Vinay Prasad | |
---|---|
Born | Vinayak K. Prasad |
Alma mater | Michigan State University University of Chicago Johns Hopkins University |
Scientific career | |
Fields | Hematology, oncology |
Institutions | University of California, San Francisco |
Website | vinayakkprasad |
Vinayak K. Prasad is an American hematologist-oncologist and health researcher. He is a professor of Epidemiology and Biostatistics at the University of California, San Francisco (UCSF). [1] He is the author of the books Ending Medical Reversal (2015) and Malignant (2020).
Prasad was raised in a suburb of Cleveland, Ohio, before moving outside of Chicago in northern Indiana. His parents immigrated from India. [2] He attended Michigan State University, where he took courses in health care ethics and physiology. In 2005, Prasad graduated summa cum laude from MSU with a double major in philosophy and physiology. [2] He gave the commencement speech to the College of Arts and Letters on behalf of the Philosophy Department. [3] He completed his medical degree at University of Chicago in 2009 and completed a residency in internal medicine at Northwestern University in 2012. Prasad was certified in internal medicine by the American Board of Internal Medicine in 2012 and earned a Master's of Public Health from Johns Hopkins University in 2014. In 2015, Prasad completed a fellowship in oncology at the National Cancer Institute and hematology at the National Heart, Lung, and Blood Institute.
From 2015 to 2020, Prasad was assistant and then associate professor at the Oregon Health & Science University. [4] He currently works at San Francisco General Hospital. Prasad is currently a full professor of hematology-oncology at UCSF. [4] He is a cancer drug and health policy researcher. He also studies the financial conflicts in drug approvals. [5] In 2015, Prasad published the book, Ending Medical Reversal , with physician and academic Adam Cifu. [6]
Prasad hosts the podcast Plenary Session [7] [8] [9] and blogs at MedPage Today. [10] Prasad has won several teaching awards, including the 2017 Craig Okada Award for best teacher in the Hematology Oncology Fellowship program, the 2018 faculty mentorship award from the internal medicine residency, the 2019 J. David Bristow award from the graduating medical students, and the 2020 excellence in research and scholarship mentoring as awarded by the internal medicine residents. [11]
In the spring of 2020, Prasad published the book, Malignant: How Bad Policy and Bad Evidence Harm People with Cancer . [12]
In 2011, Prasad and colleagues published a research letter in the Archives of Internal Medicine. [13] Charles Bankhead, a senior editor at MedPageToday, covered the topic, outlining the paper's primary point, which was the high prevalence of research articles demonstrating findings that deviated from the accepted standard of treatment at the time. [14] Separately, "Retraction Watch" reported on Prasad's personal remarks about the paper, saying "For a long time, we were interested by what we believe to be a pervasive problem in modern medicine. Namely, the spread of new technologies and therapies without clear evidence that they work, which are later (and often after considerable delay) followed by contradictions, which, in turn, after yet another delay, is followed by changes in practice and reimbursement." [15]
Matthew Hoffman, writing in 2012 for MedPageToday's KevinMD covered a paper by Prasad and colleagues on "When to abandon ship" when it comes to failing medical practices and treatments. [16] [17] Hoffman builds on the authors' proposed barriers to market entrance, such as evidence of effectiveness in large randomized controlled studies before broad usage, and links them to the insidious aspects of healthcare, such as profit and status. In 2013, Prasad and colleagues addressed the necessity for randomized controlled trials for the inferior vena cava filter (VCF) despite the intervention's bio-plausibility. [18] The authors suggest that since the intervention has known adverse effects but an uncertain benefit, well-designed studies are necessary to shed light on the intervention's efficacy. The JAMA Internal Medicine article received widespread media attention, with Reuters' Genevra Pittman interviewing Prasad about his further views on the intervention. [19] According to the interview, Prasad advises against filter placement in all but the most extreme instances owing to a lack of proof and possibility for adverse events. [19]
In 2013, Prasad's paper A Decade of Reversal: An Analysis of 146 Contradicted Practices was published; [20] The article was covered in a piece by The Huffington Post, which highlights a key lesson from the paper: patients should become more involved in their health care decisions rather than assuming a prescribed medication or device is beneficial. [21] Patients may do this by asking their physician pertinent questions, such as what patient outcomes the intervention improved. Additionally, the article discusses the concept of healthcare cost. With growing anxiety about the expense of healthcare, utilizing limited resources on questionable medical practices with a weak evidence base threatens to jeopardize both the healthcare economy and patient health. Additionally, the authors of a Lancet Oncology editorial remark that "almost 10% of practice reversals occurred in oncology," suggesting that certain fields of medicine may be more susceptible to medical reversals than others. [22]
Prasad has criticized other medical skeptics for their choices of topics to tackle, including homeopathy, as being poor use of their time. [23] Skeptics David Gorski and Steven Novella published criticisms of and counter-arguments to Prasad's stance, pointing out the perils of not challenging alternative medicine during a pandemic. [24] [25]
In October 2021, Prasad prompted social media controversy when he published a blog post comparing the U.S. COVID-19 pandemic response to the beginnings of Adolf Hitler's Third Reich. Bioethicist Arthur L. Caplan said that Prasad's arguments were specious and ignorant, and science historian Robert N. Proctor said that Prasad was "overplaying the dangers of vaccination mandates and trivializing the genuine harms to liberty posed by 1930s fascism". [26]
In November 2021, Prasad expressed his opinion that pediatricians must be honest with parents about the risks of COVID immunization. [27] However, physician Jonathan Howard noted that Prasad was selectively omitting the risks of COVID disease [28] which would not be consistent with the tenets of medical informed consent.
In January 2022, the conservative periodical City Journal published an opinion piece by Prasad in which he attempted to demonstrate that the American public health organizations were not being honest in their response to the COVID-19 pandemic. [29] Writing for Science-Based Medicine, epidemiologist Lynn Shaffer criticized Prasad's article for the various "mistruths" it contained about face masks as a COVID-19 mitigation measure, for example the unevidenced claim that mask wearing was stunting children's language development. In Shaffer's view Prasad's writing "lean[s] heavily on pushing people's emotional hot buttons" and amounted to a form of fearmongering. [30]
Prasad was an early member of the Urgency of Normal, a group that in 2022 campaigned against quarantines and mask mandates in schools during the COVID-19 pandemic. [31] He spoke in support of repealing such mandates in a March 2022 interview. [32]
Earlier in 2023, Prasad showed support for the ideas of Robert Kennedy Jr. [33] However, according to physician David Gorski, Prasad did not show sufficient understanding of bad faith debate. [34] In November 2023, the levels of kindergarten vaccine exemptions rose to the highest level in years. [35] Prasad mentioned about this outcome [36] but did not acknowledge his role in causing this outcome, per physician Jonathan Howard. [37] In 2024, Prasad expressed criticism for the funding decisions of the NIH as well as support for more cluster randomized controlled trials. [38] However, according to physician David Gorski, Prasad again demonstrated insufficient understanding of the limitations of these randomized controlled trials as well as how the NIH's funding decisions work. [39]
Urology, also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary system and the reproductive organs. Organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs.
Reiki is a pseudoscientific form of energy healing, a type of alternative medicine originating in Japan. Reiki practitioners use a technique called palm healing or hands-on healing through which, according to practitioners, a "universal energy" is transferred through the palms of the practitioner to the client, to encourage emotional or physical healing. It is based on qi ("chi"), which practitioners say is a universal life force, although there is no empirical evidence that such a life force exists.
Quackery, often synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, qualification or credentials they do not possess; a charlatan or snake oil salesman". The term quack is a clipped form of the archaic term quacksalver, derived from Dutch: kwakzalver a "hawker of salve" or rather somebody who boasted about their salves, more commonly known as ointments. In the Middle Ages the term quack meant "shouting". The quacksalvers sold their wares at markets by shouting to gain attention.
Oregon Health & Science University (OHSU) is a public research university focusing primarily on health sciences with a main campus, including two hospitals, in Portland, Oregon. The institution was founded in 1887 as the University of Oregon Medical Department and later became the University of Oregon Medical School. In 1974, the campus became an independent, self-governed institution called the University of Oregon Health Sciences Center, combining state dentistry, medicine, nursing, and public health programs into a single center. It was renamed Oregon Health Sciences University in 1981 and took its current name in 2001, as part of a merger with the Oregon Graduate Institute (OGI), in Hillsboro. The university has several partnership programs including a joint PharmD Pharmacy program with Oregon State University in Corvallis.
Anthroposophic medicine is a form of alternative medicine based on pseudoscientific and occult notions. Devised in the 1920s by Rudolf Steiner (1861–1925) in conjunction with Ita Wegman (1876–1943), anthroposophical medicine draws on Steiner's spiritual philosophy, which he called anthroposophy. Practitioners employ a variety of treatment techniques based upon anthroposophic precepts, including massage, exercise, counselling, and administration of substances.
Oregon Health & Science University Hospital is a 576-bed teaching hospital, biomedical research facility, and Level I trauma center located on the campus of Oregon Health & Science University (OHSU) in Portland in the U.S. state of Oregon. OHSU hospital has consistently been ranked by the U.S. News & World Report as the #1 hospital in the Portland metro regional area and is frequently ranked nationally in multiple medical specialties.
Functional medicine (FM) is a form of alternative medicine that encompasses a number of unproven and disproven methods and treatments. It has been described as pseudoscience, quackery, and at its essence a rebranding of complementary and alternative medicine. In the United States, FM practices have been ruled ineligible for course credits by the American Academy of Family Physicians because of concerns they may be harmful.
Brian Patrick Monahan is the Attending Physician of the United States Congress and the United States Supreme Court and holds the rank of rear admiral in the United States Navy. Monahan was nominated to the position and rank by United States President Barack Obama in January 2009. He previously served as the director of hematology and medical oncology at the National Naval Medical Center. He is a Master of The American College of Physicians and a Member of the Academy of Medicine.
Harriet A. Hall was an American family physician, U.S. Air Force flight surgeon, author, science communicator, and skeptic. She wrote about alternative medicine and quackery for the magazines Skeptic and Skeptical Inquirer and was a regular contributor and founding editor of Science-Based Medicine. She wrote under her own name or used the pseudonym "The SkepDoc". After retiring as a colonel in the U.S. Air Force, Hall was a frequent speaker at science and skepticism related conventions in the US and around the world.
Brian J. Druker, M.D. is a physician-scientist and JELD-WEN Chair of Leukemia Research at Oregon Health & Science University (OHSU) in Portland, Oregon. He previously served as chief executive officer and director of OHSU's Knight Cancer Institute, as well as Associate Dean for Oncology in the OHSU School of Medicine.
Wallace Sampson, also known as Wally, was an American medical doctor and consumer advocate against alternative medicine and other fraud schemes. He was an authority in numerous medical fields, including oncology, hematology, and pathology. He was Emeritus Professor of Clinical Medicine at Stanford University. He was the former Head of Medical Oncology at Santa Clara Valley Medical Center, and a member of the faculty at the Skeptic's Toolbox 1998–2008.
David Henry Gorski is an American surgical oncologist and professor of surgery at Wayne State University School of Medicine. He specializes in breast cancer surgery at the Karmanos Cancer Institute. Gorski is an outspoken skeptic and critic of alternative medicine and the anti-vaccination movement. He writes as Orac at Respectful Insolence and as himself at Science-Based Medicine, where he is the managing editor.
Science-Based Medicine is a website and blog with articles covering issues in science and medicine, especially medical scams and practices. Founded in 2008, it is owned and operated by the New England Skeptical Society, and run by Steven Novella and David Gorski.
The Hallwang Clinic is a private oncology clinic based in Dornstetten, Germany, founded in 2014. It is known for selling unproven and ineffective therapies alongside more conventional cancer treatments.
Medical reversal refers to when a newer and methodologically superior clinical trial produces results that contradict existing clinical practice and the older trials on which it is based. This leads to an intervention that was widely used falling out of favor, because new evidence either demonstrates that it is ineffective or that its harms exceed its benefits. It is distinct from replacement, which occurs when a newly developed medical treatment supersedes an older, less effective one as the standard of care. Medical reversals are caused when a treatment is widely adopted even when there is not compelling evidence for its safety and effectiveness. For example, an intervention may be adopted because it "makes sense", or because there are observational studies supporting its putative benefits. The negative effects of such reversals include harm to patients who received the intervention when it was considered relatively safe and effective, as well as reducing public trust in medicine.
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Adam Seth Cifu is an American physician, academic, author, and researcher. He is Professor of Medicine and Associate Director of the Bucksbaum Institute for Clinical Excellence at the University of Chicago.
Ending Medical Reversal: Improving Outcomes, Saving Lives is a nonfiction book written by Vinay Prasad and Adam Cifu, published in 2015 by Johns Hopkins University Press.
Malignant: How Bad Policy and Bad Evidence Harm People with Cancer is a nonfiction book by Vinay Prasad, published in 2020 by Johns Hopkins University Press.
Benjamin Djulbegovic is an American physician-scientist whose academic and research focus revolves around optimizing clinical research and the practice of medicine by comprehending the nature of medical evidence and decision-making. In his work, he has integrated concepts from evidence-based medicine (EBM), predictive analytics, health outcomes research, and the decision sciences.