cassowary37

16 ms·

31.
by cassowary37 8y ago
"Spending is reported in 2016 dollars"
32.
by cassowary37 8y ago
Sorry, the blanket dismissal is not entirely correct. Companies like 23andme are indeed trying to repurpose their data to efficiently enroll participants in trials, as the parent post suggests. While it's not the focus of the GSK partn
33.
by cassowary37 8y ago
sleep, sleep, sleep. Nice review here: https://www.ncbi.nlm.nih.gov/pubmed/28579842 Sleep is highly hack-resistant. The brain wants what it wants...
34.
by cassowary37 8y ago
There's high-quality evidence that SSRIs can be cardioprotective, at least in high-risk individuals: https://www.ncbi.nlm.nih.gov/pubmed/30043065
35.
by cassowary37 8y ago
Colorful analogies aside, many people find it tremendously reassuring (and surprising) just to recognize that these thoughts can be a form of OCD. my favorite book for patients is this one by Lee Baer, a bit outdated on the science but the
36.
Temporal Trends and Characteristics of Reportable Health Data Breaches(jamanetwork.com)
3 points by cassowary37 8y ago|0 comments
37.
by cassowary37 8y ago
So many things wrong with this (beyond the typos, misstatements of science, and so forth) it's hard to know where to begin. Here's a simple algorithm: if you feel lousy (=sad, flat/unmotivated, fatigued, anxious) for at least
38.
by cassowary37 8y ago
Missing a key analysis - note this sentence: "Side effects were more commonly reported for both the 4 mg dose (p = 0.039) and 8 mg dose (p = 0.057) compared to placebo" It's highly likely that participants were unblinded by
39.
by cassowary37 8y ago
Psychiatrist here, and long-time fearful flyer who benefited tremendously from CBT. Really impressed by the range of strategies expressed in this thread; I wanted to mention a few things: 1. No one solution will work for everyone, but it&#x
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by cassowary37 8y ago
I'm always struck by the intensity with which some HN folks hate their doc - reminded of this by the number of comments invoking conspiracy theories about docs scheduling extra appointments to bill more or push more generic drugs. Perh
41.
by cassowary37 8y ago
yes, journals do depend on accepting a certain number of publications... the good news is that for a good journal, that number is far far less than the number of submissions. Journals care most about their brand - that is, if journal x gets
42.
by cassowary37 8y ago
Yes, but - this is a highly regulated environment and barriers to entry are quite high. Very hard for new ideas to get a hearing.
43.
by cassowary37 8y ago
sorry, but this exhibits a complete disregard for (or lack of understanding of) the practice of medicine. Many of us love technology - some of us even read hn. But physicians have very little choice regarding use of this kind of technology,
44.
What we lose with data-driven medicine(nytimes.com)
69 points by cassowary37 8y ago|49 comments
45.
by cassowary37 8y ago
I'm late to the game but wanted to provide some context for the discussion. The dominant EMR in hospitals is Epic - can't find a cite but the ballpark is that more than 80% of academic medical centers have adopted (ie, paid thro
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by cassowary37 8y ago
pvals are a lot like the weather - everyone complains about it, nobody does anything about it. Specifically, what tends to be missing from these conversations is a good alternative - the author seems to be asking for false discovery rates&#
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by cassowary37 9y ago
The genetics would argue otherwise. Here's an interesting recent illustration: https://www.ncbi.nlm.nih.gov/pubmed/29167880
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by cassowary37 9y ago
Probably like ADHD, lots of docs would suggest that bipolar is both over- and under-diagnosed. With the rise of the atypical antipsychotics, it became sort of a 'flavor of the month' diagnosis for folks with anxious depression, or
49.
by cassowary37 9y ago
Amen, and well said. I'm a psychiatrist and I worry the most about sleep, full stop. In a disease (or set of diseases, or whatever) that can make people feel so out of control, sleep is one of the best ways to take back control.
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by cassowary37 9y ago
And forgot to mention that there's all sorts of very cool new tools coming - one of my favorites is this one for targeted protein degradation: https://www.ncbi.nlm.nih.gov/pubmed/28223226
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by cassowary37 9y ago
Well, I think it's true that traditionally folks trying to do rational drug discovery are better at targeting certain proteins (cell surface receptors; some enzymes) with small molecules than others. Also true that first generation of
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by cassowary37 9y ago
well said... in order, then... 1. Read the reference before responding; the study looked (in part) at antidepressant-placebo differences. Also - I can't prescribe placebo. 2. Got anything to back that up? 3. OK 4. Because it implies th
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by cassowary37 9y ago
yep, all those cancer cures somehow slipped out despite our best efforts to keep them secret. c'mon, let's be real. The folks who try to develop new treatments are people with family members and friends who get sick too. The reaso
54.
by cassowary37 9y ago
but when you look across 522 studies with more than 100k participants, evidence of efficacy is indisputable: https://www.ncbi.nlm.nih.gov/pubmed/29477251
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by cassowary37 9y ago
Ah, another Benedict Carey antidepressant hatchet job. Anecdotes about withdrawal symptoms + alarmist statistics about number of Americans on antidepressants + vague questions about lack of data suggesting that we know little about antidepr
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by cassowary37 9y ago
This is the right question to ask - not what NSF or NIH can do. I'm afraid I don't have a very satisfying answer, I'm still trying to figure it out myself. The first thing I tell my postdocs is that they can't put their
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by cassowary37 9y ago
What makes you think 'most' faculty appreciate the pyramid scheme? Many of us spend a lot of time worrying about our postdocs' future, in no small part because we recognize that the struggle for funding never actually ends. T
58.
by cassowary37 9y ago
Absolutely. Likely it's bidirectional - pharma identifies high prescribers (or recognized experts) and invite them to speak at conferences or dinner meetings. This increases their affinity for the product, and presumably their prescrib
59.
by cassowary37 9y ago
Apparently we can only have one conflict-of-interest story on the front page at once per mods, but some readers might be interested in further reading on the topic from last year: http://journals.plos.org/plosone/articl
60.
by cassowary37 9y ago
thought I'd repost given recent interest on HN in conflict of interest - rather than looking at impact of payments on specific medications, we wanted to see how much payments distort prescribing costs overall. The variation in impact a

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