Posts by Michel Accad
The profit motive is irrelevant
In our most recent podcast episode (Privatizing the NHS: Who Profits?), my co-host Anish Koka reacted to our guest Bob Gill’s wish that the NHS insulated itself from the “profit motive” that is characteristic of the private sector. Anish pointed out that, at least in the US, wait times for oncology or orthopedic appointments are…
Read Full PostHow normal is the normal distribution?
Reflections on the early 19th c. French military hat-shaped curve At some point in our illuminating conversation with Mike Acree (episode 57), I brought up the fact that the normal distribution curve, on which much of statistical inference rests, is open to infinity at both ends. The tails are supposed to hug but never cross the…
Read Full PostMore on sham peer review
Dr. Lawrence Huntoon, who was our guest on Ep. 37, has just returned from Jerusalem where he gave a talk at the UNESCO’s 13th World Conference on Bioethics, Medical Ethics and Health Law. In this talk, Dr. Huntoon relates some of the most outrageous examples of hospital sham peer review. Some of these cases have involved…
Read Full PostSystematic Pushback Against Evidence-Based Medicine
When Gary Klein told us that he had co-authored a paper critical of evidence-based medicine (EBM), it was music to my ears. After we finished taping the show, I quickly dug into his bibliography and found the paper in question, written by Klein and his team: “Can We Trust Best Practices? Six Cognitive Challenges of Evidence-Based…
Read Full PostHe Jian-Kui vs. Christiaan Barnard: A Tale of Two Ethical Transgressions
As I write this post, He Jian-Kui, the Chinese scientist who claimed to have brought about the first gene edited babies in history is reported “missing,” having been seen last at an international meeting of scientists where his experiment was widely criticized on ethical grounds. It is too soon to know if he is being detained (or…
Read Full PostWhen Scientists Know The Answer Ahead of the Experiment
On the day that we taped our podcast episode with Brian Nosek about the replication crisis, the renowned statistician Andrew Gelman published an essay in the New York Times on precisely that topic. Gelman echoes some of the remarks made by Nosek. In particular, he draws attention to the point we discussed regarding what to believe when…
Read Full PostGene testing: another potential medico-legal precedent in the NHS
The NHS may not be a leader in medical innovation but it certainly seems to be breaking new ground in medico-legal precedents every few months (see our previous episodes on the Alfie Evans case and on the Bawa-Garba case). This week, The Guardian announces another medico-legal first: the daughter of a man who committed suicide…
Read Full PostThe Case Against Shared Decision-Making
To conclude this 3-part series, I will discuss the relationship between shared decision-making (SDM) and evidence-based medicine (EBM), as the two are intimately connected. As I indicated in part 1, SDM did not attract the attention of academics until the late 1990s. It is only then that publications on SDM began to appear routinely in the…
Read Full PostWhen Scientists Discover New Body Parts
Soon after publishing our second podcast episode on brain death, this article from Newsweek came into my Twitter feed: “Endorestiform Nucleus: Scientist Just Discovered a New Part of the Human Brain.” According to the article, an Australian researcher may have discovered an island of neurons heretofore undescribed and which may be involved in important motor…
Read Full PostThe Totalitarianism of Population Health Management
Medical Economics just published a piece giving advice on how to “succeed” at population health management. The article is filled with pleasantries: “Population health management is about going beyond the walls of the practice to improve patient health” “It’s all about a stronger emphasis on preventative medicine and making sure these appointments happen” “It’s key…
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