What is wrong with medical research? Boston health writers raise important questions

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Do we need evidence-based evidence? How effective is our medical research system? What are we getting for the $30 billion that goes into university and hospital labs? Here are a couple of stories from local writers with some discouraging answers to those questions.

Carolyn Johnson’s piece on poor quality of medical research was tucked under the Globe’s Sunday editorial urging Elizabeth Warren to run for president. If only it could get as much attention:

Evidence of a quiet crisis in science is mounting. A growing chorus of researchers worry that far too many findings in the top research journals can’t be replicated. “There’s a whole groundswell of awareness that a lot of biomedical research is not as strongly predictive as you think it would be,” said Dr. Kevin Staley, an epilepsy researcher at Massachusetts General Hospital. “People eventually become aware because there’s a wake of silence after a false positive result,” he added. The same is true in every field of science, from neuroscience to stem cells.

Ideally, science builds on and corrects itself. In practice, the incentives facing scientists can hamper the process. It’s more exciting and advantageous to publish a new therapeutic approach for a disease than to revisit a past discovery. Yet unless researchers point out the limitations of one another’s work, the scientific literature can end up cluttered with results that are partially or, in some cases, not at all true.

Recently, researchers and the US government alike have sought to assess how much research is irreproducible — and why — and are looking for systematic ways to retest experiments that make headlines but yield no further progress.

Her story follows a piece by another local writer on how stem cell research has not yet delivered on its promises. Karen Weintraub’s piece was in the New York Times in September.     

Stem cells broke into the public consciousness in the early 1990s, alluring for their potential to help the body beat back diseases of degeneration like Alzheimer’s, and to grow new parts to treat conditions like spinal cord injuries.

Progress has been slow. The Michael J. Fox Foundation for Parkinson’s Research, an early supporter of stem cell research, pulled much of its financial backing two years ago, saying that it preferred to invest in research that was closer to providing immediate help for Parkinson’s disease patients.

But researchers have been slowly learning how to best use stem cells, what types to use and how to deliver them to the body — findings that are not singularly transformational, but progressive and pragmatic.

Finally, don’t miss this week’s Health Wonk Review, a digest of health policy blog posts.

“We punish sick people”: Doctors launch campaign to limit unnecessary care

The Boston-based Lown Institute just wrapped up it’s annual meeting, mercifully in California instead of here in the slowly melting tundra. Cheryl Clark at Health Leaders Media reports: 

It’s not that far a stretch to call the Boston-based Lown Institute’s burgeoning “Right Care, Right Now” movement a kind of 60s-style medico-political protest march against healthcare overutilization and misuse…

Indeed, during the group’s three-day conference in San Diego this week, the keynote talks were speckled with these phrases:

  • Healthcare industry “greed”
  • “A new counter culture movement”
  • “Toxic hierarchy”
  • “Medical industrial complex”
  • “Perverse incentives”

These distinguished physicians say they’ve become intolerably frustrated by a system they are part of, but desperately want to change.

More from the campaign website:

Declaration of Principles of the
Right Care Alliance

Whereas:

  • Modern medicine offers important benefits, yet it also has the capacity to cause harm;
  • Those harms arise from three central failings of medical systems: the overuse, underuse, and misuse of medical services. Of these, overuse – including overdiagnosis, overtreatment, and the use of ineffective, unnecessary, and unwanted medical tests and treatments – has received the least attention;
  • Overuse is common and tacitly accepted in modern health care.
  • Overuse exposes patients to harm, including the risk of serious injury or death, suffering, and financial ruin, with little or no possibility of benefit.
  • Overuse diverts resources from the provision of needed care, and crowds out investment in social services, education, nutrition, and other non-medical contributors to health;
  • The health care industry puts money before people and allows personal and commercial interests to distort clinical decisions, thus betraying patients’ trust.
  • Clinicians and health care leaders have an ethical obligation to protect patients from the harms of both underuse and overuse.

Therefore we, the signatories of this document, declare that performing unnecessary medical tests and treatments is unethical and unacceptable. We join the call for the medical profession to renew its sense of duty and commitment to patients. We call on health care leaders to recognize their ethical obligation to put patient care first. We call on civil society to advocate for a medical system that is affordable, effective, rational, personal, and just.

Gluten, hoarding and reading: Boston health and medicine events for week of 3/9

Selections from the Boston Science and Engineering calendar Please double check times.

Monday

Noon.  “Demystifying Drug Development.”   Jonathan Hurov.   BWH:  Carrie Hall Conference Room.  Details, Registration.

Noon.  “Reading and the Brain: A Workshop.”   Joanna Christodoulou.   Harvard School of Education:  Longfellow Hall 320, 13 Appian Way.   Details, RSVP.

Tuesday

6p.  “High-Tech Med: The newest wave of medical innovation.”   A panel discussion.   Follow events live on #HMSminimed.   HMS:  Joseph B. Martin Conference Center, 77 Avenue Louis Pasteur.  Details, Registration.

6 – 8p.  “Is There Still Room for Gluten?  Separating Science from Supposition.”   Alessio Fasano.   Russell Museum of Medical History, 2 North Grove Street.   Details.

SOLD OUT 6p.  “Decade of Discovery.”   Celebrating 10 years of groundbreaking science on stage.   Central Square Theater, 450 Massachusetts Ave.   Details, Tickets.

Wednesday 

6p.  “High-Tech Med: The newest wave of medical innovation.”   A panel discussion.   Follow events live on #HMSminimed.   HMS:  Joseph B. Martin Conference Center, 77 Avenue Louis Pasteur.  Details, Registration.

6 – 8p.  “Is There Still Room for Gluten?  Separating Science from Supposition.”   Alessio Fasano.   Russell Museum of Medical History, 2 North Grove Street.   Details.

7 – 9p.  “The Air We Breathe: An assessment of urban air pollution“.   Jordan Wilkerson.   Harvard:  Pfizer Hall, 12 Oxford St.   Details.

Thursday 

Noon.  “Overflowing and Overwhelming: Treating Hoarding Disorder.”   Gail Stekette.   McLean Hospital:    Details.

Saturday

10:30a.  “Spring into Health.”   Rhoda Kubrick, Arboretum Docent.   Arnold Arboretum, Hunnewell Bldg.   Details, Abstract, Registration.

If you can’t join them, beat them: BIDMC in takes over Milton hospital

When the Harvard hospitals decided to join forces as Partners, they cut BIDMC out of the deal. So, this story from the Globe  – on Beth Israel Deaconess Hospital-Milton –is worth noting:

partnersdownloadConsolidation in the health care industry has been viewed with suspicion, leaving critics worried that the state’s biggest health care networks want to leverage increased market power into higher rates. Partners HealthCare, the largest health care system in Massachusetts, recently abandoned its bid to acquire South Shore Hospital in Weymouth in the face of such criticism and a ruling from a judge who said Partners’ growth would raise costs for consumers.

…The Milton case shows how consolidation — though it often increases costs to consumers — can also offer a lifeline to a struggling hospital. The brand alone of a big Boston health care network can be a powerful force, analysts said.

 

Comprehensive #Boston #science #event calendar

While it leans toward the physical and earth sciences,  The no-frills Boston Science and Engineering Lectures sswebsite offers an up to date, comprehensive linked list of events related to medical research. Here’s a sample from this week. As noted, always double-check to make sure the event is not cancelled.

http://bostonsciencelectures.com/

Monday, February 23

10a.  “(Bio)molecular Probes for Non-Invasive Imaging via NMR, Optics and Acoustics.”  Gil Westmeyer.   MIT:  McGovern Seminar Room (46-3189).   Details, Abstract.

11a.  “Rare Disease Day.”   State House, Great Hall.   Details, Registration.

3p.  “Rehabilitation Robotics: From Analysis to Design to Assessment to Intervention.”  Hermano Krebs.   Tufts:  Anderson 112.   Details, Abstract.

February 24-26.   “Reconstructing Medieval Medical Libraries: Between the Codex and the Computer.”   A lecture and workshops.   Monica H.Green.   Houghton and Countway libraries.  Details, Abstract, RSVP.

Tuesday

4p.  “Thinking in Patterns: Representations in the Neural Basis of Theory of Mind.”   Jorie Koster-Hale.   Harvard:  Northwest 243, 52 Oxford St.   Details, Abstract.

7p.  “Water Quality Workshop.”   Don Blair.   Parts and Crafts, 577 Somerville Ave, Somerville.   Details, Abstract.

Wednesday

4p.  “Measles, Vaccines, and Protecting Public Health.”   A panel discussion.   HLS:  Wasserstein 1010.   Details.

Thursday

7:45a.  “Exploring the Human Connectome of Multiple Sclerosis.”   Eric Klawiter.   Harvard:  Faculty Club 10, 20 Quincy St.   Details.

Friday

10 – 11:50a.  “Building a Research Agenda for Global Mental Health.”   Pamela Y. Collins.   MIT 3-333. :    Details.

Noon.  “Top Medical Discoveries in the Last Century.”   Sanjiv Chopra and Mark Aronson.   HMS:  Medical Education Center, Walter Amphitheater, 260 Longwood Ave.   Details.*

12:30 – 4p.  “Food+ Symposium.”   Harvard:  Geological lecture Hall, 24 Oxford St.   Detail, RSVPs.

Coping with life in the snow maze #BOSnow

1st BOSnow Jan 27From CommonHealth

Debating Vitamin D: Leading Docs Still Wrangling On Best Dose For Patients

Globe on Snow Shoes for exercise. (It’s too deep to x-country ski.) 

Strap on your snowshoes and head out. Snowshoeing is one of the best winter exercises for staying fit, says Matt Heid, a contributing editor and blogger for the Appalachian Mountain Club. The cardio workout burns 420 to 1,000 calories per hour, depending on the conditions, according to a study conducted by the University of Vermont. Here are a few trappings for the newbies and experienced, with tips from Heid.

2nd BOSnow Feb  9From Our Bodies Ourselves:

What’s the Connection Between Snowfall in Boston and Health and Human Rights?

First, the health effects of extreme temperatures hit those with fewest resources — money, housing, safety, good health — hardest. It makes sense if you think about it: If you’re already sick, or living in a violent home or neighborhood, added difficulty getting around is much more serious than for healthy people who are safe at home.

Team Rubicon to the rescue:3rd BOSnow Feb 15

Team Rubicon has begun to receive requests for assistance with emergency snow removal across eastern MA and southern NH, focusing on the elderly and those who are not physically able to remove snow. Many of these residents have found themselves unable to move to/from their homes, or are not able to receive critical heating oil deliveries, a potentially dangerous situation with temperatures dropping across the region.

We are currently collecting availability for volunteers to assist with snow removal this weekend for part of or all of these days: Friday, 2/20, Saturday, 2/21, and Sunday, 2/21. We plan to shovel snow to clear pathways and potentially rake snow from roofs to prevent structural damage or collapse.

We are working with a range of other organizations (FEMA, VOADs, and various cities and towns throughout the impacted areas) to assess needs. A decision on whether to deploy strike teams will also depend on weather and safety considerations. Based on the response to this form, we will determine the appropriate area(s) of operation and timing. We could potentially have teams located in multiple areas. We will provide an update NLT 2100 on Thursday, February 19 to those who register their availability.

Can’t join in these areas this weekend? No problem. You can still participate in the #TRBigDig to ensure that first responders are able to access fire hydrants to operate safely and effectively during emergencies and to clear storm drains to prevent flooding when the snow melts. Let us know you took part by checking in athttp://bit.ly/TRbigdig.

 

 

#BOSnow How hospitals and other provider are coping with six feet of snow

Here’s the Globe story on how the hospitals are coping. Usually a perennial but this yearBOSnow feb920150209_0094 is a little different — 72 inched and it’s snowing again.

With snow piled up to historic levels, and the region’s subways and commuter rail systems halted Tuesday, administrators labored to keep their hospital doors open, hobbled by a stranded workforce and patients unable to get home.

“This has put us in a capacity crisis situation,” said Dr. Paul Biddinger, Massachusetts General Hospital’s medical director for preparedness.

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