Category Archive: NEJM

Medical Assistance in Dying — Implementing a Hospital-Based Program in Canada

An aging population and shifts in Western societies toward secularism, populism, and an emphasis on individual autonomy and personal control have fueled the movement to legalize assisted dying. It has now been legalized in some form in five European co…

Emerging from EHR Purgatory — Moving from Process to Outcomes

The widespread adoption of electronic health records (EHRs) during the past decade has been hailed as a major advance in medical practice. Recently, however, a growing number of clinicians have spoken out about the counterproductive effects of these sy…

Racial Disparities in Risks of Stroke

To the Editor: The incidence of stroke in the United States has been decreasing as efforts have been made to control vascular risk factors. However, the extent to which modifications in changes in the risk of stroke have occurred in blacks as compared …

Accelerated Approval and Expensive Drugs — A Challenging Combination

For serious or life-threatening disease, the Food and Drug Administration (FDA) can approve drugs on the basis of surrogate end points that are “reasonably likely to predict clinical benefit,” through its accelerated approval review track. This pathway…

Undermining Genetic Privacy? Employee Wellness Programs and the Law

Genetic information is becoming ubiquitous in research and medicine. The cost of genetic analysis continues to fall, and its medical and personal value continues to grow. Anticipating this age of genetic medicine, policymakers passed laws and regulations years ago to protect Americans’ privacy and…

Preserving the Fogarty International Center — Benefits for Americans and the World

In his proposed budget for fiscal year 2018, President Donald Trump recommended eliminating the Fogarty International Center (FIC) at the National Institutes of Health (NIH). Although the NIH actually received increased funding in the fiscal year 2017 budget that was signed on May 5, the FIC — a…

State Sepsis Mandates — A New Era for Regulation of Hospital Quality

Sepsis is a major cause of illness and death in the United States, affecting more than 1.5 million Americans each year at an annual cost of over $20 billion. To improve outcomes of sepsis, policymakers are increasingly using regulatory mechanisms inten…

A 21st-Century Health IT System — Creating a Real-World Information Economy

Data generated as a by-product of the day-to-day work of delivery systems are a fundamental currency of the 21st Century Cures Act. How efficiently and effectively we use this “real-world” evidence will shape the way medicine is practiced and the way d…

The Committed Perspective — Policy Principles for Regional Health Plans

At a recent Washington gathering, a bipartisan contingent of health policy wonks compared the Affordable Care Act (ACA) to the Beatles. Take away the individual mandate and purchasing subsidies, and you’re left with George and Ringo. Wipe out the Medicaid expansion and you’re down to just Ringo — a…

The March of Science — The True Story

“The human understanding when it has once adopted an opinion…draws all things else to support and agree with it.” Francis Bacon, the “Father of Empiricism,” came to this conclusion in the 17th century, and some 350 years later, three Stanford psychol…

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