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Full-Text Articles in Medicine and Health Sciences
Reasons To Be Hopeful: Streams Of Renewal In Healthcare, Ray Moynihan
Reasons To Be Hopeful: Streams Of Renewal In Healthcare, Ray Moynihan
Ray Moynihan
Extract: The iconoclastic former BMJ editor Richard Smith has mused that medicine might need to feel utterly defeated for it to undergo much needed radical renewal.1 Whether or not defeat is imminent, a culture shift is being debated,2 and renewal is inevitable. The current medical-industrial paradigm—fragmented, technocratic, mechanistic, inhuman, and imperial—is neither healthy nor sustainable. While there’s much that is hopeful in debates about clinical medicine, public health, and beyond, I’d like to identify 10 streams of change that may ultimately coalesce to form a coherent vision of radical renewal.
Estimating The Effect Of A Community-Based Intervention With Two Communities, Mark Van Der Laan, Maya Petersen, Wenjing Zheng
Estimating The Effect Of A Community-Based Intervention With Two Communities, Mark Van Der Laan, Maya Petersen, Wenjing Zheng
Wenjing Zheng
Due to the need to evaluate the effectiveness of community-based programs in practice, there is substantial interest in methods to estimate the causal effects of community-level treatments or exposures on individual level outcomes. The challenge one is confronted with is that different communities have different environmental factors affecting the individual outcomes, and all individuals in a community share the same environment and intervention. In practice, data are often available from only a small number of communities, making it difficult if not impossible to adjust for these environmental confounders. In this paper we consider an extreme version of this dilemma, in …