Venture-capital guy Bruce Booth has a provocative post, based on experience, about how reproducible those papers are that make you say, “Someone should try to start a company around that stuff”:
The unspoken rule is that at least 50% of the studies published even in top tier academic journals – Science, Nature, Cell, PNAS, etc… – can’t be repeated with the same conclusions by an industrial lab. In …
Bias in top tier academic journals
In concert with sanitation and clean water supplies, vaccination has been the most cost effective means of preventing infectious diseases.
Most vaccines have been inexpensive, easy to administer (albeit objected to by the recipient’s arm!), safe and effective. From when I was a child until today the number of new vaccines has multiplied dramatically. This will only continue at an accelerated pace in the coming years. In the future many …
The future of vaccines for infectious diseases
I had an interesting exchange with one of our nurses recently about a long-term patient of ours.
The e-mails went something like this:
Got a fax from —-’s insurance that his Lipitor won’t be covered anymore. They will cover simvastatin, lovastatin, and pravastatin. Let me know what you want to do.
Charlie
He’s on darunavir, and all three of those statins are contraindicated because of drug-drug interactions. Rosuvastatin?
Paul
Checked with them — rosuvastatin needs …
How switching from brand name drugs to generics is sometimes absurd
All thoughtful physicians I know consider the historical theory and philosophy of homeopathy to be rubbish, balderdash, preposterous, BS, or, politely, NOT PLAUSIBLE; thus, not even worth testing for safety and efficacy.
Then, why, when one asks Mr. Google by entering … Homeopathy … and clicking, does one receive 9.9 million results?
And, why does the National Health Service of the U.K. continue to fund homeopathic hospitals, clinics, and treatments?
And why are …
The accidental genius of homeopathy thrives
What a blessing and a curse it must have been to practice medicine fifty years ago.
Most internists had only about twenty or so medications that they used regularly. It was a curse not to have effective medications to treat many common ailments but somewhat of a blessing not to have the modern medical nightmare of having patients on 15-20 chronic medications with all the logistical problems of keeping track of …
Medication reconciliation brings the ER back to 1960
by Jack Cain
In the United States, there is a heated debate at all levels over the increased use of narcotic pain relievers, especially as part of a long-term treatment regimen for chronic pain. Part of that debate is fueled by the pejorative use of the term “drug” instead of “medication” in conjunction with the legal prescribing, dispensing and consumption of these substances.
Bias is …
Why the word “drug” promotes a public bias in chronic pain treatment
It was 1978 and I was a third year medical student when my friend was slowly dying of metastatic breast cancer.
Her deteriorating cervical spine, riddled with tumor, was stabilized by a metal halo drilled into her skull and attached to a scaffolding-like contraption resting on her shoulders. Vomiting while immobilized in a halo became a form of medieval torture. During her third round of chemotherapy, her nausea was so …
The unintended consequences of medical marijuana
Embryonic stem cells are present after a fertilized egg divides for two or three days. They have the seemingly miraculous ability to turn into any of the tissue types in the body—whether brain neurons, beating heart cells, bone, or pancreatic islet cells. It is important to understand just where these cells come from.
Those used in science are …
Cultural attitudes influence the benefit from stem cell therapy
The placebo effect is somewhat of a mystery in modern medicine. Wikipedia calls a placebo “a sham or simulated medical intervention.” Commonly, when we refer to a placebo we mean dummy-drugs, but the placebo effect has further applications in medicine, such as sham surgery or false information.
Now, a great video produced by an Australian journalist from the ABC Science Show has compiled …
Implications of the placebo effect for physicians
Comparative effectiveness research — investigations that determine which treatments are best — has attracted attention in the health care debate. Critics charge that these studies are designed to restrict choice. The Center for Medicine in the Public Interest released a report that suggested that they would stifle innovation. Often they are framed as studies to support efforts to keep useful but expensive …
Niaspan and how comparative effectiveness research was done well
In a thoughtful posting in the New York Times, Dr. Pauline Chen, a well respected observer of the doctor-patient relationship, points out an ethical dilemma that faces cancer researchers working in drug development conducting early phase (I) new drug studies. Ethicists have identified that patients in these studies often have unrealistic optimism about their personal outcomes despite …
Unrealistic optimism in early phase new drug studies
Stem cells will usher in the era of regenerative medicine, allowing the creation of cells, tissues and organs to treat or cure diseases and injuries. This will be a fundamental alteration in our approach to medical care and a transformational medical megatrend. And it will be very “personalized medicine” to provide the specific individual with custom tailored new cells and tissues for organ repair or …
How stem cells will impact medical care
Omega-3 fatty acids (more properly called “n-3 fatty acids”) are a group of naturally occurring fat molecules.
They are found mainly in fish and other marine-derived oils, but some can also be extracted from plants. Omega-3′s are currently very popular, but the evidence for their usefulness isn’t so clear. A recent study failed to show any benefit in preventing dementia. A new study out …
Omega 3 fatty acids and the prevention of heart disease
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Herpes zoster (or shingles) is caused by the same virus that causes chicken pox.
Zoster increases in incidence with advancing age. It is estimated that over 1 million Americans get shingles annually with the resulting acute discomfort and often chronic pain thereafter. A vaccine was introduced by Merck in 2006; the initial studies of 38,546 patients indicated …
Almost everyone over the age of 60 should receive the zoster vaccine
Holy crap.
My medication did not arrive today.
How can this possible be happening? Do they not know this medication is not optional?
Let me recap. I called over a week ago for a refill. I am only allowed (by my insurance) to use the (non-local) specialty pharmacy that they own for this medication. They told me my medication would arrive yesterday, which was the day after I’d use my last …
How a specialty pharmacy denies a physician his medication
Genomics promises to fundamentally change much of medical care. But the ultimate value of this new understanding of basic human biology will in many cases come with fits and starts. The saga of belimumab (Benlysta) and Human Genome Sciences (HGS) is illustrative.
Systemic lupus erythematosus (SLE) occurs in somewhere between 300,000 and 4 million Americans according to the …
Belimumab (Benlysta) to treat systemic lupus erythematosus (SLE)
Actually I’ll take a Ford Shelby GT500 Convertible, thank you very much …
Today’s stream of socially conscious thinking comes to you after having feasted on a tasty lunch paid for by a drug company (and no, it wasn’t Pfizer).
It has spurred me to contemplate the ever increasing scrutiny paid to the relationship between the pharmaceutical industry …
Lunch money Pharma spends on physicians
There’s been a lot of talk in the past year about how we need to re-think the role and profile of the pharmaceutical/biotech sales rep.
This dialogue needs to happen, given the trends that are rapidly shrinking the size of sales forces. Of course, when you poll the doctors, they are going to focus on the need for greater depth of clinical knowledge. …
How business will affect pharmaceutical reps
The Wall Street Journal reported that a study of prescription patterns in 2009, conducted by IMS Health, showed that 25% of children in the US were on regular medication.
IMS Health is a firm that provides “marketing intelligence” to pharmaceutical companies. The firm’s job is to keep the $800 billion per year global pharmaceutical industry on a continued pattern of growth. Hopefully these consultants accomplished something quite different this week. Hopefully they …
One in four children in the United States are on chronic medications
Little more than a decade ago, most people had never heard of the word genomics; today it is used frequently. It is indeed a revolutionary science that is and will transform medical research and medical care. To better understand how this new science will markedly change medicine, it is convenient to consider it through a few categories:
How genomics can help doctors target drug therapy
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