Health & Veritas

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”  Read an unedited transcript of this episode. Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

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” Read an unedited transcript of this episode. Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan review the results of a new study testing the effects of anti-obesity medications on cardiovascular health. Then they're joined by Yale's John Morton, a leading bariatric surgeon, to discuss the state of weight-loss surgery and its long-term impact on patients' lives. Links: Obesity Drugs “GLP-1 agonists: Diabetes drugs and weight loss” “Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes” “AMA urges insurance coverage parity for emerging obesity treatment options” “National Coverage Determination: Treatment of Obesity” “Real-World Adherence and Discontinuation of Glucagon-Like Peptide-1 Receptor Agonists Therapy in Type 2 Diabetes Mellitus Patients in the United States” “2022 Employer Health Benefits Survey: Section 10 - Plan Funding” Bariatric Surgery Mayo Clinic: Bariatric Surgery Overview John Morton: “Correlating actual one-year weight loss with predicted weight loss by the MBSAQIP: bariatric surgical risk/benefit calculator” “Outcomes of the Ontario Bariatric Network: a cohort study” “Review of the key results from the Swedish Obese Subjects (SOS) trial – a prospective controlled intervention study of bariatric surgery” “Weight loss drugs and the push for Medicare coverage” “Comparative Safety of Sleeve Gastrectomy and Gastric Bypass Up to 5 Years After Surgery in Patients With Severe Obesity” “A Short History of Bernard Fisher’s Contributions to Randomized Clinical Trials” “Persistent metabolic adaptation 6 years after The Biggest Loser competition” “Eligibility for Cardiovascular Risk Reduction Therapy in the U.S. Based on SELECT Trial Criteria: Insights from the National Health and Nutrition Examination Survey” Read an unedited transcript of this episode. Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by the New Yorker's Dhruv Khullar to talk about his life as a clinician, researcher, and journalist. Harlan looks at how direct-to-consumer healthcare companies like Hims & Hers Health are capitalizing on patients' reluctance to share sensitive issues with traditional providers; Howie reports on the health issues on the ballot in this week's election.  Links: The Loss of Trust and the Rise of Hims & Hers Health hims.com forhers.com “Hims & Hers reports 57% revenue increase, launch of AI offering and more earnings news” “Hims & Hers Health Sees Long-Term Tailwind from Weight Management Business” “FDA approves Eli Lilly’s tirzepatide for weight loss, paving way for wider use of blockbuster drug” “A study of the nature and level of trust between patients and healthcare providers, its dimensions and determinants: a scoping review protocol” Dhruv Khullar Dhruv Khullar: “Why Are We So Bad at Getting Better?" The New Yorker: Articles by Dhruv Khullar “A Program to Prevent Functional Decline in Physically Frail, Elderly Persons who Live at Home” Articles by Atul Gawande Dhruv Khullar: “What a Heat Wave Does to Your Body" Kim Stanley Robinson: The Ministry for the Future Dhruv Khullar: “The Struggle to Define Long Covid" Health on the Ballot “Democrats Take Control of Virginia Legislature” “Ohio Vote Continues a Winning Streak for Abortion Rights” “Mississippi Republican Gov. Tate Reeves wins 2nd term, defeating Democrat Brandon Presley” “Poll: 92% of Mississippi voters concerned about hospital crisis, 72% favor Medicaid expansion” “Marijuana use linked with increased risk of heart attack, heart failure” NIH: Marijuana and hallucinogen use among young adults reached all-time high in 2021 Read an unedited transcript of this episode. Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Melinda Pettigrew of the Yale School of Public Health to discuss the changes needed in the prescription and agriculture use of antibiotics to address the crisis of antimicrobial resistance. Harlan reports on a survey underlining the scale of medical misinformation among Americans; Howie discusses a new tool for the treatment of unhoused people.  Links: Medical Misinformation Harlan Krumholz: “A prescription for the US FDA for the regulation of health misinformation” “Vaccine Confidence Falls as Belief in Health Misinformation Grows” Melinda Pettigrew and Antimicrobial Resistance “Melinda Pettigrew—The next dean of SPH!” “New Law Will Help Combat Growing Threat of Antibiotic Resistance” “Short- vs Standard-Course Outpatient Antibiotic Therapy for Community-Acquired Pneumonia in Children” "Gastrointestinal Microbiome Disruption and Antibiotic-Associated Diarrhea in Children Receiving Antibiotic Therapy for Community-Acquired Pneumonia" “Two Yale alum tackle infection diagnostics” “A Review of the Effectiveness of Current US Policies on Antimicrobial Use in Meat and Poultry Production” FDA Fact Sheet: Veterinary Feed Directive Final Rule and Next Steps CDC: Measuring Outpatient Antibiotic Prescribing Treating the Unhoused “Housing Supply and the Drivers of Homelessness” CMS: Place of Service Code Set “New place of service code for treating unsheltered people” Rough Sleepers “‘You Have to Learn to Listen’: How a Doctor Cares for Boston’s Homeless” VA: VA Homeless Programs Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan discuss current issues in healthcare, including burnout at the hospital, the downsides to Medicare Advantage, and how AI is helping radiologists catch tiny blood clots. Links: COVID-19 and Vaccinations  “Newborn and Early Infant Outcomes Following Maternal COVID-19 Vaccination During Pregnancy” CDC: Stay Up to Date with COVID-19 Vaccines “Myocarditis and Pericarditis After mRNA COVID-19 Vaccination” “‘On track’: 3 percent of Americans have gotten the new Covid shot, but the CDC director remains confident” “COVID Shots May Slightly Raise Stroke Risk in the Oldest Recipients” “Evaluation of Stroke Risk Following COVID-19 mRNA Bivalent Vaccines Among U.S. Adults Aged ≥65 Years” “SARS-CoV-2 infection triggers pro-atherogenic inflammatory responses in human coronary vessels” CDC: COVID Data Tracker—USA  Medicare Advantage  2023 Medicare Open Enrollment Guide “How Health Insurers and Brokers Are Marketing Medicare” “Benchmark Survey: Annual Family Premiums for Employer Coverage Rise 7% to Nearly $24,000 in 2023; Workers Contribute $6,575 on Average Now, But Potentially More Soon” “Elevance Health Reports $13 Billion Profit and Insurer ups Forecast once again” Mental Health in Healthcare “Health care workers report increase in burnout, harassment since the COVID pandemic: CDC” “Health Workers Face a Mental Health Crisis” “Suicide Risks of Health Care Workers in the US” “Stabbed. Kicked. Spit On.Violence in American Hospitals Is Out of Control.” Artificial Intelligence in Healthcare “Prospective Evaluation of AI Triage of Pulmonary Emboli on CT Pulmonary Angiograms” “Artificial intelligence for breast cancer detection in screening mammography in Sweden: a prospective, population-based, paired-reader, non-inferiority study” “AI Risk Score on Screening Mammograms Preceding Breast Cancer Diagnosis” What’s a Normal Temperature? “Defining Usual Oral Temperature Ranges in Outpatients Using an Unsupervised Learning Algorithm”   Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by health economist Katherine Baicker of the University of Chicago to discuss her career in academia and government, the landmark Oregon Health Insurance Experiment, and the optimal design for universal healthcare coverage. Harlan asks why life expectancy in the U.S. increasingly lags behind peer nations; Howie discusses the politics threatening the PEPFAR program, which has saved millions of lives around the world.  Links: U.S. Life Expectancy “How does U.S. life expectancy compare to other countries?” The American Health Care Paradox: Why Spending More is Getting Us Less Healthcare Policy Katherine Baicker: “Oregon Health Insurance Experiment” Katherine Baicker: “The Oregon Experiment—Effects of Medicaid on Clinical Outcomes” “How to Use the Oregon Medicaid Study to Your Ideological Advantage” Katherine Baicker: “Workplace wellness programs can generate savings” Katherine Baicker: “Health And Economic Outcomes Up To Three Years After A Workplace Wellness Program: A Randomized Controlled Trial” We’ve Got You Covered: Rebooting American Health Care Katherine Baicker: “A Different Framework to Achieve Universal Coverage in the US” Yale President Howard K. Lamar’s 1993 Baccalaureate Address: “An Honorable Theatre of Action: Using A Yale Education in the 21st Century” PEPFAR The United States President’s Emergency Plan for AIDS Relief “PEPFAR Reauthorization: The Debate About Abortion” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

In the 100th episode of Health & Veritas, Howie and Harlan are joined by Peter Salovey, the president of Yale University and a pioneering psychology scholar. They discuss Salovey’s tenure as president, which ends in 2024; the future of the newly independent Yale School of Public Health; and Salovey’s influential research on emotional intelligence.  Links: “Statement regarding YSPH transitioning to an independent school at Yale” Peter Salovey: “Emotional Intelligence” Yale School of Medicine: “Medical school and health system form a new affiliation” “President's house will be a home” For Humanity: the Yale Campaign Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Marc Auerbach, a professor of pediatric emergency medicine at Yale, to discuss his work using standards and simulation to improve the treatment of children in emergency departments throughout the United States. Harlan reflects on the importance of simple, well-designed clinical trials to make rapid improvements to care; Howie reports on a congressional study asking whether the Centers for Medicare and Medicaid Innovation Center has succeeded in lowering costs and increasing quality.  Links: Timely Clinical Trials “Dexamethasone in Hospitalized Patients with Covid-19” “Now is the time to fix the evidence generation system” “The Clinical Trials Enterprise in the United States: A Call for Disruptive Innovation” The Yale Paxlovid for Long COVID (PAX LC) Trial Pediatric Emergency Medicine CDC: Emergency Department Visits Among Children Aged 0–17 by Selected Characteristics: United States, 2019–2020 “Emergency Department Pediatric Readiness and Short-term and Long-term Mortality Among Children Receiving Emergency Care” “The Emergency Medical Treatment and Active Labor Act (EMTALA): what it is and what it means for physician” Connecticut Emergency Medical Services for Children: Innovation and Improvement Center Centers for Medicare and Medicaid Innovation Center CMS: About the CMS Innovation Center “Accelerating Care Delivery Transformation—The CMS Innovation Center’s Role in the Next Decade” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan discuss the inspiring story behind the Nobel Prize in medicine, the settlement in the Cigna false billing case, and new research providing more evidence for the effectiveness of statins in reducing cardiovascular risk.  Links: The Nobel Prize “Press Release: The Nobel Prize in Physiology or Medicine”  The Daily: “The Unlikely Pioneer behind MRNA Vaccines” “Halting Progress and Happy Accidents: How mRNA Vaccines Were Made” “How Our Brutal Science System Almost Cost Us A Pioneer Of mRNA Vaccines” Katalin Karikó and Drew Weissman: “Suppression of RNA Recognition by Toll-like Receptors: The Impact of Nucleoside Modification and the Evolutionary Origin of RNA” “The Karikó problem: Lessons for funding basic research” Cigna and Medicare Advantage “Cigna Group to Pay $172 Million to Resolve False Claims Act Allegations” “Overpayments to Medicare Advantage Plans Could Exceed $75 Billion in 2023, USC Schaeffer Center Research Finds” Health & Veritas: “Helen Burstin: Research with an Impact” The Cigna Group (CI) Stock Price, News, Quote & History Humana Inc. (HUM) Stock Price, News, Quote & History HIV and Cardiovascular Outcomes “Pitavastatin to Prevent Cardiovascular Disease in HIV Infection” Health & Veritas: “Dr. Amy Justice: Unlocking the Insights in Healthcare Data” “Shifting from “Morbid Obesity” to “Class III Obesity”” Healthcare Data “Officials Struggle to Regulate Pop-Up Covid Testing Sites—and Warn Patients to Beware”   Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.