Got cancer? Here's how to think it through. Put the patient first.

Got cancer? Here's how to think it through. Put the patient first and figure out the Net Treatment Benefit for the patient. There is an 88% health illiteracy rate (Health.gov). Patients literally do not understand their medical treatments.

“Every day, patients and their caregivers are faced with crucial health care decisions while lacking key information that they need.” - PCORI

We need to translate “…existing scientific research into accessible and useable [sic] formats….” - PCORI

Download this document, which teaches you how to calculate the Net Treatment Benefit for the patient:
https://drive.google.com/file/d/1o1eoBZwPadJV_HpVZlk9KrH0vfzOBNZC/view?usp=sharing

PCORI = Patient-Centered Outcomes, Research Institute, Funding Announcement: Communication and Dissemination. Published May 22, 2012. Revised September 17, 2012. Accessed June 22, 2019.
http://www.pcori.org/assets/FINAL-PFA-Communication-and-Dissemination-v3.pdf

The Science of Medicine SOM® is Not the Same as Evidence-Based Medicine

The Science of Medicine SOM® is based on medical studies alone, and is an attempt to understand what the best medical studies say without the information being filtered through the potentially biased eyes of human beings.

The Science of Medicine SOM® is the first step of evidence-based medicine. Two people can read the same medical study and interpret it differently. So, the Science of Medicine SOM® is about the hardest data from experimental studies such as randomized controlled trials (if they exist). Experimental studies are hard science while observational studies are soft science.

Evidence-based medicine has three parts:

1. Medical studies
2. Clinical Experience
3. Values and preferences of the patient

You can also write the three steps of evidence-based medicine this way:

1. The Science of Medicine SOM®
2. Clinical experience
3. Values and preferences of the patient 

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Listen to the Patient!

What is the "Net Treatment Benefit for the Patient?" Remember, the first rule of medical ethics, FIRST DO NO HARM! Figure out the "Net Treatment Benefit" for the patient before and after treatment.

Here is a Treatment Score Calculator™ for patients, doctors, nurses, and everyone else, that you can print or download. It is a simple, easy way to understand the concept of the "Net Treatment Benefit for the Patient" using chronic pain as an example.
http://tinyurl.com/y2r7gtbl

The patient who takes Tylenol®, Motrin®, Naprosyn®, or hydrocodone will almost never receive the same "Net Treatment Benefit" from these medicationss. The treatment effects are different and side effects are different. In addition, every patient reacts differently to medications!

The Universal Treatment Score Calculator™ at the end of the document can be used to educate yourself about any treatment for any disease:
http://tinyurl.com/y2r7gtbl

Let's institute these medical principles:

• Patient empowerment 
• Transparency 
• Informed consent 
• Patient autonomy 
• Shared decision-making 
• Evidence-based medicine

Treatment Score Calculator(TM) - Chronic Pain Example

What the patient most needs to know is the "net treatment benefit" for them. When anyone gets sick they need a list of treatments with Treatment Scores.

The Treatment Score = the net treatment benefit for the patient.

This is the simplest example of how to calculate the "net treatment benefit for the patient" that we have come up with so far. You can print or download the Treatment Score Calculator(TM) - Chronic Pain Example here:

https://tinyurl.com/y24tzpw3

This example also includes a Treatment Score Calculator(TM) that can be used for any treatment for any disease.

ALWAYS SEE YOUR OWN LICENSED MEDICAL DOCTOR FOR DIAGNOSIS, TREATMENT, AND MEDICAL STATISTICS, INCLUDING TREATMENT SCORES.

The Net Treatment Benefit for the Patient

Treatment Scores, LLC suggests that the patient needs to know the "net treatment benefit for the patient" before treatment, and that the patient needs to report the "net treatment benefit for the patient" to the physician after treatment.

We also call the "net treatment benefit for the patient" the Treatment Score.

We believe that when anyone gets sick, they need a list of treatments with Treatment Scores. This information should come from patients and doctors working together doing evidence-based medicine and shared decision-making.

There is an 88% health illiteracy rate (Health.gov) and we should reduce health illiteracy with education.

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Solving Worldwide Health Illiteracy with the Science of Medicine, SOM®

The first step in solving Worldwide Health illiteracy is learning the Science of Medicine, SOM®.  What is the Science of Medicine? The Science of Medicine is the most objective part of the existing medical knowledge; the part most free of human bias and conflicts of interest.

The Science of Medicine SOM® is derived from statistics within the medical literature. For example, how much does a particular chemotherapy increase your 5-year overall survival according to the best study done so far?

Evidence-Based Medicine has three steps:

1. The Science of Medicine SOM®
2. The knowledge of the physician
3. The values and preferences of the patient

What patients, doctors, nurses, and others need is an online database of the Science of Medicine, SOM®. It's very difficult to review and summarize the over 29 million medical articles on Medline. We should have an online, and offline, database that does it for us.

We need a list of treatments with Treatment Scores for everything. We need an online database of what we actually know and don't know, and it needs to be quantified. We need a database about the medical literature, about the gross and net treatment benefit of medical treatments, and also about hypotheses regarding medical treatments.

I saw a commercial on TV for a drug called Harvoni. It is used to treat hepatitis C. Interestingly, by narrowing down the diagnosis to a more specific diagnosis, and by only reviewing randomized controlled trials, I found the gross treatment benefit for Harvoni to be 95%, as in a 95% cure rate at three months. This is impressive as the old interferon-based treatment for hepatitis C only had a Treatment Score of about 40, or 40%. Harvoni appears to be at least twice as good as the old treatment.

Healthcare should be this simple. You get a diagnosis. Then, you get a list of treatments with Treatment Scores for that diagnosis.

DISCLAIMERS: I have nothing to do with Harvoni and don't get paid by Harvoni. Always see your own physician for diagnosis and treatment. We do not give medical advice and we do not form patient-doctor relationships.

Bradley Hennenfent, M.D.
@BradMD on Twitter

Copyright (C) 2019. Treatment Scores, LLC