The Friday file of things I wish I’d addressed earlier

Better late than never, here’s some interesting catch-up reading.

• An Analysis piece in The BMJ by Ronald Koretz, Kenny Lin, John Ioannidis and Jeanne Lenzer, “Is widespread screening for hepatitis C justified?“  The key messages, as summarized in The BMJ: 
  • The CDC and other major organisations are recommending birth cohort population screening for hepatitis C infection
  • Only a minority of patients with chronic hepatitis C infection will ever develop end stage liver disease 
  • We cannot reliably identify those who will develop end stage liver disease 
  • Drug trials rely on surrogate markers such as sustained virological response, which is not a cure 
  • Physicians should resist screening until we have strong evidence that antiviral therapy is clinically effective and the benefits outweigh the harms

• Roy Poses’ piece on his Health Care Renewal blog, “The Fashion Challenges of the Emperor of Hepatitis C Treatment – Now in the BMJ, but Who Will Notice?”  Poses provides the Cliff Notes summary at the end of his post:  “As we have said until blue in the face, true health care reform would bring some skeptical thinking and regard for evidence and logic into the health policy discussion.”

Poses’ “…but Who Will Notice?” is a good question.  There has been relatively little mainstream news media coverage of The BMJ piece.  A couple I’ve seen have some flaws:

Other noteworthy items:

• On his Forbes blog, Dan Munro wrote, ” ’60 Minutes’ Stumbles On How Health Insurance Works.”  
  • He concluded:  “What we saw Sunday night didn’t serve any purpose ? least of all understanding how basic health insurance works ? how it has worked ? and how it will continue to work under Obamacare. Let’s at least get that right before we take on the monumental task of debating cost.”  
  • The piece was “reported” by Lesley Stahl.  We’ve commented on her reports before in a blog post…and in a systematic story review. 

• Cal State LA public health prof William London’s piece, “NBC Nightly News Wields the Power of Pandering in ‘Power of Prayer’ Report.“

• Yale endocrinologist Kasia Lipska’s opinion piece in the New York Times, “When Diabetes Treatment Goes Too Far.”  Excerpt:  “The diabetes drug industry has a vested interest in selling its products to as many Americans as it can, and has been incredibly successful at doing so. Sales of diabetes drugs in 2013 were about equal to the combined revenue of the National Football League, Major League Baseball and the National Basketball Association. There is nothing wrong with the industry selling its drugs, but it is the job of the medical profession to guide what treatment patients receive. To do this properly, doctors with financial ties to diabetes drug industry shouldn’t be writing guidelines on how to use these drugs. At present, this is still common. Ultimately, changing current paradigms requires that doctors partner with their patients in making decisions about treatment. Patients need to understand that there are different options, with different risks. The goal is not to get a perfect score on a report card, but to weigh these risks to make a good decision.”

• Aaron E. Carroll’s piece on the New York Times Upshot blog, “Doing More for Patients Often Does No Good.” 
• Eric Topol’s Tweet, captured below: 

Scientists say they’ll soon extend life ‘well beyond 120″ http://t.co/TqGpelfBsN @guardian #genomics I don’t think so pic.twitter.com/0t2lXf700p

— Eric Topol (@EricTopol) January 12, 2015