closer look
Doctors call out ableism in cancer care, where assumption can harm patients
Spaulding Rehabilitation Network
People who have a disability often need to educate others about what they can and can't do, including doctors whose assumptions can undermine their care. In cancer, for example, clinicians might assume a woman who uses a wheelchair isn't sexually active, so doesn't need to be tested for the virus that causes cervical cancer. After a cancer diagnosis, treatment can follow outdated decision trees that depend on a patient's ability to walk as a benchmark for tolerating chemotherapy.
"To make an assumption that a wheelchair user must inherently be someone with a significant burden of chronic disease is a very ableist assumption," Cheri Blauwet, chief medical officer at Spaulding Rehabilitation Hospital (pictured above with David Estrada), told me. It's perhaps an understatement to say she knows whereof she speaks. She's a Paralympic gold medalist and two-time winner of both the Boston Marathon and the New York City Marathon in wheelchair racing. I have more here.
health
For kids with high BMI, task force not ready to recommend weight loss drugs
In its new draft recommendation on high BMI in children and adolescents, the U.S. Preventive Services Task Force has moved from its 2017 guidance suggesting screening to urging intensive, comprehensive behavioral interventions. Today's recommendations, open for comment until Jan. 16, stop short of weight-loss medications for the roughly 20% of children and teens with high BMI in the U.S., saying "more research is needed to fully understand the long-term health outcomes for medications."
Instead, the group recommends providing or referring kids age 6 and older who have a BMI above the 95th percentile for age and sex on the growth chart to behavioral interventions such as supervised exercise, counseling for behavior change, and information about healthy eating. The American Academy of Pediatrics has come out in favor of weight-loss drugs for adolescents, but as this New York Times story tells us, many pediatricians are reluctant to prescribe them.
reproductive health
Experimental male birth-control pill enters trial
We haven't heard too much lately about male birth control, but a San Francisco startup hopes to change that story with a non-hormonal drug candidate that began its Phase 1 clinical trial today in the U.K. to test the safety, tolerability, and functioning of the oral drug in 16 participants. YourChoice Therapeutics is betting on century-old science that discovered mice, rats, and monkeys with vitamin A deficiency were infertile, which dozens of papers have since confirmed. The experimental drug is designed to stop the metabolism of vitamin A in the testicles, thus blocking both the production and the release of sperm — completely eliminating the chances of fertilizing an egg.
Ultimately, the team behind YCT-529 hopes that if their product is successful, it might help change the dynamics of contraception, and make it more of a shared responsibility. STAT's Annalisa Merelli has more, including another male contraceptive product currently being studied.
On this week's First Opinion Podcast, First Opinion Editor Torie Bosch spoke with mathematician Manil Suri and physician Daniel Morgan about how false positives can cause major problems, how both physicians and patients misunderstand statistics, and how their work plays out in their own lives. Listen here.
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