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Fighting the Number-One Killer In the US With Data
mattydread23 writes "Often, the signs of eventual heart failure are there, but they consist of a lot of weak signals over a long period of time, and doctors are not trained to look for these patterns. IBM and a couple heathcare providers, Sutter Health and Geisinger Health System, just got a $2 million grant from NIH to figure out how better data analysis can help prevent heart attack. But the trick is that doctors will have to use electronic records — it also means a lot more tests. Andy Patrizio writes, 'What this means is doctors are going to have to expand the tests they do and the amount of data they keep. Otherwise, the data isn't so Big.'"
This is the perfect use of government money: projects which are promising (though they may not pan out in the end), which will help many people, and which will not be subsidized by industry because they will not make money in the next three quarters. I don't expect any real results from this study for many years, but I think it's a very important study to do.
If you want to prevent heart disease, stop eating saturted fat and cholesterol and stick with a low-fat whole-plant-based diet. This knowledge is not new; this stuff has been known for almost a hundred years now, yet we're still spending money dancing around the fact that eating animals and their byproducts leads to heart disease.
Source: http://www.plantpositive.com/
Eh, much easier just to be theatrically 'tough on crime' and ascribe psych issues to weakness of character. Your approach sounds like effort.
That's a false choice. We can do both and one doesn't interfere with the other.
If you want to prevent heart disease, stop eating saturted fat and cholesterol and stick with a low-fat whole-plant-based diet.
That helps to reduce the risk, not prevent heart disease. That's something that makes me cringe - this idea that diet is a panacea for one's ills. ...
Genetics also have a lot to do with it, too.
Yes, eating more plants and less animals (even fish) is better for our health, our ecosystem, and our wallets, but let's not over state the benefits, please.
Not your wallet. Check out the prices in the produce aisle some time. Meat is often a cheaper source of your necessary nutrients than vegetables.
When we talk about vegetarian diets reducing your heart disease risk, it's frankly irresponsible to not provide information about how much it reduces the risk. There is an answer: 32%. http://abcnews.go.com/blogs/health/2013/02/04/vegetarians-have-lower-heart-disease-risk-study-finds/ That's significant enought to take into account, and not even close to enough to think you've done everything you can to reduce your risk if you are a vegetarian.
Also, there is little if any evidence that vegetarianism is any more healthy than eating meat a few times a week and mostly avoiding red meat. Researchers aren't sure whether meat is harming people or they are simply missing important plant nutrients.
It is a hypothesis that collecting more data will find a pattern that will predict heart failure earlier, and that will lead to earlier interventions.
They haven't demonstrated that it works.
In order to demonstrate it, they have to do a controlled trial. They have to use these data collection systems in a group of 5,000 patients, and use the usual methods in another 5,000 similar patients, and see if there's any difference in a meaningful outcome. Do the patients live any longer? Are they any less likely to get strokes?
Sometimes it works, sometimes it doesn't. The New England Journal of Medicine just published a report on the use of a high-tech surgical intervention -- implanting cardiac resynchronizing devices in a new subset of heart failure patients. http://www.nejm.org/doi/full/10.1056/NEJMoa1306687 It turned out the resynchronization patients had more deaths than the control group, and they stopped the study early. You don't know until you've done the randomized, controlled trial. That's the method of science, the experimental method. You take your brilliant ideas and put them to a test.
That's science. Everything else is bullshit.
There was a study of using an electronic medical record in a pediatric intensive care unit. The patients with the EMR had a higher death rate than the control patients. The doctors said that when they needed to write a prescription in a hurry, they would just take out their Rx pad and write it. When they needed to write it with the EMR, they had to sign in, go through screens, and find what they were looking for.
EMR replaced a simple, effective system -- paper and pen -- with a more difficult system. What's the point?
Read what doctors are actually saying about electronic medical records, http://www.kevinmd.com/blog/ http://www.nejm.org/
There are systems that actually make it easier to treat patients. As I understand it, the Veterans Affairs and Kaiser Permanente have systems that actually collect useful data. The Scandinavians have great useful databases. http://www.bmj.com/content/347/bmj.f5906 But a lot of the new systems, particularly the ones that are merely being installed because they're required and subsidized under new federal regulations, are driving doctors crazy. They complain that they have to log in, go through screens, fill out checklist after checklist, and wind up with records that go on for hundreds of pages that nobody ever looks at again. Traditionally, on paper, they were forced to write a concise narrative for their colleagues and themselves, of useful information that got to the point and helped them make a decision about what to do next. These poorly-designed EMRs stopped forcing doctors to think. It simply forced them to collect a lot of data. Data isn't information. Useless data is noise.
And maybe most of all, they complain that instead of looking at their patients, they're looking at a computer screen. If you have to tell somebody that he's going to die in 6 months if he doesn't stop smoking, you shouldn't be looking at your computer screen. Maybe there's an element of human communication that computer nerds don't appreciate.
In any computerized records, there's a tradeoff between how much data you collect, and how much time you have to spend entering data. You can spend an extra hour a day just entering more data. Is this pill a tablet or a capsule?
And more important than time, when you write a medical record, you should be filtering information for just the important information. Otherwise you're just adding noise to the record, and making it harder for the humans to spot patterns.
If you want to prevent heart failure, the basic job is to stop smoking, lose weight, and exercise. When patients get outside of certain well-understood parameters, you can give the
"Meat is often a cheaper source of your necessary nutrients than vegetables."
Ignoring how meat does not have essential phytonutrients in it (as you mention), consider the political reason of why that is the case as far as "calories":
http://www.seriouseats.com/2007/11/the-subsidized-food-pyramid.html
"The Physicians Committee for Responsible Medicine has posted an easy-to-understand visual on its site that shows which foods U.S. tax dollars go to support under the nation's farm bill. It's titled "Why Does a Salad Cost More Than a Big Mac?" and depicts two pyramids -- subsidized foods and the old recommended food pyramid. It's interesting to note that the two are almost inversely proportional to each other."
Also, consider how externalities of meat production such as destroying marine ecosystems from overfishing, manure runoff polluting fresh water supplies, and the destruction of so many forests and other land ecosystems to produce cattle feed:
http://www.westernwatersheds.org/watmess/watmess_2002/2002html_summer/article6.htm
On your other points, most vegetarians' diets probably aren't very good. They may have too many refined sugars and too few vegetables, too little variety, and too little of things like iodine. It takes a lot of learning and opportunity and time to eat well as a vegetarian. But what is important to acknowledge is that there are plant-based diet styles that will reverse heart disease. So that 32% figure might be some kind of average, but it does not reflect the best possible outcome for someone who is really trying to reverse or prevent heart disease. See my other post here for links, or see as one example, Dr. Esselstyn' work:
http://www.heartattackproof.com/
I'd agree though that some small amount of free-range organic grass-fed meat or other similar animal products can potentially be part of a reasonably healthy diet -- other ethical and financial and scalability and externality questions aside. Even Dr. Fuhrman agrees on that part as far as the research -- that if you get 10% or less of your calories from animal products, you are doing pretty well.
http://www.drfuhrman.com/library/foodpyramid.aspx
https://www.drfuhrman.com/library/article5.aspx
"Therefore I encourage consumption of a carefully planned vegetarian diet or one that includes a small amount of animal products, perhaps 10% of total calories or less, rather than 40 -60 % that children eat today. An animal-product-rich omnivorous diet cannot be considered nutritious food or called healthful."
High fat diets of animal products laced with growth hormones and such are probably bad for children in general. And also, there are few to no purely vegan diets in history. Even gorillas get some small percentage of their calories from termites and other insects they eat incidentally. B12 is another nutrient than can be an issue, usually provided by animal products, and some say can be supplied from dirty vegetables. Our food supply is in that sense too "clean" to be a pure vegan in (without special effort and selected supplements, if that). Vegans who are also neat freaks may be setting themselves up for disaster in that sense; yet on the other hand, since much "organic" food is grown using animal manure from livestock operations, not washing your vegetables well is a health risk too from E.coli contamination.
It does not take much animal products though to provide some essentials. Related example:
http://drbass.com/generations.html
"This text is still extremely important, since similar mistakes are still being made today, typically by aspiring vegans and vegan raw-foodists. Deficiencies th
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.