genomeboy.com

This is intelligent design?

Jerome Groopman offers a withering assessment of comparative effectiveness research:

There is a growing awareness among researchers, including advocates of quality measures, that past efforts to standardize and broadly mandate “best practices” were scientifically misconceived. Dr. Carolyn Clancy of the Agency for Healthcare Research and Quality, the federal body that establishes quality measures, acknowledged that clinical trials yield averages that often do not reflect the “real world” of individual patients, particularly those with multiple medical conditions. Nor do current findings on best practices take into account changes in an illness as it evolves over time. Tight control of blood sugar may help some diabetics, but not others. Such control may be prudent at one stage of the malady and not at a later stage. For years, the standards for treatment of the disease were blind to this clinical reality.^[7]

Orszag’s mandates not only ignore such conceptual concerns but also raise ethical dilemmas. Should physicians and hospitals receive refunds after they have suffered financial penalties for deviating from mistaken quality measures? Should public apologies be made for incorrect reports from government sources informing the public that certain doctors or hospitals were not providing “quality care” when they actually were? Should a physician who is skeptical about a mandated “best practice” inform the patient of his opinion? To aggressively implement a presumed but still unproven “best practice” is essentially a clinical experiment. Should the patient sign an informed consent document before he receives the treatment? Should every patient who is treated by a questionable “best practice” be told that there are credible experts who disagree with the guideline?

Amen, Jerry. CER may be well on its way to becoming the “No Child Left Behind” of health care. “Let’s create some immutable standards, wield them like a sledgehammer, and then declare victory!”

Doctors are pooh-poohing personal genomics. Yet they would put their faith in behavioral economics? Talk about going “off label”…

Words fail:

The authorities do not know exactly how many people have been killed warbling “My Way” in karaoke bars over the years in the Philippines, or how many fatal fights it has fueled. But the news media have recorded at least half a dozen victims in the past decade and includes them in a subcategory of crime dubbed the “My Way Killings.”

The killings have produced urban legends about the song and left Filipinos groping for answers. Are the killings the natural byproduct of the country’s culture of violence, drinking and machismo? Or is there something inherently sinister in the song?

You can’t make this stuff up.

An Italian court has cut the sentence given to a convicted murderer by a year because he has genes linked to violent behaviour—the first time that behavioural genetics has affected a sentence passed by a European court. But researchers contacted by Nature have questioned whether the decision was based on sound science.

***

“90% of all murders are committed by people with a Y chromosome—males. Should we always give males a shorter sentence?” says Steve Jones, a geneticist at University College London. “I have low MAOA activity but I don’t go around attacking people.”

Farahany points out that prosecutors could use the same genetic evidence to argue for tougher sentences by suggesting people with such genes are inherently ‘bad’.

“The question is where do you stop,” Jones adds.

I am assuming the timing of the “going bust” thought experiment was only a coincidence:

Personal genomics startup 23andMe has just gone through a round of layoffs, we’ve confirmed. The company declined to comment on how many people were laid off, but offered this statement:

We have reduced our staffing levels in a restructuring of our workforce. This was a very difficult decision, but one that we felt was necessary to achieve 23andMe’s long-term business development goals and maintain our strength in the industry.These cuts, which are a reflection of the current economic environment all companies are facing, will allow us to continue to invest in the growth of our Personal Genome Service and research endeavors.

I’ve always maintained that what happens between two consenting species is nobody’s business, as long as they’re happy.

The report said 85 percent of science association members surveyed said public ignorance of science was a major problem. And by large margins they deride as only “fair” or “poor” the coverage of science by newspapers and television.

Only 3 percent of the scientists said they “often” spoke to reporters.

In a telephone news conference announcing the survey, Alan I. Leshner, chief executive of the science association, said scientists must find new ways to engage with the public.

“One cannot just exhort ‘we all agree you should agree with us,’ ” Mr. Leshner said. “It’s a much more interactive process that’s involved. It’s time consuming and can be tedious. But it’s very important.”

Hmmm. The head of the most important science organization in the country, if not the world, starts from the premise that educating and interacting with the public about science is time consuming and “can be tedious.” I can’t imagine why so much of the citizenry knows and cares so little about what we do. Can you?

Dr. Kao did not deny placing large numbers of seeds outside the prostate, but he said investigators were wrong to single him out. “It’s a recognized risk of the procedure,” he told the panel.

Dr. Kao’s assertion was disputed by Steven A. Reynolds, who oversees materials safety at the N.R.C., which regulates all nuclear materials. Cases where large numbers of seeds miss the prostate, Mr. Reynolds said, “happen very, very infrequently.”

Mr. Specter called the accusations against Dr. Kao serious. Responding to questions from the senator, Dr. Kao confirmed that he had on occasion implanted seeds in the bladder.

“Did you notify the patient?” Mr. Specter asked.

“No, sir,” Dr. Kao replied.

Ahem. Take it away…