Teach the World Evidence-Based Medicine

Teach the world evidence-based medicine, because patients and patient advocates, DESPERATELY want these five horrendous problems solved:
  1. There is an 88% health illiteracy rate among patients (Health.gov)
  2. 60 to 80% of physicians don't understand treatment effects (CMAJ)
  3. The Patient-Centered Outcomes Research (PCORI) team says, “Every day, patients and their caregivers are faced with crucial health care decisions while lacking key information that they need.”
  4. PCORI also says that we need to translate “…existing scientific research into accessible and usable formats…”
  5. The majority of medical guidelines are written by authors with conflicts of interest (British Medical Journal).
We have created the solution for all five problems; we produce Treatment Scores. The Treatment Score = the net treatment benefit for the patient. It’s a way to summarize information to save time for physicians and increase understanding for patients.


How to explain Treatment Scores? Well, every year we figure out our “gross income” and “net income” when we do our taxes. So, for patients, we simply figure out the “gross treatment benefit” and the “net treatment benefit” for patients as digested from the medical literature. Did you see the movie "Moneyball" about Sabermetrics for baseball starring Brad Pitt? Treatment Scores are "Sabermetrics for medicine."

Treatment Scores put a graphical user interface (GUI) over evidence-based medicine in order to help the practicing physician.

Back in the early days of the computer, you had to know how to use machine language to use a computer. Once a graphical user interface was put over machine language by Windows and Apple everyone could use a computer. With Treatment Scores, we have put a graphical user interface over evidence-based medicine so that all physicians can do EBM quickly and easily. Every step within Treatment Scores can be validated and verified. Treatment Scores are the opposite of cookbook medicine. Patients get what they want: understandable information; and physicians get what they want: more knowledge, less wasted time, and more money.
  
REVELATIONS
When you do evidence-based medicine with a graphical user interface (GUI), and you quantify the effects of medical treatments, you can make some astonishing discoveries.

The Ebola epidemic in Africa was not optimally treated. Hundreds of patients probably died unnecessarily. With Treatment Scores, you can see who was more logical, Doctors without Borders, or one physician at the World Health Organization who saw in the data what we saw with Treatment Scores.

Harvoni (ledipasvir/sofosbuvir) is a major advance in treating a subset of hepatitis C, with a Treatment Score of 95 (as in 95% cure rate), compared to the old interferon based protocol that has a Treatment Score of 40.

A COMPLETE LIST OF TREATMENTS
Patients want a complete list of treatments. Recently, a man told me about being diagnosed with hives (urticaria of unknown etiology). He went from doctor to doctor without ever finding a cure. He was working from a list of treatments that included antihistamines and steroids, and all the subclasses of those medications orally and topically. He was also taking four showers per day for itching. The treatment that finally cured him wasn’t even on any of the typical lists of treatments. I have heard this same story many times about many different diseases. Did you know there are 130 treatments for insomnia? Did you know there are 57 treatments for an acute migraine headache? Why can’t we give patients a complete list of every treatment in the literature for every disease, and a Treatment Score for every one of those treatments? Not to say what patients must do, but to say here is what you can do, and here are how the Treatment Scores change depending on your personal preferences.

Patients want to know about all treatments whether they are Western medicine, Eastern medicine, herbal medicine, naturopathic medicine, Ayurveda, or any other type of alternative medicine. Patients spend $34 billion dollars per year on alternative medicine. You can give patients what they want with treatment lists and positive Treatment Scores, because sometimes excellent clinical studies do exist. Or, you can tell them when the Treatment Score = 0, because studies do not exist or the treatments don’t work. You can even tell patients when the Treatment Score is negative = harmful.

AUDIENCE
The essays you write with Treatment Scores will be seen by a wide audience. We have over 100,000 followers on Facebook, over 9,000 followers on Twitter, and we hold all top 10 positions on Google search. In combination, we are growing by over 1,000 followers per day on all our social media accounts. Patients clearly want better treatment transparency! You can write for your hometown newspaper and prove to your community that, with technology, you are the smartest doctor in town (if you want to build your practice).

CONTACT US
If you are a writer, blogger, reporter, or physician interested in Treatment Scores, please email:
Dr.Hennenfent@gmail.com
Feel free to send your LinkedIn profile, CV, or any other information.

There is a 1 minute explainer video about Treatment Scores on YouTube:
https://youtu.be/GLIIB3oOVJA

There is an explanatory essay about Treatment Scores and Smart Phones here:
http://www.treatmentscoresblog.com/2017/03/patients-desperately-need-treatment.html

Bradley R. Hennenfent, MD
Physician & Economist (Retired)
USA
Dr.Hennenfent@gmail.com

ABOUT
Treatment Scores was started by an anesthesiologist, an emergency physician, a physician programmer, and Dr. Hennenfent. Brad Hennenfent graduated from Northwestern University with a degree in economics, graduated medical school from the University of Illinois, and did his Emergency Medicine residency at the UIC Affiliated Hospitals Emergency Medicine Residency Program. After two years as a practicing emergency physician, he became director of an inner-city emergency department in Chicago. Then, he went into business and became the director of over 10 emergency departments and urgent care centers. Dr. Hennenfent has had five uncles with prostate cancer. He became an advocate, and, while working with a medical non-profit, helped get over $20 million dollars of federal funding released for medical research to the National Institutes of Health. He also helped get over $100,000 worth of grants in kind or donations year after year. In his retirement in Florida, he has become very interested in medical statistics and treatment transparency for patients. He believes patients should be more informed and more powerful. Dr. Hennenfent likes to combine the mathematics of economics with the mathematics of medicine.

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To support Treatment Scores and the treatment transparency movement:

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DISCLAIMER
You must always see a licensed physician for diagnosis and treatment. Treatment Scores are only an educational tool. Death or disability can result if you don't see your own medical physician or go to the emergency department for your medical issues.

Copyright © 2017 All rights reserved.

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Patients Desperately Need Treatment Scores

Treatment Scores

Patients, doctors, nurses, insurance companies, and governments desperately need Treatment Scores (they just don't know it yet). Treatment Scores are disruptive technology. This is an update of our most popular blog post.



People have chosen their computer of choice; it's the smart phone.* Smart phones are ubiquitous around the world. This means that we need to be able to get medical information on smart phones in a way that it can be easily understood. We need Treatment Scores, which represent the net treatment benefit for the patients studied in the past. Treatment Scores allow for shared decision-making and personalized medicine to actually happen, instead of just being ideas people talk about.


We need to save time and money! Imagine being a physician, nurse, or allied health care provider and having Treatment Scores figured out for every treatment that is important to your medical practice. Such Treatment Scores, created using the software tools we have created, could be used for patient education, informed consent, shared decision-making, and personalized medicine. Treatment Scores should be done at every Journal Club at every medical school and residency program worldwide.

WE DARE TO ASK THE QUESTION: Why is that we can figure out our “gross income” and “net income” every year when doing our taxes, but physicians have never been able to tell patients the “gross treatment benefit” and the “net treatment benefit” of medical treatments? It's just mathematics. That's why we tell people Treatment Scores are "Sabermetrics for medicine." Did you see the movie "Moneyball" starring Brad Pitt, which was about Sabermetrics?

Having Treatment Scores would save time. If the Treatment Scores were transparent, it would be a huge step forward in teaching the entire world how evidence-based medicine works. Such a system would finally make shared decision-making possible.

Let's say a physician is with a patient and he or she pulls up their "homework," which is their own review of the medical literature for 130 different treatments for insomnia on their cell phone. The physician may show some of the treatments to the patient, because the patient wants to learn about them.

Perhaps your Treatment Score results are typical of a recent "systematic review" of the medical literature that seems to say cognitive behavioral therapy was an effective treatment for the patients studied. You may bring up this list: cognitive behavioral therapy, Ambien (zolpidem), indiplon (off the market), and tart cherry juice (which reportedly raises melatonin levels). Your Treatment Scores are 40, 32, 9, and 8.


Personalized Medicine. Now you decide to do personalized medicine and shared-decision making with the patient. You show them the next screen behind the Treatment Score for "cognitive behavioral therapy," which is the Treatment Score Calculator™. Now, you can both see the problem.


On the right it says "not scored." The problem is that no "weight" has been given for the "side effect" on the right of having to go to group therapy for 90 minutes per day, six days per week for six weeks! (Which is one of the schedules for cognitive behavioral therapy in a study supporting it as a treatment for insomnia.)

The patient appears horrified. You ask for their input. They say, "That reduces the Treatment Score to nearly zero for me. I don't have 90 minutes per day for six weeks to go to group therapy! I have a job, kids, family...." You say, "Okay let's reduce the Treatment Score for cognitive behavioral therapy down to almost zero based upon your input."


You reduce it to 1. So, the Treatment Score for cognitive behavioral therapy drops to 1 based on the patient's input. Suddenly, Ambien (zolpidem) rises to the top of the current list based on the patient's preferences. [I have no association with companies that make Ambien (zolpidem).]

A different patient may be exactly the opposite. They may love the idea of going to cognitive behavioral therapy for 90 minutes a day. They may have the time and the inclination, and may not want to take any medications if they can avoid them. This is why patient input as part of shared decision-making is so important.

This is why we need a system that allows for patient input. In this example the patient had some input into the review of the treatments. The patient was able to let the doctor know that the time that would be needed for therapy sessions was a huge negative for them. We cannot know this without true shared decision-making between patients and physicians.

What if the side effect in question was something more serious? Like the side effect of facial nerve paralysis that can happen with brain surgery? Or the side effect of incontinence that can happen during pelvic surgery? Or the side effect of permanent neuropathy than can happen with chemotherapy? Shouldn't we have a system like this where patients can have some input? Shouldn't we be able to combine evidence-based medicine and shared decision-making? Shouldn't we help educate patients about these things before they are treated, not after they've already been treated and have suffered the consequences? Doesn't informed consent require sharing the numbers? Doesn't continuing medical education require this new and improved system?

Steve Jobs Quote

"You've got to start with the customer experience and work back toward the technology - not the other way around." - Steve Jobs. What this means is that the front end of Treatment Scores needs to be very simple, fast, and understandable. The back end can be full of statistics (ranges, confidence intervals, standard deviations, statistical power, p values, number needed to treat, ratio of means, relative risk, and so on). The front end can also be customized for the casual user versus the advanced user.

Do We understand Medical Treatments Now?

No! In a study of 531 physicians: "Do clinicians understand the size of treatment effects? A randomized survey across eight countries" (Bradley C. Johnston, PhD, et al.) They found that over 80% of physicians could not correctly figure out the treatment effects that were reported as "mean difference in natural units" or as "standardized mean difference." This is just one example of all the confusion!

I think one can reasonably assume that if physicians don't understand medical treatments, then patients don't understand medical treatments. 

A wise physician once wrote: "Figure out how to empower patients. Any enterprise that can supply patients with clear, correct, relevant, personal, and specific knowledge that enables them to protect themselves and their loved ones...will endear itself to those patients. Furthermore, anyone supplying such knowledge will be feeding a growing need for more. People's desire for the information to manage their own healthcare and the means to act on that information will become more than just a desire - it will become an expectation. A massive business opportunity awaits." - R. Fogoros, MD

Interested in Treatment Scores? Contact me at:
Dr.Hennenfent@gmail.com

Follow Treatment Scores:
Twitter:
https://Twitter.com/TreatmentScores
Facebook:
https://Facebook.com/TreatmentScores
Blog:
http://TreatmentScoresBlog.com
Website:
http://TreatmentScores.com
AngelList.co
https://angel.co/treatment-scores

DISCLAIMERS: We claim zero accuracy with Treatment Scores. You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

Copyright
Copyright © 2017 Treatment Scores, Inc.

Note:
*Someone made a similar statement before me about cell phones being so dominant, but using Google search I was unable to find the original source if there was one.


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Treatment Scores Explained in 1 Minute Video

There is a 1 minute explainer video on YouTube here:

https://youtu.be/GLIIB3oOVJA

The script of the animated video is below. (Embedding the video here did not work well, thus we have provided the link above only.)

Treatment Scores: Quantifying the science of medicine behind medical treatments. So how does it work? First, you receive a diagnosis from your physician. You want to know all your treatment options. One diagnosis can have upwards of 10, 50, or even 100 treatments. You also want to know which treatment is right for you. Treatment Scores gives you a personalized list of possible treatments. Each treatment on the list is given a Treatment Score. The Treatment Score is the number produced from a statistical analysis of the medical literature on that treatment. It summarizes the net treatment benefit for patients who have been treated in the past. You can share your Treatment Scores report with your doctor and discuss your options together. Take control of your healthcare. You need Treatment Scores. We all need Treatment Scores.

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Follow TREATMENT SCORES on Social Media:
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https://Twitter.com/TreatmentScores
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AngelList:
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Blog:
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Website:
http://TreatmentScores.com

DISCLAIMERS:
You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

COPYRIGHT:
Copyright © 2017 Treatment Scores, Inc. All Rights Reserved.

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You Get Diagnosed with a Disease: You Need Treatment Scores


Number 1. Unfortunately, you get diagnosed with a disease.
Number 2. You demand a long list of possible treatments for your disease instead of a short list.
Number 3. You are given a Treatment Score for each treatment, which summarizes the "net treatment benefit" for patients who have been treated in the past.
Number 4. With Treatment Scores you can understand your treatment options better than you did before. With Treatment Scores you can see the science behind the treatments. With Treatment Scores you can finally do personalized medicine and shared decision-making with your physician.

The YouTube link to this video is here:
https://youtu.be/v0Csjr9MzU8

FOLLOW THIS BLOG:
Follow this blog by entering your email address in the box at the top right. You MUST CONFIRM your subscription VIA EMAIL. Then, you will automatically receive all new posts. If you have any problems, search for "feedburner" to make sure the confirmation email did not go into your spam folder.

Follow TREATMENT SCORES on Social Media:
Twitter:
https://Twitter.com/TreatmentScores
Facebook:
https://Facebook.com/TreatmentScores
AngelList:
https://angel.co/treatment-scores
Blog:
http://TreatmentScoresBlog.com
Website:
http://TreatmentScores.com

DISCLAIMERS:
You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

COPYRIGHT:
Copyright © 2017 Treatment Scores, Inc. All Rights Reserved.


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Why You Need Treatment Scores

When you get sick you need a list of all the possible treatments for your disease. You also need the Treatment Score for each treatment. The Treatment Score represents the "net treatment benefit" for the patient as summarized from the existing medical literature.

Why haven't Treatment Scores been done before?
Because a typical diagnosis has 10,000 variables that must be digested to create a list of Treatment Scores. My physician colleagues and I have spent years creating the mathematics and programming to do Treatment Scores.

Why is something so simple so hard?
When you do your taxes you figure out your gross income, then you figure out your net income.

Net income = gross income - expenses.

When you get sick you need to know the "gross treatment benefit," and then the "net treatment benefit."

Net treatment benefit = gross treatment benefit - side effects.

It all sounds simple, but patients have never had this kind of treatment transparency.

Patients desperately need to know the "net treatment benefit" for patients like them who have been previously treated. Once you know the net treatment benefit, the Treatment Score, as your starting point, shared decision-making and personalized medicine can actually happen.

Treatment Scores solve a lot of problems in healthcare!

The way Treatment Scores work is:
  1. You get a diagnosis
  2. You get a list of treatments with Treatment Scores
  3. When you click on the Treatment Score you can see the underlying statistics in the Treatment Score Calculator™
  4. You and your physician can now do shared decision-making, where input from the patient is used to further refine the Treatment Score to do personalized medicine.
Treatment Scores do the following: 
  1. Save time
  2. Save money
  3. Solve the healthcare illiteracy problem
  4. Solve the treatment transparency problem
  5. Allow for true informed consent
  6. Solve the previously unsolvable quality assurance problem
  7. Enable more people to get more healthcare at lower cost
The following entities need Treatment Scores:
  1. physicians
  2. nurses
  3. patients
  4. medical schools
  5. residency programs
  6. medical journals
  7. health insurance companies
  8. governments around the world
  9. all businesses providing healthcare to employees
  10. reporters who report on medical news, whether web-based, television, or radio.
Treatment Scores will disrupt healthcare. They are needed by consumers, businesses, and governments. Throughout history, quantification has disrupted every industry it has touched.

Follow TREATMENT SCORES on Social Media:
Twitter:
https://Twitter.com/TreatmentScores
Facebook:
https://Facebook.com/TreatmentScores
AngelList:
https://angel.co/treatment-scores
Blog:
http://TreatmentScoresBlog.com
Website:
http://TreatmentScores.com

FOLLOW THIS BLOG:
Follow this blog by entering your email address in the box at the top right. You MUST CONFIRM your subscription VIA EMAIL. Then, you will automatically receive all new posts. If you have any problems, search for "feedburner" to make sure the confirmation email did not go into your spam folder.

DISCLAIMERS:
You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

COPYRIGHT:
Copyright © 2016 Treatment Scores, Inc.
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