Date post: | 20-Jan-2017 |
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“e-Patient Dave” deBronkartTwitter: @ePatientDave
facebook.com/ePatientDaveLinkedIn.com/in/[email protected]
If you live long enough,the future changes
If you live long enough,reality changes
“e-Patient Dave” deBronkartTwitter: @ePatientDave
facebook.com/ePatientDaveLinkedIn.com/in/[email protected]
Classic Stage IV, Grade 4
Renal Cell Carcinoma
Illustration on the drug company’s
web site
Median Survival:24 weeks
Transformation of Knowledge Access
Slide by @ePatientDave 2015 based on Engelen & Derksen 2010 at
Closed system Open network
Slide by @ePatientDave 2015 based on Engelen & Derksen 2010 at
Transformation of Knowledge Access
Adoption of new practices years after discoveryThe “17 years” thingFrom A. Balas, Institute of Medicine, in Yearbook of Medical Informatics 2000
Flu vaccine, year 32: 55% doing it, 45% still not
Beta blockers, year 18: 62% doing it, 38% still not
Diabetic foot care, year 7: 20% doing it, 80% still not
Cholesterol, year 16: 65% doing it, 35% still not
Creative Commons Attribution / Share-AlikeMay be distributed with this license included
After 30 years of practicing peer review and 15 years of studying it experimentally, I’m unconvinced of its value.
Evidence on the upside of peer review is sparse, whereas evidence on the downside is abundant.
Most of what appears in peer reviewed journals is scientifically weak.
Richard Smith, 25 year editorof the British Medical Journal, 2009
Richard Smith25 year editor of the BMJ
“Quantified Self” #OpenAPS
Public Health conferenceSan Diego, May 18 (n=1)*59 (n=1)*59
August 13: *103
Half of everyone who’s ever been 65 is alive today
Population today: ~7.0 billionEnd of World War II: ~2.3 billion
42
1871: Oliver Wendell Holmes
“Your patient has no more right to all the truth you know than he has to all the medicine in your saddle-bags. He should get only just so much as is good for him.”
Bellevue graduation speech
“A new scientific truth does not triumph by convincing its opponentsand making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”
Max Planck Nobel Prize, 1918