“Landeiro and colleagues computed the economic burden of four diseases (cancer, coronary heart disease [CHD], dementia, and stroke) in England using consistent methodology and a broad definition of disease burden. This analysis is an important advance that will allow policy makers, researchers, and other stakeholders to assess the absolute and relative burden of these diseases in a meaningful way. The Global Burden of Disease also uses a consistent methodology for estimating the burden of many diseases across countries. However, its methodology focuses only on mortality and morbidity, which are evaluated comprehensively, but does not account for many other costs included … Read More
All posts in Measurement
“While overdose deaths and related outcomes, such as the prevalence of substance use disorders (SUDs), are helpful indices, they fail to capture the broader dimensions of drug-attributable harm, including non-overdose deaths, chronic disease morbidity, and other conditions that cause people who use drugs to live in a state of less than full health. [..] The DALY [disability-adjusted life-years, the sum of years lived with disability and the years of life lost due to premature death] index captures the health burden beyond overdose deaths and SUDs, to encompass other morbidity and mortality attributable to substance use. Such outcomes could include conditions … Read More
“Obesity spans a spectrum of health states, from an asymptomatic predisease risk factor—where excess adiposity (however defined) has yet to manifest overt signs or symptoms—to advanced disease stages complicated by downstream comorbid conditions, including diabetes, heart disease, and cancer. Obesity causes health effects and poses risks on a continuum; greater excess adiposity leads to higher health risk. In this way, obesity is analogous to many cardiometabolic risk factors, such as elevated blood pressure, dyslipidemia, and hyperglycemia. The location of adipose tissue also matters for some metabolic effects, whereas for others (for example, obesity’s mechanical effects), total adipose tissue affects functional … Read More
“The use of BMI has long been criticized as fundamentally flawed because it does not distinguish fat mass from lean mass. Despite this limitation, one nationally representative analysis found that BMI is strongly correlated (Pearson correlation coefficient of approximately 0.9) with fat mass adjusted for height as measured by dual x-ray absorptiometry (DXA), which is considered a gold standard. Moreover, BMI is strongly associated with indicators of cardiovascular risk, such as blood pressure and blood lipid levels, and is similar to DXA as a predictor of these risk factors and metabolic syndrome. The correlation between BMI and fat mass measured … Read More
“I had to learn over and over again that extreme conviction requires extraordinary evidence, and the evidence we have is usually far from extraordinary. For instance, our frontline anti-depression drugs are supposed to work by changing serotonin levels in the brain, but a review published last year found that there’s no consistent evidence that serotonin has much to do with depression at all. (Maybe that’s why antidepressants don’t seem to work that well, especially in the long term.) It seems obvious that sunscreen should protect you from skin cancer, but a 2018 meta-analysis could not confirm that this is true … Read More
“Analyzing the nature of misdiagnoses also provides significant opportunities for solutions: The errors are many, but they are quite concentrated. According to the study, 15 diseases account for about half the misdiagnoses, and five diseases alone — stroke, sepsis, pneumonia, venous thromboembolism, and lung cancer — caused 300,000 serious harms, or almost 40% of the total, because clinicians failed to identify them in patients. “That’s a lot that you could accomplish if you cut those harms by 50% for just those five diseases — that would be 150,000 prevented serious permanent disabilities or death,” said [lead author of the BMJ … Read More
“Since the early 2000s, hospitals have been developing metrics to define high-quality care. In addition to readmission rates and the incidence of various iatrogenic infections, reducing hospital length of stay has been a popular target. Most people prefer nonhospital days to hospitalized days, and insofar as effective treatments hasten the return to health, it seems plausible to assume that shorter stays correlate with effective stays. As an ancillary benefit, shorter stays may cost less and increase “throughput,” resulting in more revenue for hospitals. Because tallying the length of stay is easier than quantifying high-quality care for heterogeneous “hospital problems,” patients … Read More
“Like people of Middle Eastern and North African origins, millions of other Americans have been funneled into one side of our country’s enduring binary of whiteness or the other. According to today’s census forms, Greeks, Irish, Italians, Slavs (who were systematically excluded for a century), and Jews—who are still the target of white-supremacist violence—are indistinct from people with Mayflower backgrounds. Being an unspecified “white” person has allowed many of us to blend in, when the most unifying thing we might do in this era of identity-driven polarization is acknowledge all the ways we are different. Today’s nationalist identity politics are … Read More
From the article abstract: “[Objective] [..] We developed machine-learning models to detect CKD [chronic kidney disease] without blood collection, predicting an eGFR [estimated glomerular filtration rate in ml/min/1.73 m2] less than 60 (eGFR60 model) or 45 (eGFR45 model) using a urine dipstick test. [Materials and Methods] The electronic health record data (n = 220 018) obtained from university hospitals were used for XGBoost-derived model construction. The model variables were age, sex, and 10 measurements from the urine dipstick test. The models were validated using health checkup center data (n = 74 380) and nationwide public data (KNHANES data, n = 62 945) for the general population in Korea. [Results] The … Read More
“Primary care is where most people have relationships with a health professional, where more than one-third of all health care visits happen, and the only part of the health system that demonstrably produces longer lives and more equity. However, primary care is experiencing widespread and longstanding shortages and skyrocketing rates of burnout and moral injury. Primary care physician turnover, often associated with burnout, is estimated to cost CMS nearly one billion dollars annually. Before the COVID-19 pandemic, more than one-third of family physicians reported frequent burnout. Since the pandemic, primary care physicians are stepping up to meet patient needs even … Read More