Comments on: Why Comparative Effectiveness Research Will Enhance Personalized Medicine

By: Michael F. Sarabia

Michael F. Sarabia — Tue, 07 Jul 2009 05:48:49 +0000

How Comparative Effectiveness Research Could Enhance Personalized Medicine
For example, millions are being treated for Hypertension or high blood pressure.
Yet, while it is known that Japanese and Chinese have a lower blood pressure than Europeans, it is not well accepted that the natives of Africa and Latino America have higher blood pressure than Europeans.
There is disagreement between doctors on the best treatment yet, to my knowledge, there has been only one “Longitudinal” or long term study on the treatment and effect of high blood pressure.
The existance of only one study means that all ethnic groups must be treated with the same doses to achive the standard blood pressure objective, disregarding ethinic differences.

Some, may doubt this is the actual situation and imagine reasons that, presumably, could justify this situation.
They forget that Congress had to mandate that women be included in the tests for the doses to treat cancer.
Evidently, the medical profession overlooked that women have s serious cancer risk.
Evidently, Congress will have to mandate that separate studies be conducted to determine the most effective way to treat hypertesion and, we might as well also include, Diabetes which also has settled on a set of numbers for all ethnic groups. This is my unclear recollection and would be very happy to learn that I am wrong on that.

However, if I am right, perhaps ALL treatments based on a single set of numbers but used, without any confirmation tests on all ethnic groups, must be reconsidered.

At first sight it even appears racists to assume that a treatment that works for those of White Anglo Saxon descend, must also be used for all others, without any tests to prove this is the right decsion.
This reconsideration is urgently needed. I do not wish to lose more relatives.

By: Beverly Smith

Beverly Smith — Mon, 06 Jul 2009 17:06:58 +0000

I want to ask everyone I can reach to read the ANNALS OF MEDICINE, “The Cost Conundrum”, in the New Yorker Magazine of June 1, 2009. It is an investigative piece which compares two
U.S. locations and their use of health care. It is VERY eye-opening!

By: stateofthedivision

stateofthedivision — Sat, 04 Jul 2009 17:18:07 +0000

recall the massive growth in educational testing under Bush’s No Child Left Untested?

It seems two new industries will pop up under health care reform. CER enables insurance companies to mine their databases for profit.

Now we have business process organizations, i.e. layers of contractors like our federal government. The worst hospital administrators I ran across worked like general contractors. They farmed out every department possible to firms with large profit margins. Those administrators couldn’t manage their way out of a wet paper bag.

http://www.reuters.com/article/smallBusinessNews/idUSTRE5613ZF20090702

America suffers from abysmal political and business leadership. Heavy losses are hear and more are coming.

By: stateofthedivision

stateofthedivision — Fri, 03 Jul 2009 22:30:41 +0000

From the NYT article on the top 100 health topics:

and systems for gathering such data by mining hospital or insurance industry records are also very limited.

That’s not personalized medicine, but a scientific cluster _uck.

By: stateofthedivision

stateofthedivision — Fri, 03 Jul 2009 22:23:27 +0000

$1.1 billion for comparative effectiveness including $300 million to the Agency for Healthcare Research and Quality; $400 million for the National Institutes of Health; and $400 million for the Office of the Secretary of Health and Human Services.

Those three agencies have different missions/priorities. It will be interesting which ones set up prospective studies vs. mining existing databases.

By: stateofthedivision

stateofthedivision — Fri, 03 Jul 2009 22:06:47 +0000

“patient-centered, pragmatic, ‘real world’ research”

That’s not insurance companies mining their huge billing data bases for medical effectiveness. They clearly want to do the latter and sell it as CER.

It’s not research in the least.