Howie and Harlan are joined by Manisha Juthani, a Yale infectious disease specialist and commissioner of the Connecticut Department of Public Health. They discuss her research, including a study casting doubt on the use of cranberries to prevent urinary tract infection, and her priorities for Connecticut. Harlan reports on a wave of study retractions from the Dana-Farber Cancer Institute; Howie reflects on the progress made toward eradicating Guinea worm and malaria. 

Links:

Retractions from the Dana-Farber Cancer Institute

“Dana-Farber Cancer Institute Researchers Accused of Manipulating Data”

“Top Cancer Center Seeks to Retract or Correct Dozens of Studies”

Pubpeer: The Online Journal Club

“‘A lot of it is sloppiness’: the biologist who finds flaws in scientific papers”

Manisha Juthani

“An Outbreak of Domestically Acquired Typhoid Fever in Queens, NY”

Manisha Juthani: “Effect of Cranberry Capsules on Bacteriuria Plus Pyuria Among Older Women in Nursing Homes—A Randomized Clinical Trial”

“Reduction of Bacteriuria and Pyuria After Ingestion of Cranberry Juice” 

Yale School of Medicine Medical Grand Rounds: “Debunking a myth: cranberry products for UTI prevention”

Connecticut Department of Public Health

Connecticut Department of Public Health: About the Commissioner

Connecticut Department of Public Health: Statistics and Research

“Court: CT can keep law that ends religious exemptions for vaccines”

“Congenital syphilis cases in the U.S. have skyrocketed, CDC says”

Eradicating Parasites

“Jimmy Carter took on the awful Guinea worm when no one else would—and he triumphed”

“Cape Verde reaches malaria-free milestone”

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Howie and Harlan are joined by Yale SOM alum Claudine Litman, a designer and the director of Yale‘s Center for Outcomes Research & Evaluation, to talk about using the tools of design to build more effective healthcare spaces and processes. Harlan looks at seven charts illustrating the state of healthcare in 2023; Howie reports on the FDA reprimanding a drug company for misleading advertising.

Links:

Healthcare in 2023

"Seven Charts That Sum Up U.S. Healthcare In 2023"

Designing Better Healthcare

Yale School of Medicine:Center for Outcomes Research & Evaluation

Design for Care: Innovating Healthcare Experience

This Is Service Design Doing: Applying Service Design Thinking in the Real World

The Design of Business: Why Design Thinking is the Next Competitive Advantage

Misleading Advertising

"FDA scolds Novartis over a misleading TV ad for a breast cancer treatment"

Public Law 87-781, 76 STAT 780

FDA: Letter to PharmD

Direct-to-Consumer Prescription Drug Advertisements:  Presentation of the Major Statement in a Clear, Conspicuous, and Neutral Manner in Advertisements in Television and Radio Format Final Rule Questions and Answers Guidance for Industry

NIH: Direct-to-Consumer Pharmaceutical Advertising

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Howie and Harlan are joined by Reshma Ramachandran, a Yale family physician and co-director of Yale Collaboration for Regulatory Rigor, Integrity, and Transparency. They discuss the potential ramifications for healthcare regulation if the Supreme Court overturns the Chevron decision requiring judges to defer to federal agencies. Harlan looks at surveys suggesting an erosion of trust in medicine; Howie reports on the growing measles outbreak.

LInks:

Trust in Healthcare

“Nurses First, Doctors Distant Second in Healthcare Provider Ratings”

“KFF Health Tracking Poll: Health Care Issues Emerge as Important Topics on 2024 Campaign Trail, Plus Concerns Loom Large Around Medicaid Unwinding”

Reshma Ramachandran

“What is Ayurveda?”

“On Writ of Certiorari to the United States Court of Appeals for the First Circuit: BRIEF OF DR. RESHMA RAMACHANDRAN AND DR. JOSEPH S. ROSS AS AMICI CURIAE IN SUPPORT OF RESPONDENTS”

“Agencies’ Power Under Scrutiny in Supreme Court Arguments”

“Supreme Court could reel in power of federal agencies with dual fights over fishing rule”

“Case brought to Supreme Court by herring fishermen may gut federal rulemaking power”

Reshma Ramachandran: “Medical Product Industry Ties to Patient Advocacy Organizations’ Executive Leadership”

Reshma Ramachandran: “Do Advocacy Groups Always Put Patient Interests First?”

“Citizens United Explained”

The Measles Outbreak

“Another person infected with measles at a Northeast daycare as Philadelphia outbreaks grows to nine cases”

“DC Cautions Residents of a Potential Measles Exposure”

CDC: Measles Cases and Outbreaks

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Howie and Harlan discuss the winter wave of COVID-19 and Howie’s experience with the Novovax vaccine, report on potential side effects of the next-generation weight-loss drugs, and unpack the economics of Florida’s plan to import drugs from Canada. 

Links:

Sid Wolfe

“Sidney M. Wolfe, Scourge of the Pharmaceutical Industry, Dies at 86”

COVID-19

“Florida surgeon general calls for halt on mRNA covid vaccines, citing debunked claim”

"Safety and Adverse Events Related to Inactivated COVID-19 Vaccines and Novavax;a Systematic Review"

“Paul Offit Debunks Florida Surgeon General's Anti-Vax Warning”

“Does Novavax's Covid vaccine cause fewer side effects?”

“SOTP: State-of-the-Pandemic: The pandemic's 2nd biggest wave of infections and what the JN.1 variant is telling us”

“Deaths induced by compassionate use of hydroxychloroquine during the first COVID-19 wave: an estimate”

Weight-Loss Drugs 

“FDA looking into reports of hair loss, suicidal thoughts in people using popular drugs for diabetes and weight loss”

“Semaglutide and risk of suicidal ideations”

“January - March 2023 | Potential Signals of Serious Risks/New Safety Information Identified by the FDA Adverse Event Reporting System (FAERS)”

Elevance and Medicare

“Elevance sues HHS over Medicare Advantage star ratings”

“How the Tukey Method Could Impact Star Ratings”

TriNetX: Explore. Discover. Connect

Large Language Models

“Diagnostic Accuracy of a Large Language Model in Pediatric Case Studies”

“Artificial Intelligence and Machine Learning in Clinical Medicine, 2023”

Drug Imports

“US FDA to allow Florida to import cheaper drugs from Canada”

“FDA approves Florida's request to import cheaper drugs from Canada”

“Price-Fixing Case Reveals Vulnerability of Generic Drug Policies”

June Jackson Christmas 

“June Jackson Christmas, Pioneering Psychiatrist, Dies at 99”

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Howie and Harlan are joined by Julie Ann Sosa, chair of the University of California San Francisco department of surgery. She reports on new approaches to treating thyroid nodules, addressing sexual harassment within the medical profession, and supporting personal and professional success for doctors caring for elderly parents. Harlan and Howie discuss the upswing in COVID-19 cases and research on whether the benefits of exercise could be delivered by a pill.

Links:

Prospects for Faculty in the Arts and Sciences: A Study of Factors Affecting Demand and Supply, 1987 to 2012

Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013

Active Surveillance Versus Thyroid Surgery for Differentiated Thyroid Cancer: A Systematic Review

The importance of surgeon experience for clinical and economic outcomes from thyroidectomy.

Addressing Eldercare to Promote Gender Equity in Academic Medicine

Sexual harassment, sexual assault and rape by colleagues in the surgical workforce, and how women and men are living different realities: observational study using NHS population-derived weights

CDC | COVID Data Tracker

CDC | Stay Up to Date with COVID-19 Vaccines

"Could exercise pills help create a healthier society?" 

Safety and Efficacy of Plasma Transfusion From Exercise-trained Donors in Patients With Early Alzheimer's Disease (ExPlas)

"Latest data shows millions of eligible Americans have been disenrolled from Medicaid" 

KFF | Medicaid Enrollment and Unwinding Tracker

National Bureau of Economic Research | Oregon Health Insurance Experiment

"More than 13 million people lost Medicaid coverage this year, with Texas an epicenter of the 'unwinding'"

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Howie and Harlan are joined by Eric Winer, director of the Yale Cancer Center and president of Yale's Smilow Cancer Hospital. They discuss his career, his personal experiences with hemophilia and HIV, and the state of breast cancer treatment. Harlan reports on the retraction of a high-profile study on the effect of hearing aids on dementia; Howie provides some good news from an annual report on health expenditures in the U.S. 

Links:

A Retracted Study

“Retraction—Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohort”

The original study: “RETRACTED: Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohort”

Eric Winer

Dana Farber Cancer Institute

Wikipedia: Alexei Nikolaevich, Tsarevich of Russia

Wikipedia: Nicholas and Alexandra

CDC: What is Hemophilia?

“Bayer division 'knowingly sold' HIV-infected protein”

Eric Winer: 2023 ASCO Presidential Address, “Partnering With Patients: The Cornerstone of Clinical Care and Research”

Eric Winer: “Breast Cancer Treatment: A Review”

"‘I’m Scared to Death.’ Behind the Shortage Keeping Cancer Patients From Chemo"

National Health Expenditures

CDC: National Health Expenditure Data

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Howie and Harlan are joined by Tina Loarte-Rodríguez, associate director, health equity measures, at Yale’s Center for Outcomes Research & Evaluation and the author of Latinas in Nursing: Stories of Determination, Inspiration, and Trust. And Howie and Harlan discuss the clinical and economic dimensions of two newly approved CRISPR-based treatments for sickle cell disease. 

Links:

Tina Loarte-Rodríguez

Tina Loarte-Rodríguez: Latinas in Nursing: Stories of Determination, Inspiration, and Trust

Center for Outcomes Research & Evaluation (CORE)

Center for Outcomes Research & Evaluation: Quality Measurement

“Sociodemographic Disparities in Queue Jumping for Emergency Department Care”

New Treatments for Sickle Cell Disease

“In historic decision, FDA approves a CRISPR-based medicine for treatment of sickle cell disease”

“F.D.A. Approves Sickle Cell Treatments, Including One That Uses CRISPR”

The Nobel Prize in Chemistry 2020

Yale New Haven Health: Sickle Cell Program

“Milestones in Sickle Cell Research and Care”

Bluebird Bio

Yahoo Finance: Bluebird Bio, Inc.

“Tough road ahead for Bluebird Bio despite FDA approval for sickle cell therapy”

“Harlan M. Krumholz Named Next Editor-in-Chief of JACC”

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Howie and Harlan are joined by Tara Sanft, chief patient experience officer at Yale’s Smilow Cancer Hospital and director of the Survivorship Program at the Yale Cancer Center. Harlan reports on his study of patients with long-lasting symptoms after the COVID-19 vaccine; Howie reflects on the historic decline in cigarette smoking in the United States. 

Links:

Post-Vaccination Syndrome

Harlan Krumholz: “Post-Vaccination Syndrome: A Descriptive Analysis of Reported Symptoms and Patient Experiences After Covid-19 Immunization”

Patient Experience and Cancer Survivorship

Tara Sanft: “Rekindling Joy in Medicine Through Thoughtful Communication: A Practical Guide”

“Impact of the COVID-19 Pandemic on Breast Cancer Screening and Operative Treatment”

“Impact of Financial Burden of Cancer on Survivors’ Quality of Life”

Yale Medicine: Cancer Survivorship

The White House: Cancer Moonshot

The Decline in Smoking

“Trends in US Adult Smoking Prevalence, 2011 to 2022”

"BAT Writing Off £25 Billion on US Cigarettes, Shares Fall"

"Vaping Declines Among High School Students, Survey Shows"

"Why Philip Morris Stock Is Falling After Earnings Beat Expectations"

"Big Tobacco Rethinks Its Smoking Addiction"

National Cancer Institute: Cancer Stat Facts: Common Cancer Sites

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Howie and Harlan are joined by Stephanie Sudikoff, an expert on using simulation to train healthcare professionals, to discuss her new venture working to expand treatment for neonatal jaundice and how simulating procedures can assist in quality control and ongoing training. They also look at new developments in AI in radiology and the economics of a powerful treatment for inflammation. 

Links:

AI and Radiology

“Imaging AI hogs the spotlight at RSNA, with debuts from GE, Siemens, Philips”

“Accuracy of ChatGPT, Google Bard, and Microsoft Bing for Simplifying Radiology Reports”

“Characterizing the Clinical Adoption of Medical AI Devices through U.S. Insurance Claims”

“Kim Kardashian Got a Full Body Scan, Why Medical Experts are Concerned”

“Design goal: Photon Counting CT engineered with Deep Silicon technology to enable advanced CT Imaging”

Heart Flow: Revolutionizing Precision Heart Care

Neonatal Jaundice and Medical Simulation

Little Sparrows Technologies: Big Ideas for Little Babies

Stephanie Sudikoff: “Variability in quality of chest compressions provided during simulated cardiac arrest across nine pediatric institutions”

“‘The Damar Effect’—the nationwide backorder on a lifesaving machine and the 620% increase in CPR”

Stephanie Sudikoff: “An Approach to Confederate Training Within the Context of Simulation-Based Research”

"Assessing the quality of primary healthcare in seven Chinese provinces with unannounced standardised patients: protocol of a cross-sectional survey"

The Economics of Dupixent

“Sanofi, Regeneron say Dupixent succeeds in another late-stage COPD study, setting up filing for FDA approval”

“With new trial data, a blockbuster therapy from Sanofi, Regeneron could find an even bigger market”

“A Drug for Itchy Dogs Costs $1,200. Why Is the Human Equivalent $43,000?”

“Dupilumab for COPD with Type 2 Inflammation Indicated by Eosinophil Counts”

Regeneron: “Dupixent ® (Dupilumab) significantly reduced COPD exacerbations in second trial”

“HHS Selects the First Drugs for Medicare Drug Price Negotiation”

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Howie and Harlan are joined by Jerold Mande, a nutrition expert who has served in the FDA, where he led the graphic design of the Nutrition Facts label, and the USDA. Harlan reports on promising new therapies for sickle cell disease, high cholesterol, and hypertension; Howie reflects on the Thanksgiving holiday and the contributions of former First Lady Rosalynn Carter, who died this week.

Links:

New Therapies

“Sickle-Cell Treatment Created With Gene Editing Wins U.K. Approval”

“Updated data show long-term benefits of CRISPR treatment for sickle cell, beta thalassemia”

“A Randomized, Double-Blind, Dose-Ranging Study of Zilebesiran in Patients With Mild-to-Moderate Hypertension—KARDIA-1”

“Effects of Intensive Blood Pressure Lowering Treatment in Reducing Risk of Cardiovascular Events —ESPRIT”

“VERVE-101: CRISPR-Based Gene Editing Therapy Shows Promise in Reducing LDL-C and PCSK9 Levels in Patients With HeFH”

Food and Health

“An Epidemic of Chronic Illness Is Killing Us Too Soon”

“Fatty Liver Was a Disease of the Old. Then Kids Started Getting Sick.”

“Bariatric Surgery at 16”

Nourish Science

USDA: Characteristics and Influential Factors of Food Deserts

Tufts University | Food Prices for Nutrition | Diet cost metrics for a better-fed world

Trouble With Erythritol

“Lead and Cadmium Could Be in Your Dark Chocolate”

“New evidence links ultra-processed foods with a range of health risks”

“Americans Are Addicted to 'Ultra-Processed' Foods, and It's Killing Us”

The End of Overeating: Taking Control of the Insatiable American Appetite

USDA: Learn how to eat healthy with MyPlate

Rosalynn Carter and Doing Good

“Altruism, Happiness, and Health: It’s Good to Be Good”

The Carter Center: Remarks of Former First Lady Rosalynn Carter at the National Press Club, Washington, D.C

“It’s Good To Be Good: 2014 Biennial Scientific Report On  Health, Happiness, Longevity, And Helping Others”

“Rosalynn Carter, First Lady and a Political Partner, Dies at 96”

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