“Population genomic screening, which was envisioned almost 20 years ago with the publication of the draft human genome sequence, is recognized by the Centers for Disease Control and Prevention (CDC) as having notable potential to improve public health. In 2014, the CDC’s Office of Public Health Genomics designated Tier 1 genomic applications as those with evidence-based guidelines and recommendations to prevent morbidity and mortality associated with genetic risk. The initial 3 autosomal dominant conditions assigned to Tier 1—Lynch syndrome (LS) (high risk for colorectal cancer [CRC]), hereditary breast and ovarian cancer syndrome (HBOC), and familial hypercholesterolemia (FH)—cause a high lifetime … Read More
All posts by Anupam
Excerpt – “When we started in 2010, we were appropriately concerned that genetic engineering would create so-called Frankenstein cells that would be uncontrollable,” [professor at the University of Pennsylvania and a CAR-T pioneer Carl] June said. “There were lots of regulatory issues put in that has slowed research. But 11 to 12 years in, more than 20,000 people treated, and it’s never happened — the Frankenstein cell turned into a CAR-T tumor hasn’t happened. Autologous cells are safe, they don’t need to be regulated as in experimental, early stage by the FDA.” [..] Innovation is needed in the CAR-T field, … Read More
“Commensurate with the rise in telehealth has been a proliferation in publications assessing the cost, experience, efficiency, safety, and unintended consequences of telehealth. Many publications aim to answer the “Goldilocks question”: what is the right amount of telehealth that optimizes its benefits while minimizing potential problems? The right dose of telehealth needs to balance (1) concerns by payers and policy makers that it will increase cost and cause unintended consequences (eg, misdiagnosis or duplicative care) and (2) the desire of its proponents who want to allow clinicians to use it as they see fit, with few restrictions. [..] To date, … Read More
The pandemic and the need to respond remain. “ending the emergency doesn’t mean that the world has fully addressed the problems that made this an emergency. Global vaccine distribution remains wildly inequitable, leaving many people susceptible to the virus’s worst effects; deaths are still concentrated among those most vulnerable; the virus’s evolutionary and transmission patterns are far from predictable or seasonal. Now, ending the emergency is less an epidemiological decision than a political one: Our tolerance for these dangers has grown to the extent that most people are doing their best to look away from the remaining risk, and will … Read More
As antibiotic resistance spreads, bacteriophages could help avert a crisis “Antibiotics are vital to modern medicine. [..] Life expectancy would drop by a third if they did not exist. But after decades of overuse their powers are fading. Some bacteria have evolved resistance, creating a growing army of “superbugs” against which there is no effective treatment. Antimicrobial resistance is expected to kill 10m people a year by 2050, up from around 1m in 2019. [..] Microbiologists have known for decades that disease-causing bacteria can suffer from illnesses of their own. They are susceptible to attack by bacteriophages (“phages” for short): … Read More
“the American Medical Informatics Association, with seed funding from the National Library of Medicine, formed a group under the moniker of 25 × 5 to reduce clinician documentation burden by three-quarters during the next 5 years. A workshop in 2022 allied with the 25 × 5 initiative identified 6 major EHR issues: Based on those discussions and our professional observations, 4 issues emerged as most salient and 3 as most actionable. The continued lack of nationally used unique personal safety identifiers for health as originally mandated in the HIPAA (Health Insurance Portability and Accountability Act) in the mid-1990s presents a continuing threat to privacy, … Read More
“Abstract: Health insurance coverage in the United States is highly uncertain. In the post-Affordable Care Act (ACA), pre-COVID United States, we estimate that while 12.5% of individuals under 65 are uninsured at a point in time, twice as many—one in four—are uninsured at some point over a 2-y period. Moreover, the risk of losing insurance remained virtually unchanged with the introduction of the landmark ACA. Risk of insurance loss is particularly high for those with health insurance through Medicaid or private exchanges; they have a 20% chance of losing coverage at some point over a 2-y period, compared to 8.5% … Read More
“Tens of millions of Americans are suffering pain. But chronic pain is not just a result of car accidents and workplace injuries but is also linked to troubled childhoods, loneliness, job insecurity and a hundred other pressures on working families. [..] [..] cluster of tightly woven problems that hold back our people and our country: childhood trauma, educational failure, addiction, mental health issues, homelessness, loneliness, family breakdown, unemployment — and, we increasingly recognize, physical pain. “People’s lives are coming apart, and this leads to huge increases in physical pain,” said Angus Deaton, a Nobel Prize winner in economics who with … Read More
“More than five decades after the introduction of CABG and four decades after the introduction of PCI into clinical practice, the procedural and long-term outcomes of the two revascularisation methods are now well characterised. Although technological improvements will continue to increase their safety and efficacy, the relative advantages and disadvantages of the two interventions will probably remain substantially unchanged. A limitation of available data is that they are from prevalently young, White, male, HIC [high-income countries] populations. The results of coronary revascularisation in women, non-White racial and ethnic groups, older adults, and LMICs [low- and middle-income countries] require further and … Read More
“A new Washington state law will require companies to receive a user’s explicit consent before they can collect, share, or sell their health data. Washington Governor Jay Inslee signed the My Health, My Data bill into law on Thursday, giving users the right to withdraw consent at any time and have their data deleted. The law should help shield users’ health data from the companies and organizations not included under the HIPAA Privacy Rule, which prevents certain medical providers from disclosing “individually identifiable” health information without consent. The HIPAA Privacy Rule doesn’t cover many of the health apps and sites that collect medical data, … Read More