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Avoiding Overuse is Key to Medical Professionalism | The Medical Professionalism Blog

Professionalism Prize Winner Deborah Korenstein, MD describes how researching overuse lead to her article on medical professionalism.
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Disease mongering
Overdiagnosis of disease: a modern epidemic sickness.
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MSD minaccia azioni legali per far cessare le critiche ad un suo prodotto. Pillole.org

La MSD ha minacciato azioni legali contro l'epidemiologo clinico Alberto Donzelli, per indurlo a cessare di esprimere critiche nei confronti dell'uso di un prodotto dell'azienda. 

Assume connotati internazionali la controversia tra la Merck Sharp & Dohme e il Dottor Alberto Donzelli, responsabile appropriatezza clinica della ASL di Milano. Il BMJ ha pubblicato un articolo che riassume la vicenda.

La filiale italiana della compagnia farmaceutica Merck Sharp & Dohme (MSD) ha stoppato un medico di primo piano nella gestione della salute pubblica intimandogli di cessare di indirizzare ai Medici di Medicina Generale testi medici critici nei confronti dell'uso di uno dei farmaci della società. 

Nei testi, Alberto Donzelli, il capo della formazione, appropriatezza e medicina basata sulle evidenze presso l'azienda di sanità pubblica di Milano (ASL Milano), aveva analizzato le prove pubblicate sul farmaco ezetimibe scoraggiandone l'uso in aggiunta alle statine. 

Una lettera a "cessare e desistere" è stata inviata in febbraio dal direttore medico di MSD, Patrizia Nardini, ed è stata recapitata dal direttore degli affari legali della società. Hanno accusato Donzelli di colpa grave e di una violazione dell'etica medica e minacciato di far causa a lui e a Milano Sanità per una cifra di € 1,3 milioni (1 milione di sterline; $ 1.78m). La lettera era indirizzata a Donzelli, con copia inviata al direttore generale della ASL di Milano e al presidente dell'Ordine dei Medici di Milano Roberto Carlo Rossi.  aggiornamento, ricerca, supporto, promozione del ruolo dei medici.
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Cancro, chi è povero muore

Cancro, chi è povero muore | Disease mongering | Scoop.it
Per la prima volta in Italia due farmaci oncologici sono in vendita solo a pagamento: chi vuole curarsi deve pagare più di mille euro a settimana. Si viola la Costituzione, ma il governo fa finta di niente
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Putting Us All at Risk for Measles

Putting Us All at Risk for Measles | Disease mongering | Scoop.it
When it comes to public health, bad personal choices can have potentially devastating effects on others.

Via Jeff French
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Lo strano caso del dottor Donzelli e del Signor MSD | Partecipasalute.it

Lo strano caso del dottor Donzelli e del Signor MSD | Partecipasalute.it | Disease mongering | Scoop.it


Pillole è una rivista di informazione curata dal Servizio educazione alla Appropriatezza ed EBM (medicina basata sulle prove) della ASL di Milano. In seguito ad un articolo su un farmaco ha ricevuto da una azienda farmaceutica una richiesta di risarcimento danni.

I referenti delle riviste ISDB (*) hanno sottoscritto una lettera di sostegno all’attività di questa rivista nel pubblicare informazioni basate sulle prove, spingendo altresì ad un confronto costruttivo sui dati e non alla sterile querelle legale. Vi invitiamo a leggere la lettera, a sostenerla e farla girare. http://www.slideshare.net/sfwebm/lo-strano-caso-del-dr-donzelli-finale-2...

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MSD Italy is criticised for threatening legal action over prescription advice to GPs

The Italian branch of the drug company Merck Sharp and Dohme (MSD) has stopped a leading public health doctor and administrator from circulating texts to GPs advising them about the use of one of the company’s drugs.

In the texts, Alberto Donzelli—the head of education, appropriateness, and evidence based medicine at the public health authority of Milan (Milan Healthcare)—had analysed the published evidence on the cholesterol lowering drug ezetimibe and discouraged its prescription in addition to statins.

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Will today's children die earlier than their parents?

Will today's children die earlier than their parents? | Disease mongering | Scoop.it
It's said that today's children will live shorter lives than their parents because of obesity. However they could live longer - just in poor health.
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Using Evidence to Combat Overdiagnosis and Overtreatment: Evaluating Treatments, Tests, and Disease Definitions in the Time of Too Much

  • Overdiagnosis and related overtreatment are increasingly recognised as major problems.
  • “Positive” average results from trials of treatments can mask situations where many participants at low risk of disease may receive no benefit.
  • The evaluation of diagnostic tests usually involves assessing how well tests detect presence versus absence of a certain disease—rather than how well they detect clinically meaningful stages of disease.
  • Changes to disease definitions typically do not involve evaluation of potential harms of overdiagnosis, and are often conducted by heavily conflicted panels.
  • We offer suggestions for improving the way evidence is produced, analysed, and interpreted, to help combat overdiagnosis and related overtreatment. These include routine consideration of overdiagnosis and related overtreatment in studies of tests and treatments, and clearer stratification by baseline risk to identify treatment thresholds where benefits are likely to outweigh harms.
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Social Media and Medical Malpractice: Six Tips - Seattle Malpractice Lawyers

Social Media and Medical Malpractice: Six Tips - Seattle Malpractice Lawyers | Disease mongering | Scoop.it
Imagine you are a medical malpractice defense lawyer performing some online research concerning a plaintiff in one of your cases.  Now, imagine running across this: A Facebook Status update: “I can’t believe how much I drank last night!  Remember kids, don’t mix pain pills with alcohol!” A Twitter feed:  “We are stuck in the ER …
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Doctors, stay safe: The malpractice implications of social media

Doctors, stay safe: The malpractice implications of social media | Disease mongering | Scoop.it
Is the phone in your pocket increasing your risk of being sued for medical malpractice?
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ChoosingWisely - The PSA blood test for prostate cancer. When men need it and when they don’t

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Andrea Robotti's curator insight, July 7, 4:52 AM

Argomento che ritengo molto utile ed attuale, non solo perché sono un uomo e un individuo conscio del significato pratico del termine prevenzione!

Consiglio quindi a tutti di non allarmarsi di fronte ad un eventuale riscontro di alti livelli di PSA nel sangue, dal momento che non è un indicatore di alto rischio e la sua variazione non è sempre associata alla presenza di cellule neoplastiche.

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Imaging tests for lower-back pain You probably do not need an X-ray, CT scan, or MRI

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Was the flu drug zanamivir a breakthrough or money for old rope?

A drug company executive hailed it as “one of the greatest discoveries of the 20th century” and an Australian politician predicted two decades ago it might be a “breakthrough as significant as penicillin.” The Independent on Sunday in the UK ran a front page story declaring “a cure for flu that actually works,” and Australian tabloids quoted a patient saying that within 24 hours of taking it, “I was completely cured.” Given the sober findings of the recent Cochrane review of the drug,1 and the resources invested in pandemic stockpiles, all this misleading hype about zanamivir (Relenza) now seems obscene. Yet, inside the offices of the world’s most powerful drug regulator, a young biostatistician had concluded 15 years ago that the drug’s benefits were extremely limited. His findings back in 1999 would ignite the fury of one of the world’s most powerful drug companies and set the scene for a case study in failed regulation.

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Using Evidence to Combat Overdiagnosis and Overtreatment: Evaluating Treatments, Tests, and Disease Definitions in the Time of Too Much

Using Evidence to Combat Overdiagnosis and Overtreatment: Evaluating Treatments, Tests, and Disease Definitions in the Time of Too Much | Disease mongering | Scoop.it
  • Overdiagnosis and related overtreatment are increasingly recognised as major problems.
  • “Positive” average results from trials of treatments can mask situations where many participants at low risk of disease may receive no benefit.
  • The evaluation of diagnostic tests usually involves assessing how well tests detect presence versus absence of a certain disease—rather than how well they detect clinically meaningful stages of disease.
  • Changes to disease definitions typically do not involve evaluation of potential harms of overdiagnosis, and are often conducted by heavily conflicted panels.
  • We offer suggestions for improving the way evidence is produced, analysed, and interpreted, to help combat overdiagnosis and related overtreatment. These include routine consideration of overdiagnosis and related overtreatment in studies of tests and treatments, and clearer stratification by baseline risk to identify treatment thresholds where benefits are likely to outweigh harms
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Drug Companies' Patient-Assistance Programs — Helping Patients or Profits? — NEJM

Drug Companies' Patient-Assistance Programs — Helping Patients or Profits? — NEJM | Disease mongering | Scoop.it
Implementing patient cost sharing in the form of copayments, coinsurance, and deductibles is one of the more reliable methods for reducing health care costs. But imposing cost sharing reduces patients' demand for medical care, which sets the interests of insurers at odds with the interests of health care providers and drug and device manufacturers, who generally benefit when patients use more services.
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CDC - Measles: Cases and Outbreaks. January 1 to July 3, 2014

CDC - Measles: Cases and Outbreaks. January 1 to July 3, 2014 | Disease mongering | Scoop.it

This year the United States is experiencing a record number of measles cases. From January 1 to July 3, 2014, there have been 554 confirmed measles cases reported to CDC's National Center for Immunization and Respiratory Diseases (NCIRD). This is the highest number of cases since measles elimination was documented in the U.S. in 2000.

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Top Influencers and Analytics for #DiseaseMongering

Top Influencers and Analytics for #DiseaseMongering | Disease mongering | Scoop.it
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#pilloleamare: cosa stiamo imparando? | dottprof.com

#pilloleamare: cosa stiamo imparando? | dottprof.com | Disease mongering | Scoop.it
Alberto Donzelli è una persona perbene che da anni cura - per il servizio di educazione all'appropriatezza e medicina basata sulle evidenze della ASL di Milano
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Merck Says It Regrets Strong-Arming Italian Researcher

Merck Says It Regrets Strong-Arming Italian Researcher | Disease mongering | Scoop.it
Merck says that it "regrets" using legal threats to push a leading Italian researcher to muffle his public critiques of one of the company's cholesterol drugs. Merck spokesman Steve Cragle writes: Merck is committed to the open and transparent exchange of scientific information. We believe this exchange should take place [...]
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Merck Uses Legal Threats To Stifle Negative Advice About Zetia And Vytorin In Italy

Merck Uses Legal Threats To Stifle Negative Advice About Zetia And Vytorin In Italy | Disease mongering | Scoop.it
(Updated) In response to repeated legal threats, a public health doctor in Italy has withdrawn advice to curtail use of a controversial drug. The drug, ezetimibe, is a key ingredient in Zetia and Vytorin, which is manufactured by Merck. The cholesterol-lowering drug has been the subject of fierce controversy because it [...]
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La trasparenza nella ricerca. Cosa insegna il Caso Tamiflu | SaluteInternazionale

La trasparenza nella ricerca. Cosa insegna il Caso Tamiflu | SaluteInternazionale | Disease mongering | Scoop.it
L'accesso ai dati delle sperimentazioni non può limitarsi ai nuovi farmaci, deve essere garantita la trasparenza dei dati grezzi di tutte le sperimentazioni per
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Anti-Vaccination Attitudes within the Chiropractic Profession: Implications for Public Health Ethics

Anti-Vaccination Attitudes within the Chiropractic Profession: Implications for Public Health Ethics | Disease mongering | Scoop.it
Even though vaccination is generally seen as one of the great successes of modern public health, pockets of resistance to vaccination exist. One such
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Lying with Statistics: The National Climate Assessment Falsely Hypes Ice Loss in Greenland and Antarctica

Lying with Statistics: The National Climate Assessment Falsely Hypes Ice Loss in Greenland and Antarctica | Disease mongering | Scoop.it
by E. Calvin Beisner and J.C. Keister How fast are Greenland and Antarctica losing ice? If you trust the National Climate Assessment (NCA), you’ll think, “Very fast!” And that’s intentional.

Via Hans Gruen
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Bone-density tests When you need a test and when you don’t

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Can doctors reduce harmful medical overuse worldwide?

Doctors order unnecessary interventions for a multitude of other reasons, including fear of malpractice suits, to appear to be doing something rather than nothing, to try to demonstrate thoroughness, and because of how they were taught. 

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Inactivity Is ‘The Single Greatest Risk Factor for Heart Disease’ in Women Over 30

Inactivity Is ‘The Single Greatest Risk Factor for Heart Disease’ in Women Over 30 | Disease mongering | Scoop.it
(PRWEB) June 27, 2014 -- TrekDesk continues its campaign to change the sedentary lifestyle progression in America. A new study helps spread its message.
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