Medical syntax is designed to communicate information in a predictable sequence with key elements prioritized to facilitate efficient communication and formation of an assessment and plan
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In medicine, reckoning with racism includes reappraising the very syntax we use every day. Proud to add my voice w/ @J_Ikeme and @RWGrantMD in this @JAMAInternMed pub addressing:
Does race/ethnicity belong in the first line of the patient
Medical syntax is designed to communicate information in a predictable sequence with key elements prioritized to facilitate efficient communication and formation of an assessment and plan
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I grew accustomed to reading/hearing: a 70-year-old Black man w/ history of x, a 50-year-old Hispanic woman presented w/ y.
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https://t.co/GMKXsx6Z02
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https://t.co/8Ej4LvDi2a
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-race is not a meaningful scientific construct in the absence of context
-race is not a biologic category based on innate differences that produce unequal health outcomes.
-it is a social category that reflects the impact of unequal social experiences on health
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-Unfortunately, race in medical education often misses the mark and can lead to race-based diagnostic bias or pathologizing race (see below table)
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https://t.co/Yt28mUqPqg
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- Race, ethnicity, and ancestry have a complex and intertwined relationship that demands nuanced analyses
- we should not assume that environmental, social, or genetic factors represent the only contributors to a given disease until causation has been proven
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https://t.co/aVM0k4GCEv
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Is race correction based on robust evidence?
Is there a plausible causal mechanism for the racial difference?
Would implementing this correction relieve or exacerbate health inequities?
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More from Health
I applaud the #EUCancerPlan *BUT* caution: putting #meat 🥩 (a nourishing, evolutionary food) in the same box as 🚬 to solve a contemporary health challenge, would be basing policy on assumptions rather than robust data.
#FollowTheScience yes, but not just part of it!
THREAD👇
1/ Granted, some studies have pointed to ASSOCIATIONS of HIGH intake of red & processed meats with (slightly!) increased colorectal cancer incidence. Also, @WHO/IARC is often mentioned in support (usually hyperbolically so).
But, let’s have a closer look at all this! 🔍
2/ First, meat being “associated” with cancer is very different from stating that meat CAUSES cancer.
Unwarranted use of causal language is widespread in nutritional sciences, posing a systemic problem & undermining credibility.
3/ That’s because observational data are CONFOUNDED (even after statistical adjustment).
Healthy user bias is a major problem. Healthy middle classes are TOLD to eat less red meat (due to historical rather than rational reasons, cf link). So, they
4/ What’s captured here is sociology, not physiology.
Health-focused Westerners eat less red meat, whereas those who don’t adhere to dietary advice tend to have unhealthier lifestyles.
That tells us very little about meat AS SUCH being responsible for disease.
#FollowTheScience yes, but not just part of it!
THREAD👇
\U0001f534LIVE \U0001f4c5Today \u23f012:00 CET
— EU_HEALTH - #EUCancerPlan (@EU_Health) February 3, 2021
We are presenting today the #EUCancerPlan as part of a strong \U0001f1ea\U0001f1fa#HealthUnion
Follow the presentation live here: https://t.co/Cr8ATvzNkg#WorldCancerDay pic.twitter.com/zdByuklWV6
1/ Granted, some studies have pointed to ASSOCIATIONS of HIGH intake of red & processed meats with (slightly!) increased colorectal cancer incidence. Also, @WHO/IARC is often mentioned in support (usually hyperbolically so).
But, let’s have a closer look at all this! 🔍
2/ First, meat being “associated” with cancer is very different from stating that meat CAUSES cancer.
Unwarranted use of causal language is widespread in nutritional sciences, posing a systemic problem & undermining credibility.
3/ That’s because observational data are CONFOUNDED (even after statistical adjustment).
Healthy user bias is a major problem. Healthy middle classes are TOLD to eat less red meat (due to historical rather than rational reasons, cf link). So, they
4/ What’s captured here is sociology, not physiology.
Health-focused Westerners eat less red meat, whereas those who don’t adhere to dietary advice tend to have unhealthier lifestyles.
That tells us very little about meat AS SUCH being responsible for disease.
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1/x Fort Detrick History
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Under Mr. Patrick’s direction, scientists at Fort Detrick developed a tularemia agent that, if disseminated by airplane, could cause casualties & sickness over 1000s mi². In a 10,000 mi² range, it had 90% casualty rate & 50% fatality rate
3/x His team explored Q fever, plague, & Venezuelan equine encephalitis, testing more than 20 anthrax strains to discern most lethal variety. Fort Detrick scientists used aerosol spray systems inside fountain pens, walking sticks, light bulbs, & even in 1953 Mercury exhaust pipes
4/x After retiring in 1986, Mr. Patrick remained one of the world’s foremost specialists on biological warfare & was a consultant to the CIA, FBI, & US military. He debriefed Soviet defector Ken Alibek, the deputy chief of the Soviet biowarfare program
https://t.co/sHqSaTSqtB
5/x Back in Time
In 1949 the Army created a small team of chemists at "Camp Detrick" called Special Operations Division. Its assignment was to find military uses for toxic bacteria. The coercive use of toxins was a new field, which fascinated Allen Dulles, later head of the CIA
Mr. Patrick, one of the chief scientists at the Army Biological Warfare Laboratories at Fort Detrick in Frederick, Md., held five classified US patents for the process of weaponizing anthrax.
2/x
Under Mr. Patrick’s direction, scientists at Fort Detrick developed a tularemia agent that, if disseminated by airplane, could cause casualties & sickness over 1000s mi². In a 10,000 mi² range, it had 90% casualty rate & 50% fatality rate
3/x His team explored Q fever, plague, & Venezuelan equine encephalitis, testing more than 20 anthrax strains to discern most lethal variety. Fort Detrick scientists used aerosol spray systems inside fountain pens, walking sticks, light bulbs, & even in 1953 Mercury exhaust pipes
4/x After retiring in 1986, Mr. Patrick remained one of the world’s foremost specialists on biological warfare & was a consultant to the CIA, FBI, & US military. He debriefed Soviet defector Ken Alibek, the deputy chief of the Soviet biowarfare program
https://t.co/sHqSaTSqtB
5/x Back in Time
In 1949 the Army created a small team of chemists at "Camp Detrick" called Special Operations Division. Its assignment was to find military uses for toxic bacteria. The coercive use of toxins was a new field, which fascinated Allen Dulles, later head of the CIA
