My goal is to share my reflections on healthcare, learning, marketing, communications. technology and anything else that catches my attention or interest. My hope is that you will first learn something new, see it differently, or engage.
I am sure many of you have seen the stories, posts, article, etc. about Katie Couric's abysmal understanding of HPV vaccination and her complete failure to address the evidence. I have linked to five articles on this topic. Please link to these or Tweet links to them so we can raise awareness for this reckless and selfish act on her part all in the name of improving her Q Score.
Her FB page has no place to leave a comment but it does have a place to ask Katie a question. I asked her if she knows what evidence based medicine is? You could do that too.
Respectful Insolence has the following post "Katie Couric on the HPV vaccine: Antivaccine or irresponsible journalist? You be the judge!" This is a long well referenced piece and the answer is clear even before you read word one. She is pandering to a fringe audience to raise her Q Score.
David Kroll contributor at Forbes " Katie Couric and Cervical Cancer Prevention with the HPV vaccines, Gardasil and Cervarix" This is an excellent overview of the topic on HPV and cancer.
A two-dose regimen also has significant implications for preventing HPV-triggered cancers worldwide, especially in regions with poor access to sustained healthcare. Worldwide, 500,000 women are diagnosed each year with cervical cancer alone, and 250,000 will die of their disease.
Matthew Herper on the Forbes Staff "Four Ways Katie Couric Stacked the Deck Against Gardasil". Great deconstruction of what Couric did and why it was so wrong.
But deaths – including deaths by seizures or unexplained causes – do occur for all sorts of reasons, without explanation, and just because a death happened 18 days after a vaccine was given, as in the example on Katie’s show, does not mean the vaccine caused it. So far, investigations trying to link Gardasil and Cervarix to serious side effects have come up empty.
Emily Willngham Contributor at Forbes "Katie Couric Promotes Anticancer Vaccine Alarmism". This is a good analysis of Couric who has worked tirelessly to help prevent death from colon cancer. Willingham closes with the following:
Lives may well have been saved (colonoscopies) because of her name recognition and promotion. What will the balance become, I have to wonder, now that she has used her profile instead in ways that may very well influence parents to opt out of a life-saving anti-cancer vaccine for their children?
Alexandra Sifferlin writing on Time.com "Is Katie Couric The Next Jenny McCarthy?" The subhead on this sums it up well "A former Playboy Bunny spreading misinformation is bad enough". We have just found a respected journalist or on air personality French kissing Jenny McCarthy…. ewwwww. gross on so many level.
Laughing Squid has a great post "Intimate X-Ray Portraits of Cuddling Couples". It is a Japanese site based on the work of Ayako Kanda and Mayuka Hayashi from Musashino Art University. These are x-ray portraits of couples cuddling.
It is brilliant, touching, and personal. But I gotta wonder, at least for a guy like me who fights with his dentist every time I am given an x-ray how these couples were convinced to do this?
Take a look you will be amazed.
Larry Husten a Contributor at Forbes has an excellent review "Stents Lose In Comparisons With Surgery And Medical Therapy". He takes a look at two new meta-analyses in JAMA Internal Medicine looking at alternatives to stents percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG).
The first of the two papers by Sipahi and colleagues did a meta-analysis of six RCT comparing PCI and CABG in patients with multivessel disease.
With an average 4.1 years of followup, CABG was associated with significant reductions in total mortality, myocardial infarction, repeat revascularization and the rate of major adverse cardiovascular and cerebrovascular events (MACCE). CABG was also associated with a trend for excess strokes.
Here are the risk ratios for CABG:
Mortality: 0.73, CI 0.62-0.86, p<0.001
MI: 0.58, CI 0.48-0.72, p<0.001
Stroke: 1.36, CI 0.99-1.86, p=0.06
Repeat revascularization: 0.29, CI 0.21-0.41, p<0.001
MACCE: 0.61, CI 0.54-0.68, p<0.001
As noted the authors concluded that "CABG should be the preferred revascularization method for most patients with multi vessel coronary artery disease."
A second paper by Kathleen Stergiopoulos and colleagues looked at studies comparing medical therapy with PCI in >4,000 patients with stable coronary artery disease and documented ischemia and a five year median follow-up there were no significant difference in death, nonfatal MI, unplanned revascularization, or angina.
“Finally,” the authors write, “these findings call into question the common practice of ischemia-guided revascularization (either using noninvasive testing techniques or FFR) where the presence of myocardial ischemia routinely determines patient selection for coronary angiography and revascularization.”
So we have a changing landscape in the world of stents, CABG, and medical therapy based on an excellent set of studies looking at the current available data. As Husten closes his article with PCI is "a cornerstone of daily practice in evaluation of patients with CAD and endorsed by the American College of Cardiology Foundation AHA and European Society of Cardiology guidelines".
Data is pointing a different direction regarding the management of ischemia guided revascularization. Do patients have to wait years until prospective studies are completed to show that this meta analysis was accurate? Will patients with CAD know enough or have enough time to find this data and ask their cardiologist about stents vs. CABG or medical therapy? Will cardiologists step up and present this data to their patients? Is this a case of trickle down knowledge where the gate keepers are the one's performing the work?
Frakt notes rightly so the majority of the slowdown (interesting word hints that it will pick up) is due to lower use and intensity growth. Which speaks to the economy in part and in part to what I believe are Americans become hypersensitive to healthcare, aging population seeking to improve outcomes, the screaming about the ACA. We can not go a day without a healthcare story slapping us in the face. Which is good.
Frakt final points to the obvious "price growth remains robust by comparison". The cynic in me sees this as the price setters are raising prices in response to the slowdown. That's what occurs in a free market. Or is that as spending slows prices drop since more and more consumers and insurance companies are looking for low cost high value healthcare.