Patient care under uncertainty: Or why I learned to stop loving clinical practice guidelines

The National Cancer Institute defines personalized medicine as “uses information about a person’s genes, proteins, and environment to prevent, diagnose, and treat disease”. In practice, however, patient treatment is rarely personalized by individual since evidence to support complete personalization is rarely available. Personalization in practice more often means care that varies with some individual characteristics.…

The Fourth of July is fun, but…

The Fourth of July is a fun holiday. We celebrate America’s independence, bar-b-que, and watch fireworks.  I have many good memories watching the fireworks on July 3 (yes, in Milwaukee the largest fireworks display actually happens July 3). At the same time, the Fourth of July does have a number of health hazards to be…

Are e-cigarettes healthy?

Clearly, the answer is no.  It is best not to smoke at all.  From a policy perspective, however, there is a question of whether e-cigarettes should be regulated and taxed heavily–like regular cigarettes–or more lightly.  If e-cigarettes are relatively healthier than standard cigarettes, less taxes/regulation would be merited.  If, however, e-cigarettes induce more individuals to…

What is evidence-based health policy?

Many people have heard of evidence-based medicine (EBM).  A perspective piece in the New England Journal of Medicine by Katherine Baicker and Amitabh Chandra, however, tries to define what evidence-based health policy (EBHP) is.  They list three key criteria: Policies need to be well-specified.  For instance, “expand Medicaid coverage” is too general, whereas specifying that benefit package A…