The online anti-vaccine movement in the age of COVID-19

“A new report by the Centre for Countering Digital Hate (CCDH) has lambasted social media companies for allowing the anti-vaccine movement to remain on their platforms. The report’s authors noted that social media accounts held by so-called anti-vaxxers have increased their following by at least 7·8 million people since 2019. “The decision to continue hosting known misinformation content and actors left online anti-vaxxers ready to pounce on the opportunity presented by coronavirus”, stated the report. [..] The CCDH calculated that the anti-vaccine movement could realise US$1 billion in annual revenues for social media firms. As much as $989 million could … Read More

This Overlooked Variable Is the Key to the Pandemic: It’s not R.

Excerpt – many people have heard about R0—the basic reproductive number of a pathogen, a measure of its contagiousness on average. But unless you’ve been reading scientific journals, you’re less likely to have encountered k, the measure of its dispersion. The definition of k is a mouthful, but it’s simply a way of asking whether a virus spreads in a steady manner or in big bursts, whereby one person infects many, all at once. After nine months of collecting epidemiological data, we know that this is an overdispersed pathogen, meaning that it tends to spread in clusters, but this knowledge … Read More

Adjuvant or early salvage radiotherapy for the treatment of localised and locally advanced prostate cancer: a prospectively planned systematic review and meta-analysis of aggregate data

“It is unclear whether adjuvant or early salvage radiotherapy following radical prostatectomy is more appropriate for men who present with localised or locally advanced prostate cancer. We aimed to prospectively plan a systematic review of randomised controlled trials (RCTs) comparing these radiotherapy approaches. [..] We identified three eligible trials and were able to obtain updated results for event-free survival for 2153 patients recruited between November, 2007, and December, 2016. Median follow-up ranged from 60 months to 78 months, with a maximum follow-up of 132 months. 1075 patients were randomly assigned to receive adjuvant radiotherapy and 1078 to a policy of … Read More

A global review of publicly available datasets for ophthalmological imaging: barriers to access, usability, and generalisability

“High-quality health data research and the development of ML [machine learning] models requires meaningful data at a sufficient scale. Such data undoubtedly exist. Most health institutions hold clinical imaging data at a scale ranging from tens of thousands to tens of millions of scans. However, these data are often inaccessible to researchers, even where there is an intention to make them available for research, because of barriers of access and usability. Barriers of access can include: governance barriers (difficulties in understanding and working through governance frameworks regulating data usage); cost barriers (there can be considerable overhead costs to datasets and … Read More

Oncology’s “Hockey Stick” Moment for the Cost of Cancer Drugs—The Climate Is About to Change

“During the active phase of treatment for a patient with cancer in Medicare’s Oncology Care Model, antineoplastic drug costs represented more than 50% of the total cost of care in 2018 and are expected to contribute nearly 70% of the total cost of active care by 2025 and more than 80% by 2030, 10 years from now. [..] Any solution that relies solely on one of the actors in the drug distribution and delivery system is doomed to failure because no one wants to be the “bad guy.” What is needed is a convener with power (likely the US federal … Read More

What drives health spending in the U.S. compared to other countries

“The United States spends significantly more on healthcare than comparable countries, and yet has worse health outcomes. Much of the national conversation has focused on spending on prescription drugs and administrative costs as the primary drivers of health spending in the U.S. [..] While it is true that many brand-name prescription drugs are priced higher in the U.S. than in peer countries, health spending data indicates that other spending categories – particularly hospital and physician payments – are greater drivers of health spending. [..] In 2018, the U.S. spent nearly twice as much per capita on health as comparable countries. … Read More

From Basic Science to Clinical Application of Polygenic Risk Scores: A Primer

“Genome-wide association studies have shown that common diseases are polygenic, ie, thousands of DNA variants contribute to risk, and most of these have very small effect. In spite of this complexity, it is now possible to estimate the degree to which an individual is at risk of common illnesses owing to their genetic makeup. The so-called polygenic risk scores (PRS) are generated from DNA taken from a saliva or blood sample with DNA variants measured using genotyping technologies that are inexpensive (< US $100 per person). From these data, PRS can be calculated for a wide range of diseases (by … Read More

Frequency and Outcomes of Preoperative Stress Testing in Total Hip and Knee Arthroplasty from 2004 to 2017

“The American College of Cardiology and American Heart Association (ACC/AHA) practice guidelines for perioperative cardiovascular evaluation for noncardiac surgery aim to improve the effectiveness of perioperative care, optimize patient outcomes, and improve resource use. The guidelines have consistently deemphasized preoperative cardiac testing prompted solely by the upcoming surgery in the absence of signs or symptoms that would warrant testing outside of the preoperative setting. [..] Using MarketScan inpatient claims data from 2003 to 2017, we selected patients according to International Classification of Diseases, Ninth Revision, Clinical Modification and International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-9-CM and ICD-10-CM, … Read More

How to Stop the Superbugs

“Superbugs are not a unique problem to COVID-19, of course; they already kill 35,000 Americans every year. If bacteria continue evolving to outwit antibiotics, however, the World Health Organization estimates they will become the leading global cause of death by 2050. [..] The ability of biotech upstarts to earn revenue clashes with the basics of evolutionary biology. Superbugs develop as bacteria accumulate mutations over time, forming strains that elegantly evade our existing antibiotic arsenal. The more consistently a bug goes up against one of our trusted antibiotics, the more likely it is to evolve to escape it. Accordingly, to prevent … Read More

Letter to the Editor: A Multifactorial Trial to Prevent Serious Fall Injuries

“In the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) study (July 9 issue), Bhasin et al. evaluated the effectiveness of individualized recommendations to prevent fall injuries. We find the lack of significant success with this strategy to be wholly unsurprising. Referrals or recommendations alone are insufficient to reduce falls. The STRIDE intervention successfully expanded the role of primary care providers to include fall-risk screening, assessment, and individualized care plans. It did not include any direct procedural interventions (e.g., exercise, medication management, home safety modifications, and vision care) or the necessary extensive support to ensure their receipt. [..] … Read More