Health & Veritas

Howie and Harlan are joined by Leora Horwitz, director of the Rapid Randomized Controlled Trial Lab at NYU Langone Health, to discuss her work using experimentation to improve the delivery of care, and her experience as a clinician and researcher in the chaotic first months of the COVID-19 outbreak in New York City. Harlan reports on his new study examining the impact on patients of early-morning blood draws in hospitals; Howie reflects on new business models for delivering discounted generic drugs. Links: Harlan Krumholz: “Timing of Blood Draws Among Patients Hospitalized in a Large Academic Medical Center” Leora Horwitz: “Constant, rapid testing is key to creating the ‘learning health system’ of the future” NYY Langone Health: Rapid Randomized Controlled Trial Lab Leora Horwitz: “‘I Am Not the Same as I Was Before’: A Qualitative Analysis of COVID-19 Survivors” Leora Horwitz and Harlan Krumholz: “Comprehensive quality of discharge summaries at an academic medical center” Leora Horwitz: “Tweeting Into the Void: Effective Use of Social Media for Healthcare Professionals” Leora Horwitz on Twitter Mark Cuban Cost Plus Drugs "Amazon launches $5-a-month unlimited prescription plan" “Introducing RxPass from Amazon Pharmacy, a $5 prescription subscription that helps Prime members who take multiple medications save time and money” Amazon: RxPass

Howie and Harlan talk with Gil Addo, CEO and co-founder of RubiconMD, which is aiming to expand access to specialty care by providing virtual consultations to primary care physicians. A new study from Harlan examines a loophole that is allowing unreliable medical devices to enter the market; Howie provides an update on legislature that will soon cause millions to lose Medicaid coverage. Links: Harlan Krumholz: “Use of Recalled Devices in New Device Authorizations Under the US Food and Drug Administration’s 510(k) Pathway and Risk of Subsequent Recalls” “Association Between Regulatory Submission Characteristics and Recalls of Medical Devices Receiving 510(k) Clearance” RubiconMD: Virtual Specialty Care & Online Consultation “Oak Street Health Acquires Virtual Specialty Care Provider RubiconMD” “Consolidated Appropriations Act, 2023: Medicaid and CHIP Provisions Explained” “Medical bills still plague Americans, more than a decade after the ACA” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan check in on health issues that are in the news—or will be soon. Harlan discusses his work measuring patient outcomes and new avenues of research on long COVID; Howie reports on the perverse effects of private equity investment in specialty healthcare practices and the looming deadline facing state Medicaid programs.  Links: "What we learned about the NFL in the aftermath of Damar Hamlin’s cardiac arrest" Céline Gounder: "Grant Wahl Was a Loving Husband. I Will Always Protect His Legacy." Harlan Krumholz: “Outcomes Research: Generating Evidence for Best Practice and Policies” Harlan Krumholz: “Real-world Imperative of Outcomes Research” Academy of Managed Care Pharmacy: Outcomes Research "Families First Coronavirus Response Act Medicaid and CHIP Provisions Explained" "Millions Could Lose Medicaid by April as Pandemic Rules Ease" "More Orthopedic Physicians Sell Out to Private Equity Firms, Raising Alarms About Costs and Quality" Harlan Krumholz: “A Decentralized Phase 2 Efficacy and Safety Study of Nirmatrelvir/Ritonavir in Adult Participants With Long COVID (PAXLC)” Harlan Krumholz: "Long Covid: Understanding Immune, Symptom, and Treatment Experiences Nationwide (LISTEN Study)" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Harlan answers questions about the cardiac arrest suffered by Buffalo Bills player Damar Hamlin in a nationally televised football game; Howie reports on the rapid spread of the XBB 1.5 variant of COVID-19. And they are joined by F. Perry Wilson, a Yale nephrologist and an expert in the translation of medical research into clinical care, to discuss his new book, How Medicine Works and When It Doesn’t: Learning Who to Trust to Get and Stay Healthy. Links: “Buffalo Bills player Damar Hamlin suffers a cardiac arrest during Monday's game” “What Is Cardiac Arrest? What to Know About Why Damar Hamlin Collapsed” F. Perry Wilson: How Medicine Works and When it Doesn't: Learning Who to Trust to Get and Stay Healthy “Exposed: conman's role in prayer-power IVF ‘miracle’” “The MMR vaccine and autism: Sensation, refutation, retraction, and fraud” “Omicron offshoot XBB.1.5 could drive new Covid-19 surge in US” Eric Topol: “A new variant alert” Eric Topol on Twitter: “Why hasn't Paxlovid implementation lived up to its expectations?”

Howie and Harlan are joined by Lisa Sanders, the Yale internist who writes the "Diagnosis" column in the New York Times. Harlan reports on new studies demonstrating the ineffectiveness of ivermectin in treating COVID-19, and the effectiveness of the bivalent booster in improving outcomes. And Howie reacts to headlines about frequent misdiagnoses in emergency departments.  Links: “Effect of Ivermectin 600 μg/kg for 6 days vs Placebo on Time to Sustained Recovery in Outpatients with Mild to Moderate COVID-19: A Randomized Clinical Trial” Katelyn Jetelina: “Fall bivalent boosters: Science update round 4” Eric Topol: “A quick update on the bivalent boosters” “DeSantis calls for grand jury to investigate Covid-19 vaccines” Diagnosis: Dr. Lisa Sanders on hard-to-solve medical mysteries “Introducing 'Diagnosis,' a New Show From The Times and Netflix” “Diagnostic Errors in the Emergency Department: A Systematic Review” “E.R. Doctors Misdiagnose Patients With Unusual Symptoms” “More than 7 million incorrect diagnoses made in US emergency rooms every year, government report finds”

Harlan reports on a new study suggesting dramatic health benefits from bursts of vigorous activity; Howie explains how genetic science is starting to illuminate a mystery in his own medical history. And they are joined by Yale physician and scientist Jeffrey Gruen to discuss his work identifying the genetic variants associated with dyslexia and designing early interventions for kids with learning disabilities.  Links: ”Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality” Dr. Jeffrey Gruen –The New Yale Program for Learning Disabilities Research New Haven Lexinome Project Sherman Weissman, MD “Revenge of the gaslit patients: Now, as scientists, they’re tackling Ehlers-Danlos syndromes” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Harlan reports on new research on effective prostate cancer screening; Howie explores the potential of the AI language model ChatGPT. And they’re joined by Dr. Kristen Nwanyanwu, a Yale ophthalmologist with a focus on closing the racial gap in the treatment of diabetic retinopathy. Links: “Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only” Kristen Nwanyanwu: “Addressing Disparities in Ophthalmic Research” “U.S. Supreme Court rules on University of Michigan cases” “The Pandemic’s Legacy Is Already Clear” Kristen Nwanyanwu: “Ophthalmology Departments Remain Among the Least Diverse Clinical Departments at United States Medical Schools” Minority Ophthalmology Mentoring Eyeful LLC ChatGPT: Optimizing Language Models for Dialogue Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Dr. Eric Topol, a physician and writer who is widely recognized both as a leading researcher and a public voice on medicine and health. They discuss his career turn toward genomics and digital health, and the fight against misinformation on Twitter.  Links: “Adding Salt to Foods and Risk of Cardiovascular Disease” Eric Topol: Ground Truths Eric Topol: The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care (2011) Eric Topol: The Patient Will See You Now: The Future of Medicine Is in Your Hands (2015) Eric Topol: Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again (2019) Eric Topol on Twitter Scott Gottlieb on LinkedIn: “The GLP-1s emerge as the largest class of peptide drugs of all time” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Harlan reports on a unprecedented recall of ventilators and CPAP machines; Howie discusses a new approach to tackling the issue of antimicrobial resistance. And they’re joined by Dr. Nancy Brown, dean of the Yale School of Medicine, to discuss her career path and her investments in developing talent. Links: FDA Update: Certain Philips Respironics Ventilators, BiPAP Machines, and CPAP Machines Recalled Due to Potential Health Risks “Getting to know Yale leaders—Nancy Brown” WHO fact sheet: antimicrobial resistance PASTEUR Act of 2021 “The PASTEUR Act can help win the war against superbugs” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Harlan provides updates on R.S.V., flu, and COVID-19; Howie considers the growing use of hallucinogens for treatment of severe depression. And they are joined by Dr. Vineet Arora, dean of medical education at the University of Chicago, to discuss the future of medical Twitter and how medical education is changing in the wake of the pandemic. Links: “A ‘Tripledemic’? Flu, R.S.V. and Covid May Collide This Winter, Experts Say” “Twitter has spent years trying to combat health misinformation. Will Musk’s takeover make that harder?” ”A fake tweet sparked panic at Eli Lilly and may have cost Twitter millions” “The ‘bot holiday’ and why clinicians can’t tackle disinformation alone” “What is #MedMastodon & why might we need it?” “Some Twitter users flying the coop hope Mastodon will be a safe landing” University of Chicago: Pritzker EVOLVES “Colorado Legalizes Magic Mushrooms” “Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression” Learn more about the MBA for Executives program at Yale SOM Email Howie and Harlan comments or questions.