Happy December, and thanks and welcome to the 100+ folks who signed up since the last newsletter. This time around I've a bit of a holiday hodgepodge, something like our Thanksgiving dinner at Chief O'Neill's in Chicago (amazing and recommended)
The family that buffets together...
The past few weeks, I've been beavering away on commercial strategy for our NewCo. Am loving the beginning-ness of it and the chance to learn and explore new (to me) parts of healthcare and technology. Though we're a little ways from market, I keep hearing echoes of Roger Martin going on about strategy vs planning. Strategy "imagines a desirable future and makes a set of choices with the best chance of bringing it about. It is fundamentally not analytical." But everywhere and usually: "if you ask for strategy, you are likely to get planning." I love the concept of strategy as a theory about how to produce outputs you don't directly control. More to come soon on the new business and what we're up to.
With our NewCo, I've been paying more attention to AI/ML in medicine. Here's something: A new ML model can identify male from female human retinas. 👁️ Before this work, no one realized there was a difference! As Benedict Evans put it: "ML can give you infinite interns, but it can also give you one intern with infinite patience - that can look at 85k photos of retinas and spot a pattern no-one knew was there." Full-text
In the respiratory literature, I was struck by this study of the "invisibility" of breathlessness in clinical consultations. Despite how disabling this symptom can be, many people who want to talk with their physicians about it don't get the chance to do so. How do we get people brought up more regularly in the exam room?
There's also a new report in the ERJ showing how well adopted the guidelines are in Finnish adult asthma care. Overall, more than 97 percent of participants (from a large, unselected sample of Finnish adults with asthma using any asthma medication) were using inhaled corticosteroids, the majority of patients had good symptom control, and hospitalizations were rare. Boy, we are so much worse at all of this in the US! Finland has long been front of the class -- its 10-yr program for community-based asthma control is a leading example of applied chronic disease public health at scale -- but this paper just about rubs our noses in it. Coincidentally, I've been working my way through the recent updates to the respiratory guidelines. I keep concluding they stop short of what we need today. How else might guidelines be produced and distributed to speed and maximize their desired outcomes? I'm collecting some ideas in a longer piece about what we'd improve if we built guidelines as APIs. Full-text
🥁 I pick up a lot of music recommendations from Sasha Frere-Jones's newsletter. A couple of weeks back he recommended a playlist that's since been on early winter repeat for me. Saturnalia: Deep Jazz for Long Nights, 1969-1980, from the team at Aquarium Drunkard is a groovy mix, the perfect soundtrack for writing or all the upcoming family gatherings. Plus, you can download (!) the music files, and there's a hard-to-find and amazing Ahmad Jamal cover of Superstition.
🐍 Maybe it's the Arizona in me, or my time in India, but I'm always shocked by the ongoing impact of snakebite (>100k deaths a year and hundreds of thousands more injured and permanently disabled) and our lack of progress in treating them. We still hand-milk snakes for venom! Mathias Kirk Bonde argues in Advancing antivenom that we need to make treatments for snakebites a lot cheaper and easier to distribute and get ourselves a synthetic, manufacturable anti-venom. I'd love to see more new companies tackling problems like this.
📙 While exploring some claims data, I got sidetracked by a promising new book, Data Analysis for Social Science, by Kosuke Imai and Elena Llaudet, whose thread here about it caught my eye. It's a well-written introduction to analyzing real-world data (esp great sample projects) with R that assumes minimal prior knowledge of statistics or coding. Awesome high school or undergrad textbook.
🚨 Job alert - I'm helping a friend sleuth around for someone with a strong strategic finance background to join a great digital healthcare company as VP Finance. Please hit me up if you know anyone who might be a fit.
🧪 I've got a sick boy at home today. Stat News answers my question, "Why in the world don't we have at-home flu tests in the US?"
Snow and cold on their way here this week ☃️. Have a great rest of the year and see you in January 🎉
David