Posted in Methodology, Population medicine on Jul 25th, 2011
Of all the problems regarding large scale clinical trials cataloged by James Penston, the most compelling is the inverse relationship between practical value and trial size. This could almost be formulated as a law: The clinical value of a randomized controlled trial is inversely related to its size Of course, clinical is used in the [...]
Posted in Database medicine, Population medicine on Jun 30th, 2011
The NEJM has just published another promotional piece on “Comparative Effectiveness Research” in its on-going series on health policy and reform. But this time, behind the usual grandiose claims of CER, authors Tinetti and Studenski betray a certain tone of apprehension… The aim of comparative effectiveness research (CER) is to improve the quality, effectiveness, and [...]
Posted in Hermeneutics in medicine, Population medicine on Dec 3rd, 2009
There was a time when the foretelling of future events was an undertaking of prophets, palm-readers, and weathermen. In recent years, however, the medical profession seems to have embraced this activity with a great deal of enthusiasm…Read full Article @ PubMed Central.
Posted in Database medicine, Guideline medicine, Hermeneutics in medicine, Population medicine on Jan 22nd, 2009
In the broadest sense, medical collectivism results from the belief that medicine cannot be left to voluntary and unrestricted transactions between individual patients and individual healers but must be improved, directly or indirectly, by the hand of government. Medical collectivism has a long history that begins with the licensing of practitioners by the state, increases [...]
Posted in Medical economics, Population medicine on Jan 3rd, 2009
In 1961 the Framingham study investigators coined the term ‘risk factor’ and unwittingly ushered in a period in the history of medicine dominated by the advancement of risk modification as a strategy to prevent disease. Academic careers have succeeded and private enterprises have flourished on the promotion of this paradigm. Risk factor reversal is now [...]
Posted in Medical news, Population medicine, Prevention on Dec 3rd, 2008
Like any political activity, public health advocacy must rely on the ordinary tools of political propaganda to advance its intended agenda. Such is the case with public health proposals for the prevention of cardiovascular disease. A critical examination of the topic exposes the blurred line between prevention and pretension.
Complete Heart Blog!