Excerpt – For a company that’s been around for more than a decade, it seems to have appeared out of nowhere. Athletic Greens aggressively advertises (and sells) only one product: AG1, a moss-toned powder that costs $99 for a 30-serving bag and claims to be “all you really need, really.” But it isn’t a meal replacement nor is it a pre- or post-workout drink, as the brand’s name implies. AG1 promises “75 vitamins, minerals, whole-food sourced superfoods, probiotics and adaptogens” in one scoop. The ingredient list is biblically long and rife with parentheses, its components categorized by wellness buzzwords: “Alkaline, … Read More
All posts by Anupam
“US data from the period 1996–2016 are now available on health care spending by cause from the Disease Expenditure Project (DEX) and on DALYs [disability-adjusted life-years] by cause from the Global Burden of Disease (GBD) Study 2017. DALYs are the sum of years of life lost due to premature mortality, as well as years lived with disability among people living with a given cause. Intuitively, DALYs are a measure of burden, and therefore the goal of health systems is to avert DALYs. A decrease in DALYs is a measure of health gain referred to as DALYs averted. [..] We estimated … Read More
David H Jiang et al. published an article in Health Affairs last month arguing for a set of diabetes quality measures that are actually linked to optimal diabetes health. Composite measures that include “all-or-nothing” components will incentivize providers to focus on patients who are most likely to achieve the measure rather than those who would benefit the most clinically. This would also adversely affect patients with socioeconomic barriers to optimal health, as those patients are more likely to have multiple unmet measures or not meet a measure that is more difficult to achieve (e.g., smoking cessation). A more equitable approach … Read More
Excerpt – In the early 2000s, advances in the ability to detect the activity of genes in various tissues revealed that the cell clocks are organized into separate organ-level clocks representing every physiological system: There’s a skin clock and a liver clock and an immune-system clock; there’s a clock for the kidney, heart, lungs, muscles and reproductive system. Each of those clocks syncs itself to the central clock in the brain like an orchestra section following its conductor. But those sections also adjust how and when they perform based on guidance they receive both from the environment and from one … Read More
“as Vox reporter Sara Morrison wisely observed, “[D]eleting a period tracker app is like taking a teaspoon of water out of the ocean.” So much data is collected about people these days that removing a small amount of data from an app or a phone is not going to erase all traces of a newly criminalized activity. The Electronic Frontier Foundation notes that pregnant people are far more likely to be turned over to law enforcement by hospital staff, a partner or a family member than by data in an app —and that the types of digital evidence used to … Read More
“While the medical risks of SMA [self-managed] may be few, the legal risks for people attempting SMA may be significant. Although only three states currently have laws explicitly criminalizing SMA, almost half of U.S. states have at least one law in place that could be used to prosecute people attempting or assisting with SMA. These policies include legislation explicitly banning SMA, criminalizing harm to the fetus, and criminalizing abortion. For those who have been targeted with criminalization for SMA, many came into contact with law enforcement following interactions with healthcare professionals. However, to date, legal experts are unaware of any … Read More
“A new review paper, published Monday in Nature Biotechnology, explores the wide range of apps rolled out to combat the pandemic [..]. Here are four questions that still need to be answered about how apps can combat Covid. [1] How do you get broad swaths of the public to adopt an app? “Contact tracing had a lot of problems,” said [physician and Director of Digital Medicine at Scripps Research Translational Institute and a co-author of the new paper Jay] Pandit. [..] The initial goal for the U.K. National Health Service’s Covid-19 app was to reach a 60% adoption rate. [..] … Read More
“Explanatory trials evaluating the efficacy and safety of adding a new drug or device to current clinical care (A vs A-plus) are traditionally powered to detect the smallest difference in clinical outcomes that would justify incorporating the new treatment into care, considering its added risks, costs, and burdens. For example, the median minimal clinically important difference in mortality targeted by acute care trials has been approximately 8%, implying that smaller differences in mortality might not justify incorporation of the new treatments into care. These types of trials ask, “is this new treatment better than current care by enough to offset … Read More
“As [health economist Jonathan] Kolstad explained, much of the insurance–industrial complex is built on the assumption that profit-seeking physicians will always consume excess resources unless barriers are put in their way. Formularies and prior authorizations, for example, create adversarial relationships between insurers and physicians, who may bristle at having nonphysicians dictate what’s best for their patients. Contributing to this tension is our dependence on randomized, controlled trials to tell us the “right” way to treat any one patient on the basis of average treatment effects in large study populations. The resultant technocratic approach to quality often fails to account for … Read More
“[Kaiser Health News chief Washington correspondent Julie Rovner:] So Covered California operates very differently from most of the other state-based marketplaces. And, as a result, it has done a better job covering more people at lower premiums than I think any other state, right? [Executive Director of Covered California, the largest state-run ACA marketplace, Peter Lee:] Absolutely. Well, lower premiums relative to where we start. California’s an expensive state, but our premiums in California in the last seven years went up about 45%. Nationally, they went up about 80%. So we’ve seen premiums increase dramatically. But you’re right, we’ve done … Read More