Sorry to healthcare renewal blog for getting their url wrong. That's not as bad as 1) failing to directly engage in serious debate and then 2) posting comments to say you engage in debate when you really don't.
I usually don't live in the past but since Dr. Poses is fairly well-intentioned and we actually see eye to eye more or less on the how comparative effectiveness should be conducted, constructed and used (I think?) I because he is real doctor I just want to point out the following regarding his criticisms about my article in The Washington Times on comparative effectiveness.
1. He beats up on me for conflating hypertension with congestive heart failure in discussing BiDil. I hereby announce that he wins this one. BiDil was first rejected as a treatment for hypertension but approved later for advanced heart failure because of clinical measures, not surrogate measures that everyone drools about these days. I then compounded the mistake by hauling up examples about how one uses the combination of drugs in BiDil (isosorbide dinitrate and hydralazine) are used to treat hypertension.
2, But then Poses goes to nitpick on my analysis of ALLHAT rather than engage me at the larger point I was trying to make: that the same people who were beating up on the use of BiDil which was designed to target excess mortality from CHF in blacks had no problem with ALLHAT which had a design that lead to excess stroke and mortality due to heart failure -- all in the name of well-designed comparative effectiveness and we urging even more ALLHAT like research to guide FDA and insurance reimbursement decisions.
3. I won't use time or space now to respond to the Poses nitpick on ALLHAT: that I am wrong to claim that the ALLHAT study design except to say that when African American blood pressure levels are beyond acceptable levels and they are generally deprived of optimal care as part of the study protocol I will leave it to Poses to defend excess mortality among blacks and Jerry Avorn's peddling of the ALLHAT results as the gold standard for comparative effectiveness...which I frankly think Dr. Poses does not want to do. If he wants to go in depth on the ALLHAT mess I can refer him to other who were and are actually involved.
4. In short, I believe Dr. Poses to be much more fair minded and rigorous than many others, more driven by data and science than by ideology. I may be wrong on that point but my re-reading of his criticisms of me and his post suggests that.
hcrenewal.blogspot.com
I usually don't live in the past but since Dr. Poses is fairly well-intentioned and we actually see eye to eye more or less on the how comparative effectiveness should be conducted, constructed and used (I think?) I because he is real doctor I just want to point out the following regarding his criticisms about my article in The Washington Times on comparative effectiveness.
1. He beats up on me for conflating hypertension with congestive heart failure in discussing BiDil. I hereby announce that he wins this one. BiDil was first rejected as a treatment for hypertension but approved later for advanced heart failure because of clinical measures, not surrogate measures that everyone drools about these days. I then compounded the mistake by hauling up examples about how one uses the combination of drugs in BiDil (isosorbide dinitrate and hydralazine) are used to treat hypertension.
2, But then Poses goes to nitpick on my analysis of ALLHAT rather than engage me at the larger point I was trying to make: that the same people who were beating up on the use of BiDil which was designed to target excess mortality from CHF in blacks had no problem with ALLHAT which had a design that lead to excess stroke and mortality due to heart failure -- all in the name of well-designed comparative effectiveness and we urging even more ALLHAT like research to guide FDA and insurance reimbursement decisions.
3. I won't use time or space now to respond to the Poses nitpick on ALLHAT: that I am wrong to claim that the ALLHAT study design except to say that when African American blood pressure levels are beyond acceptable levels and they are generally deprived of optimal care as part of the study protocol I will leave it to Poses to defend excess mortality among blacks and Jerry Avorn's peddling of the ALLHAT results as the gold standard for comparative effectiveness...which I frankly think Dr. Poses does not want to do. If he wants to go in depth on the ALLHAT mess I can refer him to other who were and are actually involved.
4. In short, I believe Dr. Poses to be much more fair minded and rigorous than many others, more driven by data and science than by ideology. I may be wrong on that point but my re-reading of his criticisms of me and his post suggests that.
hcrenewal.blogspot.com
