The medium is the medicine: a novel history

Medicine’s history is often portrayed as a sequence of discoveries, all made in laboratories. In fact, though, the biggest changes in US medicine over the last 200 years were propelled by forces beyond medicine, specifically, in media. How medicine’s stakeholders communicated in different eras ⁠— in formats including medicine shows, newspapers, cars, telephones, medical journals, and TVs ⁠— determined what, and how much, was communicated. Where information flows, medicine follows: now social media and biomonitors are ushering in a new age, one of patient generated medicine.

What are n-of-1 trials, and what are they good for?

Definition of an n-of-1 trial An n-of-1 trial is a experiment conducted for a single person in which treatment blocks are randomly rotated, symptoms are systematically logged, and results are statistically analyzed. Since many treatments work differently for different individuals, n-of-1 trials help determine a treatment’s efficacy for a specific individual. N-of-1 trials are typically […]

Which strategy works best to disrupt a social media addiction?

In an article in Harvard Business Review, author Sarah Peck sums up the relative success of four strategies she tested to break her own social media addiction. No social media for 30 days, which was ‘easier than expected.’ Result: after the month was over, Peck discovered her phone was her addiction enabler.  Allowed social sites […]

Research into best practices for personal experiments (aka n-of-trials)

“We spend so much effort on precision in diagnosis, yet we have very little precision about treatment,” observed Dr. Eric Larson, a professor of medicine at the University of Washington.  Experts say that even for widely-studied drugs, “the trial and error approach to medicine is not cost efficient because several of the most prominent drugs […]

Why heterogeneous treatment effects matter… but are often ignored

Roughly a century ago, modern medicine got off to a roaring start with the steady introduction of population-wide solutions for illnesses. Louis Pasteur’s discovery in 1870 of the bacterial origin of many illnesses laid a foundation; handwashing cut deaths from operations and childbirth; antibiotics cured many infections; vaccines wiped out polio, smallpox and chicken pox. […]

Eleven cognitive biases and statistical errors that can interfere with identifying an optimal treatment

When there’s not an obvious best treatment for a chronic condition, humans often use trial and error, moving through a list of treatments until one hits. Research into human decision-making suggests that this unstructured approach introduces numerous biases.

Experimenting with melatonin

There’s lots of anecdotal evidence that melatonin supplements help some people sleep but not others. There’s also much debate about the proper dose and timing. For one thing, the amount of melatonin the body produces is miniscule compared with commercial dosages. For another, there’s strong evidence that morning exposure to sunlight leads to a melatonin […]

What’s a good duration for a treatment block in a personal experiment?

The literature on treatment blocks says broadly that blocks may be shorter for faster acting treatments (a one day treatment might be appropriate for pain and aspirin) and longer for treatments that have a slow, cumulative effect. But digging into the literature for both RTCs and n-of-1 experiments, you find a wide variety of treatment […]

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