“In 2021, I interviewed Ted Chiang, one of the great living sci-fi writers. Something he said to me then keeps coming to mind now. “I tend to think that most fears about A.I. are best understood as fears about capitalism,” Chiang told me. “And I think that this is actually true of most fears of technology, too. Most of our fears or anxieties about technology are best understood as fears or anxiety about how capitalism will use technology against us. And technology and capitalism have been so closely intertwined that it’s hard to distinguish the two.” [..] We are talking so much … Read More
All posts by Anupam
Lessons in longevity from Seventh-day Adventists Excerpt – “Seventh-day Adventists believe God made the body as a temple to hold the soul,” says Hans Diehl, a best-selling author on health and nutrition, and a lifelong Adventist. [..] “We believe that taking care of the body is proper. It’s honouring God,” he says. Devout followers eat mostly plants—vegetables, fruits, nuts, legumes and whole grains. Some eat animal products, but most do so sparingly. [..] One Seventh-day Adventist community, Loma Linda, California, has been dubbed a “Blue Zone”—an area of the world with a large share of centenarians—by two researchers, Michel Poulain … Read More
“The PHQ-9 became a means for time-crunched primary care doctors, under pressure to see more and more patients in shorter appointments, to dole out prescriptions with barely a conversation. Despite its prevalence, data suggesting that PHQ-9 has actually improved outcomes is ambiguous at best. Meanwhile, mental health outcomes for patients are dismal and only getting worse, with depressive symptoms and suicide climbing ever higher. A combination of good intentions and straightforward business savvy lies behind the PHQ-9. Pfizer invested hundreds of thousands of dollars in its development [..]. The company naturally hoped its investment would pay off with increased Zoloft … Read More
I have been framing the future of health care as diagnosis through face-to-face interactions for making a diagnosis (and getting the patient to buy-in to the treatment plan) and ongoing maintenance or surveillance using telemedicine with supporting technologies. This article has forced me to reconsider how we might deploy artificial intelligence to support patients and clinicians during the triage and diagnosis stages of a medical journey. “Symptom checkers serve two main functions: they facilitate self-diagnosis and assist with self-triage. They typically provide the user with a list of potential diagnoses and a recommendation of how quickly they should seek care, … Read More
“The twenty-two-member council is a nonpartisan, multidisciplinary expert working group under the leadership of cochairs William Frist [former US Senate majority leader] and Margaret Hamburg [former commissioner of the Food and Drug Administration]. This report contains the council’s recommendations. [..] The goal of the recommendations in this report is to achieve higher-value health care spending and growth in the US. The mechanism for achieving this goal involves four levers: The council examined literature and received input from experts in its inquiry into drivers of spending and growth that met the following criteria: a meaningful amount of money is potentially at … Read More
“[Introduction] [..] MyHEART is a multicomponent, patient-centered, and theoretically based; it includes 4 evidence-based self-management components: (1) telephone-based health coaching with adult education specialists to teach and monitor self-management skills, (2) documentation of coach-patient telephone contacts, (3) individualized hypertension education materials, and (4) home BP monitoring. [..] The primary aim of this study was to evaluate the effect of MyHEART on clinical outcomes, ie, the change in systolic and diastolic BP (primary) and hypertension control (secondary) after 6 and 12 months, compared with usual care. [..] [Methods] [..] The inclusion criteria included (1) aged 18 to 39 years at enrollment; … Read More
“The perpetual diet wars between factions promoting low-carbohydrate, keto, paleo, high-protein, low-fat, plant-based, vegan, and a seemingly endless list of other diets have led to substantial public confusion and mistrust in nutrition science. While debate rages about the relative merits and demerits of various so-called healthy diets, less attention is paid to the fact that otherwise diverse diet recommendations often share a common piece of advice: avoid ultra-processed foods. [..] The rise in obesity and type 2 diabetes prevalence occurred in parallel with an increasingly industrialized food system characterized by large-scale production of high-yield, inexpensive, agricultural “inputs” (primarily corn, soy, … Read More
Select Key Findings Policy Issues Debating the Future: Does H@H Save Costs and Improve Patient Care? “[..] Recent studies of cost savings from H@H programs range from 20 percent (Reese 2021) to 40 percent (Brigham and Women’s Hospital in Boston, Levine et al. 2020). But these findings are not generalizable as they are based entirely on single case studies of highly structured programs involving small samples of very carefully selected patients. For example, the study of Brigham and Women’s program examined 91 adults who were admitted to the hospital’s ED and randomly assigned to the hospital vs home for treatment. [..] While … Read More
“[..] spending on hospital care makes up the largest single component of personal health care spending, an estimated 39 percent of the total in 2023, compared to 24 percent for physician and clinical services and 10 percent for prescription drugs. National spending on hospital care is projected to exceed $1.5 trillion in 2023, and is expected to grow by about 5.6 percent per year over the coming decade (a rate likely to significantly exceed general inflation). Much of this growth is driven by consolidation among hospitals and health systems, which then use their size and local market power to demand … Read More
“Screening colonoscopy has been shown to reduce colorectal cancer (CRC) incidence and mortality by enabling detection and removal of precancerous lesions. However, the available evidence about the optimal screening interval is limited. [..] More targeted screening offers would potentially reduce the burden of testing and demand of capacities and costs associated with colonoscopy, thereby also counteracting the frequently reported overuse and underuse of screening examinations in considerable proportions of the population. [..] Anonymized registration of screening colonoscopy findings and the use of the anonymized data for program evaluation by the Central Research Institute of Ambulatory Health Care in Germany is … Read More