Tag Archives: information

How Well Does A Drug Work? Look Beyond The Fine Print

July 25, 2014 4:35 PM ET
 
 
Traditional warning labels on medicine boxes tend to be long on confusing language, critics say, but short on helpful numbers.

Traditional warning labels on medicine boxes tend to be long on confusing language, critics say, but short on helpful numbers.

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“Anybody who has ever seen a drug advertisement or talked over the pros and cons of a medicine with a doctor can be forgiven for being confused.

Sorting out the risks and benefits of taking a medicine can be complicated even for professionals.

This 2007 ad for the sleeping pill Lunesta stresses insomnia relief — not the relative usefulness of the drug.This 2007 ad for the sleeping pill Lunesta stresses insomnia relief — not the relative usefulness of the drug.

Lunesta

This spring, the Institute of Medicine convened a workshop with the Food and Drug Administration. The topic: How best to communicate to doctors and patients the uncertainty in the assessment of benefits and risks of pharmaceuticals.

The FDA not only approves drugs, it also approves the prescribing instructions that come along with them. For some drugs, the wad of paper filled with fine print about the risks and benefits of using the drug is accompanied by a medication guide that is supposed to summarize the main points.

During one question-and-answer session, Dr. Robert Temple of the FDA’s Center for Drug Evaluation and Research, acknowledged that those guides are full of information. “But it’s remarkably nonquantitative for the most part,” he said. “And I think we should try to think about whether there are quantitative ways of presenting that stuff.”

He then referred to Drs. Steven Woloshin and Lisa Schwartz, two of his fellow panelists, who have said it’s possible to pull that off.

The husband-and-wife team from Dartmouth are on a decade-long mission. They have been pushing the FDA to get useful and readable quantitative data about drugs to doctors and their patients.

Schwartz and Woloshin have designed a format they call a drug facts box. It shows the gist of what they say is buried in all the fine print: How does the drug compare to a placebo?

Drs. Lisa Schwartz and Steven Woloshin designed this "fact box" as a prototype to show how package inserts for medicines could be more helpful.

Drs. Lisa Schwartz and Steven Woloshin designed this “fact box” as a prototype to show how package inserts for medicines could be more helpful.

Courtesy of Dr. Steven Woloshin

That’s in contrast to what usually happens, Schwartz says. “The prescribing info is written by industry, and then negotiated with FDA, and then FDA ultimately approves it. And we have documented examples where important info — like how well the drug works — is not in the label.”

This drives Schwartz and Woloshin crazy.

Better Than A Sugar Pill

So, here’s their experiment: They showed people ads for two competing heartburn drugs, one plainly more effective than the other.

They also showed people two of their drug facts boxes, one for each of those two heartburn drugs, showing how each drug fared against a placebo (a sugar pill) in testing.

“When the people are presented with the standard information they see — like a drug ad — about 30 percent of people chose the better drug,” Woloshin says. “But when we showed them information in the drug facts box form, 68 percent of people were able to choose the objectively better drug. So that’s a really dramatic improvement. It just shows you that if you show people information in a way that’s understandable, they can use it, and it can improve their decision.”

Using FDA data, Woloshin and Schwartz developed a drug facts box for the sleep aid Lunesta.

Two columns compare people with insomnia who took Lunesta and people with insomnia who, unknowingly, took a sugar pill.

The results? Those who used Lunesta took 30 minutes to fall asleep. Those who got a sugar pill took 45 minutes — a difference of 15 minutes. Those who took Lunesta stayed asleep 37 minutes longer than those who took a sugar pill.

Woloshin and Schwartz say some people might consider those benefits worth taking the drug, and some might not.

“That’s the whole point of the drugs facts box,” Woloshin says, “to let people look at the evidence and come to their own judgments. But you can’t make those judgments without the facts.

He and Schwartz believe passionately in the numeracy of patients. They say we can handle numbers, like percents. It’s just that too often we’re given incomplete or misleading information.

How Good A Deal Is That Sale?

For example, a claim that some drug reduces the likelihood of a particular disease by 50 percent can be misleading.

Woloshin explains why. “If you heard about a sale, and it said 50 percent off, would you travel a great distance to go to the sale? Well, you might if it was on things that are really expensive, like a flat-screen TV or something,” he says. “But what if the thing that was on sale was gum, and you save only a couple of cents? So when you hear 50 percent reduction, you have to ask 50 percent of what?”

The doctors’ dream is to get those drug facts boxes into health systems and electronic medical records, so that doctors and patients can study the information and decide what’s best before the drug is prescribed.

“What we hope is that the box will encourage people to take drugs that are effective and that work, and discourage people from taking drugs that don’t work or are just harmful,” Woloshin says. “And also that just having this information in front of people will stimulate better drug research, because drug companies realize people are paying attention and looking at these numbers — and then we’d have a better quality of drug trials.”

Woloshin and Schwartz say medical information should be as quantitative as other information. And we digest quantitative data all the time.

“If you were reporting on an election, you wouldn’t say Obama won by a little,” he says. “You’d give the numbers. If you were reporting sports scores, you wouldn’t say the Celtics, won, hopefully won, by a bit. You’d give the score.”

Why should health care be different?

He and Schwartz are convinced that we can understand risk described by numbers, provided the numbers are clearly and honestly presented.

They have been lobbying the FDA to develop drug facts boxes, but say that seems unlikely. So they started their own company to do it — Informulary. It’s funded by the Robert Wood Johnson Foundation, which also supports NPR.

This is the final part of an All Things Considered series on Risk and Reason.”

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We’re Not No. 1! We’re Not No. 1! – NYTimes.com

http://mobile.nytimes.com/2014/04/03/opinion/were-not-no-1-were-not-no-1.html?referrer=

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Facebook Likes Predict Sexual Orientation, Religion, & More

Facebook Likes Predict Sexual Orientation, Religion, & More

Today at 11:44 am by Sarah Downey

“A new study takes the saying “what you like says a lot about you” to a whole new level. Researchers from Cambridge University analyzed 58,000 Facebook profiles and found that a person’s Facebook Likes, which are public by default, are highly accurate in predicting personal, sometimes sensitive details about him or her.

Simply analyzing a person’s Facebook Likes was 88% accurate in predicting whether a man is gay or straight, 95% accurate in predicting whether a person is Caucasian or African American, and 85% accurate in determining whether someone is a Democrat or a Republican.

The researchers concluded that Facebook Likes, these “relatively basic digital records of human behavior,” “can be used to automatically and accurately estimate a wide range of personal attributes that people would typically assume to be private.”

Most Likes that serve as predictors of other attributes, including whether a person is in a relationship or a substance abuser, aren’t obvious–it’s not as if single people Like pages called “I like being single” and Beyonce’s “Single Ladies.” Instead, Likes that have seemingly no connection to certain personality traits are surprisingly linked. The researchers gave a few good examples:

The best predictors of high intelligence include “Thunderstorms,” “The Colbert Report,” “Science,” and “Curly Fries,” whereas low intelligence was indicated by “Sephora,” “I Love Being A Mom,” “Harley Davidson,” and “Lady Antebellum.” Good predictors of male homosexuality included “No H8 Campaign,” “Mac Cosmetics,” and “Wicked The Musical,” whereas strong predictors of male heterosexuality included “Wu-Tang Clan,” “Shaq,” and “Being Confused After Waking Up From Naps.”

7.4 million websites have Facebook Like buttons on them (not to mention the buttons all over Facebook itself), and that number is growing. Users can Like almost anything: photos, comments, musicians, brands, celebrities, and pages. As we’ve written about extensively, social buttons like Facebook’s Like button aren’t just for sharing: they’re trackers. Unless you’re using a tool like DoNotTrackMe to block them, they know which sites you visit and what you do on a website, even if you never click them. The mere fact that they’re present on a page means they’re tracking you.

This study illustrates how the little things you do online add up to create a highly detailed picture of who you are. You may not think that a Like here and there says anything about you, but they all add up–especially with Facebook’s new Graph Search that displays all your Likes with a single search…and those searches can be incriminating, embarrassing, or even dangerous (“Men in Iran who are interested in other men,” for example). Plus the long list of people with whom Facebook shares data includes advertisers, app developers, law enforcement, and other companies.

Even if you’re trying to be discreet by leaving personal information out of your profile, others can figure it out through your public Likes. If researchers with a limited budget can learn this much about a person through their Facebook Likes, imagine how big companies, advertisers, or governments could use–or misuse–that data. Are you the type of person who takes risks? Maybe an insurance company will hike up your rates. Are you politically conservative? Maybe a potential employer will pass on hiring you because of it. Are you someone who loves coffee? Maybe online retailers will charge you more for it than someone else (Google filed a patent for price discrimination based on online social data).

Your past Facebook Likes are listed chronologically in your Activity Log.

The only solution Facebook offers is using your Facebook Activity Log to un-like things one by one, but for many users with hundreds or thousands of Likes, this process will take hours. Be wary of third-party apps that say they’ll let you delete all your Likes at once; search for reviews to learn more about whether they’re legitimate. We advise you to rethink every Like you click, knowing that all of them can come back to bite you.”

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March 12, 2013 · 6:42 pm

Truly inspiring…

She’s Got Some Big Ideas

By BRUCE FEILER

Published: November 30, 2012

“SHE is the mastermind of the one of the faster growing literary empires on the Internet, yet she is virtually unknown. She is the champion of old-fashioned ideas, yet she is only 28 years old. She is a fierce defender of books, yet she insists she will never write one herself.

Her exhaustively assembled grab bag of scientific curiosities, forgotten photographs, snippets of old love letters and mash notes to creativity — imagine the high-mindedness of a TED talk mixed with the pop sensibility of P. T. Barnum — spans a blog (500,000 visitors a month), anewsletter (150,000 subscribers) and a Twitter feed(263,000 followers). Her output, which she calls a “human-powered discovery engine for interestingness,” has attracted an eclectic group of devotees including the novelist William Gibson, the singer Josh Groban, the comedian Drew Carey, the neuroscientist David Eagleman, the actress Mia Farrow and the Twitter founders Biz Stone and Evan Williams.

“She’s a celebrator,” said Anne-Marie Slaughter, a Princeton professor and former State Department official. “You feel the tremendous amount of pleasure she takes in finding these things and sharing them. It’s like walking into the Museum of Modern Art and having somebody give you a customized, guided tour.”

So what exactly is it that she does? Ms. Popova says she views her job as “helping people become interested in things they didn’t know they were interested in, until they are.” One entry might discuss how to find your true passion, with links to a talk by Alain de Botton, a book by the cartoonist Hugh MacLeod and a commencement address by Steve Jobs; another, how she asked an artist friend to illustrate thoughts on love from Susan Sontag’s diaries. Recently she recounted an aging Helen Keller’s visit to Martha Graham’s studio.

She has faced criticism, of course. She has been dismissed as elitist and condescending. An initiative she helped start last spring, the Curator’s Code, which called for more respect and attribution in the Twittersphere, was harshly criticized. Ms. Popova responded in a blog post that began, “In times of turmoil, I often turn to one of my existential pillars of comfort: Albert Einstein’s ‘Ideas and Opinion.’ ” She ended with this thought: “There is a way to critique intelligently and respectfully, without eroding the validity of your disagreement. It boils down to manners.”

As for her future, Ms. Popova said she had little interest in expanding her brand. “I get asked all the time, ‘How’s it going to scale?’ ‘What’s next?’ ” she said. “What I do is what I do, and I don’t think I’m ever going to change that.” The woman who rails against her contemporaries for turning their backs on old books said she had no interest in writing one. “That’s such an antiquated model of thinking,” she said. “Why would I want to write something that’s going to have the shelf life of a banana?””

 

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December 3, 2012 · 7:31 pm

lifetip #6

lifetip #6

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December 3, 2012 · 6:50 pm