What a Sham: The Power of Placebo

The November 2, 2017 issue of The Lancet included an online first article (R. Al-Lamee et al) describing a sham-controlled trial of percutaneous coronary intervention (PCI) in the treatment of stable angina pectoris. Each year more than 500,000 PCI procedures are done for stable angina worldwide and unblinded randomized trials have shown significant relief of […]

One Drug Interaction

The unveiling of Drug Interactions from The Medical Letter® reminded me of the profound effects of a single drug interaction that occurred in the emergency room of New York Hospital in 1984. Libby Zion was an 18-year-old college student who came to the hospital seeking treatment for a flu-like illness. She had been taking the […]

O Canada!

The current issue of The Medical Letter (May 22, 2017) leads off with a contentious topic: drug prices. I could think of a lot of good reasons for not publishing an article on this subject: not our usual thing, more questions than answers, everyone in the world has already written about this, etc. But many […]

The USPSTF and Vision Screening in Older Adults

In 2009, the Affordable Care Act required Medicare and private insurance plans to cover, without a copay, preventive services given grades of A (high certainty of substantial net benefit) or B (high certainty of moderate net benefit, or moderate certainty of moderate to substantial net benefit) by the US Preventive Services Task Force (USPSTF). The […]

1500 Issues and Counting

The Medical Letter was founded in 1959 by Arthur Kallet, a layman, and Harold Aaron, an internist. Arthur was a co-founder of Consumer Research, which became Consumers Union, and he started the publication of Consumer Reports. Harold was on the advisory board of Consumers Union, and The Medical Letter was his idea. The early years […]

Why Not Screen for Melanoma?

We will soon publish our tenth article in the last 4 years on yet another drug for the treatment of unresectable or metastatic melanoma. All of these drugs are obscenely expensive. None of them cures the disease. Melanoma detected early is nearly 100% curable. Unresectable or metastatic melanoma is usually fatal. Early detection of melanoma […]

Beefed-Up Flu Vaccine for Seniors

The current issue of The Medical Letter (1486; January 18, 2016) includes an article on Fluad, an adjuvanted seasonal flu vaccine for older adults that will become available in the US later this year for use in the 2016-2017 influenza season. Fluad has been available in Europe since 1997 for persons >65 years old, so […]