Interesting tidbit the other day on the Wall Street Journal Health blog. Excerpt:

“Would-be medical-device entrepreneurs got a sobering message Wednesday at a Boston conference of academic researchers and medical-device companies.

“You can’t keep stuffing gizmos into people to treat end-stage disease,” the keynote speaker said. “When biotechnology gets right, we’re finished. Because it’s restorative, not palliative as devices are.”

The seemingly pessimistic speaker? Device giant Medtronic’s senior vice president for medicine and technology, Stephen Oesterle.

Oesterle, an ex-Harvard cardiologist, joked that he was contributing to “the destruction of my own company.” His remarks, clearly containing some hyperbole to drive home a bigger point, were made to a few hundred academic and industry device researchers gathered for a meeting of the Boston-based Center for Integration of Medicine & Innovative Technology. Medtronic, Boston Scientific and General Electric were among the corporate sponsors for the event.

The bottom line? “It’s done. Devices ultimately are done,” Oesterle said.

In his address, he also contended that America’s leadership in medical devices –- including Medtronic’s –- is due less to American ingenuity than it is to the availability of risk capital in the U.S.

The pacemaker, the coronary stent, the dual-chambered pacemaker, the implanted defibrillator, and the implanted cardiac resynchronizer were all originally invented in Europe, South America, or Israel, Oesterle said, then commercialized here.”

Now sit back and watch the device industry’s spin machine go into high gear.

Labs that conduct the highest number of routine blood tests are more likely than others to report estimated glomerular filtration rate (eGFR), an important measure of kidney function that can identify early kidney disease, as per a survey funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH). The work is published in the recent issue of the American Journal of Kidney Diseases…….

Arthritis is the nation’s most common cause of disability. The number of adults with doctor-diagnosed arthritis is projected to increase to 67 million by 2030, and a large proportion of U.S. adults will limit their activity as a result, as per the Centers for Disease Control and Prevention. Now, in a new study, University of Missouri scientists observed that adults with arthritis who received exercise interventions that included educational components significantly increased their physical activity levels and experienced improvements in pain and physical functioning……..

See Niko Karvounis’s blog entry, “The Case of Patients v. Big Pharma.” It starts:

On November 3rd the Supreme Court will hear the case of Wyeth v. Levine, which has been called the “business case of the century”—and with good reason. In essence, Monday’s ruling will decide if patients have the right to sue pharmaceutical companies for personal injuries stemming from prescription drugs approved by the Food and Drug Administration (FDA). This is the big one, folks.

I’m pleased to be able to contribute a piece for The Daily Beast on the rash of stories that fail to tell the whole story about screening tests.

I write in that piece:

“A few simple reminders could guide journalists and the public:

* Newer isn’t always better.
* More isn’t always better.
* Screening doesn’t make sense for everyone.
* Many screening tests do good; many also do harm.

Such stories stoke the fears of the “worried well.” They raise undue demand for unproven technologies. They raise unrealistic expectations of what screening—and health care—can achieve.

And they overlook evidence, harms and costs.

Trudy Lieberman wrote a column for the Columbia Journalism Review asking if journalists deserve some of the blame for the high cost of health care when they write stories like this.

We spend more on health care than any other country on the globe, yet we have outcomes for some conditions that are worse than developing countries. And we still have more than 40-million neighbors who are uninsured.

That might be a better reference point for a discussion on health care reform and health policy than what we get from stories that make us all think that we should be screened because we all have something silent lurking inside us that should be found and treated.”

When an object moves fast, we follow it with our eyes: our brain correspondingly calculates the speed of the object and adapts our eye movement to it. This in itself is an enormous achievement, yet our brain can do even more than that. In the real world, a car will typically accelerate or brake faster than, say, a pedestrian. But the control of eye movement in fact responds more sensitively to changes in the speed of fast moving objects than slow moving objects. “Gain control” is the name for this phenomenon, which has been known for some time now, but which has now just been recently analyzed more closely by a group working with associate professor Dr. Stefan Glasauer from the Bernstein Center for Computational Neuroscience and Ludwig-Maximilians-Universitt (LMU) Mnchen. The scientists determined the location in the brain where gain control is calculated, and what neuronal networks are behind this complex process. The results were postulated in a mathematical model and experimentally verified and could be of great help in the diagnosis of eye movement disorders……..

Trudy Lieberman, in Columbia Journalism Review, describes what the magazine calls ineptitude by CNN and Dr. Sanjay Gupta in coverage of health policy news. Excerpt:

“Gupta’s attempt to explain John McCain’s health plan offered a confusing and ultimately misleading picture of how the candidate’s proposals might work. McCain, you may recall, has proposed giving every family a $5,000 tax credit and every individual a $2,500 credit to help buy insurance policies in the commercial market. So it was reasonable for Gupta’s show to ask: How far will five grand really get you? Too bad it didn’t answer the question.

Gupta began by citing a study done a couple of years ago by America’s Health Insurance Plans (AHIP), the insurance industry trade association. Gupta was wrong at the outset when he called AHIP “the largest provider of health insurance.” AHIP is a lobbying organization for its insurance company members. It does not—does not—provide health insurance. Gupta said AHIP had found that the average family’s premium was $5,799; he didn’t say that the data had been collected two years ago, and he didn’t explain that any study done by an insurance trade association is necessarily of limited value. (In fact, no organization has adequately studied the so-called individual market, where McCain wants people to buy their policies with his tax credit.) The take-away for viewers, though, was that a family could buy a policy for the amount offered by McCain’s tax credit.

I asked a neutral insurance expert, Paul Fronstin, who directs research for EBRI, the Employee Benefit Research Institute, to translate Gupta’s wonk talk. Fronstin said Gupta “gives a gross oversimplification.”

Instead of all the red-white-and-blue sets and the computer games, CNN should have invested in someone who could explain the issues that are of such importance to voters.”

Within the past two weeks, ABC and NBC have had forgettable health stories, reviewed on HealthNewsReview.org.

ABC’s Good Morning America had a segment on “detox diets.” The review summary of that story:

“A waste of air time. More like free advertising than anything you could describe as journalism. Anecdote, not evidence. No independent expert interviewed. No harms or costs discussed. Awful.”

The NBC Today Show had a segment on vitamin D deficiencies.The review summary stated:

“This segment didn’t tell viewers who had made the new recommendation, how the conclusion had been reached, how great the danger was, or how much benefit they might hope to gain.”

I don’t know why I don’t go into business for myself. It would be so easy to promote one’s product or idea through today’s unquestioning free-for-all, free-advertising that we call TV health news.

CNN says a new drug store in a Virginia strip mall is refusing to sell any contraceptives of any kind. They are doing this because of religious beliefs. You can also read an here about the Divine Mercy Care Pharmacy (DMC Pharmacy) in Virginia.

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The Wall Street Journal today has a big splash, “CT Scans Gain Favor as Option for Colonoscopy.” But in this 1,300-word article, there isn’t one mention of the recent statement by the U.S. Preventive Services Task Force “that the evidence is insufficient to assess the benefits and harms of computed tomographic colonography” and that “there is potential for both benefit and harm. Potential harms arise from additional diagnostic testing and procedures for lesions found incidentally, which may have no clinical significance. This additional testing also has the potential to burden the patient and adversely impact the health system.”

This insistence by journalists to trumpet new technologies and their refusal to acknowledge an independent, evidence-based conclusion is very troubling.

I just don’t get it.

The USPSTF statement was issued just 3 weeks ago, so it isn’t like it gathered dust or is outdated.

And it’s written by independent experts from various fields with no skin in the game – not by radiologists or gastroenterologists or by any interest group.

Evidence insufficient. Harms may occur. Newer isn’t always better. Why isn’t that part of the story?

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