Monday, June 19, 2017

Help Patients: Blog and Write with Treatment Scores

Patients, and patient advocates, DESPERATELY need these five horrendous problems solved:

1. There is an 88% health illiteracy rate among patients (Health.gov)
2. 60 to 80% of physicians don't understand treatment effects (CMAJ)
3. The Patient-Centered Outcomes Research (PCORI) team says, “Every day, patients and their caregivers are faced with crucial health care decisions while lacking key information that they need.”
4. PCORI also says that we need to translate “…existing scientific research into accessible and usable formats…”
5. The majority of medical guidelines are written by authors with conflicts of interest (British Medical Journal).

We have created the solution for all five problems; we produce Treatment Scores. The Treatment Score = the net treatment benefit for the patient. It’s a way to summarize information to help patients understand medical treatments.


Patients are suffering from health illiteracy, medical scams, under-treatment, over-treatment, mistreatment, and being lied to with statistics. It’s horrible right now.

How to explain Treatment Scores? Well, every year we figure out our “gross income” and “net income” when we do our income taxes. So, we simply figure out the “gross treatment benefit” and the “net treatment benefit” for patients as digested from the medical literature. Did you see the movie "Moneyball" about Sabermetrics for baseball starring Brad Pitt? Treatment Scores are "Sabermetrics for medicine."



Treatment Scores put a graphical user interface (GUI) over evidence-based medicine (EBM). In the early days of the computer, you had to know how to use machine language to use a computer. Once Windows and Apple put a GUI over machine language everyone could use a computer. We have put a GUI over evidence-based medicine (EBM) so that everyone can do EBM.

Every step within Treatment Scores can be validated and verified. Treatment Scores are the opposite of cookbook medicine. Patients get what they want: understandable information. Physicians get what they want: Evidence-Based Medicine in a format that saves time. Bloggers and writers can stop lying with statistics.

REVELATIONS
When you do evidence-based medicine (EBM) with a graphical user interface (GUI), and you quantify the effects of medical treatments, you can make some astonishing discoveries.

A colleague looked at the trend not to give antibiotics to children under 2 years of age who present with ear aches (otitis media). He calculated a Treatment Score of 10% for symptom resolution for giving amoxicillin. He was surprised, because he thought the Treatment Score would be much higher. On the other hand, why withhold any treatment that has a “net treatment benefit” of 10% for resolving symptoms? It should be up to the patient. Patients want to know all the choices and all the information about each treatment; they want shared-decision making, because personal preferences can change the Treatment Score.

The Ebola epidemic in Africa was not optimally treated. Hundreds of patients probably died unnecessarily. With Treatment Scores, you can see who was more logical, Doctors without Borders, or one physician at the World Health Organization who saw in the data what we saw with Treatment Scores.

Harvoni (ledipasvir/sofosbuvir) is a major advance in treating a subset of hepatitis C, having a Treatment Score of 95% (as in 95% cure rate), compared to the old interferon based protocol that has a Treatment Score of 40%.

The Xiao procedure for incontinence in children with spina bifida has been reported as being 80% successful in some studies. When evidence-based medicine is applied and biased are removed the Treatment Score = 0% (or even turns negative because of harm from the surgery).

Steve Jobs (of Apple) allegedly had stage 1, neuroendocrine, pancreatic cancer found by accident. No doubt, such a smart, wealthy CEO would immediately undergo the "best treatment" for this most curable form of all pancreatic cancers, right? No! Remember, there is an 88% health illiteracy rate among patients (Health.gov). Even “the genius” Steve Jobs wasted precious time, apparently 6 months or more, doing treatments that were not backed by clinical evidence. How many times did the tumor double in size over the 180-day delay? Doubling time can be as low as 62 days (Pancreas, 2001). Would Steve Jobs still be alive today if he had simply had immediate access to a list of all possible treatments with Treatment Scores? His disease reportedly became metastatic and he passed away.

A COMPLETE LIST OF TREATMENTS
Patients want a complete list of treatments. Recently, a man told me about being diagnosed with hives (urticaria of unknown etiology). He went from doctor to doctor without ever finding a cure. He was working from a list of treatments that included antihistamines and steroids, and all the sub-classes of those medications orally and topically. He was also taking four showers per day for itching. The treatment that finally cured him wasn’t even on any of the typical lists of treatments. I have heard this same story many times about many different diseases. Did you know there are 130 treatments for insomnia? Did you know there are 57 treatments for an acute migraine headache? Why can’t we give patients a complete list of every treatment in the literature for every disease, and a Treatment Score for every one of those treatments? Not to say what patients must do, but to say here is what you can do, and here are how the Treatment Scores change depending on your personal preferences.

Patients want to know about all treatments whether they are Western medicine, Eastern medicine, herbal medicine, naturopathic medicine, Ayurveda, or any other type of alternative medicine. Patients spend $34 billion dollars per year on alternative medicine. You can give patients what they want with treatment lists and positive Treatment Scores, because sometimes excellent clinical studies do exist. Or, you can tell them when the Treatment Score = 0, because studies do not exist or the treatments don’t work. You can even tell patients when the Treatment Score is negative (harmful).

LOOKING
We are looking for a person (or a group of people) who can help lead the movement for treatment transparency using Treatment Scores. We are looking for people passionate about patient education, shared decision-making, patient engagement, patient empowerment, and personalized medicine. This will be a great educational opportunity (over the Internet).

AUDIENCE
The essays you write with Treatment Scores will be seen by a wide audience. We have over 100,000 followers on Facebook, over 9,000 followers on Twitter, and we hold all top 10 positions on Google search. As I write this, we are growing by over 1,000 followers per day on all our social media accounts. Patients clearly want better treatment transparency. You can also write for your hometown newspaper and prove to your local community that, with technology, you are the smartest patient advocate in town. Major publishers also need Treatment Scores.

LEARNING
What will Treatment Scores give you besides worldwide and local publicity? You will receive an extraordinary education in evidence-based medicine. You will discover amazing revelations currently hidden in the medical literature. You will find “scoops” and information that needs to “go viral.”

If you want to help patients, you should be interested in social media: Facebook, Twitter, YouTube, and blogging. You should not be afraid of appearing on TV, and you should be good with a smart phone.

IMAGINE A FUTURE
Imagine a future where patients actually understand evidence-based medicine and where treatment transparency disrupts the entire medical industry.

CONTACT
If you are interested in Treatment Scores, please email:
Dr.Hennenfent@gmail.com
Feel free to send your LinkedIn profile, CV, or any other information.

There is a 1 minute explainer video about Treatment Scores on YouTube:
https://youtu.be/GLIIB3oOVJA

There is an explanatory essay about Treatment Scores and Smart Phones here:
http://www.treatmentscoresblog.com/2017/03/patients-desperately-need-treatment.html

Bradley R. Hennenfent, MD
Physician & Economist (Retired)
Florida, USA
Dr.Hennenfent@gmail.com

ABOUT
Treatment Scores was started by an anesthesiologist, an emergency physician, a physician programmer, and Dr. Hennenfent. Brad Hennenfent graduated from Northwestern University with a degree in economics, graduated medical school from the University of Illinois, and did his Emergency Medicine residency at the UIC Affiliated Hospitals Emergency Medicine Residency Program. After two years as a practicing emergency physician, he became director of an inner-city emergency department in Chicago. Then, he went into business and became the director of over 10 emergency departments and urgent care centers. Dr. Hennenfent has had five uncles with prostate cancer. He became an advocate, and, while working with a medical non-profit, helped get over $20 million dollars of federal funding released for medical research to the National Institutes of Health. He also helped get over $100,000 worth of grants in kind or donations year after year. In his retirement in Florida, he has become very interested in medical statistics and treatment transparency for patients. He believes patients should be more informed and more powerful. Dr. Hennenfent likes to combine the mathematics of economics with the mathematics of medicine.

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DISCLAIMER
You must always see a licensed physician for diagnosis and treatment. Treatment Scores are only an educational exercise. Death or disability can result if you don't see your own medical physician, call an ambulance, or go to the emergency department immediately for your medical issues.

Copyright © 2017 Bradley R. Hennenfent, M.D. All rights reserved.

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