
A Few Billionaires Are Turning Medical Philanthropy on Its Head - seycombi
https://www.bloomberg.com/news/articles/2016-12-02/a-few-billionaires-are-turning-medical-philanthropy-on-its-head
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tcj_phx
Medical science will make great progress when it's able to to challenge some
of its basic assumptions.

No single person did more damage to the progress of Medical Science than Ancel
Keys [1]. Dr. Keys hypothesized that heart disease was caused by the
consumption of saturated fats, and recommended that people avoid the
consumption of animal fat, in favor of deodorized polyunsaturated vegetable
oil.

We now know that partially-hydrogenated oils (such as were used in Crisco,
before it was reformulated in the early 2000's) are the real villains. But the
grocery store shelves are still lined with 'healthy' Safflower, Soybean, Corn,
and Cottonseed oils.

[1]
[https://en.wikipedia.org/wiki/Ancel_Keys#Seven_Countries_Stu...](https://en.wikipedia.org/wiki/Ancel_Keys#Seven_Countries_Study)

The drug industry has done a lot of damage too. For example, Doctors have
spent decades suppressing cholesterol levels, instead of trying to figure out
the meaning of high cholesterol levels. Dissidents against the cholesterol
hypothesis have been gaining traction in recent years, even among the
professional class.

In _Anatomy of an Epidemic,_ [2] Robert Whitaker covers how the pharmaceutical
industry conquered the psychiatric profession in the 1980's.

[2]
[http://robertwhitaker.org/robertwhitaker.org/Anatomy%20of%20...](http://robertwhitaker.org/robertwhitaker.org/Anatomy%20of%20an%20Epidemic.html)

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tptacek
Wait, statins are bad now?

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carbocation
Statins are an extremely powerful tool for reducing morbidity and mortality.
Statins are like vaccines in their ability to attract deniers, but the genetic
data are in complete alignment with the clinical trial results.

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tcj_phx
So says the cardiology fellow… One theory as to why statins have a small
degree of influence is that they actually have an anti-inflammatory action.
When my father talks with his patients, he finds many of them couldn't
tolerate statins' side effects.

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carbocation
> So says the cardiology fellow…

Would you say "so says the cryptographer" to circumscribe something that
`tptacek says about cryptography?

> One theory as to why statins have a small degree of influence is that they
> actually have an anti-inflammatory action. When my father talks with his
> patients, he finds many of them couldn't tolerate statins' side effects.

Given the predictable effects of LDL-cholesterol lowering on MACE and death,
invoking beneficial mechanisms of statins beyond LDL-cholesterol lowering
(e.g., by anti-inflammatory effects) is not that well supported (or necessary
to explain the benefits), but it's not out of the realm of possibility.

~~~
tcj_phx
> Would you say "so says the cryptographer" to circumscribe something that
> `tptacek says about cryptography?

The American Heart Association still promotes Ancel Keys' dietary philosophy,
so everything they touch is tainted. An appology for The Mistake (promoting
vegetable oil) is necessary to begin the process of rebuilding trust.

I subscribe to a medical news email - one of the recent editorials was about
needing to re-examine the profession's obsession with cholesterol. When I find
the link I'll post again. But basically the gist is that the CETP agents are
good at lowering cholesterol levels, but not so good at lowering mortality, so
maybe the hypothesis needs to be reconsidered.

~~~
carbocation
Apheresis, HMG-CoA reductase inhibition (statins), PCSK9 inhibition (-cumabs),
and NPC1L1 inhibition (ezetimibe) all lead to reduced LDL-C. Statins and
ezetimibe lead to reduced MACE and death. The -cumabs should be reporting
trial results in the next 12 months, but the genetic data strongly suggests
that they will reduce mortality.

Unusual for cholesterol modification agents, some of the CETP drugs (which
were designed around their HDL-C raising properties but do lower LDL-C)
increased MACE, while others had neutral effect, so there is something about
CETP that we have yet to understand.

~~~
tcj_phx
I can't match you on credentials or acronyms, but I'm pretty good at figuring
out what matters for improving my own health.

"Should cardiologists evaluate their obsession with LDLs and HDLs?" \-
[http://www.kevinmd.com/blog/2016/04/should-cardiologists-
eva...](http://www.kevinmd.com/blog/2016/04/should-cardiologists-evaluate-
their-obsession-with-ldls-and-hdls.html?pop=0&ba=1) (April 2016)

Saw this link on the sidebar:

"Slow Medicine: Pressing Pause on Statins For Primary Prevention" \-
[http://www.medpagetoday.com/Blogs/SlowMedicine/61836](http://www.medpagetoday.com/Blogs/SlowMedicine/61836)
(December 4 2016)

I would estimate that the cholesterol fetish has about 2 more years before it
begins to slide into irrelevance, and the field begins to refocus on the
causes behind the symptom.

A classic fun movie clip: [https://www.youtube.com/watch?v=02Or-
Hx3yqc](https://www.youtube.com/watch?v=02Or-Hx3yqc)

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KKKKkkkk1
> What’s more, marketable discoveries will be group affairs, with
> collaborative licensing deals -- no matter who led the research.

I've been talking to a colleague this week, who casually observed to me that I
will be dinged in my annual reviews if I'm not perceived to be "a team
player". People don't understand that only the most trivial jobs are done
"collaboratively". When you're digging a ditch, you need a team. When you're
making an intellectual effort, you need to encourage individual effort or
you'll just get a herd of researchers rehashing known results. That's the
major problem with "team science", and Parker is doubling down on this.

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nerdponx
It's both. You need intense individual focus, but you also need to get those
individuals in a room together so they can bounce ideas off each other,
synchronize their work, and hash out issues they weren't able to solve on
their own.

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preordained
It's definitely both. Via personally experience, a bunch of people in a room
hashing out ideas real time--the more difficult the problem, the more this has
to be counter-balanced by intense personal study to mature a concept enough to
bring it to the group.

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kaonashi
This seems incredibly inefficient. Medical research should not be driven this
much by people who got lucky in unrelated fields.

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forgotpwagain
It has the potential to be inefficient if they choose the wrong group of
scientific advisors. But, for most of these initiatives, they're very careful
to choose smart people to actually lead the details of the project and figure
out how to best distribute the money.

Sometimes, we're actually within striking zone of these targeted diseases and
funding more translational research is good. Other times, we still don't
understand the underlying diseases well enough, and so we still need to do an
enormous amount of basic science before trying to cure these diseases in the
clinic. A team of good scientific advisors who are at the cutting edge of
their respective fields can provide the insight and decision-making that this
needs, to extract the maximum value from the money provided.

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andrewfromx
this is great. rather than trying to setup a charity or give money away, they
just run the standard ruthless capitalism play and make a business deal. They
just purposely make a very bad deal for themselves in order to give the money
away.

~~~
adolph
Which approach has a tax advantage?

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EGreg
Yes! Collaboration may lead even to open source drugs:

[http://magarshak.com/blog/?p=93](http://magarshak.com/blog/?p=93)

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abrax3141
This is all confusion. Science is a "Bayesian Community" (to coin a phrase).
It collaborates already, as needed, albeit inefficiently. One could improve
the collaborative process, but to strong arm it is just ignorance of
everything about science. This is just rich children throwing their money
around.

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jokoon
I guess after Trump's election, people who have money will try to stand out
and show that capitalism is not always inhumane. Either that or they will
realize that wealth is not just a reward of power, it's also a responsibility
to their country and their citizens. I wish the wealthy would see their
achievement as a success for their nation and employees, not for their own
self. The whole anti government anti collectivism anti taxes and "I did it
myself" is really a plague.

There are many example of very wealthy individuals of the 19th and 20th
century who gave a lot and it still lives to that day.

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melling
This article has nothing to do with the election, or politics.

Hacking research, and medical research in particular, is beneficial to
everyone. It would be helpful to figure out a way for more people to
contribute rather than throwing out your political feelings.

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japhyr
The rise of anti-intellectual politicians and policies makes politics quite
relevant to discussions like these. Ignoring the political impact on positive
endeavors is wishful thinking.

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based2
[https://www.reddit.com/r/Futurology/comments/5gerym/a_few_bi...](https://www.reddit.com/r/Futurology/comments/5gerym/a_few_billionaires_are_turning_medical/)

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funnyfacts365
Why?

