Do we need Robin Hood to improve our access to medical research?

A graduate student from Kazakhstan named Alexandra Elbakyan  went into hiding after illegally providing free online access to just about every scientific paper ever published, on topics ranging from acoustics to zymology. Paraphrasing part of the United Nations Charter, Ms. Elbakyan said, “Everyone has the right to freely share in scientific advancement and its benefits.” Her file-sharing website is here: Sci-Hub. A New YorkContinue reading “Do we need Robin Hood to improve our access to medical research?”

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The difference between the parties’ health care proposals boils down to how they distribute risk

In a Health Affairs blog post today, two Urban Institute scholars–economist Linda Blumberg and policy fellow John Holahan–state that the fundamental difference between the two parties’ health care proposals is how they propose to share health care expenditures between those currently healthy and those with costly health care needs. The health policies of the two political parties and theirContinue reading “The difference between the parties’ health care proposals boils down to how they distribute risk”

Emergency Department Return Visits as a Quality Metric

A recent JAMA publication lead-authored by Dr. Amber Sabbatini examined the scientific soundness of emergency department (ED) return visits as a measure of the ED’s quality of care. Emergency department return visits have been considered for wider adoption as a quality metric, especially for those patients who are hospitalized during the return ED visit. The “quality”Continue reading “Emergency Department Return Visits as a Quality Metric”

Twenty year trends in female first authorship in medical journals

A study in the British Medical Journal examined the sex of first authors in six of the highest impact medical journals (Annals of Internal Medicine, Archives of Internal Medicine, The BMJ, JAMA, The Lancet, and the New England Journal of Medicine (NEJM)) and found that the proportion of research article first authors who are women rose from 27% in 1994 to 37% in 2014.Continue reading “Twenty year trends in female first authorship in medical journals”

Avoid peanut allergy by early introduction of peanuts

A study released today in the New England Journal of Medicine showed that giving infants small amounts of peanut butter in their first year of life substantially reduced the prevalence of peanut allergy when compared to infants who avoided peanuts for their first year. The investigators found that the safeguard lasted for a year after the children stoppedContinue reading “Avoid peanut allergy by early introduction of peanuts”

Social determinants of health and pay-for-performance readmissions measures

In an article released by JAMA Pediatrics today, my co-authors and I show that social determinants of health (patient factors such as health insurance, poverty and other sociodemographic measures) are risk factors for readmissions-related penalties for children’s hospitals. Without adjusting pay-for-performance (P4P) measures for social determinants of health (SDH), hospitals may receive penalties partially related to patient SDH factors beyondContinue reading “Social determinants of health and pay-for-performance readmissions measures”

Readmissions revisited

I am reposting  a post by Garret Johnson and Zoe Lyon, both research assistants for Dr. Ashish Jha at the Harvard T.H. Chan School of Public Health (who also has a great post on risk-adjustment for readmissions.  The post eloquently explores an issue I’ve visited in a recent post: the importance of understanding the diverseContinue reading “Readmissions revisited”

Guns, Drugs and Cars

This week’s JAMA released a comparison of major causes of injury death and how they contribute to the gap in life expectancy between the US and other high-income countries. Here are their findings: Men in the comparison countries had a life expectancy advantage of 2.2 years over US men (78.6 years vs 76.4 years), asContinue reading “Guns, Drugs and Cars”

How Performance Metrics Fail Healthcare

A recent New York Times article calls attention to the unintended consequences of healthcare performance metrics.  (Disclaimer: I am am favorably disposed to cite any piece that quotes Avedis Donabedian, one of the fore-parents of health quality research methods.)  With widespread use of the electronic health record, gathering data for performance metrics increasingly overshadows clinical care. AContinue reading “How Performance Metrics Fail Healthcare”

Your Team Made the Super Bowl? Better Get a Flu Shot

As an emergency medicine physician, popular spectator events such as the Super Bowl usually mean little more than a temporary slowing in the rate of patient arrivals, especially among males, a phenomenon described in several countries in addition to the U.S. A recent Upshot post shows that the impact of widely popular spectator events extendsContinue reading “Your Team Made the Super Bowl? Better Get a Flu Shot”