Dear clients and friends: Given your interest in health and medicine, we would like to share with you our collection of the most interesting perspectives on our industry's trends and developments. We are happy to share them with you — and hope you share your thoughts with us.

1. Why Doctors Get It Wrong

Dr. Aaron Carroll, the chief health officer of Indiana University, argues that the best way to manage the pandemic is to stop thinking like doctors. The question isn’t “what’s best for this person?” but “what’s best for the population?” Neither the FDA nor the CDC has adopted this view:

Our focus on individuals has often led us in the wrong direction during the pandemic. Much of my frustration at the response to Covid is that too many officials in senior positions at the FDA and CDC seem to be thinking this way — if something isn’t close to perfect or doesn’t maximize the safety of each individual person, it’s not worth it at all. Some of the greatest initial and continuing failures of public health policy have stemmed from this view…Getting many people to be somewhat safer might achieve more than getting fewer people to be really safe.

2. Why Data Gets It Wrong

In 2018, Henry Kissinger wrote an alarming article in The Atlantic describing a future when AI would grow so large it would eat rational decision-making. With medicine, the proposition is frightening. Could data outperform people at diagnosis and treatment? Maybe. But The Guardian is skeptical that it will come to be:

The first reason is that we’ve realised that artificial intelligences (AIs)…are themselves fallible. Think of the prejudice that has been documented in Google’s search engines and Amazon’s hiring tools.

The second is that humans turn out to be deeply uncomfortable with theory-free science. We don’t like dealing with a black box – we want to know why.

And third, there may still be plenty of theory of the traditional kind – that is, graspable by humans – that usefully explains much but has yet to be uncovered.

3. There’s No Evidence King Henry VIII Had a Spleen

Scott Alexander, your favorite grumpy internet uncle, takes aim at the use of “no evidence” in headlines about science and medicine. The problem, he argues, is that “no evidence” can have two very different meanings:

- This thing is super plausible, and honestly very likely true, but we haven’t checked yet, so we can’t be sure.

- We have hard-and-fast evidence that this is false, stop repeating this easily debunked lie.

4. From Bad to Worse

Finally, CMS announced its coverage policy for Aduhelm. Patient groups are up in arms. Biogen wants to talk it out. Investors are spooked. But the real fallout from CMS’s decision is much larger than Aduhelm. The coverage in the New York Times representsthe broader media reaction. They are failing to grasp the extent of the decision:

The agency’s final decision, expected by April 11 after a public comment period that runs from now until mid-February, would also apply to similar drugs for Alzheimer’s that are currently in trials and expected to be considered for F.D.A. approval. [emphasis added]

In a shocking move that has implications for all disease areas, CMS is making a decision on one therapy that will affect a whole class of treatments in development.

5. Blogging the “Cool Science”

Dr. Larry Tabak, acting NIH director, kicks off a new blog series on “the cool science” in the NIH’s research portfolio. He takes a look at the top four NIH-funded biomedical advances of 2021. Number one:

This year, the NIH-funded lab of David Baker and Minkyung Baek, University of Washington, Seattle, Institute for Protein Design, published that their artificial intelligence approach, dubbed RoseTTAFold, could accurately predict 3D protein structures from amino acid sequences with only a fraction of the computational processing power and time that AlphaFold [the previous solution] required. They immediately applied it to solve hundreds of new protein structures, including many poorly known human proteins with important implications for human health.

You can also check out the NIH’s full list of 2021’s most important medical advances, promising findings, and basic research insights.