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This week, Aaron recaps the year on Healthcare Triage. All of it. Hear about all the stuff we made in 2015, with links!


Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=68657

John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics

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We know you love Healthcare Triage, but you're also busy.  We get it.  Sure, you'd love to watch every single episode of the show, but maybe you missed some.  That's okay, we still love you.  This is our gift to you.  All the episodes of Healthcare Triage in one show.  2015 in review.  That's the topic of this week's Healthcare Triage.

(Intro)

Starting off the year, we talked about over the counter cough and cold medications.  Guess what?  They don't work.  Don't waste your time.

Next up was e-cigarettes.  The research shows that they probably aren't as harmful as regular cigarettes, but they ain't breathing water vapor either.  Ironically the stuff that might be the most harmful is the flavorings, not the nicotine, so it may be okay for harm reduction, but it's not candy.

John and I spent the next two weeks answering your questions on healthcare and health policy.  My favorite line came in the 2nd episode, when I made John laugh by answer a question on losing muscle mass over time by saying "It's just the way bodies are built.  You sorta develop for a while and then it's a long slow decline to death."  It happens at 3:35.  

We covered sleep.  Turns out that your probably don't need eight hours a night.  What you need is likely different from everyone else, though.  It's probably somewhat genetic.  

Then we talked about what happens when you're sleep deprived.  Lots of teenagers are, 'cause we're probably making them go to school too early.

On February 17th, you got a whole episode on life expectancy.  It was wonky, but it's important to understand that life expectancy is not going up for everyone and there's likely some inequality in there.

My research got featured next in a special effect loaded episode, where I assessed myself to determine the health utilities for various disease states.  That's how we quantify the value of health and it's an important aspect of cost effectiveness research, which was the topic of the next episode.

King V. Burwell was a big Supreme Court case that got a lot of attention this year because it had the potential to strip insurance exchange subsidies from millions of Americans.  We covered it before the case was decided and for the record, I correctly predicted the outcome.  Take that, Nick Bagley!

We did lots of nutrition episodes this year.  First we talked about dietary cholesterol and how it's not nearly as impactful as we used to think.  Dietary guidelines are finally catching up to my first book on medical myths.  

Next, we talked about the evidence or lack thereof of low-fat diets.  Those are getting less love these days, too.  

Then we went back to policy to talk about under-insurance.  Uninsurance gets the most attention, but under-insurance, where people have coverage but still have to pay a lot out of pocket for care is still a real problem and it's not clear whether the Affordable Care Act is gonna make that better.

We got all wonky and statistical with a discussion of the number needed to treat and the number needed to harm.  So many treatments you believe are awesome have very, very tiny absolute effects.  Things also have harms.  They need to be weighed against each other.  It's a lesson we stress often on the show.

Choosing wisely is an effort to get doctors to stop doing stuff that's been shown not to work.  I applauded the spirit but remain skeptical about the impact.

Guns are a major cause of morbidity and mortality in children, especially with relation to suicide.  We talked about how important that is and how we do too little to make it better.

I reviewed some of the existing literature on menu labeling.  We're putting calorie counts on menus but there's almost no evidence that makes a difference.  Some new research just came out and we'll likely do another episode on that in the near future.

Then I got into a bit of an argument with Mark Cuban on Twitter about the value of frequent lab testing.  So I covered that.  It's not a good idea to do it.

We're still paying women less than men, even in medicine.  I reviewed the literature for you.  It's not good.

Back to nutrition for my food recommenations.  Mark even made a great poster about them, which you can download for free from our Facebook page.  Go do it!

Our first year we covered sensitivity and specificity.  This year, we did positive predictive value and negative predictive value.  The PPV is the chance that you have a disease if your test is positive, and the NPV is your chance of being healthy if the test is negative.  Both are somewhat flawed because they're dependent on disease prevalence.  Don't understand what I'm saying?  Go watch the episode!

Then we had a whole month of parasites.  Bed bugs, lice, tape worms, ticks, we even did a related mental_floss episode.  Go be horrified.

The evidence that coffee is dangerous is pretty much non-existent and there's a ton of epidemiological evidence that it may be healthy.  Bottom line: don't be afraid or feel guilty about drinking it.  I sure don't.

Vaccines still don't cause autism.  I'm not sure why we're doing more research.  I talked about why.

Our awesome Healthcare Triage intern Rachel Hoffman helped us out with back to back episodes.  First, we talked about how the FDA approves a drug.  Then we covered flibanserin, also known as "female viagra".  It got approved.  Lots of people don't think it should have.

How can doctors avoid malpractice suits?  Be nicer.  Be better human beings.

We covered all the evidence of why exercise is good for you.  It really is, but you probably need less of it than many people think.  

Know what it's not good for?  Weight loss.  We reviewed why that's so in the next episode.

Sitting is also really bad for you.  Stand up.  Walk around.  Seriously.  I'll wait.

Advance directives aren't death panels.  They weren't then and they aren't now.  What they are is a chance for you to think and say how you'd like to be treated when you get really sick.  Why is that bad?

IUDs, or intrauterine devices are pretty great, but way underused.  Why?  Go watch the episode.  Then watch the next episode we did on IUD myths.

Worm wars.  Wasn't our most popular episode, but it's one of the ones I'm most proud of.  It's a complicated issue and I think we did a pretty good job covering it.  You probably missed it.  Your loss.

We talked about why labels like 'alternative' and 'conventional' or 'Eastern' and 'Western' medicine are bad.  We should stick to stuff that's proven to work and unproven to work, and forget about who's pushing it.

You don't need to drink eight glasses of water a day.  You really, really don't.

I made an argument for universal autism screening, because I think the evidence is pretty strong and I don't think more research is coming even if the USPSTF asks for it.

Strangers hurting kids by poisoning Halloween candy is a myth.  Many of you sent me news stories after Halloween and a lot of those turned out to be hoaxes.  What did kill kids on Halloween?  Cars.  Go worry about them.

Rachel came back for two more episodes.  First we talked about how drugs get their names, then we talked about the differences or lack thereof between brand name drugs and generics.  

Tea, another evidence review.  I wasn't as impressed as I was by coffee, but it also appears to be safe and potentially healthy.

Nutrition research often sucks.  Sorry.  We talked about why.

Nootropics are supposed to make you smarter.  They really don't.

Vaccine denialism by doctors is important, too.  It comes into play with the HPV vaccine.  We talked about how.

We ended the year with another questions episode with John and an episode on probiotics so recent, I ain't recapping it here, and that's the whole year of Healthcare Triage.  We hope you enjoyed watching as much as we enjoyed creating it.  We love you, and we'll see you soon in January of 2016.  Happy new year.

Healthcare Triage is supported in part by viewers like you through patreon.com, a service that allows you to support the show through a monthly donation.  Your support makes this show bigger and better.  We'd especially like to thank our research associate, Joe Sevits, and our surgeon admiral, Sam.  Thanks Joe, thanks Sam.  More information can be found at patreon.com/healthcaretriage.  

(Endscreen/Credits)