Top killers in U.S.

January 14, 2009 at 9:57 pm | In BioMedicine, Modern Research, Science, Social Medicine | 3 Comments
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Top three killers in the u.s.

Tope three killers in the u.s. as reported in JAMA: 1 700000 2. 553000 3. 250000

(* Note: I made two errors when making my beautiful piechart – I cited 250,000 as the number of iatrogenic deaths, when the actual number is 280,000. I also mistakenly switched two sources for the deaths, ADRs and total injuries. Source below.)

Over a million patients are injured in U.S. hospitals each year, and approximately 280,000 die annually as a result of these injuries. Therefore, the iatrogenic death rate dwarfs the annual automobile accident mortality rate of 45,000 and accounts for more deaths than all other accidents combined.

Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, Laffel G, Sweitzer BJ, SheaBF, Hallisey R, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA. 1995 Jul 5;274(1):29-34.

When these numbers came out in 1995, Reuters didn’t pick them up. Why? These are shocking numbers.

It’s not the only piece of research that paints this shocking picture either: Gary Null paints a picture far more gruesome – total deaths due to conventional medical interventions and problems picked up in hospitals (such as infections) is 783,936 per year. Then, depending on the numbers for the other two top killers, Heart Disease and Cancer, Conventional medicine takes either the top or second spot.

Let’s look at another pie graph:

Top three killers in the u.s.

Top three killers in the u.s. as reported by G Null

The modern healthcare system is not supposed to do this. This is out of bounds. What now?

References:

Lazarou J, Pomeranz BH, Corey PN, Incidence of Adverse Drug Reactions in Hospitalized Patients, Journal of the American Medical Association (JAMA), Vol. 279. April 15, 1998, pp. 1200-05.

Bates, DW., Drugs and Adverse Drug Reactions: How Worried Should We Be? JAMA, Vol. 279. April 15, 1998, pp. 1216-17.

Leape L, Error in medicine, JAMA 1994;272:1851-7.

Schuster M, McGlynn E, Brook R. How good is the quality of health care in the United States? Milbank Q. 1998;76:517-563.

Starfield B. Evaluating the State Children’s Health Insurance Program: critical considerations. Annu Rev Public Health.

Phillips D, Christenfeld N, Glynn L. Increase in US medication-error deaths between 1983 and 1993. Lancet. 1998;351:643-644.

Leape L. Unnecessary surgery. Annu Rev Public Health. 1992;13:363-383.

Weingart SN, Wilson RM, Gibberd RW, Harrison B. Epidemiology and medical error. BMJ. 2000;320:774-777.

Guyer B, Hoyert D, Martin J, Ventura S, MacDorman M, Strobino D. Annual summary of vital statistics 1998. Pediatrics. 1999;104:1229-1246.

HarHolland E, Degruy F. Drug-Induced Disorders – November 1, 1997 – American Family Physicianrold LR, Field TS,

Gurwitz JH. Knowledge, patterns of care, and outcomes of care for generalists and specialists. J Gen Intern Med. 1999;14:499-511.

World Health Report 2000. Available at: http://www.who.int/whr/2000/en/report.htm. 2000;21:569-585.

There is a Rhyme and a Reason

December 8, 2008 at 12:54 am | In Chinese Medicine, Herbal Medicine, Modern Research, Science | Leave a Comment
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While I don’t like to go on about reductionism and its assumed evils and so forth, there are grains of truth in these criticisms.
There is a difference between a complex, open (interconnected) system and a small, (relatively) closed system – the former is like the weather, and the latter is like a motor vehicle. I believe we are all familiar with the viscissitudes of weather forecasting, and yet, on the other hand, how generally reliable and unperplexing our vehicles are.
In essence, the first system cannot be reduced without losing its essential complexity and interrelatedness, while the second one can (for a deeper discussion on the relative aspects of this idea, click here). This means that in order to understand a complex, open system, it must be met in its arena of effect. Reducing the arena changes the game and damages the data irretrievably.
In a previous post (Herb Comparable to Prednisone), I wrote about how the oversimplification of Chinese Medical principles tended to damage the effectiveness of the intervention, sometimes completely, and how it was important to understand that in Chinese Medicine we do things for a reason.
More careful research can illuminate some of these reasons, and I would like to provide you with a brief glimpse into one of these investigations:

Chinese Medicine almost always uses herbal combinations rather than single herbs, not only because a single herb has a weak effect, but because herbs can act in synergistic or antagonistic ways to each other (amongst other effects). Thus a properly constructed formula with the individual patient in mind provides a superior effect than the administration of a single herb, or of a non-individualised formula.
The following graph from the Biological and Pharmaceutical Bulletin (2003;26(7):911-919) dramatically illustrates this phenomenon:

The blood concentration of wagonoside from HuangQinTang was twice as high as that of HuangQin alone.

The blood concentration of wagonoside from HuangQinTang was twice as high as that of HuangQin alone.

HuangQin Tang is a Chinese Herbal Combination, Huang Qin is merely the lead herb.
HuangQin Tang contains: huáng qín, huáng lián, gé gēn, and zhì gān cǎo.
This type of investigation makes two points:
1. There is a reason that herbal combinations are the standard of care in CM.
2. Deconstructing an open, complex system is fraught with dangers if the aim is to illuminate the true mechanisms or energetic dynamics of said system.
In the western world, and even the eastern world, too much effort has been spent on “identifying” the one herb in a formula which provides the effect, and then further “isolating” “active ingredients” in order to provide the end-user with a “real” medicinal in a “more potent” form for, ostensibly, superior clinical effect.
It’s as if a scientist wanted to provide us with a better vehicle, and decided the active ingredient was the piston, made us a big giant piston to use and acted all proud.
It is my hope that our understanding of the ancient and wise medical systems of this world becomes much more mature in the next short little while.
Incidentally, HuangQin Tang is primarily used for something called “Damp-Heat in the Lower Burner”, one manifestation of which is dysentery. Years ago, a chemical called “berberine” was isolated from another herb in this formula, huáng lián, and used in cases of dysentery. And yes, you guessed it, it doesn’t work as well as HuangQin Tang for the indicated condition.
Oh well.

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