Can there be value-based medicine without … values?

Peter J. Pitts

doi:10.5912/jcb823

Can there be value-based medicine without … values?

Journal of Commercial Biotechnology ◽

10.5912/jcb823 ◽

2018 ◽

Vol 23 (4) ◽

Author(s):

Peter J. Pitts

Keyword(s):

The Media ◽

Design Value ◽

It Impact ◽

Out Of Pocket Expenses ◽

Access And Affordability ◽

Based Medicine ◽

Formulary Design

“Value-based” is the new, hot prefix. Value-based medicine, value-based insurance design, value-based contracting. It seems that everyone agrees that everything should be based on “value.” But do they – really? Do we really all agree that “value” is the denominator” rather than “price?” Clearly not considering that the “price of medicine” is still very much driving the media and political conversation.But “value” is what patients care about, because “value” means clinical outcomes.When patients say, “My drugs are too expensive!” – what do they mean? As a rule it means that their co-pays and co-insurance fees (their out of pocket expenses) are too high. What are we doing about that? Who sets those costs? What do they mean? How do they impact formulary design and … value-based contracting?Let’s simplify that question: How does value-based contracting impact access and affordability – the only things patients care about and generally the last things that are taken into consideration. And how does it impact PBM and payer profitability?

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Which has more influence on perception of pseudo-therapies: the media’s information, friends or acquaintances opinion, or educational background?

Communication & Society ◽

10.15581/003.32.3.35-48 ◽

2019 ◽

Vol 32 (3) ◽

pp. 35 ◽

Cited By ~ 2

Author(s):

Carolina University of Valencia Moreno-Castro ◽

Mavi Florida Universitaria Corell-Doménech ◽

Ramón Universitat de València Camaño-Puig

Keyword(s):

Nursing Students ◽

Quantitative Research ◽

Educational Background ◽

Alternative Therapies ◽

Discussion Groups ◽

Scientific Controversies ◽

Survey Results ◽

The Media ◽

Journalism Students ◽

Based Medicine

This study analyses the discourses of Education and Journalism students in order to understand their perception of complementary and alternative therapies. Likewise, to know if educational background or friends or acquaintances opinion has a more considerable influence on their knowledge and use of these socially controversial techniques than the media. This study uses qualitative research methods based upon 12 discussion groups with 102 participants. Once transcriptions were completed, discourse analysis was conducted using linguistic corpus software (T-LAB. 9.1.). In the design of the research, these students were selected for their social involvement in their future careers, such as when they are going to address or analyse scientific controversies, both in classrooms and media, or evidence-based medicine. Also, to complement the results of the qualitative study, and thus obtain more robust conclusions, this work compares the data collected in discussion groups, with results of a survey (quantitative research) administered to 718 students of Education, Journalism, Medicine and Nursing. One hand, the focus groups revealed that the information channels through which students learned about these therapies were by word of mouth and through networks of family members, friends and acquaintances and their digital equivalents, social networks and blogs. In all the discussion groups, a lack of scientific knowledge was detected. Second hand, survey results showed that the Education and Nursing students presented a higher level of acceptance of alternative therapies compared with the Medicine and Journalism students, who were the most unaccepting

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What should medical students know about artificial intelligence in medicine?

Journal of Educational Evaluation for Health Professions ◽

10.3352/jeehp.2019.16.18 ◽

2019 ◽

Vol 16 ◽

pp. 18 ◽

Cited By ~ 12

Author(s):

Seong Ho Park ◽

Kyung-Hyun Do ◽

Sungwon Kim ◽

Joo Hyun Park ◽

Young-Suk Lim

Keyword(s):

Artificial Intelligence ◽

Medical Students ◽

Data Science ◽

Medical Professionals ◽

The Internet ◽

Evidence Based ◽

The Public ◽

Correct Information ◽

The Media ◽

Based Medicine

Artificial intelligence (AI) is expected to affect various fields of medicine substantially and has the potential to improve many aspects of healthcare. However, AI has been creating much hype, too. In applying AI technology to patients, medical professionals should be able to resolve any anxiety, confusion, and questions that patients and the public may have. Also, they are responsible for ensuring that AI becomes a technology beneficial for patient care. These make the acquisition of sound knowledge and experience about AI a task of high importance for medical students. Preparing for AI does not merely mean learning information technology such as computer programming. One should acquire sufficient knowledge of basic and clinical medicines, data science, biostatistics, and evidence-based medicine. As a medical student, one should not passively accept stories related to AI in medicine in the media and on the Internet. Medical students should try to develop abilities to distinguish correct information from hype and spin and even capabilities to create thoroughly validated, trustworthy information for patients and the public.

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Clinical trial through the eyes of patients: benefit or unjustified risk?

Health Care of the Russian Federation ◽

10.47470/0044-197x-2021-65-2-118-124 ◽

2021 ◽

Vol 65 (2) ◽

pp. 118-124

Author(s):

Olga I. Zvonareva ◽

Olga S. Kobyakova ◽

Igor’ D. Pimenov ◽

Maria Yu. Egorova ◽

Vera Е. Yun ◽

...

Keyword(s):

Primary Source ◽

Local Context ◽

Russian Society ◽

The Public ◽

Personal Benefit ◽

Incurable Disease ◽

The Media ◽

Motivating Factor ◽

Based Medicine ◽

Source Of Information

Introduction. Clinical trials (CTs) are the footing foundation of evidence-based medicine. In Russia many aspects of CT implementation remain unexplored; one of them is the attitude of Russian society. Aims. This study aims to determine the knowledge and perception of CTs by potential participants. Analysis of the perception of CTs through the eyes of patients: CTs - is it a benefit or an unjustified risk? Materials. The primary method of research was a questionnaire. A total of 488 anonymous, voluntary surveys of patients from hospitals in Tomsk were studied. Results. More than half of the respondents heard about CTs, while the primary source of information was the media. The participants adequately assess the importance of conducting CTs to develop medicine and medical care for society. The primary goal of CTs is to determine the effectiveness and safety of drugs, and respondents regard their engagement as an opportunity to contribute to the development of science. The primary motivating factor in participating in CTs is receiving treatment for an incurable disease and observing conditions by a qualified doctor. The central negative aspect is the possibility of causing a risk to own health. The questionnaire demonstrated the need and importance of all points of informed consent. Several questions concerned the public attitude to researchers. According to patients, medical researchers arouse trust and confidence in altruistic motives during the CTs. Conclusion. This study revealed a low interest of Russians in participating in CTs, except for personal benefit. The behavior of the doctors, the ability to convey reliable information to the patient to adequately assess benefits and possible risks play an important role in deciding on the involvement of patients in the CTs. The results of this work will allow us to adapt the process of organizing CTs to the needs of patients in the local context.

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Incarnation and the dynamics of medical promises: DHEA as a fountain of youth hormone

Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine ◽

10.1177/1363459318769437 ◽

2018 ◽

Vol 23 (6) ◽

pp. 639-655

Author(s):

Boris Hauray ◽

Sébastien Dalgalarrondo

Keyword(s):

Evidence Based ◽

Sources Of Information ◽

Risks And Benefits ◽

Medical Sector ◽

The Social ◽

The Media ◽

Normative Dimension ◽

Fountain Of Youth ◽

Based Medicine

For more than a decade, the sociology of hope and expectations has gained growing influence in the social studies of health, medicine, and healthcare. This literature has stressed the role of representations of the future—through images, metaphors, theories, or visions—in the medical sector and analyzed the translation of these discursive contents into social practices and organizations. This article builds on these results and intends to explore a dimension that has received less attention: the incarnation of medical promises. Looking at the evolving case of a particular molecule, dehydroepiandrosterone (DHEA)—which has been promoted from the mid-1990s onwards as a “fountain of youth” pill—, we emphasize that testimonies by and portrayals of those who are undergoing a treatment with uncertain risks and benefits, and representations of their bodies in the media, can play a key role in the performativity of a medical promise. We analyze this incarnation as a specific “form of veridiction” and stress its normative dimension. This leads us to underline how evidence-based medicine and experiential knowledge—which are often analyzed as two opposite sources of information—can intricate and give rise to the same incarnation dynamics.

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Oedipus to Jack the Ripper

Psychiatric Bulletin ◽

10.1192/pb.23.8.497 ◽

1999 ◽

Vol 23 (8) ◽

pp. 497-499 ◽

Cited By ~ 3

Author(s):

Gillian Combe ◽

Sara Cunningham ◽

Anne Read

Keyword(s):

Critical Appraisal ◽

Medical Profession ◽

Original Research ◽

Journal Clubs ◽

Eastern Usa ◽

The Media ◽

Perceived Relevance ◽

Critical Appraisal Skills ◽

Based Medicine ◽

Published Research

Since the first journal clubs were started this educational tool has been used by the medical profession with varying degrees of success (Linzer, 1987). Journal clubs allow trainees to review a piece of published research and discuss it with senior colleagues. They are frequently plagued by poor attendance and perceived as less than exciting, and at worst frankly boring. The enormous choice of journals compared with 100 years ago and the diversity of the media available mean that journal clubs should look towards developing in their format. Various methods have been tried to improve attendance, perceived relevance and enjoyment, such as evidence-based medicine reviews (Gilbody, 1996), teaching critical appraisal skills, and using structured review methods (Burstein et al, 1996). Sidorov (1995) surveyed 131 postgraduate programmes in the eastern USA and found the following features were associated with high attendance and continuous existence of journal clubs: smaller residency programmes, making attendance mandatory, providing food and promoting original research articles.

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Media representations of complementary and alternative medicine in the Italian press: A criminological perspective

European Journal of Criminology ◽

10.1177/1477370817748589 ◽

2017 ◽

Vol 15 (4) ◽

pp. 421-441 ◽

Cited By ~ 5

Author(s):

Anita Lavorgna ◽

Anna Di Ronco

Keyword(s):

Medical Profession ◽

Media Representations ◽

Systematic Analysis ◽

Alternative Medicines ◽

The Press ◽

Public Debates ◽

Criminological Perspective ◽

The Media ◽

Based Medicine ◽

Complementary And Alternative

Complementary and alternative medicines (CAMs), here broadly intended as all those healthcare approaches developed outside standard science-based medicine, are increasingly the object of highly polarized public debates. Some CAMs can cause great social harm, with serious repercussions both on the health of people and on their confidence in the medical profession and the scientific method. This notwithstanding, criminologists have so far overlooked this issue. Based on the awareness that people’s perceptions of CAMs often depend on what they learn about them through the media, this exploratory study presents a longitudinal systematic analysis of media representations of CAMs in the Italian press. The results indicate that media have conveyed confused and ambivalent messages on the topic of CAMs, partly because of the lack of preparation of journalists on this subject and partly because of the insubstantial presence of the voices of experts and medical organizations in the press discourse. In addition, the study identifies avenues for further criminological research on this topic.

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Adam Briggs and Paul Cobley (eds.), The Media: An Introduction,Harlow: Longman, 1998, £16.99 pbk, xii+449 pp. (ISSN: 0-5822-7798-1).

Sociology ◽

10.1017/s0038038598220281 ◽

1998 ◽

Vol 32 (4) ◽

pp. 881-900

Author(s):

Sara O'Sullivan

Keyword(s):

The Media

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Using the scanning electron microscope for failure analysis of high density magnetic media

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100126755 ◽

1987 ◽

Vol 45 ◽

pp. 392-393

Author(s):

Evelyn R. Ackerman ◽

Gary D. Burnett

Keyword(s):

Electron Microscope ◽

Scanning Electron Microscope ◽

Failure Analysis ◽

High Density ◽

Magnetic Media ◽

Specific Data ◽

Retrieval Systems ◽

Operating Environments ◽

The Media ◽

Scanning Electron

Advancements in state of the art high density Head/Disk retrieval systems has increased the demand for sophisticated failure analysis methods. From 1968 to 1974 the emphasis was on the number of tracks per inch. (TPI) ranging from 100 to 400 as summarized in Table 1. This emphasis shifted with the increase in densities to include the number of bits per inch (BPI). A bit is formed by magnetizing the Fe203 particles of the media in one direction and allowing magnetic heads to recognize specific data patterns. From 1977 to 1986 the tracks per inch increased from 470 to 1400 corresponding to an increase from 6300 to 10,800 bits per inch respectively. Due to the reduction in the bit and track sizes, build and operating environments of systems have become critical factors in media reliability.Using the Ferrofluid pattern developing technique, the scanning electron microscope can be a valuable diagnostic tool in the examination of failure sites on disks.

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