Category: Audio

Diagnostic tests : how to minimise harm

We must develop new diagnostic tests to tackle real health problems, not to generate them

New diagnostic tests: more harm than good, BMJ 2017;358:j3314,
06 January 2016.

Defenders against overdiagnosis, BMJ 2017;358:j3487, 20 July 2017.

Although new diagnostics may advance the time of diagnoses in selected patients, they will increase the frequency of false alarms, overdiagnosis, and overtreatment in others.

Bjorn Hofmann, professor of medical ethics at Norwegian University of Science and Technology, explains how to minimise harm. Press Play > to listen to the recording.

Key messages

  • Innovative technologies and ample venture capital are combining to produce new disease biomarkers and mobile monitoring devices
  • These new diagnostics are technologically advanced but do not automatically provide improvements in clinical care and population health
  • They have the potential to help some but also to increase the frequency of false alarms, overdiagnosis, and overtreatment in others
  • Excessive testing and false alarms may increase healthcare workload and shift clinicians’ focus towards the healthy
  • Misleading feedback at both the population and individual levels tends to favour further market growth
  • Clinicians must provide a strong counterbalance: educating patients, respecting baseline risk, thinking downstream, and expecting misleading feedback

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Testing Medical Treatments : DiEthylStilbestrol

Testing Treatments Interactive, promoting better research for better healthcare

Audio published mid 2016 by Testing Treatments Interactive, promoting better research for better healthcare.

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Over 50 years later, DES’ adverse effects continue

Women Exposed to DiEthylStilbestrol In Utero Face Ongoing Risks for Adverse Health Outcomes

October 8th, 2011, NEJM Journal Watch talked with two authors of the report “Adverse Health Outcomes in Women Exposed In Utero to Diethylstilbestrol“.

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Medical error is the third leading cause of death in the US

Today in the US there are more medications, diagnoses and procedures than ever ; overtreatment is endemic

Medical error—the third leading cause of death in the US, The BMJ, dx.doi.org/10.1136/bmj.i2139, 03 May 2016.

Medical error is not included on death certificates or in rankings of cause of death.

Martin Makary and Michael Daniel assess its contribution to mortality and call for better reporting.
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” Medical error has been defined as an unintended act (either of omission or commission) or one that does not achieve its intended outcome, the failure of a planned action to be completed as intended (an error of execution), the use of a wrong plan to achieve an aim (an error of planning), or a deviation from the process of care that may or may not cause harm to the patient. Patient harm from medical error can occur at the individual or system level. The taxonomy of errors is expanding to better categorize preventable factors and events. We focus on preventable lethal events to highlight the scale of potential for improvement. “…

…Continue reading: Medical error—the third leading cause of death in the US, The BMJ, 03 May 2016. See also the responses.

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How charitable giving is profitable to the pharmaceutical industry

Drug companies won’t support charities if they can’t be sure they’re also helping themselves…

How Big Pharma Uses Charity Programs to Cover for Drug Price Hikes, bloomberg, May 19, 2016.

A billion-dollar system in which charitable giving is profitable for Big Pharma…
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” In August 2015, Turing Pharmaceuticals and its then-chief executive, Martin Shkreli, purchased a drug called Daraprim and immediately raised its price more than 5,000 percent. Within days, Turing contacted Patient Services Inc., or PSI, a charity that helps people meet the insurance copayments on costly drugs. Turing wanted PSI to create a fund for patients with toxoplasmosis, a parasitic infection that is most often treated with Daraprim.

Having just made Daraprim much more costly, Turing was now offering to make it more affordable. But this is not a feel-good story. It’s a story about why expensive drugs keep getting more expensive, and how U.S. taxpayers support a billion-dollar system in which charitable giving is, in effect, a very profitable form of investing for drug companies—one that may also be tax-deductible. “…

…Continue reading: How Big Pharma Uses Charity Programs to Cover for Drug Price Hikes, bloomberg, May 19, 2016.

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A quand une individualisation du processus vaccinal?

Il nous faut prendre notre santé en main!

Emission “Secrets d’info” du 1er janvier 2016 sur France inter.
Avec le Docteur Dominique Eraud.

Appuyez sur > pour écouter l’enregistrement.

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Cancer screening – does it save lives?

Healthcare providers are encouraged to be frank about the limitations of screening—the harms of screening are certain, but the benefits in overall mortality are not

Why cancer screening has never been shown to “save lives”—and what we can do about it, BMJ 2016;352:h6080,
06 January 2016.

The claim that cancer screening saves lives is based on fewer deaths due to the target cancer. Vinay Prasad and colleagues argue that reductions in overall mortality should be the benchmark and call for higher standards of evidence for cancer screening.
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On the Same Topic

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What it means when the EU Commission delays decision for identifying dangerous EDCs

HEAL’s Lisette van Vliet speaks to Euranet Plus, the leading radio network for EU news

pregnancy image
The Commission was supposed to adopt rules setting a criteria for identifying hormone disrupting chemicals, so-called endocrine disrupting chemicals (EDCs) by the end of 2013.

Euranet Plus Central,
December 16, 2015

The Commission breached EU law when it failed to put in place criteria for identifying hormone disrupting chemicals two years ago, says the European Court in a judgement. But despite the ruling and scientific reports saying it is urgent to act now, the EU authority will not speed up the identification of dangerous chemicals.

Listen to Lisette van Vliet of @HealthandEnv on #ECJ #EUEDC outcome via @EuranetPlus!

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Toxic Bodies: the history of endocrine disrupting chemicals

LIVING ON EARTH with Jeff Young and Nancy Langston

Endocrine disrupting chemicals like bisphenol A have been making news lately, with several states passing regulations limiting or banning their use. The trajectory of BPA is similar to another chemical, commonly known as DES, once prescribed for pregnant and menopausal women. Host Jeff Young talks with Professor Nancy Langston about the history of endocrine disrupting chemicals and how this history can inform future chemical regulation. Her book is called, “Toxic Bodies: Hormone Disruptors and the Legacy of DES.” (published March 19, 2010).

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Hormone Disruptors Linked To Genital Changes and Sexual Preference

Hermaphroditic, demasculinized frogs after exposure to the herbicide atrazine at low ecologically relevant doses

Tyrone Hayes’ at work in his lab in Berkeley

Scientists are continuing to sound the alarm about some common chemicals, including the herbicide atrazine, and link them to changes in reproductive health and development. Endocrine disrupting toxic chemicals have been found to feminize male frogs and cause homosexual behavior. Ashley Ahearn reports on how these substances may be affecting human development and behavior.

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