The Industrial Medical-Letter-Writing Complex

“I am an unwilling, unwitting part of the Industrial Medical-Letter-Writing Complex, which pulls every clinician, every health worker, and every patient into its roiling, gasping vortex. It is the ever-hungry ghost. With a bottomless stomach and inky black eyes, it eats good intentions for breakfast, inhales reams of paper for lunch, and takes your sanity and humanity for its dinner. It laughs at boundaries, derides common sense. It matters not how long ago it was when I last saw the patient. It matters not if I have ever met them before. It matters not who made the form, or if … Read More

When They Couldn’t Get Benzos Anymore, Quitting Was Torture

The drugs treat disorders such as anxiety, panic attacks and insomnia, but stopping them abruptly can compound users’ symptoms and even endanger their lives. “Prescriptions for benzodiazepines like Xanax, Ativan and Valium have been trending down since 2016, in part because of doctors’ concerns. Even so, these medications are considered quick and efficacious, and they remain among the most commonly prescribed drugs in the country to treat conditions including anxiety and sleep disorders. In 2019, an estimated 92 million benzodiazepine prescriptions were dispensed in the United States, according to the Food and Drug Administration. Current guidelines recommend prescribing the lowest effective dose … Read More

Your A.I. Radiologist Will Not Be With You Soon

Experts predicted that artificial intelligence would steal radiology jobs. But at the Mayo Clinic, the technology has been more friend than foe. Excerpt – radiologists [..] are still in high demand. A recent study from the American College of Radiology projected a steadily growing work force through 2055. [..] in recent years, they [radiologists] have begun using A.I. [artificial intelligence] to sharpen images, automate routine tasks, identify medical abnormalities and predict disease. A.I. can also serve as “a second set of eyes.” “But would it replace radiologists? We didn’t think so,” said Dr. Matthew Callstrom, the Mayo Clinic’s chair of radiology, … Read More

Dollars Needed to Pay per Early-Detected Colorectal Cancer Case in Stool-Based Screening

“Objective: To compare screening costs per relevant target finding of CRC [colorectal cancer] screening (that is, CRC, advanced adenoma, or sessile serrated polyp ≥1 cm) for FIT [fecal immunochemical tests], MSDT [multitarget stool DNA tests (e.g., Cologard [Exact Sciences])], and N-G [next-generation] MSDT. Methods and Findings: [..] We summed the test costs for all participants, including costs for follow-up colonoscopies, and we divided those costs by number of participants with detected CRC or any advanced neoplasia (CRC, advanced adenoma, or sessile serrated polyp ≥1 cm). Furthermore, we calculated costs per additional early-detected CRC case or any advanced neoplasia with MSDT-based and … Read More

Debating the Risks and Benefits of Firearms in the US—Make the Other Side Panicky

“In the survey by Kleck and Gertz, more than 4% of gun-owning respondents reported a history of DGU within the previous 5 years. In this survey by Anestis et al, 8% of gun owners reported a lifetime history of DGU. Anestis et al. suggest approximately 489 000 DGU events of firing at or in the vicinity of a perceived threat occur each year. But combining with the number of people who either tell a threat about their firearm or show said firearm could raise that number to nearly 1.17 million annual DGU events. As these estimates fall within the previously reported range of … Read More

Application of Artificial Intelligence to Deliver Healthcare From the Eye

“The process of extracting systemic health insights by analyzing ocular data, including retinal images with AI, is referred to as oculomics. We define prescreening as a preliminary assessment of disease or potential disease in asymptomatic individuals. Healthcare From the Eye (Topcon Healthcare Inc) prescreening is utilization of retinal images to identify ocular or systemic disease or potential disease in asymptomatic individuals in a coordinated care system that includes eye care professionals (ECPs), primary care professionals (PCPs), and specialty care professionals using secure and responsible technology. It offers the potential for rapid, cost-effective, and accessible prescreening for a wide range of devastating diseases. Such … Read More

There Are Ways to Die With Dignity, but Not Like This

“Many patients and their families understandably wish to delay death. Others find the experience torturous: the ever-mounting costs, the endless cycle of interventions, the literal and figurative sterility of the hospital environment. Some doctors and nurses secretly wonder whether these practices are in the best interests of their patients. I am one of them. Some years ago, I began to advocate a revival of the medieval practice of ars moriendi, or the art of dying — a more accepting, less fearful, more community-based approach to the end of life. I believe that in many cases, it is wise to forgo … Read More

AI Is Not Your Friend

How the “opinionated” chatbots destroyed AI’s potential, and how we can fix it “Recently, after an update that was supposed to make ChatGPT “better at guiding conversations toward productive outcomes,” according to release notes from OpenAI, the bot couldn’t stop telling users how brilliant their bad ideas were. ChatGPT reportedly told one person that their plan to sell literal “shit on a stick” was “not just smart—it’s genius.” Many more examples cropped up, and OpenAI rolled back the product in response, explaining in a blog post that “the update we removed was overly flattering or agreeable—often described as sycophantic.” The … Read More

50 years of SSRIs: weighing benefits and harms

“In her book Chemically Imbalanced, Joanna Moncrieff, Professor of Critical and Social Psychiatry at University College London, synthesizes three key questions around the use of SSRIs [selective serotonin reuptake inhibitors]. First, on effectiveness, Moncrieff references a 2002 meta-analysis, which concluded that compared with placebo their effects were clinically negligible. However, other studies have shown effectiveness, including a 2018 meta-analysis in The Lancet, which concluded that all antidepressants are more efficacious than placebo in adults with a diagnosis of major depressive disorder, with odds ratios ranging between 2·23 and 1·37. Second, Moncrieff reviews the so-called serotonin hypothesis of depression. In 1975, … Read More

The Paradoxes of Feminine Muscle

In a new book, the author Casey Johnston argues that pumping iron helped her “escape diet culture.” But a preoccupation with strength can take many forms. Excerpt – “Ask a man why he lifts, and that man will lie to your face,” he [Lifter, classical music critic and author of “Swole: The Making of Men and the Meaning of Muscle” Michael Andor Brodeur] writes. “He will assert and insist that his ‘training’ is purely in service of health, fitness, strength, endurance, stamina, and whatever other buzzwords he can throw in to throw you off the trail.” It is somewhat déclassé … Read More