A few months ago I posted about a new website that could help you find the Number Needed to Treat, aka the NNT.
How many people need to be treated with a drug or procedure before one person is helped? That’s the NNT.
It’s a tool I wish more patients and physicians used. Medical interventions should be limited to those that are proven to work for more people than not.
That seems like a pretty simple aim, doesn’t it? But you’d be surprised how many commonly used treatments are either useless or do more harm than good.
Aaron Carroll, … Continue reading
A study coming out of Harvard this week reveals that ordinary headaches are being overtreated, and it’s costing billions of extra dollars in health care spending.
Each year more than 12 million Americans visit their doctors complaining of headaches, which result in lost productivity and costs of upward of $31 billion annually. A new study by researchers from Beth Israel Deaconess Medical Center (BIDMC) suggests some of that cost could be offset by physicians ordering fewer tests and an increased focus on counseling about lifestyle changes.
The study looked at over 9,000 doctor visits for headaches over a 10-year … Continue reading
The Journal of the American Medical Association (JAMA) published a short article on screening mammograms that included a spiffy infographic on the benefits vs. the harms.
Looking at the graphic I can easily see that if 10,000 50-year-old women are screened, 10 will be “saved”, but 940 will undergo an unnecessary biopsy and 57 will be overdiagnosed. (For copyright reasons I can’t reprint the graphic here, but you can view see it yourself by clicking on the above link.)
The author of the article explains:
Another possible harm of screening is overdiagnosis. This means finding something on a mammogram
… Continue reading
Isn’t Florida known as the “Sunshine State”?
Then why do they have so many tanning beds?
That’s what I learned in a recent New York Times article regarding the dangers of tanning beds: Warning: That Tan Could Be Hazardous.
Here in the Sunshine State, there are more tanning salons than McDonald’s restaurants, CVS stores or Bank of America branches, according to a 2014 study by University of Miami researchers.
Interesting. I would have expected my city of Seattle (and yes, it is just as gray and wet as rumors say) to have more, but it doesn’t. And for that … Continue reading
News stories like this make me crazy: Disneyland measles outbreak grows, sparks concern. Or this from my local newspaper: Measles makes it to Seattle from Disneyland.
At least 17 people have been infected in the outbreak, which occurred among people who visited Disneyland or Disney California Adventure Park in Orange County, Calif….It’s likely that a person who was contagious visited the theme park during that period and spread it to others.
A 20-something young woman from Washington state was one of those infected with measles while at Disneyland. Judging by her age, she is most likely one of … Continue reading
Lack of support for vitamin D
I’ve written several posts on vitamin D. That’s because it’s one of my pet peeves.
Because there was a lot of hype surrounding it several years ago when it became the latest health care fad. Suddenly a low vitamin D level was suspected of contributing to many types of cancer and chronic diseases. Physicians began testing everyone’s vitamin D levels and recommending vitamin D supplements, either over-the-counter or a stronger prescription form.
Further research on vitamin D, however, has not provided evidence that general screening for low vitamin D levels is helpful, … Continue reading
New treatments for hepatitis C
I read an article online the other day in which the author practically shouted at her readers to “Run as fast as you can to your doctor’s office and get screened for hepatitis C!”
OK, what she actually wrote was:
Overall, the outlook for patients with hepatitis C is much better than it was just a couple of years ago. So if you’re a baby boomer who hasn’t been screened for hepatitis C yet, don’t wait.
Still, let’s step back and look at the big picture.
Hepatitis C screening has been in the news a … Continue reading
The power of positive thinking
I’ve been meaning for some time to write a post about the placebo effect.
A placebo (from the Latin “I shall please”) is a fake treatment—such as a sugar pill—that is intended to deceive the patient. If that patient improves, or at least thinks so, that is known as the placebo effect.
Before a new drug can be approved by the Food and Drug Administration (FDA), the drug maker must have studies to prove that it is more effective than a placebo. If neither the patients nor the researchers know who is getting the … Continue reading
How many are helped; how many are hurt
My son sent me a great link to an article in Wired magazine about a physician and his colleagues who have started a website called TheNNT.com.
What is the NNT? It stands for “the number needed to treat” and it’s a pretty common measurement talked about in health care. Simply put, it quantifies how many people need to be treated for one person to be helped.
The best therapies have a low NNT:
If your kid is throwing up and you take her to the hospital, she might get a drug
… Continue reading
Or whose best interests are being served?
It’s no secret that our health care system is filled with conflicts of interest.
That’s because, for the most part, the doctors, hospitals and insurance companies that are the framework of the system are for-profit businesses. Like any other for-profit industry, health care sells a product and encourages you (or your insurance company) to buy it.
A friend of mine had a recent experience with for-profit health care that she wanted to share:
In my opinion, anyone who has been told they “must” replace their orthotic inserts every year or every few years … Continue reading