Category Archives: Healthcare

The suicide rate is increasing. Why is that?

The suicide rate is increasing. Why is that? – KevinMD – Christopher Johnson, MD | Conditions | April 11, 2017

After years of declining, the suicide rate in our country has been increasing, now at about 125 percent of the rate of several decades ago.

This increase accelerated after 2006.  Although all age groups showed an increase, the rate among women, particularly adolescent girls, took a notable jump.

In 2012 suicide was the second leading cause of death in adolescents aged 12 to 19 years, accounting for more deaths in this age group than cancer, heart disease, influenza, pneumonia, diabetes mellitus, human immunodeficiency virus, and stroke combined.   Continue reading

Is It Negligent For a Doctor to Abandon a Patient?

Is It Negligent For a Doctor to Abandon a Patient? – AllLaw.com – by Andrew Suszek

When a patient is harmed by a doctor’s cessation of treatment – commonly called “patient abandonment’, or “medical abandonment” – a malpractice case may result.

A patient will often visit a doctor at a fairly distressing time, often at the height of the patient’s vulnerability.

As a result, a doctor may harm a patient merely by declining to provide treatment or by ceasing the provision of care before it is medically reasonable to do so.   Continue reading

Quantifying quality doesn’t help patients

Quantifying quality doesn’t help patients | KevinMD.com | Kjell Benson, MD | April 4, 2017

Metrics did not always exist in medicine.

The moment we got serious about quality is often cited as Caper’s 1988 article “Defining Quality in Medical Care.”

Even as medicine invented “quality” in the 1980s, Caper pointed to some misgivings about the terminology. His Health Affairs article suggests abandoning the word “quality” and instead using three terms that correlate to desirable medical outcomes: efficacy, appropriateness and the caring function.   Continue reading

Spinal Manipulation Therapy – A Sham Procedure?

Spinal Manipulation Therapy – A Sham Procedure? | Medpage Today | Apr 2017

Proponents have proclaimed a slew of benefits of spinal manipulation therapy, but most data is anecdotal. Spinal manipulation therapy is one of those treatments that just thrives on anecdote.

If you’re like me, you’re skeptical about some of the claims certain providers make about spinal manipulation. Mostly because a lot of these claims lack biologic plausibility

So I was intrigued to see this meta-analysis appearing in the Journal of the American Medical Association: Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis.   Continue reading

Statins Increase Diabetes Risk by up to 50% in Older Women

Statins Increase Diabetes Risk by up to 50% in Older Women – By Pam Harrison – March 2017

Statin therapy increases the risk of new-onset diabetes in elderly women by 33%, and the higher the dose, the greater the risk, a new analysis of the observational Australian Longitudinal Study on Women’s Health shows.

The new analysis included 8372 Australian women aged between 76 and 82 years at baseline who were followed for 10 years; it is published in the March issue of Drugs and Aging.

Dr Jones and colleagues note that the majority of participants in statin trials have been males and that females, especially elderly ones, have been underrepresented.   Continue reading

Early Penicillin Use Induces Long-Term Changes in Behaviour

Low-Dose Penicillin in Early Life Induces Long-Term Changes in Behaviour – newswise.com – April 4th 2017

I’m posting this only to illustrate the increasingly obvious important of our gut microbes. In seeking to destroy harmful pathogens, antibiotics ravage the colonies of microbes living in our gut that we rely on for good health – physical and even mental.

Low-dose penicillin in early life induces long-term changes in behaviour, gut microbes and brain inflammation

In a landmark study, researchers at St. Joseph’s Healthcare Hamilton and McMaster University have found that providing clinical (low) doses of penicillin to pregnant mice and their offspring results in long-term behavioural changes.   Continue reading

Why I Don’t Believe In Science

Why I Don’t Believe In Science | THCB – By Michel Accad, MD – Feb 16, 2016

As a case in point, a few weeks ago the New England Journal of Medicine published the results of the SPRINT trial which had randomized patients with high blood pressure to one of two treatment protocols:

  1. high intensity therapy, to try to achieve a systolic blood pressure less than 120 mmHg, or
  2. low intensity treatment for a more modest reduction in blood pressure (less than 140 mmHg).

To the surprise of many, the trial was stopped early because the difference in mortality rates between the two groups was statistically strong enough to trigger an automatic termination. Continue reading

Why Most Published Research Findings Are False

Why Most Published Research Findings Are False – PLoS Med. 2005 Aug – free full-text PMC article

There is increasing concern that most current published research findings are false.

Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true.

Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias.

In this essay, I discuss the implications of these problems for the conduct and interpretation of research.  Continue reading

Statistics: Beware of Exaggerated Certainty

Beware of Exaggerated Certainty – Know Your Chances – NCBI Bookshelf

This is one chapter from an online “Book” from the NIH: Know Your Chances: Understanding Health Statistics.

Of course, the numbers you see in health messages are not the whole story. We’d now like to add another bit of advice: once you have the numbers, ask yourself whether or not you should believe them.

Unfortunately, many statistics should not be accepted at face value, because they convey a sense of exaggerated certainty.

There are at least two reasons why reported research findings might not be right:

  1. much research is based on weak science, and
  2. many results are disseminated too early  Continue reading

Glut of Anesthesia Guidelines a Disservice

Glut of Anesthesia Guidelines a Disservice, Except for Lawyers – Pain Medicine News – Mar 2017 – By Robert E. Johnstone, MD

Anesthesia practice guidelines are out of control—too many to adopt, too anecdotal to accept and too political to take seriously!

Every society seems to issue them now, in order to announce their existence, promote their brand or troll for members. I would ignore most of them, but unfortunately lawyers use society guidelines as standards of practice for malpractice suits, to evidence actionable breaches.

I might try to follow them, except their scientific bases are weak and they sometimes conflict with each other.  Continue reading