Though doctors and drug makers tout “average” effects, many treatments deliver a smorgasbord of results—substantial benefits for some people, little benefit for many, and harm for a few. Why don’t we hear more about this variability?
Author Archives: Hank Copeland
Eleven cognitive biases and statistical errors that can interfere with finding the best treatment
Most people’s tests of potential treatments for chronic conditions involve haphazard cycling through doses and brands, spotty symptom diaries and no statistical analysis of results. This lack of rigor introduces numerous cognitive biases.
Why the name (and question mark)?
In the spring of 2019, we had been talking for nearly a year about building a software toolkit to help automate what many people already do informally—track symptoms and statistically evaluate the effects of various treatments. As the idea started to jell, we started casting about for names for the toolkit. Though there are a […]
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 […]
Positive outcomes in Random Control Trials (RCTs) seem anything but random
Industrial medicine views random control trials (RCTs) as the gold standard for determining the efficacy of medications. The thinking goes: blinding, controls/placebos and regular reporting produce objectively reliable, generalizable results. Yet critics argue that RCTs, at least the ones that clinicians habitually read in the reprints of medical journal articles shared by drug company reps, […]
Many drugs have no extra benefits for many patients
A new study of recently introduced drugs in Germany finds that many of the drugs confer no appreciable benefit relative to existing drugs: Between 2011 and 2017, IQWiG assessed 216 drugs entering the German market following regulatory approval, they explain. Almost all of these drugs were approved by the European Medicines Agency for use throughout […]
8) What’s ahead?
Medicine beyond the clinic: wearables + genomics + networked patients + AI Pulling together everything that’s above, we can predict the location and shape — if not the exact form — of what what’s ahead in the next 20 years. Obviously, large chunks of the industry of medicine will remain intact. Health care specialists and institutions focused on obstetrics, orthopedics, […]
7) What does all this mean for the medical industry?
Simpler, cheaper and serving non-consumers, disruption creeps in from the edges To get a glimpse of what’s ahead for health care — both the medical industry and the consumer services that will grow up, around and below that industry — there’s no better guide than the theory of innovation and industrial life cycles first described in 1995 by Clayton Christensen, […]
6) The medical industry can’t keep up
Diagnostics and treatments already lag best practices by 17 years Given these cascading exponential changes, what might we say about the future of US healthcare, beyond the most obvious — expect the unexpected? Let’s start with the effect of this multi-dimensional convergence of change shock waves on the existing US medical industry. First, obviously, many innovations will be […]
