by Tony Cusano | Dec 30, 2018 | Public
The FDA recently issued a warning about the old and very commonly used antibiotics like ciprofloxacin.
The side effect is rare, but the loss ratio of aneurysm rupture is devastatingly large.
Anytime you need to make a medical decision, even one that seems as trivial as taking an antibiotic, be sure to fully understand the benefits, risks, alternatives and unknowns. And share your values and goals with your doctor so the decision is right for you.
We can help if you feel uncertain how to do that.
Email us, or call 203-692-4422 for a free consultation.
by Tony Cusano | Dec 16, 2018 | Public
An expert consensus statement such as this one recently released by the American Heart Association about a topic with such incomplete science should include a full transcript of all the deliberations in order to allow physicians and the public to judge the logic and factual accuracy behind the consensus statement.
Much data for performing a full scientific evaluation of these medications remains uncollected. In that setting it is not appropriate for experts to make a “scientific” statement that does not fully describe the derivation of the statement.
Statins, like any medical therapy, should only be used after shared decision between a patient and doctor after they fully discuss the benefits, risks, alternatives and unknowns of the treatment planned.
If you need help collaborating with your doctor to make medical decisions, we can help. Contact us for a free consultation.
by Tony Cusano | Nov 17, 2018 | Public
Many new and promising medications have been approved by the FDA over the past few years. While these drugs offer novel benefits for difficult diseases like Diabetes Mellitus, heart disease and cancer, the science behind them is incomplete.
A recent plea by an expert physician for his colleagues to use a new type of diabetes drug reveals the danger of biased emotions in making medical decisions to use such new drugs.
1) This physician has disclosed significant financial ties to the pharmaceutical industry
2) He states real facts about these drugs, and those facts indicate that for now the drugs should be available in every physician’s armamentarium for treating patients with DM.
3) The bias is to loosen the criteria used to decide on when to use them. Their serious adverse effects are likely more common than reported, as is usually discovered once drugs tested on limited numbers of subjects are used on larger numbers of patients in less rigorously controlled community practice settings.
Additionally, there are unknown adverse effects that are likely to be discovered as they are used for longer periods than the initial testing covered.
Finally, although they were effective as tested, the effectiveness was in a small minority of all patients who received them. Their benefits only slightly outweighed the risks.
In this situation, each decision must rigorously account for the balance of benefits, risks, alternatives and unknowns. There are patients who should get them based on their situation without more established alternatives, but those patients should be carefully chosen, and be fully educated about the BRAU that goes into the decision.
These drugs may someday be widely used, or they may have a niche use, but enthusiasm is neither scientific nor disciplined medical practice.
It has no place in medical decisions.
Be sure to collaborate fully with your doctor to make a shared decision when he or she offers a new medication for any condition.
by Tony Cusano | Nov 11, 2018 | Public
This harrowing five-part story adapted from ‘The Digital Doctor’ by Robert Wachter describes a near disaster due to a medication error augmented by a high-quality hospital’s Electronic Health Record. It starkly reveals the risks of medical care in the digital age. Too much system noise and overwhelmed caregivers make even routine decisions and tasks take on a high level of risk.
Vigilance is required at every turn. If you feel that you are overwhelmed managing a hospital episode for yourself or a loved one, or in keeping track of the complex facts of your medical care, we can help.
by Tony Cusano | Sep 20, 2018 | Public
This very well written review of scientific issues regarding complementary and alternative medicine reminds us of the challenges in making good medical decisions when medical science is incomplete.
The author points to one study of an asthma remedy that improved breathing symptoms without changing lung function. That could lead to fatal consequences,
Yet, as author Andrew Solomon says In this wise and humorous story of how exorcism can cure depression, “for depression, if I can stand on my head and jump up and down three times and feel better, that works.”
Conditions that involve less pathology than symptomatology are perfect for traditional remedies. But seemingly harmless remedies that relieve symptoms without improving the underlying pathology can be very dangerous.
We encourage you to take charge of your health care. We also advise rigorous evaluation of the benefits, risks, alternatives and unknowns of any treatment, whether the science behind it is rigorous, or weak.
We can help you find information or sort out the information you have.
Call for a free consultation.
by Tony Cusano | Sep 17, 2018 | Public
A large and rigorous study to look an the question of whether aspirin makes sense for older people to prevent cardiovascular events raises serious questions about its benefits and risks.
The study showed more risk than benefit, and found more death from cancer in those using aspirin. This raises great concern that previous positive studies were statistical flukes.
Unfortunately, The way medical statistics are used by medical scientists leads to most medical studies turning out to be wrong.
This is another spectacular example of why you should make a careful and collaborative evaluation of the benefits, risks, alternatives and unknowns of every medical decision.
The use of single chemicals to alter the human body, Even those found in natural sources like willow bark and other traditional medicinal plants which contain the main ingredient of aspirin, has some merit, but may make little sense for many people.
If you want to learn more about how to evaluate medical studies, or to collaborate with your doctor better to make good medical decisions, we can help.
Call is for a free consultation.
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