Aug 23, 2022Liked by Arpan Parikh, MD MBA FAPA, Amit Parikh, MD
Thanks for writing this, extremely clear and digestable--personally was listening to a popular podcast called the All-In Podcast and they were talking about exactly this issue but without the important clinical intuition demonstrated here!
Not an expert, but my hypothesis re: 1) apart from the obvious one of stigma is lack of great measurability. Cancer has much more defined diagnostic criteria linked to physical measurements that are discrete, as opposed to it feels like items like the GAD-7 are self-reported and not measuring the fundamental physical components that cause anxiety/depression. This also makes it more difficult to extrapolate potential cost-savings without a high degree of variance -> less incentive for grant funding/research. On example in mental health, Alzheimers, stands out which has received a ton of funding (albeit recent Nature article debunking this)-- I believe it's because there was something measurable (e.g. amyloid plaques) that one could point to and try to develop therapeutics for.
Thanks Jon, appreciate it! I agree, we're probably one of (if not the) last specialties to really hone in on quantitative measurements in care, and this makes both research and extrapolating (/attributing) cost-savings difficult. The point on amyloid plaques seems totally right to me; I do think we need some of our neurology peers to write a similar piece on the amyloid plaques (the TLDR I've heard from colleagues is similar - they've known plaque density wasn't the end all be all for years!).
Aug 22, 2022Liked by Arpan Parikh, MD MBA FAPA, Amit Parikh, MD
To your second question about medical misinformation (+ disinformation) running rampant, I feel like the pandemic has really highlighted the need for a more robust, unified federal public health system.
Health communication is its own art for a reason; building trust with the public by communicating in a straightforward manner, while still giving the tools to follow up on nuance for those who want to go deeper, would go a long way toward combating sensationalized headlines. Axios’s “Smart Brevity” style is a great example of trying to appeal to multiple audiences when reporting on complex issues!
Agree with you both! Of course, the difficulty being sensationalized headlines -> more clicks -> revenue. I believe that ~60% of articles are shared without the person reading it. We need unified messaging that is produced in a highly engaging way.
Totally agree on 1. The need for robust, unified public health messaging, and 2. Healthcare communication being an art in and of itself. Maybe something that should be added to the list of topics medical students ought to be taught about but aren't!
Aug 22, 2022Liked by Arpan Parikh, MD MBA FAPA, Amit Parikh, MD
Thanks for writing this up. I was waiting for more thoughtful responses to the review. Do you know of any others? I'm surprised that their review found no direct correlations at all. I previously assumed at least some of the GWAS studies had good data. Is it correct to assume the umbrella review method doesn't do an adequate job job considering heterogeneous populations/responses (eg maybe data on some subgroups of patients with depression show more direct links with serotonin and some subgroups do not)?
Aug 22, 2022Liked by Arpan Parikh, MD MBA FAPA, Amit Parikh, MD
Also I love the enthusiasm and I also love that you're applying more thoroughness than most on these topics, but from my point of view I'm finding the quantity of emoji use a little distracting.
Thanks for the thoughtful feedback! There have certainly been some good Twitter threads and short pieces here and there, but no robust and singular response piece that we had seen thus far. And yes - I think the umbrella review method (amongst other potential shortcomings) wasn't able to account for the heterogeneity amongst the varied patient populations of each underlying study.
Thanks for writing this, extremely clear and digestable--personally was listening to a popular podcast called the All-In Podcast and they were talking about exactly this issue but without the important clinical intuition demonstrated here!
Not an expert, but my hypothesis re: 1) apart from the obvious one of stigma is lack of great measurability. Cancer has much more defined diagnostic criteria linked to physical measurements that are discrete, as opposed to it feels like items like the GAD-7 are self-reported and not measuring the fundamental physical components that cause anxiety/depression. This also makes it more difficult to extrapolate potential cost-savings without a high degree of variance -> less incentive for grant funding/research. On example in mental health, Alzheimers, stands out which has received a ton of funding (albeit recent Nature article debunking this)-- I believe it's because there was something measurable (e.g. amyloid plaques) that one could point to and try to develop therapeutics for.
Thanks Jon, appreciate it! I agree, we're probably one of (if not the) last specialties to really hone in on quantitative measurements in care, and this makes both research and extrapolating (/attributing) cost-savings difficult. The point on amyloid plaques seems totally right to me; I do think we need some of our neurology peers to write a similar piece on the amyloid plaques (the TLDR I've heard from colleagues is similar - they've known plaque density wasn't the end all be all for years!).
To your second question about medical misinformation (+ disinformation) running rampant, I feel like the pandemic has really highlighted the need for a more robust, unified federal public health system.
Health communication is its own art for a reason; building trust with the public by communicating in a straightforward manner, while still giving the tools to follow up on nuance for those who want to go deeper, would go a long way toward combating sensationalized headlines. Axios’s “Smart Brevity” style is a great example of trying to appeal to multiple audiences when reporting on complex issues!
Agree with you both! Of course, the difficulty being sensationalized headlines -> more clicks -> revenue. I believe that ~60% of articles are shared without the person reading it. We need unified messaging that is produced in a highly engaging way.
Totally agree on 1. The need for robust, unified public health messaging, and 2. Healthcare communication being an art in and of itself. Maybe something that should be added to the list of topics medical students ought to be taught about but aren't!
Thanks for writing this up. I was waiting for more thoughtful responses to the review. Do you know of any others? I'm surprised that their review found no direct correlations at all. I previously assumed at least some of the GWAS studies had good data. Is it correct to assume the umbrella review method doesn't do an adequate job job considering heterogeneous populations/responses (eg maybe data on some subgroups of patients with depression show more direct links with serotonin and some subgroups do not)?
Also I love the enthusiasm and I also love that you're applying more thoroughness than most on these topics, but from my point of view I'm finding the quantity of emoji use a little distracting.
Thanks for the thoughtful feedback! There have certainly been some good Twitter threads and short pieces here and there, but no robust and singular response piece that we had seen thus far. And yes - I think the umbrella review method (amongst other potential shortcomings) wasn't able to account for the heterogeneity amongst the varied patient populations of each underlying study.
Super insightful! Thanks guys.