tag:blogger.com,1999:blog-14743001.post302008659090334526..comments2024-01-02T02:45:17.328-06:00Comments on Notes from Dr. RW: Anticoagulation for superficial vein thrombosis: NEJM reports important study and New York Times misses the boat as usualRobert W Donnellhttp://www.blogger.com/profile/16944231400440786271noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-14743001.post-773857330059457802010-10-14T05:50:07.060-05:002010-10-14T05:50:07.060-05:00The NEJM article is an excellent peice of research...The NEJM article is an excellent peice of research. The editorial is interesting and highlights some important issues - however, from a European perspective, the editorial misses some key clinical aspects - ie. extension to the saphenofemoral junction of the superficial-vein thrombosis, recurrence of the thrombosis, and surgery for the thrombosis were all significantly lower among fondaparinux asAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-14743001.post-20235569577740317092010-09-29T23:01:17.362-05:002010-09-29T23:01:17.362-05:00Virginia Doc,
Yes, I'm conservative, but not t...Virginia Doc,<br />Yes, I'm conservative, but not the wing nut you might think.<br /><br />Thanks for the kind words, though!Robert W Donnellhttps://www.blogger.com/profile/16944231400440786271noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-89764019745127398132010-09-29T10:57:56.138-05:002010-09-29T10:57:56.138-05:00RW,
I think you are being paranoid in your fear of...RW,<br />I think you are being paranoid in your fear of bureaucrats making clinical judgements. Insurance companies try, but they have a powerful interest in doing so. To bureaucrats, they also have an interest in forcing such decisions (money), but they have an overwhelming interest in staying out of it--politics. If there was any shred of good that came out of the shameful "death panel&Patrick Barocohttps://www.blogger.com/profile/08798267564773719932noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-76362615659514305612010-09-28T07:54:51.078-05:002010-09-28T07:54:51.078-05:00"... but I'm equally concerned about any ..."... but I'm equally concerned about any non-clinical outsider making clinical decisions, whether they are Federal czars or people who work for insurance companies."<br />Where do you think we're headed?<br />@Virginia, I presume that you support the president's plan. Public support for it, which was always soft, is steadily eroding. It's not the Tea Partiers behind thisMichael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-7776329341021798912010-09-27T23:50:03.067-05:002010-09-27T23:50:03.067-05:00Virginia Doc,
The czars haven't started making...Virginia Doc,<br />The czars haven't started making those decisions yet, and while it's too early to really say I believe that's the ultimate aim of many policy makers. I'm not being disingenuous when I express concern about scientifically challenged bureaucrats making clinical decisions.<br /><br />I'm not shocked at all---not the least bit surprised---about the poor job theRobert W Donnellhttps://www.blogger.com/profile/16944231400440786271noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-83975205483850944782010-09-27T23:13:58.147-05:002010-09-27T23:13:58.147-05:00Michael,
I agree with your point about cost, which...Michael,<br />I agree with your point about cost, which is why I suggested we could apply the lessons of this paper but using cheaper alternatives (generic Lovenox).<br /><br />I still think the NYT was way off base. You may disagree with my analysis, but the point was that Arixtra for DVT prophylaxis held up in this study as well, from a cost effectiveness standpoint, as Lovenox did in the Robert W Donnellhttps://www.blogger.com/profile/16944231400440786271noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-19981648518133566482010-09-27T17:19:22.409-05:002010-09-27T17:19:22.409-05:00You made a good argument until you start throwing ...You made a good argument until you start throwing around suggestions that "Obamacare czars" make the decisions about what is covered and what isn't. The cynic in me says you know better and are just muckraking using a milder version of the "death panel" argument. But I'll give you the benefit of the doubt and say it's probably just a matter of ignorance and Patrick Barocohttps://www.blogger.com/profile/08798267564773719932noreply@blogger.comtag:blogger.com,1999:blog-14743001.post-52363238788633066892010-09-27T08:32:43.841-05:002010-09-27T08:32:43.841-05:00I mentioned the Times study in my blog also, but d...I mentioned the Times study in my blog also, but don't think that the piece was uninformed. We spend too much money on stuff that doesn't work or barely works. Any treatment will have its advocates, often for self-serving reasons. Here's a piece from USA Today presenting some rather pricey medical care of dubious value. Cost is never a factor, when someone else is paying for it. Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.com