“Nearly 1 in 7 working-age US adults had experienced long COVID by late 2023, and socially disadvantaged adults were over 150% more likely to have persistent symptoms, two new studies find. [..] [First study] An age- and sex-adjusted model of 2022 data from 154,430 participants estimated that those vaccinated against COVID-19 had a 14% lower risk of protracted symptoms than their unvaccinated peers, but a fully adjusted model found no difference in risk. In comparison, a fully adjusted model of 2023 data from 220,664 respondents found a higher risk of long COVID among the vaccinated than the unvaccinated. Risk factors … Read More
“Primary care doctors now spend, on average, two hours a day filling out patients’ electronic health records. From 2009 to 2018, EHR length has increased by 60 percent. And yet most of this work is simply documentation, not problem-solving or reasoning. Why take doctors away from their patients or hire other teams of humans, like medical scribes, to transcribe and enter all this data, when AI can now do it instead? [..] they listen in on the conversation between a patient and physician, create a transcript, then organize the information from the transcript into the standard format doctors use, generating … Read More
From an editorial commenting on a recent prostate cancer screening trial using polygenic risk scoring to stratify patients: “After decades of undergoing epidemiologic study, prostate cancer remains an enigmatic disease; the only established risk factors are older age, family history of prostate cancer, and African ancestry (apart from uncommon cases among men with variants in the genes associated with hereditary breast cancer and the Lynch syndrome). Of interest, then, is a study of a polygenic risk score as an adjunct to screening, the results of which are reported by McHugh et al. in this issue of the Journal. Currently, screening … Read More
“Opioid overdose continues to be the leading cause of death due to injury in the US. Recent data from the Drug Abuse Warning Network estimated 882 000 emergency department (ED) opioid-related visits in 2023, a rate of 263 per 100 000 visits, with the highest rates among Black individuals (425 per 100 000). Access to treatment with medications for opioid use disorder, specifically buprenorphine, continues to be challenging for patients in active addiction, and these disparities by race are widening. [..] In many states, rural patients with opioid use disorder have worse outcomes than urban patients. Rural hospitals are also less likely to … Read More
“VBP [Value-Based Payment] was ushered in by the Affordable Care Act (ACA), but it is best understood as a rebranding of the larger managed care paradigm that took hold during the 1980s. Managed care delegates total-cost containment to insurance companies and large provider groups, tasking these private-sector “risk-bearing entities” to restrict spending. Spearheaded by health maintenance organizations, the rise of managed care promoted now-familiar utilization management tactics, such as prior authorization and narrow provider networks. It also promoted capitation or risk-based payments—what we call VBP today. Unlike FFS [fee-for-service], insurance companies would incentivize providers to manage utilization by making them … Read More
“In her tightly argued essay “Online Gambling and the Problem of Sin Markets,” [Rachel] Lu confronts a dilemma over the regulation of the market for so-called vices—sex, drugs, and gambling, with a primary focus on the latter. The obvious inclination—and the trend that seems to be the dominant one in the twenty-first century United States—dictates that pleasurable activities should be basically unchecked, subject entirely to the whims of the market. But, Lu argues, unchecked sin markets provide too many incentives for sellers to prey on and exploit vulnerable or addicted users. An unfettered marketplace ultimately creates negative externalities that will … Read More
“At some point, it is what many of us experience in our lives as the physician-child paradox. You hold out hope for the best possible outcome, but when the data and your parent are staring you in the face, it is hard to deny the odds and experience. [..] At the end of the day, the look of defeat remained on his face. He had been a good sport, but the outcome was not going to change. Either he or fate had decided it. I could not tell. “I love you,” he said. “I love you, too, Dad,” I replied. … Read More
“Akido Labs is using artificial intelligence to bring medical care to the streets of New York. The Los Angeles-based healthcare provider has created an AI doctor that suggests diagnoses and treatments based on patients’ symptoms and medical histories. A human doctor approves, modifies or rejects the recommendations. Now Akido is bringing this technology, ScopeAI, to ride-share drivers in New York through a partnership with two groups that can help it connect with these workers: the Independent Drivers Guild, an advocacy group, and Workers Benefit Fund, which works with labor unions and policy leaders to provide health and other benefits to … Read More
“The COLONPREV trial—published online in The Lancet—is, therefore, a landmark study. It is the first randomised controlled trial to compare colorectal cancer deaths in people screened with the two most commonly used methods: colonoscopy and faecal immunochemical test (FIT), an antibody-based test for haemoglobin, indicative of blood in the stool. The study finds that invitation to biennial FIT-based screening is non-inferior to invitation to one-time colonoscopy in terms of colorectal cancer mortality at 10 years. These results build on the NordICC trial, published in The New England Journal of Medicine, which showed that invitation to colonoscopy reduced colorectal cancer risk … Read More
“[Green] I was really surprised to learn that tuberculosis is the deadliest infectious disease in the world. Even though I cared about global health, I would have bet my life that it was malaria or H.I.V., because those diseases get so much more attention. They still don’t get nearly enough attention, it must be said; people don’t pay enough attention in the rich world to problems in the global South. [..] It’s not easy to cure, but neither was my brother’s cancer. My brother had cancer a couple of years ago; it cost about 150 times more to cure than … Read More