never mind that 57% (25) of adverse events were weighted from one study and that none of the 14 studies had odds ratios that did not cross the unity line.

Despite this, the lead author concluded:

Despite the limitations of our analysis, our findings have potential regulatory and clinical implications.

Sorry, this is not correct. There are no clinical implications of this trial. Like all metanalyses, meta-anaylses simply cannot determine cause and effect. (Note to main stream media: are you folks listening?!?)

That being said, there’s another concern I have Read more »

*This blog post was originally published at Dr. Wes*

Taking The Mystery Out Of Clinical Trials

About 10 days ago I appeared in Phoenix as a speaker at a regional education seminar put on by the Leukemia and Lymphoma Society. My topic was sharing my experience as a participant in a clinical trial. I was delighted to do so, as I feel that trial saved my life and restored me to good health.

I am hoping my words encouraged others to consider being in a trial. There are no guarantees of the result, but trials are always worth considering. Unfortunately, few patients do. That may limit their choices and certainly holds back research that could help others. What a shame.

Clinical trials are defined as human subject research. It is through these trials that we determine if new drugs or devices can better serve patients than what is currently available. Clinical trials are available for almost every disease — although finding these trials can be challenging. Read more »

*This blog post was originally published at Andrew's Blog*

Bias In Clinical Research Is Inevitable

DrRich has said many times that clinical science is among the least exact of the sciences, and therefore, the results of clinical research are particularly susceptible to “spinning” by various interested parties, in order to yield the kind of results they would prefer to see.

Until recent times in American medicine, the parties who have been most interested in spinning clinical research have been the people who run drug companies and medical device companies (who need clinical research which supports the use of their products), and the medical specialists (who are more likely to be paid for performing medical procedures that are supported by clinical research). In writing about such data-spinning abuses, DrRich has particularly targeted his own Cardiology Guild, but only because he knows and loves cardiologists the best. He suspects that other specialists are doing exactly the same thing.

While DrRich has used reasonably gentle humor (laced, to be sure, with sarcasm and irony) to criticize doctors and their industry collaborators for twisting clinical data to their own ends, others have expressed the same concerns in much more indignant terms, and have threatened to employ professional sanctions, civil and criminal penalties, and everlasting perdition, to curtail such behaviors. Read more »

*This blog post was originally published at The Covert Rationing Blog*

The Mystery Of Alcoholics Anonymous

To further emphasize my admiration for superb sci/med/health writing, I wish to add another writer to my growing blog category of “Journalists, Awesome.”

Via my drug abuse research colleague, DrugMonkey, my attention was drawn to a new Wired magazine article by Brendan I. Koerner entitled, Secret of AA: After 75 Years, We Don’t Know How It Works. I strongly recommend this long-form article for anyone in the field of substance abuse and dependence research, psychology and general clinical research, students of excellent science writing, alcoholics and their family members, and anyone who thinks that good science writing no longer exists.

I don’t want to influence your views any further, other than to say that since I poured my first whiskey and water for my grandmother when I was around 7, I’ve had a longstanding interest in why Alcoholics Anonymous helps so many alcohol-dependent folks kick the disease for decades while others trying the approach continue to crash and burn or otherwise abhor its very tenets, especially the “Higher Power” focus. The reader comments there also reflect this bipolar view of the unorganized organization. Read more »

*This blog post was originally published at Terra Sigillata*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »