Notes & Links: November 18, 2013

Cholesterol Risk Calculator Debacle
Aaron Carroll at The Incidental Economist weighs in on the new cholesterol guidelines and the nifty online calculator to help our overworked HCP hone right in on the best treatment options based on carefully assessment using the new guidelines. Not so fast since it appears that this calculator doesn’t calculate as much as throw poop against the wall to see what sticks. Okay that is cruel. The New York Times “Risk Calculator for Cholesterol Appears Flawed” presents the information.

Carroll has the Cliff notes and the Times has the full article. Either one will make you stop and wonder WTF. Are the guidelines flawed or is the calculator flawed?

Dr. Nissen entered the figures for a 60-year-old African-American man with no risk factors — total cholesterol of 150, HDL (the good cholesterol) of 45, systolic blood pressure of 125 — who was not a diabetic or a smoker. He ended up with a 10-year risk of 7.5 percent, meaning he should be taking cholesterol-lowering statins despite being in a seemingly low-risk group.

Wow that was complex computation to do to test an algorithm/calculator. Is it any harder then putting 2 x 2 into your calculator and seeing is you get 4 or not.

5 On-Demand Fulfillment Platforms For Holiday Shoppers
Just in time for the holiday fun filled shopping craziness. Stephanie Miles at StreetFight has a cool list of on-demand fulfillment platforms. It works like this:

“…on-demand fulfillment platforms go a step beyond same-day delivery services, actually fulfilling customer requests by locating products, purchasing those items, and then quickly bringing them to the customer’s doorstep”.

WunWun: What you need. When you need it. A little elf helper selects a story, finds the booty, confirms its what you want, a price you agree to, and delivers it. How cool.

TaskRabbit: Make your list check it twice with tons of details if you want or a little and a “runner” will fill the list based on pre-negotiated price. Fee is 20% of each accepted bid.

Nearbors: A crowd-based delivery platform. I create shopping list, a vetted couriers receives and alert based on that list. The courier picks up the goods from a nearby store. Courier pays with a code charging the shopper’s account and same day delivery is set up

Postmates: This is a one-houor courier service available in Seattle, New York, and San Francisco tracked via smartphones. You post a request, using Postmates’ Get It Now service see where your goodies are all in less then an hour.

Google Shopping Express: Google helps you purchase from local retailers without leaving home.

The debate over conflicting experts
At db’s Medical Rants he links to the NY Times debate “Why Medical Experts Disagree” it addresses the cholesterol guidelines and how different experts have a particular opinion based on their own bias. db captures what this debate looks like. db has a good analysis of why they disagree and the NY Times is a good read especially in light of the calculator flaw. 

As one reads the various debaters, one can understand their contributions as resulting from the affect heuristic. One debater sees the pharmaceutical influence as a major evil – thus blames the pharmaceutical conflicts of interest (while apparently ignoring other conflicts). One debater clearly focuses on drug side effects, and cautions against using any new drugs, unless the new drug has proven major benefits.

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