Causality: Bradford Hill criteria

If you observe two things occuring, how can you know whether event A causes event B. For instance, consider the case of patients who use a given treatment and finding that they have better health outcomes. While this relationship could be causal in nature, it may not be. For instance, if only people with higher…

The Placebo Effect

The placebo effect is well-known in medicine. Give people a sugar pill, they have shown, and those patients — especially if they have one of the chronic, stress-related conditions that register the strongest placebo effects and if the treatment is delivered by someone in whom they have confidence — will improve. Tell someone a normal…

Estimated prevalence of undiagnosed atrial fibrillation in the United States

This paper–written with co-authors Mintu P. Turakhia, Katalin Bognar, Jeffrey Trocio, Younos Abdulsattar, Daniel Wiederkehr, and Dana P. Goldman–is now up at PLOS One.  The study abstract is pasted below. Introduction As atrial fibrillation (AF) is often asymptomatic, it may remain undiagnosed until or even after development of complications, such as stroke. Consequently the observed…

Why fighting disease is hard

Without a doubt, medicine has made tremendous gains over the last decades and even more progress when viewed across centuries.  Often to treat diseases, physicians and researchers identify a single or primary pathway that is causing the disease.  Maybe there is a gene mutation which causes an abnormality.  Maybe there is a bacteria or virus…

How doctor’s die

Although this Saturday Evening Post article comparing how physicians and patients prefer end of life treatment is from 2013, it is interesting throughout. Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This…