Mammogram Reading Not Better With Computer Assistance

… or “Read this mammogram, HAL.” “I'm sorry, Dave. I'm afraid I can't do that.” I went to college in the late 1980s, at perhaps the peak of optimism about computer intelligence. Personal computers had just become available and there was a general expectation that computers would soon be driving our cars, accepting our commands in spoken English, and generally doing everything better than humans could. The reality has been much less consistent. There have been impressive gains in computer intel...
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The Power of Placebo

We’ve all heard of the power of the placebo effect – the benefit from receiving an inactive medication or a phony simulated treatment. But how do placebos work? Do they improve objective measures of disease? Do they improve the patient’s subjective symptoms? Do they do both? A cleverly designed study in last week’s New England Journal of Medicine (link 1 below) answers that question. The investigators chose asthma as the disease in which to study the effect of placebo because asthma can cause u...
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Spiral CT Scans Save Lives from Lung Cancer

In November I wrote about preliminary data from the National Lung Screening Trial, a large study funded by the National Cancer Institute that attempted to find out if catching lung cancer early with spiral CT scans made a difference. (See link 1 below for my November post.) Last week, the New England Journal of Medicine published the trial results (2) and an accompanying editorial (3). The study randomized over 50,000 people who were
  • aged 55 to 74,
  • were either current smoker...
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Rescuing Primary Care

For almost any category of product or service you can think of, a huge variety of price and quality is available. From clothes to food to transportation we can all think of lousy but inexpensive choices that we wouldn’t like and incredibly luxurious choices that we can’t afford. For almost all of us somewhere in the middle there are choices that are both pleasing and affordable. That doesn’t mean that my choice is the same as yours. You may not be happy with anything less than a BMW, while I’m t...
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