“In the observational study [published in the European Heart Journal on 2022.8.7], researchers analyzed health data from 3,680 people with chronic kidney disease for nearly 10 years. Those with elevated levels of aldosterone, a crucial, salt-conserving hormone made by the adrenal glands, which sit atop the kidneys, had a higher risk of serious kidney disease progression during the study period: they are more likely to lose half their kidney function, start dialysis, or develop end-stage kidney disease. [Excerpts of an interview with Ashish Verma, kidney specialist and assistant professor of medicine at Boston University School of Medicine:] [Verma:] We found … Read More
All posts by Anupam
“[Nir] Barzilai, the head of the Institute for Aging Research at the Albert Einstein College of Medicine, and scientific director for AFAR — the American Federation for Aging Research — has for more than a decade been leading the charge to test the idea of using drugs to extend human healthspan. In 2013, he and two other researchers got a grant from the National Institutes of Aging to develop a roadmap to conduct, for the first time in history, a clinical trial that targets aging. They planned to test metformin, a drug that had been approved in the ’90s for … Read More
“Other industries, like travel, banking, entertainment, publishing, retail et al have built successful business models on the premise that their consumers—armed with needed information—engage directly in decisions and actions consonant with their self-interests. In so doing, fewer workers are required, replaced by technologies and online tools that are customized to their individual needs and preferences. In healthcare delivery circles, self-care is dismissed because diseases and treatments are deemed too complicated thus “consult your doctor” or “visit the ED” are the default. That’s the problem: the health system is staffed to the presumption that most consumers are incapable of acting rationally … Read More
“The concept of value-based payment became widespread among U.S. health policymakers and analysts during the 2000s. It collectively refers to interventions that offer doctors and hospitals financial incentives that, in theory, induce them to improve both components of health-care value — cost and quality — without generating the hostility provoked by managed care insurance companies during the HMO [health maintenance organization] backlash of the late 1990s. [The Center for Medicare and Medicaid Innovation reviewed 54 models of value-based payment. Only four were certified to be expanded:] The Home Health Value-based Purchasing Model demonstration cut Medicare spending by 1% with mixed … Read More
“recent research demonstrates that hospital mortality rates can vary by a factor of 3 to 1 and health plans by 4 to 1, and publicly available quality ratings of health care plans and services do not correlate well with outcomes. What is more, lack of transparency among health plans and provider organizations prevents purchasers from making informed choices based on relative quality of provider organizations and health plan networks. Currently available outcomes data are limited to Medicare fee-for-service. [..] For at least five decades, the public health care conversation has focused primarily on rising costs, while the US has lagged … Read More
“After more than five decades of federal service under seven presidents, Anthony Fauci says he’s leaving by the end of President Joe Biden’s term. [..] his assessment, that we’ll live with Covid-19 for many years to come, is a startling admission from the longtime infectious disease expert who said the country could flatten the curve and achieve herd immunity, first through social distancing and then vaccination. [..] If called to testify [to Congress], Fauci will stress the importance of vaccines and boosters, but acknowledge there may never be a definitive moment when the country can claim victory over an evolving … Read More
“The existing encryption standards that underpin just about every online exchange of information are a bit of gnarly mathematics designed to be well-nigh impossible for today’s computers to crack without just the right arithmetical key. But NIST’s scientists have not been pondering today’s machines. They worry about a coming era of quantum computers. These exploit the weirdness of the quantum world to perform calculations in fundamentally different ways from those used by conventional computers. This confers an enormous theoretical advantage in a small number of problem types—including identifying a large number’s prime factors (numbers, divisible only by themselves and one, … Read More
“while the U.S. lags behind in adopting value-based agreements, many policymakers are realizing that value-based pricing can be an important, viable solution to the high and rising expenditures that payers lay out for prescription drugs. Developing value-based agreements has never been easier. A large number of value-based agreements are now available and can be used to help payers, manufacturers, and providers develop new ones appropriate to their specific situations. [..] Here are four scenarios for which I believe value-based pricing is appropriate. When expected outcomes for a new treatment are clear and objectively measurable. [..] Treatments with clearly defined, meaningful, … Read More
“During the diagnostic process, it is not unusual, or incorrect, for working diagnostic labels to change as new information is acquired and as the patient’s condition evolves both naturally and in response to interventions. The language used to communicate risk of disease and uncertainty about diagnosis is not uniform and may be overly ambiguous (eg, “cannot rule out,” “consider the possibility”). Thus, attempts to standardize and measure diagnostic processes should avoid unrealistic expectations or overzealous judgments to be both accurate and fair in judgment (eg, driving performance not feasible under the conditions at the time, or expecting actions predicated on … Read More
“The proposed rule would establish an Additional Condition for Nonprescription Use [ACNU] category for prescription products the FDA says consumers currently can’t appropriately self-select and use without a prescription. This is somewhat analogous to the Risk Evaluation and Mitigation Strategies, which allow certain prescription drugs with potential safety issues to be approved for patients with additional requirements for use, such as verifying a negative pregnancy test for a drug that can cause birth defects or requiring a monthly lab test before the drug can be dispensed. With an ACNU, a drug company must meet several FDA-approved conditions to ensure that … Read More