Don’t Trust The Conventional Wisdom In Healthcare—Part 1

By Michael D. Shaw

 

While he may not have been the first to say it, Steven D. Levitt, co-author of Freakonomics: A Rogue Economist Explores the Hidden Side of Everything (2005) is credited with the quotation: “The conventional wisdom is often wrong.” Levitt bundles this concept with a distinction between positive and normative analysis.

In the purest sense, positive economics is objective and fact based, while normative economics is subjective and value based. However, this clear distinction can become muddied. As Investopedia reminds us, “Positive economic statements do not have to be correct, but they must be able to be tested and proved or disproved. Normative economic statements are opinion based, so they cannot be proved or disproved.”

By way of example, the statement, “Government should provide basic healthcare to all citizens” is a normative economic statement. The statement, “Government-provided healthcare increases public expenditures” is a positive economic statement, because it can be proved or disproved by examining healthcare spending data.......Read the complete article.

Yet more on two unethical clinical trials - This HND piece continues to shine some needed light on the FIRST and iCOMPARE clinical trials. Make no mistake. The purpose of this research was to create data justifying the rollback of certain limitations on the maximum duty hours for medical residents.   There are a host of things wrong with these studies, not the least of which is the researchers' nonsensical contention that no human subjects were involved in work that encompassed 4,330 surgical residents and 138,691 patients.    What makes this even more pathetic is that NIH could have done better simply eliminating the middleman! Why not take the money allocated for this garbage research, and spend it instead on...more residents.....Read the complete article.

Let's save a billion lives--with e-cigs - This HND piece once again covers the topic of e-cigarettes, and this time spotlights an upcoming feature entitled A Billion Lives.  Regular readers of my columns will already be familiar with the sad truth of officialdom being dead set against e-cigs, for completely selfish reasons--that have nothing to do with public health.
Helmer Aaron Biebert has created a compelling work that is sure to spread the message beyond the e-cig community...... Read the complete article.

An unethical clinical trial, a leading journal, and the sketchy motives of NGOs - This HND piece is a follow-up to an earlier story describing how three healthcare-related non-governmental organizations (NGOs) are conspiring to undo hard-fought improvements in work rules, pertaining to surgical resident physicians. The NGOs in question are the American Board of Surgery, the American College of Surgeons, and the Accreditation Council for Graduate Medical Education (ACGME).

Now, the research—such as it is—supporting more hours for the residents, has been published in no less than the New England Journal of Medicine.

Mark well that this is a double travesty, in that the research itself clearly violates long-established ethics guidelines, and it being published in NEJM violates the Journal's longstanding policies on accepting manuscripts from human subjects research. In short, this is failure beyond failure, only it doesn't seem to matter. Inasmuch as NEJM surely has no shortage of submissions, it is simply mind-boggling that they would fast-track such crapola.

God knows why the academic surgeon from Northwestern heading up the study would waste his time with this egregious nonsense, or why the editorial board of the Journal has turned into a bunch of feckless Kool-Aid drinkers.....Read the complete article.