The big medical news archive

Infra-red Helmet May Help Alzheimer’s Patients

Administrator — Tue, 05 Feb 2008 06:00:10 +0000

A helmet that looks like it came from a sci-fi flick may offer real help to Alzheimer's sufferers. The Daily Mail reports that the helmet bathes the wearer with infra-red light. The helmet only needs to be worn for ten minutes each day.

Dr Dougal claims that only ten minutes under the hat a day is enough to have an effect.

"Currently all you can do with dementia is to slow down the rate of decay - this new process will not only stop that rate of decay but partially reverse it," he said.

Low level infra-red red is thought to stimulate the growth of cells of all types of tissue and encourage their repair. It is able to penetrate the skin and even get through the skull.

"The implications of this research at Sunderland are enormous - so much so that in the future we could be able to affect and change the rate at which our bodies age," he said.

"We age because our cells lose the desire to regenerate and repair themselves. This ultimately results in cell death and decline of the organ functions - for the brain resulting in memory decay and deterioration in general intellectual performance.

The reason the scientists believe the infra-red helmet may work is because there was study conducted on mice that showed infra-red treatments can reduce memory loss. It worked for mice so it might work for humans.

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Original source here ...

Hiddenc Brain Injuries Linked to Social and Educational Failures

Administrator — Tue, 05 Feb 2008 06:00:10 +0000

The Phall of Pharmed

Administrator — Mon, 04 Feb 2008 21:43:00 +0000

The Miami Herald documented the rise and fall of a prominent medical supply company.

Before its spectacular collapse, Pharmed Group was one of the great South Florida success stories, a medical supply company created by two brothers who started with nothing and built the eighth-largest Hispanic-owned business in America. In 2003, their profit was $48 million.

What happened to this once fabulous company, where brothers Carlos and Jorge de C
Original source here ...

How To Demoralize Pharma Workers in One Easy Lesson

Administrator — Mon, 04 Feb 2008 00:12:00 +0000

In "Avandia Mystery ... Elementary, My Dear Watson" I wrote that the mysterious disclosure outside GSK of an equally mysterious "leak" to GSK of a pre-publication article critical of Avandia might have been initiated by unhappy GSK employee(s).

Those who made the disclosure knew, or should have known, the devastating effects on the article reviewer, UT San Antonio researcher Dr. Steven Haffner. Honesty and fear of the imbroglio with the likes of Sen. Grassley might have played a role, but still, such a career-ending move against an ostensibly friendly scientist seems unusual.

If unhappiness was involved, why might GSK employees be unhappy?

In my post "Happy Accidents in pharma doubtful: Tax Break Used by Drug Makers Failed to Add Jobs" I wrote:

... as I understand it from former employees, during a downsizing people are required to justify their position and/or "bid on their own job" in a competitive fashion. If they fail and cannot then "find another position in the company" (after losing your own job that you may have had for years, what's the likelihood that will happen?), then it's out the door. IMO that is simply horrible management of those "precious" "human resources." What could be more humiliating than bidding on your own job?

I recently became aware of several former collaborators who were GSK employees and "lost" on bidding for their own jobs during downsizing, and were shown the door as a result. My interactions further reinforce my belief that such policies are poorly engineered from a social perspective; they are alienating, strategically unsound, and to be plain about it, idiotic. Many fundamental questions arise:

Notwithstanding whether downsizing is really necessary, if downsizing is going to occur, do people made to bid on their own jobs have performance reviews on file?
Are these reviews unsatisfactory, and if they are unsatisfactory, why not simply lay the person off?
If they are satisfactory, does not being forced to bid on your own job send the explicit message that performance reviews mean little? Why is time wasted on reviews?
If performance reviews are irrelevant, does that not mean bonus determination is bogus and partial?
If employees are reviewed once a year and/or quarterly, and have been so for several years, they should be a very well known quantity to the company. How is it possible for them to be complete unknowns? If they are not complete unknowns, why are they treated as such in being made to bid for their own jobs?
Either a company knows what its employees can do, or they don't. If they do not know what their employees can do, then what do they really know about their business, and why are the decision makers in charge in the first place?
Why is it impossible for a company to match it needs to its assets without resorting to an idiotic process that is neither efficient nor litigation proof?
If incumbents are made to bid on their own jobs, does the company have any idea why these people are in the jobs they hold in the first place?
If performance reviews are satisfactory, might being forced to bid on your own job against internal competitors create intraprofessional animosities and enemies and an environment of paranoia that harm the company, both short and long term?
Is such social instability, where people never know when they will have to bid on their own jobs, good for worker morale and for the community?
Might it be better for morale to just have managers select people to be laid off, or have employees draw lots?
Does GSK feel employee morale matters?

Ultimately, the following question needs to be asked:

Do the demoralizing effects of such idiotic human relations policies affect the company's ability to create and monitor the safety of their drugs?

-- SS

Original source here ...

GSK, Avandia and Medical Informatics: More on Why Pharma Fails

Administrator — Sun, 03 Feb 2008 20:30:00 +0000

The GSK diabetes drug Avandia and the Pfizer anti-smoking drug Chantix are new entries in a long "honor roll" of drugs from major pharmaceutical companies to come under suspicion of having an unacceptable degree of adverse drug effects (ADE's).

The recent Avandia issues reminded me of assertions about need for more medical informatics expertise in pharma to help track drug ADE's and improve drug safety. These recommendations come from organizations such as Gartner Group and from the prestigious Institute of Medicine of the National Academies (link).

The Avandia issue also reminded me of essays I've written about the lack of understanding of the formal specialty of Medical Informatics in the pharma industry e.g., "Why Pharma Fails" and "We don't need medical informatics here Part 2." I am also reminded how this problem, complicated by the conflation of IT and information science, cause the industry to suffer at both ends of the pipeline, that is, discovery and postmarketing surveillance.

Finally, in those cases and others I have written about the dangers of non-medical personnel holding leadership positions in healthcare that permit them to make decisions best left to medical or cross-disciplinary (e.g., medicine and information science) professionals, or otherwise put them outside the bounds of their competencies.

All this brought me back to GSK and, on searching my files, yet another experience I had with pharma illustrating my concern about their hiring practices. The experience may also shed some light on why pharma seems to have a problem with drug monitoring.

In July 2004 I received an unsolicited email about a new job opening from a prestigious British recruiting firm ("headhunter") retained by GSK, Armstrong Craven Ltd:

Subj: Roles with GSK

Date: 7/5/2004 10:04:06 AM Eastern Daylight Time

From: (recruiter name) at armstrongcraven.com

To: MedInformaticsMD

Dear Doctor,

Please accept my apologies for contacting you out of the blue like this. I work for a company called Armstrong Craven in Executive Search. We are a partner of GlaxoSmithKline, handling many searches for them on a global basis.

Your name was mentioned to me by GSK following an application you made to the GSK website for a role in Cheminformatics [to which I never received a reply - ed.]

I wish to make contact so that we may speak about the Cheminformatics opportunity but also to draw your attention to another role I'm handling for GSK: Director of Medical Informatics.

Please can you indicate a convenient time for us to talk, alternatively feel free to contact me on the telephone number below.

Kind regards

(Name)

Account Manager

Armstrong Craven Healthcare

tel: +44-161-499-####

I set up a phone interview with the recruiter, who called me from the UK a short while later. We spoke for over an hour about the Director of Medical Informatics role. As a result of our detailed conversation, the recruiter felt I was highly qualified for the position. As a further check, he emailed me a GSK document that described the position in great detail. It included a description of the Informatics and Knowledge Management unit at GSK:

Informatics & Knowledge Management

Medical Informatics is a discipline that studies, invents and implements the structures and algorithms necessary to improve communication, understanding, value derivation and management of pharmaceutical scientific information. The objective is the coalescing of data, knowledge and tools necessary to apply these data and knowledge in the decision making process, at the time and place that a decisions needs to be made.

With a strong interface with the various CEDDs, the function takes a truly holistic view of R&D from early stage research to proof of concept. Informatics & Knowledge Management has cross functional responsibility across both the Drug Discovery function and across R&D IT. Its remit is to guide R&D IT activities to provide better solutions to enable multi-disciplinary research.

Informatics and Knowledge Management is headed by Dr Tom Flores and the division consists of roughly 50 staff in Harlow (UK), Stevenage (UK), Upper Merion (US) and Research Triangle Park (US).

I felt the definition of medical informatics a bit dated. It was written by a pioneer who is now semi-retired, Homer Warner, MD, PhD of Univ. of Utah, who I knew from various informatics professional meetings. However, it was clear why the recruiter was interested in me. With extensive medical informatics training and experience at Yale and in the provider sector, and having been Director of Scientific Information Resources and Director of The Merck Index of Chemicals, Drugs & Biologicals at Merck Research Labs, I seemed to him well qualified for the job description including items such as:

... identify, prioritize and partner on projects where Medical Informatics can deliver business impact. Develop both strategic (long term) collaborations that will have a sustained impact as well as short term efforts that will impact high-priority R&D projects

Establish an interface with the other informatics or relevant organizations within R&D to ensure activities are complementary and build relationships with these organizations to partner on projects when appropriate
Provide input and guidance to R&D IT activities to provide better solutions that enable multi-disciplinary research through engagement with the strategic consultants from the business aligned IT groups
... Wide ranging knowledge of advanced computer science and AI techniques with proven experience in the successful delivery of research projects, broad knowledge and understanding of the pharmaceutical R&D business with appreciation of the trends that are impacting such businesses

... and others typical of a mid level matrixed management position.

Finally, the job was described as reporting to the Vice President, Informatics & Knowledge Management who apparently authored this description, Dr. Tomas Flores, a Ph.D. The recruiter told me he would speak with the hiring team and present my credentials to them ASAP. He fully expected at least a follow up interview.

Unfortunately, this was not to occur.

I received a call back from the recruiting firm several days later to tell me that GSK had no interest in my background, and Dr. Flores did not wish to speak to me at all. When I inquired why, I was told he was looking for someone with "an extensive CS background to write algorithms to solve business problems."

Needless to say, I was rather disappointed by this response. The Armstrong Craven response raises a number of important questions:

Why do we have computer-oriented VP's lacking medical credentials evaluating resumes of those who do?
Did the lack of medical credentials and experience prevent proper understanding of critical line items on my resume?
Why was a dated definition of "Medical Informatics" being employed in this job description for a new Director of Medical Informatics, when broader, more current definitions of the field were readily available?
Was the Homer Warner definition itself taken far too literally regarding "algorithms?" Could Dr. Warner have meant something more than computer algorithms?
How was the prejudicial decision that algorithms needed to be written by a Medical Informatics specialist made? Who set this as a strategic objective? Why was it done by someone with no apparent Medical Informatics credentials?
Is the best use of a medical informatics specialist to write algorithms (i.e., do programming), or is it to create and direct the writing of algorithms, separating the high-level biomedical cognitive tasks form the lower ones (i.e., programming)? See example of this issue here.
Was there anything in my resume with regard to my training and experience in computing and in healthcare suggesting I could not write such algorithms to solve biomedical business problems?
Was it typical at GSK for a hiring manager to read a resume that came from its own retained recruiter and, on the basis of secondhand knowledge from the recruiter and line items on a piece of paper, make a decision not to even talk to the recommended candidate - or even meet in person, since that candidate lived perhaps fifteen miles from one of the sites the hiring manager frequented? Is this above-board, state-of-the-art talent management in an industry as critical and under such societal mistrust as pharma?
Finally, was my resume actually read? Was this a preferential job posting? Was there a favored internal candidate? (HR departments, usually annoyed when lawsuits happen, force hiring managers to advertise new positions per company policies on same, rather than allow favoritism. However, HR cannot challenge hiring managers' stated reasons why outside candidates they might not have expected to apply might not be suitable for a role.)
Were other potentially valuable candidates turned away on similar reasoning?

Some of these questions can be answered by my response to Armstrong Craven, cc'd also to the hiring manager:

Date: Wed, 28 Jul 2004 06:10:16 -0400 (EDT)

From: MedInformaticsMD

Subject: Re: GSK Director of Medical Informatics

To: (recruiter)@armstrongcraven.com

Cc: tomas.flores@gsk.com

Re: GSK Director of Medical Informatics

Dear (recruiter name),

Thanks for presenting my resume to GSK regarding a position in Medical Informatics. Your colleague explained to me yesterday that the GSK Informatics & Knowledge Management group is seeking someone with an "extensive CS background to write algorithms to solve business problems."

As what sounds like a programmer's position would not be of interest to me at this point in my career, I wish to inquire if other executives within the CEDD's or business-facing IT groups at GSK might be interested in my background.

More detail on my accomplishments from the perspective of scientists and executives for whom I've led projects can be seen at this link.

Alternately, if you can suggest the names of any appropriate GSK contacts within the CEDD's, I would like to contact them directly.

Finally, by way of education after this experience and the experiences I had with Smithkline Beecham's recruiter Iain Mackenzie in 2000 regarding medical informatics, prior to my employ at Merck--

It is my belief that a view of medical informatics professionals as "writers of algorithms to solve business problems" reflects a fundamentally narrow and mechanistic view of the field, or perhaps a mislabeling of the position as being one of Medical Informatics. The lack of a requirement for formal Medical Informatics education and training suggests the latter.

One of Medical Informatics' founders, Dr. Homer Warner, was the author many years ago of the definition adapted for the ArmstrongCraven draft brief. Homer wrote that "medical informatics is the study, invention and implementation of structures and algorithms to improve communication, understanding and management of medical information." See my website on this and other definitions of the field at http://home.aol.com/medinformatic1/index_org.htm#definitions .

By "algorithms", however, Homer meant not computer algorithms but more broadly the development of processes, procedures, methodologies -- and software systems -- for management, process control, decision making and scientific analysis in healthcare. That is the current understanding of the field that my academic colleagues and I teach our students.

The value of the field stems not so much from writing algorithms (as in bioinformatics or computational biology), but from an integrative approach focusing on data definitional issues, language issues, human factors, organizational issues, information needs and flows, and strategies for indexing, retrieval and information dissemination. It is in the latter areas that I excel (although having done the former -- the writing of software and algorithms -- earlier in my career).

My definition of the field is that Medical Informatics is the science and art of modeling and recording real-world clinical concepts and events into computable data used to derive actionable information, based on expertise in medicine, information science, information technology, and the scholarly study of issues that impact upon the productive use of information systems by clinical personnel.

Perhaps a better definition of Medical Informatics is found in MeSH itself, written by the National Library of Medicine itself: "Medical Informatics is the field of information science concerned with the analysis and dissemination of medical data through the application of computers to various aspects of health care and medicine."

I hope this information is of value to ArmstrongCraven.

I received a thank you from Armstrong Craven for helping them understand the field better (which helps their competitive position in the headhunting domain), but did not receive a reply from Flores.

Even worse, this was not my first encounter with GSK / SKB. I had also had fruitless discussions with SKB in the 1996-8 timeframe, while I was Director of Clinical Informatics at Christiana Care. In February 2000 as well, a senior recruiter named Iain McKenzie had contacted me, interviewed me in person after a phone discussion and then enthusiastically tried to sell my background to GSK discovery scientists. He was quite puzzled that they expressed no interest.

In conclusion, one wonders if it is wise to put nonmedical personnel in charge in pharma of what basically amounts to the hiring of medical/medical information professionals.

One also wonders if such hiring practices impair companies' abilities to monitor the safety of their drugs, and if Avandia and other safety issues would have been detected earlier if, as IOM suggests, more Medical Informatics professionals were involved in roles beyond "writing computer algorithms to solve business problems."

I report, you decide.

Finally, I'm not sure I would have wanted to work for this company anyway. For some of the reasons why, see my post "How To Demoralize Pharma Workers in One Easy Lesson."

-- SS

Original source here ...

Real Estate Deals, Conflicts of Interest, and North Shore - Long Island Jewish Health System: A “Simple Issue” Because “We Need More Space?”

Administrator — Sun, 03 Feb 2008 20:05:00 +0000

Last week, an article in Newsday raised concerns about conflicts of interest affecting one of the largest US health care systems.

The Northshore - Long Island Jewish Health System claims to be the third-largest, not-for-profit secular health care system in the US. It has a $4 billion yearly operating budget, employs 37,000, and claims to be the ninth-largest employer in the New York City area.

The Newsday article recounted a large real-estate transaction between the hospital system and a company lead by a prominent member of its board of trustees.

The North Shore-Long Island Jewish Health System is paying about $300 million to lease a major facility from its own vice chairman's real estate partnership, leading some to question how Long Island's biggest nonprofit handles potential conflicts of interest on its board.

William Mack, a longtime executive committee member of the health system and one of its leading donors, is a general partner of a private-equity real estate fund that owns the former Lockheed-Martin defense plant just across the street from Long Island Jewish Medical Center in New Hyde Park. That plant and its 94 acres, then called i-park Lake Success, were bought for $20.5 million in 2000, in a deal led by Mack's son Richard. Now the Macks' partnership is leasing a third of the plant to the health system for $300 million in base rent over 25 years.

When leases at i-park came under review, Mack disclosed his role as founding senior partner of Apollo Real Estate Advisors, the fund manager behind the deal, and recused himself from the process.

Mack's dual role as one of the health system's most powerful stewards and its biggest landlord has prompted continuing concerns by some current and former health system officials about the propriety of the deal and the integrity of the health system's governance.

There were several aspects of this transaction that seemed unusual.

For one thing, the matter was never brought to North Shore-LIJ's board of trustees, though an attorney general's written opinion says state law requires nonprofits to do so for land deals. Instead, the lease was reviewed by the board's executive committee, which wasn't given copies of two reports on which its decision was based, relying instead on a short memo and one-page summary of the lease terms. North Shore has declined to release the reports, saying they contain confidential business information; it contends the attorney general's opinion doesn't apply to a nonprofit such as North Shore.

In addition, there were complexities in the relationships involved.

Mack was one of several people who had business relationships with those involved in the deal:

[North Shore board chairman from 2000 to 2004 and former Goldman Sachs vice chairman Roy] Zuckerberg, who led the health system's real estate review, has ties to Mack through an unrelated business: He sits on the executive committee of the $2.3-billion Mack-Cali Realty Corp., a real estate investment trust chaired by Mack, and owns 33,500 shares of its common stock.

Newmark & Co. (now called Newmark Knight Frank), hired to keep Apollo at arm's length as North Shore's tenant representative, has done periodic business with that company, and Brian Waterman, one of its two principals handling the i-park talks, has listed Apollo among his leading clients.

Though Mack recused himself from the matter, his son Richard, an Apollo managing partner, signed the preliminary lease term sheet for i-park in November 2004, records show.

Hospital system leaders denied that the conflict of interest was significant.

Mack said his partnership has plowed huge sums into renovating a property that had sat unsold for five years. 'I think it would have been worse of me to say, 'Don't deal with them [the health system] and meet ... the needs of the community,'' Mack said.

Former Goldman Sachs vice chairman Roy Zuckerberg, who led the real estate search as North Shore's chairman from 2000 to 2004, can't understand why anyone would give the deal a second look. 'We need more space,' he said. 'I see this as a pretty simple issue.'

The i-park site was selected by a tenant representative through an 'arm's-length' process, the health system reported in its tax returns, and the lease terms were found reasonable by an independent appraiser.

Generally, spokesman Terry Lynam said, the health system goes out of its way to avoid conflicts of interest with its board members. But the health system is governed by a board of 130 of Long Island's most prominent and wealthiest citizens. Many preside over companies that sell the kinds of goods and services a hospital might want, and North Shore will deliver about $4.6 billion in health care this year -- a budget almost as big as Nassau and Suffolk counties combined.

The health system said Zuckerberg's ties to William Mack through Mack-Cali are irrelevant. Waterman said he won 'a very good deal for the hospital.' Richard Mack said he was 'barely involved' in the lease talks, which he described as lengthy and contentious.

Mack said there was no missed business opportunity for Long Island Jewish, and he made clear he is affronted that any question might be raised about his loyalty to the health system.

On the other hand, some people raised ethical questions about the deal.

'It may not be illegal, but it smells bad,' said Pablo Eisenberg, a senior fellow at Georgetown University's Center for Public & Nonprofit Leadership.

Although federal tax law strictly bars private foundations from doing business with their insiders, public nonprofits such as hospitals face no such restrictions, said Eisenberg, who has advocated for such limits in congressional testimony. 'There was a tradition in nonprofits that board members served for nothing, and they were prohibited from self-dealing. Now ... [doing business with board members] is increasingly popular.'

Manhattan attorney William Josephson, who headed the state Charities Bureau under then-Attorney General Eliot Spitzer, said the i-park lease deserves careful review because of its size alone. But, he said, it also calls to mind the state's 2000 lawsuit that toppled Port Authority chief Robert Boyle, the chairman of a Westchester hospital board who steered a development deal to attorney Albert Pirro in exchange for a secret partnership stake.

Mack never concealed his role, as Boyle did, an omission that led to a civil fraud charge against the latter. But otherwise, 'the facts of this transaction raise the same issues,' Josephson said. 'Under state law, trustees owe their charities a duty of loyalty. If a trustee has a business opportunity, he must offer it to the charity and not make an extraordinary profit in the process.'

Most other current and former health system officials reached by Newsday have declined to speak about the lease deal. But four of them, asking not to be named because they did not want to damage their relationships with the health system or with Mack, expressed discomfort at Mack's being both a senior board member and major landlord, and concern about the decision-making process.

Although the conflicts of interest that most often appear in Health Care Renewal seem to involve physicians' and health care academics' financial arrangements with drug, biotechnology, and device companies, this case illustrates that all sorts of conflicts are now prevalent in health care.

This case is also a reminder of just how big not-for-profit hospitals and health care systems have become. This means that the potential for big conflicts of interest affecting their leadership is increasing.

Yet there seems to be much less disclosure and discusison of such conflicts than of conflicts involving, say, academic physicians and pharmaceutical companies.

Furthermore, these conflicts more often may involve organizational leaders who might reasonably be called members of the power elite. To me, the most striking aspect of this case was how blithely such powerful individuals on the health care system's board dismissed any concerns about conflicts of interest.

As F Scott Fitzgerald wrote, "Let me tell you about the very rich. They are different from you and me." But they now seem to be running health care organizations that are supposed to take care of you and me.

Original source here ...

Women’s Health News Update, 2/2/07

Administrator — Sat, 02 Feb 2008 18:00:14 +0000

Posts from January, at the new place.

Saturday News Round-Up, 2/2/08

Ridiculous Lawmaker of the Day: Mayhall Wants to Ban Obese from Eating

On Sushi, Mercury, and Women's Health: Can't See the Pollution for the Fish

I'm Cranky, and These Labor Nurses Aren't Helping

Learn About Organ Donation

The Bedtime Chronicles, Vol. 4

*Blushes*

Labor'Lert: A Stopwatch for Your Uterus

Check Out the Sex Ed Video Contest Winners!

Reproductive Health and the Catholic Hospital Conundrum

Another Lost Tampon Story

Prophylactics, Propaganda, and Posters, Oh My!

Friday News Round-Up

Best Cities to Have a Baby

Are Women Really Requesting C-Sections?

Blog for Choice Day 2008

Hand in a Box

Caffeine and Increased Miscarriage Risk - A Portion Problem?

Newsweek Gets "Gay" MRSA Story Right, CWA Gets it Oh So Wrong

Contraceptive Patch Label Updated to Address Blood Clot Risks

Birth Control Sabotage - Submit Your Stories

WIC Program (Barely) Increasing Access to Fruits & Veggies

Heather Corinna Writes the Best Rants

Go Do Your Thing

International Carnival of Pozitivities

Health Disparities A-Go-Go

WTF, Underwear?

Randomized Birth Studies and Ethical Questions

Education of the Pregnant Teen

Spanish Abortion Providers on Strike

The Bedtime Chronicles, Vol. 3

Oh, Tennessee

The Ethical Concerns of Paid Surrogacy

This Just Seems Mean-Spirited

Update on Problems at Afghan Maternity Hospital

Mandatory HIV Testing of Pregnant Women?

One Thing to Hate About the New Year

Headlines of 2008 Meme

Happy New Year!

Pretty Bird Woman House Fundraising Drive a Success!

Inaugural Pro-Choice Blog Carnival

The Year in Review, 2007

Visit Women's Health News at its new home - http://womenshealthnews.wordpress.com

Original source here ...

One Step in Healthcare Renewal is Academic Renewal

Administrator — Sat, 02 Feb 2008 16:50:00 +0000

In this post about Duke's decent into intellectual anarchy, I made the observation that academics have significant influence on their students, and the influence affects those students when those students become our industry's and nation's leaders.

I have been reading the various debates about the actions Duke's "Group of 88" professors, who tried to take advantage of the anger created via fabricated accusations by a dancer that the Duke lacrosse team members assaulted and raped her.

One observation was striking. The "Group of 88" refer to their writings in a most peculiar way.

They called their rush-to-judgment support of campus demonstrators who had widely distributed a "wanted poster" branding the team as "rapists" the "Listening Statement." (As a former practicing occupational medicine physician, I can vouch for the degree of emotional suffering and damage the "Listening Statement" likely caused these lacrosse team students.) A later release was called the "Clarifying Statement."

One wonders why they didn't use the simpler title "Our Views on the Recent Unpleasantness" or something more apppriate to scholars? Why the faux avant-garde terminology "Listening Statement" and "Clarifying Statement?"

I am surprised they didn't add the term "Communique" to the names they did use. It occurs that such language is just the terminology that would be used by a group of self-important, pompous, wannabe-revolutionary fools who might dream of sending out "Popular Liberation Front Statements" on a clandestine Soviet crank-powered shortwave transmitter with a wire aerial strung across the jungle treetops.

This rush-to-judgement, hang-them-then-hold-a-trial attitude seems not just accepted at universities like Duke, but defended and applauded. No "Apology Statement" was ever issued, even after the students were found innocent and the prosecutor jailed. What message are the students taking away? Perhaps the message that being a pompous fool is a virtue?

Now, think about all the observations in Healthcare Renewal about corruption, conflicts of interest, etc. in the healthcare industry committed by healthcare professionals and executives. I argue that one root cause of these phenomena are the beliefs of the people behind the actions. Pompous jacka** is probably a reasonable characterization of many. Are their attitudes affected by a debased educational environment? I think that is likely.

I again state my premise: one step in healthcare renewal is academic renewal.

Finally, regarding Duke, if I were those Group of 88 faculty, I might want to transfer my assets to a trusted third party ASAP. Considering the swath of lawsuits coming down the pike, and a likely class action to follow the current civil suit initiated by a few members of the team, I might want my assets squirreled away.

I did try to contact Duke's Office of General Counsel about the mischaracterization of my writings put into print by Miriam Cooke as described in the post about Duke linked above. However, the response I received indicated they have bigger fish to fry and that my complaint was moot considering changes that will likely be coming down the pike there, after the inevitable leadership shakeup.

Maybe the Group of 88 will release an "Impoverishing Statement" when the dust settles.

-- SS

Original source here ...

Avandia: “Why I sent it is a mystery” = plausible deniability done poorly?

Administrator — Fri, 01 Feb 2008 16:04:00 +0000

At "Why I Sent It Is a Mystery - More About Avandia, Conflicts of Interest, and Confused Thinking" Roy Poses documents a response from a prominent biomedical researcher, Steven Haffner of the University of Texas Health Science Center at San Antonio, as to why he rather blatantly breached scientific reviewer's code of conduct. This code of conduct is not a mystery and is quite explicit.

It is crystal clear he should not have FAXed anything or communicated about the paper he was reviewing in any way whatsover to GlaxoSmithKline (GSK):

'Why I sent it is a mystery,' Haffner told Nature . 'I don't really understand it. I wasn't feeling well. It was bad judgement.'

This statement is simply not credible on its face, coming from a scientist with high ability, a large number of federal grants, and who probably sits on many study sections where the rules are emphatically stated at every session - and where participants have to sign off in writing, as I do before a section.

I review papers too. Hypothetically speaking, what might motivate me, if I were not strongly ethical, to do something like this? Something else is likely going on here for someone to risk their reputation, and it is not credible to believe it is ideological or random due to "having a bad day." If this person was having a bad day, it was in "spin generation" upon confrontation. That response rates about a "0.2 out of 10" on the MedInformaticsMD Plausible Deniability Scale.

Let's not beat around the bush. This person could have slowed or halted publication through comments in his review. Something more was at stake. What would it plausibly take for a person to assume such risk? It would take a significant quid pro quo.

Again, hypothetically speaking, knowing how people (e.g., people I saw in my occupational medicine role in highly-unionized heavy industries) who get caught doing things that "they should not be doing" react, my concern is that this person of some type (including and/or over and above the promise of speaking engagements), or could have had an explicit or implicit agreement to be (money, stock options, internal information related to investing, etc.).

Of course, a pharma engaged in such activities would make sure their tracks were well-covered and create a situation of "plausible deniability." It would therefore be quite difficult to investigate this type of arrangement.

I emphasize that I have no knowledge of such activity, nor am I making an accusation. I'm just thinking as a Sherlock Holmes in a "mystery" novel might think, from the "means, motive, opportunity" angle.

That said, I hope this issue will be investigated. This affair raises a number of questions:

Could there be other instances of leaks to pharmas regarding other scientific papers reviewed by this individual?
Just how widespread is this problem?
Could other scientists also be "leaking" and we just have not discovered it yet?
Could pharmas have created a network of "advance scouts" in the biomedical/academic industry, i.e., people who have agreements to tip them off about negative publicity pre-publication ?
Could such a "pre-emptive strike force" be utilized for quiet montoring of the writings of a pharma "enemies list"?
Could compromised reviewers be affecting or manipulating the career advancement of scientific authors behind their backs (either negatively or positively, depending on their "alignment" to the interests on pharma), e.g., via conversations with formal or informal connections, without the authors knowing about it?

An unscrupulous consultant advising pharma marketing and strategic planners on methods to "pave the road" in the biomedical literature would probably tell them to do something like this.

Considering what goes on in pharma and academia (such as at another southern university of high renown), such a discovery would disappoint me, but not at all surprise me.

-- SS

Addendum: to those who might think me a flaming leftwing totalitarian anti-pharma Pajamablogger, my "Political Compass" questionnaire results are here.

Original source here ...

Truly disturbing lawsuit against Duke University

Administrator — Thu, 31 Jan 2008 16:56:00 +0000

Most everyone is aware of the Duke lacrosse team scandal, the debacle about alleged rape by Duke lacrosse team students that led to the resignation of prosecutor Nifong for prosecutorial misconduct, exoneration of the accused, an expose of the radical agendas of a subset of Duke's faculty, and a great deal of national publicity, or, I should say, notoriety.

Now, in Dec. 2007 several of the team members have filed a civil suit. The lawsuit filing documents are downloadable from these links (PDF files):

Part 1 (100 kb PDF)

Part 2 (1.3 Mb PDF)

I recommend downloading and perusing these in their entirely. Absolutely stunning.

Using Adobe Acrobat, a search in them upon the term "medical" is of great concern. Named in the suit as defendants are Duke University Health Systems, a private diagnostic clinic contracted to Duke, a number of physicians and RN's, and unversity officials overseeing medical affairs.

What caught my attention were:

A massive conspiracy to deprive three young men of their rights under the U.S. Constitution, of Stalin-police state proportions
Sections on production of falsified medical records to support fabrications regarding sexual assault examinations
The naming of a number of Duke medical center and medical center-associated officials including the Chancellor for Health Affairs (a physician Victor Dzau MD) as direct participants by commission and/or omission (e.g., indifference to, and failure to act against obvious impropriety)
The collusion or tepid reactions of the most senior Duke officials right up to the Chairman of the Board of Trustees.

Overall, this story would make for the most stunning of movies of Serpico proportions - and probably will be, and should be.

If the allegations are even partially true, we have the most candid expose of the severe state of moral decay that afflicts our educational system (a system that produces our leaders of other organizations), our healthcare system, our justice system, and our culture.

More on the Duke situation can be found at this extensive, well-written fellow blogspot site, put together by one non-Duke professor named KC Johnson, Durham-in-Wonderland.

How I became aware of this is a story unto itself.

I noted the following passage in a polemical November 2007 article most ironically entitled Academic Freedom: The 'Danger' of Critical Thinking", International Studies Perspectives 8 (4), 396-400, doi:10.1111/j.1528-3585.2007.00306.x by Duke Professor of Asian and African Languages and Literature Miriam Cooke (fulltext here):

In this time of war that allows some people to lie and cheat, it is taboo for others to think critically ... It is dangerous even "to speculate about the relation between this war (in Iraq) and the geopolitical interests of Israel." These are the words of Paul Gilroy, who, at the time of speaking, was chair of African-American studies at Yale. Enraged, his colleague Scott Silverstein compared him with Hitler and claimed that his words "illustrated the moral psychosis and perhaps psychological sadism that appears to have infected leftist academia." (Younge 2006).

This discovery led me to a literature search that led me to the Duke lawsuit documents. Cooke is profiled here.

Cooke actually misquotes a misquote by writer Gary Younge in the British newspaper The Guardian in an article "Silence in Class", April 4, 2006. In turn, Younge had misquoted an editorial authored by me that appeared in the Wall Street Journal on April 17, 2003 (see this link for my original).

Duke Prof. Cooke didn't bother to contact me, a fellow academic, nor apparently do a simple google search or utilize the considerable informatics resources of her own university's library to find my original Wall St. Journal letter and my online response to Younge (link). (Another possibility is that she did find them and ignored them, of course.) Cooke simply invented my being "enraged" at my "colleague" (a simple fact check would have shown that I was not Gilroy's "colleague" and that our times at Yale did not intersect).

In other words, academic research for this tenured professor and Oxford graduate consists of quoting secondary sources such as The Guardian as fact, inventing events and relationships that did not exist, and not bothering to check primary sources either directly or indirectly, a fundamental tenet of reputable academic research. Or perhaps Cooke chose to ignore primary sources, a rather shoddy and irreputable approach to scholarly research. To Cooke, "critical thinking" apparently means "reckless criticism of everything she does not agree with."

I subscribe to a different definition, consistent with the teachings of my early mentor Victor P Satinsky, inventor of the Satinsky clamp and many other cardiothoracic surgery tools and techniques used to this day. Dr. Satinsky ran ran rigorous programs emphasizing critical thinking, responsibility, and clear, direct language in the interests of patient care:

Critical thinking means correct thinking in the pursuit of relevant and reliable knowledge about the world. Another way to describe it is reasonable, reflective, responsible, and skillful thinking that is focused on deciding what to believe or do. A person who thinks critically can ask appropriate questions, gather relevant information, efficiently and creatively sort through this information, reason logically from this information, and come to reliable and trustworthy conclusions about the world that enable one to live and act successfully in it.

(It's not a simple matter of incompetence. "Quackademics" who do not believe in reason and logic - the tools of the "oppressors" - are largely incapable of true critical thinking. Hysterical rants, they can do. Distortions and mistruths are no problem for them, since in their minds the means justifies the ideological ends. Put plainly, they are deceptive liars. But they are not incompetent. In the Art of Political War, they are actually quite competent. It does, however, scare the daylights out of such academics when people who do think rationally have "got their number" on that particular skill. Thanks to advances in information and communication technologies, an increasing number of ordinary people are "getting their number." Of that they are truly terrified. But I digress.)

Not surprisingly, I discovered that Cooke was a member of the "Group of 88", a group of Duke professors who apparently gave the accused students a behind-closed-doors fair trial (of course, defendants' presence not required), then lined them up and had them figuratively shot with a well-publicized statement implying their guilt. From the Inside Higher Ed article linked above:

... The 88 signatories affirmed that they were "listening" to a select group of students troubled by sexism and racism at Duke. Yet 8 of the 11 quotes supplied from students to whom these professors had been talking, 8 contained no attribution - of any sort, even to the extent of claiming to come from anonymous Duke students. Nonetheless, according to the faculty members, "The disaster didn't begin on March 13th and won't end with what the police say or the court decides." It's hard to imagine that college professors could openly dismiss how the ultimate legal judgment would shape this case's legacy. Such sentiments perhaps explain why no member of the Duke Law School faculty signed the letter.

I contacted Cooke, pointing out her errors and providing rather sarcastic commentary on how I was part of the Great Walt and Mearsheimer Cabal against academic freedom (a metaphor for another rather tenuous and tendentious piece of 'research' from yet another Ivy, Harvard). I have not received any reply. This is typical of academic tyrants, who are cowards when confronted outside of their power base. I contacted by email and phone the office of Duke President Richard H. Brodhead inquiring if Brodhead believed citing secondary sources constituted good research practice. He also has not replied.

Finally, I wonder if current Duke president Brodhead, who was an official at Yale until 2004 and implicated in this Duke lawsuit for sins of omission and commission, was involved in events covered in the previous post about an ongoing Federal investigation of Yale research grant accounting ("Lux et Veritas, or Trust But Verify? Yale discovers eDiscovery"). Another interesting PDF on that matter is here.

I think a comment made on the Duke-in-Wonderland site is particularly apropos:

"Another development on the local Duke scene is the "raised consciousness" of sensible alumni and institutional friends ... Any intelligent Duke alumnus of whatever age should now realize that he or she probably has more sensible and constructive ideas that many prominent Duke faculty."

This Duke disgrace is perhaps an epitaph for today's tenured, $100,000+ annually, pot-smoking, "oppressed" 1960's misfit-dominated academia.

-- SS

Addendum: there is much wisdom in this posting by KC Johnson regarding intellectual decay in academia. Many of the points raised also apply to the matters discussed on this blog. That academia sets the tone through its influence on students suggests that one path to "healthcare renewal" is via "academic renewal."

Original source here ...