What 20th century misinformation tells us today

The collision of health care and technology.

Feb 02, 2022 View in browser   By Darius Tahir GETTING YOUR GOAT: Connoisseurs of medical-misinformation tales have probably heard of Kansas doctor John Brinkley. His claim to fame can be summed up very simply: He became rich and famous — able to win 30 percent of the vote for Kansas governor as a write-in candidate — due to his avid promotion of the transplantation of goat testicular glands as a medical treatment in the early 20th century. Seemingly a funny story, but a deeper inspection reveals Brinkley's life is more serious and has close parallels with our current time. Some doctors today are also promoting unlikely cures as established treatments — specifically for Covid-19. But there's a twist: Brinkley's message, carried on radio waves, traveled a shorter distance than today's internet warriors' postings do. Brinkley, a North Carolina native who gained his degree from a diploma mill, rose to local prominence in Milford, Kansas, owing to his diligent care for patients in the 1918 flu epidemic — a pandemic even more devastating than today's. He had "an uncanny knack with the flu," an associate recalled. From there, Brinkley built an interlocking empire: a radio station, a pharmaceutical firm; and a hospital. Brinkley allied himself with rural patients against big-city profiteers. And, in a forerunner of today's misinformation factories, Brinkley used the radio station to diagnose patients from afar — before typically recommending they use his company's products, a court review concluded. Species at high elevations, such as mountain goats, will face significant challenges as climate change ushers in new, warmer conditions in their primary habitat areas. | Alexandra Beier/Getty Images When the federal government tried to revoke Brinkley's radio license, he claimed censorship. (The courts agreed with the government that the show was "inimical to the public health and safety, and for that reason is not in the public interest.") Later, after Brinkley's close-but-no-cigar runs for governor and eventual death, he was regarded as an interesting curio and an example of how fast bad information can spread when supercharged by technology. "He shouted the catchphrases at millions instead of mere scores," a 1942 New York Times retrospective concluded before citing dangers to the country's institutions from other contemporary populists. "How mighty a force is radio for evil as well as good, even in a democracy." Radio: the social media of its time. Or was it? Brinkley's audience was confined to the mountain states and just east of the Mississippi — and he built that audience after massive investments to his radio station's equipment. Today's opponents to the medical establishment are more numerous and reach far more people: The Center for Countering Digital Hate identified 425 anti-vaccine accounts whose cumulative Twitter-follower counts number in the tens of millions. And it takes nothing but time to post your way to prominence. The situation has changed even in the past decade or so. "The difference between 2009 and now is the ubiquity of social media," Humayun Chaudhry, the leader of the Federation of State Medical Boards. Chaudry is one of a number of doctors' regulators who want to address today's medical misinformation problem but perceive it as a big lift. "Any lone voice suddenly has the ability to get tens of thousands of followers, or hundreds of thousands, for an outrageous comment," he concluded. Welcome back to Future Pulse, where we explore the convergence of health care and technology. Share your news and feedback: @dariustahir, @samsabin923 , @_BenLeonard_. Tweet of the Week Arien Malec @amalec "There are zero technical barrier to interoperability - barriers are *entirely* health care business model based. We have insufficient interoperability for the same reason the patient experience in health "care" is poor. Health care actors don't _care_ enough" CONGRESS PRODS ON USER FEE AGREEMENT: Congressional health leaders are urging the Food and Drug Administration and medical device industry to wrap up negotiations on the next round of user fee agreements to help fund future product evaluations. The agency and industry missed a Jan. 15 deadline to transmit a commitment letter to Congress, leaving lawmakers antsy. Senate health committee Chair Sen. Patty Murray (D-Wash.) and ranking Republican Sen. Richard Burr (R-N.C.), plus House Energy and Commerce leaders Rep. Frank Pallone (D-N.J.) and Rep. Cathy McMorris Rodgers (R-Wash.), requested a Feb. 9 briefing for an update on the talks and an expected timeline. "The FDA and medical device industry's significant delay in transmitting the MDUFA commitment letter jeopardizes our ability to thoroughly review the commitments under the letter," the lawmakers wrote. As we've reported, device makers want fewer user fees and funds spent to speed up premarket reviews and cut application backlogs. The FDA wants more user fees, partly to boost postmarket surveillance to identify and fix device safety problems. The current user fee agreement runs through fiscal 2022, providing a deadline for lawmakers to finish must-pass legislation. GAO CITES SAFETY ISSUES WITH VA PROJECT: Data transferred between the Department of Veterans Affairs' old medical record system and a new one developed by Kansas City–based Cerner was flawed, leaving clinicians at an agency center in Spokane, Washington, with inaccurate information about patients' allergies, according to a new report from the Government Accountability Office . It's the latest documented problem surrounding the department's troubled medical records modernization program. Previous government reports cited concerns with accounting controls that contributed to inaccurate cost estimates to Congress and with the effectiveness of its training programs for health providers expected to use the system. The VA relies on a legacy system, called VistA, that stores patients' medical records and an associated "corporate data warehouse" that retains information used for research and business analytics purposes. The information needed to be transferred to new systems with different capabilities. But information was displayed in counterintuitive and inaccurate ways, GAO said. Interviews with clinicians cited an inability to find immunization and allergies data, creating a patient safety problem. The Next Cures A VAX STRATEGY FOR TRANSPLANT RECIPIENTS? Researchers backed by the National Institutes of Health are beginning to study whether temporarily reducing immunosuppressive drugs in kidney and liver transplant recipients days before and after a dose of an mRNA Covid-19 vaccine delivers a better antibody response. The trial will take place at about 15 transplant centers across the country and enroll up to 400 adults who received a donor organ a year or more before enrollment. It aims to address why organ transplant recipients who take drugs to prevent organ rejection fail to develop antibodies against the virus that causes Covid-19 after receiving their primary vaccine regimen. An insufficient antibody response, along with other risk factors like obesity and diabetes, leaves transplant recipients at high risk for coronavirus infection and severe Covid-19. Researchers will track whether reducing immunosuppressants yields a predefined antibody response at the 30-day mark and follow participants for a year after enrollment. What We're Clicking On A review of Africa's health tech scene in Project Syndicate. Why some rapid tests persistently return negative test results — even when you feel sick — in BuzzFeed. And a tech review of one buzzy health wearable, the Oura Ring, in The New York Times.   Follow us

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