Tag: "heart disease"

Right Diagnosis, Wrong Cure

Writing in The New York Times, Sanjay Gupta notes that defensive medicine leads doctors to order tests and procedures that can cause other errors:

In a recent anonymous survey, orthopedic surgeons said 24 percent of the tests they ordered were medically unnecessary. This kind of treatment is a form of defensive medicine, meant less to protect the patient than to protect the doctor or hospital against potential lawsuits.

Herein lies a stunning irony. Defensive medicine is rooted in the goal of avoiding mistakes. But each additional procedure or test, no matter how cautiously performed, injects a fresh possibility of error. CT and M.R.I. scans can lead to false positives and unnecessary operations, which carry the risk of complications like infections and bleeding. The more medications patients are prescribed, the more likely they are to accidentally overdose or suffer an allergic reaction. Even routine operations like gallbladder removals require anesthesia, which can increase the risk of heart attack and stroke.

But Gupta misses the obvious solution: don’t have a medical malpractice system that compensates patients only for adverse events found to constitute “malpractice.”  Instead, have a voluntary no-fault system that compensates for all adverse events — regardless of cause.

Headlines I Wish I Hadn’t Seen

Why You Get Ill

What do heart disease, diabetes, Alzheimer’s, stroke and cancer have in common? Scientists have linked each of these to a condition known as chronic inflammation, and they are studying how high-fat foods and excess body weight may increase the risk for fatal disorders.

More from Laura Landro.

Unbearable Heat, and Other Links

The FDA Is Killing Us

In November, the U.S. Food and Drug Administration (FDA) approved an innovative product called the Sapien Transcatheter Heart Valve, for the treatment of severe aortic valve stenosis. The Sapien valve can be implanted endoscopically, making it a boon for patients who are too sick to endure open-heart surgery. Clinical trials found that almost 70% of patients receiving Sapien valves were alive one year after treatment, while only 50% of those receiving alternative treatments survived that long.

This would be a great story for American patients, but for one frustrating detail: The Sapien valve has been available in Europe since 2007, saving lives there but not here.

More on the FDA’s unnecessary regulatory burdens in the WSJ.

Why Can’t We Be More like Other Countries?

[D]espite the evidence that cardiac rehabilitation is very effective for patients with coronary heart disease, this latest study shows that services in Europe are much underused, with poor referral and a low participation rate…

  • In France 32.4% of CHD patients were advised to attend rehabilitation, and of those advised 90% attended.
  • In Germany 56.6% were advised, and 91.1% attended.
  • In Italy 51.5% were advised, and 88.7% attended.
  • In the UK 43.0% were advised, and 80.6 attended.
  • In Spain 3% were advised and < 1% attended.

Stone Hearth News (Will this be in the next Commonwealth Fund Press Release?)

Unskilled Labor, and Other News

EPA Experiments on People

Which do you find more shocking: that the Environmental Protection Agency conducts experiments on humans that its own risk assessments would deem potentially lethal, or that it hides the results of those experiments from Congress and the public because they debunk those very same risk assessments?

JunkScience.com recently obtained through the Freedom of Information Act the results of tests conducted on 41 people who were exposed by EPA researchers to high levels of airborne fine particulate matter – soot and dust known as PM2.5.

If we are to believe the congressional testimony of EPA Administrator Lisa P. Jackson, these experiments risked the lives of these 41 people, at least one of whom was already suffering from heart problems.

Steve Milloy editorial in the Washington Times.

Fatty Foods and Marijuanalike Chemicals, Rural Life Expectancy, and Other News Items

After the rats ate fatty foods, their bodies immediately began to release natural marijuanalike chemicals in the gut that kept them craving more.

Rural areas have 25% of the people but only 15% of the doctors. Life expectancy is one year shorter.

A chilling discovery: after cardiac arrest the body is quickly cooled after the heartbeat restored, and survived to be discharged from the hospital—92% of them with most or all of their cognitive function intact.

I hope they didn’t spend very much money on this study. Conclusion: Low health literacy is associated with poorer health outcomes and poorer use of health care services. (HT: Morning Consult)

Making Cigarette Smoking Uncool

Pause to consider the logic here. We decide it is not a good idea to let the government ban this product, or to require a doctor’s prescription to consume it. We think everyone should be allowed to consume it if they choose. But, we also decide it is a good idea to let government to decide if this product can seem “cool.”

Actually, I see a fundamental contradiction in the idea of government regulating “cool.” While we have many social processes which tell us about what others might approve or disapprove, the “cool” process seems inherently decentralized, and not to be mediated by authorities. We the masses are supposed to each decide what we think is “cool,” and we are not supposed to accept declarations by teachers, employers, etc. on the subject. Whatever authorities recommend as a good idea, it can only accidentally be “cool.”

“Cool” just doesn’t seem the sort of thing government can actually regulate.

This is from Robin Hanson. See also Megan McArdle, plus gruesome pictures.