Category Archive: NEJM

Effect of Aspirin on All-Cause Mortality in the Healthy Elderly

The Aspirin in Reducing Events in the Elderly (ASPREE) trial was a primary prevention trial that was established to investigate whether the daily use of 100 mg of enteric-coated aspirin would prolong the healthy life span of older adults. The trial, wh…

Effect of Aspirin on Disability-free Survival in the Healthy Elderly

Several large, randomized trials have shown the efficacy of aspirin for the secondary prevention of cardiovascular disease among persons with a history of coronary heart disease or stroke. The evidence supporting a benefit of aspirin therapy in the pri…

Voluntary Euthanasia — Implications for Organ Donation

In 2015, the Supreme Court of Canada decided to decriminalize medical assistance in dying for patients who are experiencing “grievous and irremediable” suffering. The next year, the Canadian government passed legislation that permits physicians to hast…

The Violence of Uncertainty — Undermining Immigrant and Refugee Health

Hawa rushed her husband Ahmed to the emergency department when she found him unconscious. For months, Ahmed had refused to go to the hospital because he knew Immigration and Customs Enforcement (ICE) officers were nearby. Ahmed is a U.S. citizen, but h…

Quality of Care in the United Kingdom after Removal of Financial Incentives

Pay-for-performance schemes are increasingly used by health care payers to support improvement in the quality of care and have become widespread in many health systems, including those in the United States, the United Kingdom, Canada, Germany, Israel, …

“Precision” Public Health — Between Novelty and Hype

In May 2018, the National Institutes of Health (NIH) began enrollment for a vast medical research cohort. Named “All of Us,” it’s meant to include 1 million U.S. volunteers, who will be studied over 10 years at a cost of $1.45 billion. The project prom…

Medicare Spending after 3 Years of the Medicare Shared Savings Program

Since the first accountable care organizations (ACOs) entered the Medicare Shared Savings Program (MSSP) in 2012, it has expanded annually to include 561 ACOs covering approximately one third of the fee-for-service Medicare population. ACOs in the volu…

Personalized Hospital Ratings — Transparency for the Internet Age

Each release of new overall hospital ratings is captivating to journalists, hospital leaders, and health care consumers in the United States. These overall ratings, whether published by U.S. News, Consumer Reports, or Hospital Compare, aggregate a wide…

Ending Use of Oral Poliovirus Vaccine — A Difficult Move in the Polio Endgame

When the world embarked on a mission of global polio eradication with the adoption of a World Health Assembly resolution in 1988, there was only minimal consideration of what would happen after the eradication of wild poliovirus (WPV) had been certifie…

“Transparency” as Mask? The EPA’s Proposed Rule on Scientific Data

The Environmental Protection Agency (EPA) recently proposed excluding from consideration in setting environmental standards any studies whose raw, individual-level data are not publicly available. This proposal was preceded by the wholesale exclusion f…

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