December 11, 2024Dec 11 I think his numbers are a bit off in terms of market cap but the point remains.
December 11, 2024Dec 11 1 hour ago, BBE said: Do you feel better now? Actually, what you call pearl clutching, most call terrible statics knowledge. I only commented on what you put on full display. And your response was but you know it can't be this because I went to medical school. Go ahead, join wgb in attacking me personally without having a clue as to what I did and what it takes to formulate, validate, test, and bring an animal or human supplement to market. I do actually. See here I thought you had some background in what you were talking about about, when it turns out you're just talking out your ass and mistaking biomedical research background for expertise in epidemiology. But she since we've established this us neither of our fields maybe we should go ahead and see what actual epidemiologists say. Good news for you, the maid of honor at our wedding is a reproductive health epidemiologist out of Harvard. When she got done laughing at your assertion that gap in outcomes is solely related to comorbidities, she sent me a few links. https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison "Our findings suggest that an undersupply of maternity providers, especially midwives, and lack of access to comprehensive postpartum support, including maternity care coverage and mandated paid maternity leave, are contributing factors." "https://www.scientificamerican.com/article/to-prevent-women-from-dying-in-childbirth-first-stop-blaming-them/ "The high maternal mortality rate (MMR) in the U.S. is often blamed on the poor health of mothers, but a comparison with other wealthy countries undermines this argument. MMR—shown here using two estimates, one by the World Health Organization (WHO) and one by the Institute for Health Metrics and Evaluation (IHME)—is not rising in countries with similarly increased rates of cardiovascular disease, obesity, diabetes and other conditions during pregnancy. Different factors must therefore be contributing to the rise in MMR in the U.S. As a 2018 paper in Obstetrics & Gynecology concluded" https://www.ama-assn.org/delivering-care/population-care/what-s-behind-spike-us-maternal-mortality "The AMA has identified other factors that contribute to bad maternal outcomes: poor insurance coverage prior to, during and after pregnancy; lack of interprofessional teams trained in best practices; and closure of maternity units in many rural and urban communities." How about the Maternal Mortality Review Committees that we're specifically designed to study this at a state level? "Improving access to care" is one area 9 of them specifically identified as likely to have the largest impact on maternal M&M in the US. Gee it sure seems that everyone who actually studies this stuff agrees that system issues are a major contributing factor the the issues the US is facing.
December 11, 2024Dec 11 Now maybe we can get this thread back on track and focus on the important stuff: memes.
December 11, 2024Dec 11 28 minutes ago, DEagle7 said: I do actually. See here I thought you had some background in what you were talking about about, when it turns out you're just talking out your ass and mistaking biomedical research background for expertise in epidemiology. But she since we've established this us neither of our fields maybe we should go ahead and see what actual epidemiologists say. Good news for you, the maid of honor at our wedding is a reproductive health epidemiologist out of Harvard. When she got done laughing at your assertion that gap in outcomes is solely related to comorbidities, she sent me a few links. https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison "Our findings suggest that an undersupply of maternity providers, especially midwives, and lack of access to comprehensive postpartum support, including maternity care coverage and mandated paid maternity leave, are contributing factors." "https://www.scientificamerican.com/article/to-prevent-women-from-dying-in-childbirth-first-stop-blaming-them/ "The high maternal mortality rate (MMR) in the U.S. is often blamed on the poor health of mothers, but a comparison with other wealthy countries undermines this argument. MMR—shown here using two estimates, one by the World Health Organization (WHO) and one by the Institute for Health Metrics and Evaluation (IHME)—is not rising in countries with similarly increased rates of cardiovascular disease, obesity, diabetes and other conditions during pregnancy. Different factors must therefore be contributing to the rise in MMR in the U.S. As a 2018 paper in Obstetrics & Gynecology concluded" https://www.ama-assn.org/delivering-care/population-care/what-s-behind-spike-us-maternal-mortality "The AMA has identified other factors that contribute to bad maternal outcomes: poor insurance coverage prior to, during and after pregnancy; lack of interprofessional teams trained in best practices; and closure of maternity units in many rural and urban communities." How about the Maternal Mortality Review Committees that we're specifically designed to study this at a state level? "Improving access to care" is one area 9 of them specifically identified as likely to have the largest impact on maternal M&M in the US. Gee it sure seems that everyone who actually studies this stuff agrees that system issues are a major contributing factor the the issues the US is facing. First, i stated that comorbidities were not accounted for. You strawmanned that argument. As a matter of fact, one of your sources speaks to comorbidities. Join / Renew Population Care What’s behind the spike in U.S. maternal mortality May 25, 2023 . 4 MIN READ By Jennifer Lubell, Contributing News Writer Member Benefits U.S. maternal deaths are on a worrisome trajectory. The Centers for Disease Control and Prevention (CDC) has reported that mortality rose from 861 maternal deaths in 2020 to 1,205 maternal deaths in 2021, a 40% overall increase. Advancing public health AMA membership offers unique access to savings and resources tailored to enrich the personal and professional lives of physicians, residents and medical students. Learn More Those 1,200-plus maternal deaths translate to a maternal mortality rate of 32.9 deaths per 100,000 live births for 2021, compared with 23.8 in 2020 and 20.1 in 2019, according to Sandra Adamson Fryhofer, MD, chair of the AMA Board of Trustees. Also in 2021, the maternal mortality rate for Black women was 69.9 deaths per 100,000 live births. That is 2.6 times the mortality rate for white women. During a recent episode of "AMA Update,” Dr. Fryhofer joined ob-gyn and maternal-fetal medicine specialist Nicole Lee Plenty, MD, MPH, MS, to discuss the latest CDC data and what physicians and patients can do to improve maternal health outcomes. Related Coverage New law provides data-mapping tool to lower maternal mortality Intersecting factors at play Maternal mortality rates in the U.S. are, shockingly, at their highest level since 1965. The reasons are multifactorial, said Dr. Fryhofer. Black women are three times likelier than white women to die from a pregnancy-related cause. Health care access problems, underlying chronic conditions, and structural racism and implicit bias all contribute to these bleak statistics. Social determinants of health prevent Black women and other patients from historically marginalized racial and ethnic groups "from having fair opportunities for economic physical and emotional health,” said Dr. Fryhofer, an Atlanta internist. Underlying comorbidities heighten the risk of maternal mortality, said Dr. Plenty, an AMA member who serves as delegate of the AMA Women Physicians Section Governing Council. "A lot of times patients are not controlled when they come into the pregnancy. So, people are not getting as much prenatal care or preconception care early on or before pregnancy,” she noted. Getting hypertension or diabetes under control pre-pregnancy would help offset the risk of complications later in pregnancy, said Dr. Plenty. Secondly, thank you for posting literature. I will take the time to read it.
December 11, 2024Dec 11 The first article speaks to issues with ob/gyn and midwives shortages which has been a persistent issue. I haven't seen the latest statistics, but are ob/gyn still at the top of the list for most malpractice claims? That seems to be one of if not the most critical factors, would you not agree? Limited supply and a definite demand.
December 11, 2024Dec 11 2 minutes ago, BBE said: And your scientific American article cites racism as a factor. The government should give out some grants to research that.
December 11, 2024Dec 11 Looks like we have another poster rivalry building. This one feels like it might be a good one.
December 11, 2024Dec 11 2 minutes ago, Paul852 said: The government should give out some grants to research that. Exactly, someone should start studying racism in the US and look to uncover any issues that may be affecting things.
December 11, 2024Dec 11 13 minutes ago, BBE said: And your scientific American article cites racism as a factor. Of course it does
December 11, 2024Dec 11 29 minutes ago, BBE said: First, i stated that comorbidities were not accounted for. You strawmanned that argument. As a matter of fact, one of your sources speaks to comorbidities. Join / Renew Population Care What’s behind the spike in U.S. maternal mortality May 25, 2023 . 4 MIN READ By Jennifer Lubell, Contributing News Writer Member Benefits U.S. maternal deaths are on a worrisome trajectory. The Centers for Disease Control and Prevention (CDC) has reported that mortality rose from 861 maternal deaths in 2020 to 1,205 maternal deaths in 2021, a 40% overall increase. Advancing public health AMA membership offers unique access to savings and resources tailored to enrich the personal and professional lives of physicians, residents and medical students. Learn More Those 1,200-plus maternal deaths translate to a maternal mortality rate of 32.9 deaths per 100,000 live births for 2021, compared with 23.8 in 2020 and 20.1 in 2019, according to Sandra Adamson Fryhofer, MD, chair of the AMA Board of Trustees. Also in 2021, the maternal mortality rate for Black women was 69.9 deaths per 100,000 live births. That is 2.6 times the mortality rate for white women. During a recent episode of "AMA Update,” Dr. Fryhofer joined ob-gyn and maternal-fetal medicine specialist Nicole Lee Plenty, MD, MPH, MS, to discuss the latest CDC data and what physicians and patients can do to improve maternal health outcomes. Related Coverage New law provides data-mapping tool to lower maternal mortality Intersecting factors at play Maternal mortality rates in the U.S. are, shockingly, at their highest level since 1965. The reasons are multifactorial, said Dr. Fryhofer. Black women are three times likelier than white women to die from a pregnancy-related cause. Health care access problems, underlying chronic conditions, and structural racism and implicit bias all contribute to these bleak statistics. Social determinants of health prevent Black women and other patients from historically marginalized racial and ethnic groups "from having fair opportunities for economic physical and emotional health,” said Dr. Fryhofer, an Atlanta internist. Underlying comorbidities heighten the risk of maternal mortality, said Dr. Plenty, an AMA member who serves as delegate of the AMA Women Physicians Section Governing Council. "A lot of times patients are not controlled when they come into the pregnancy. So, people are not getting as much prenatal care or preconception care early on or before pregnancy,” she noted. Getting hypertension or diabetes under control pre-pregnancy would help offset the risk of complications later in pregnancy, said Dr. Plenty. Secondly, thank you for posting literature. I will take the time to read it. Yes, comorbidities are a factor. I have fully acknowledged that from the beginning and most of the articles I have posted and looked at identify those as well. However they also specifically identify an overall decrease in those comorbidities across the western world. In other countries this has correlated with improved maternal M&M, but not in the US. Which once again speaks to other issues being afoot. 18 minutes ago, BBE said: The first article speaks to issues with ob/gyn and midwives shortages which has been a persistent issue. I haven't seen the latest statistics, but are ob/gyn still at the top of the list for most malpractice claims? That seems to be one of if not the most critical factors, would you not agree? Limited supply and a definite demand. Malpractice is one factor but the most critical factor is poor compensation for OBGYN care. GYN surgeries are compensated at significantly lower rates than comparable male surgeries (eg hysterectomy vs prostatectomy), obstetric care is bundled at a flat rate by insurance companies meaning increasing complexity is not compensated, they are not paid for supervision of midwives/residents/NPs etc. IMO hospital systems have done a poor job of advocating for improved insurance compensation for women's care and insurance companies have taken advantage. That is the largest factor in the worsening access problem 16 minutes ago, BBE said: And your scientific American article cites racism as a factor. They all comment on racism as a factor and for good reason. Racial differences in health outcomes exist in every country and every field, but in OBGYN in the US the gap is significantly wider and widening year by year. This isn't necessarily a "doctors hate black people" kind of racism, but related to factor like increased difficulty detecting clinical anemia in patients with dark skin due to lack of exposure/training, and systems issues like insurance companies not compensating offices for translation services despite the fact that they mandate their use when it comes to yearly health measures. These are systems issues just like any other.
December 11, 2024Dec 11 28 minutes ago, DrPhilly said: Looks like we have another poster rivalry building. This one feels like it might be a good one. Little too nerdy/wordy for my liking.
December 11, 2024Dec 11 4 minutes ago, xBMTx said: Can someone give me a TLDR summary on what this argument is about Some scientist said some doctor is stupid.
December 11, 2024Dec 11 1 minute ago, xBMTx said: Can someone give me a TLDR summary on what this argument is about A guy who optimized the Beggin Strip formula and a guy who gives out Paw Patrol stickers for a living are arguing over whether or not the American Healthcare system negatively impacts maternal morbidity and mortality rates
December 11, 2024Dec 11 Additional comment/question: SA article mentions excessive interventions. Is there still a philosophy among ob/gyn community that if all things equal it is better to intervene than not in potential risky deliveries? I am working on 15 year old experience and that is what the teaching hospital ob/gyn department was teaching.
December 11, 2024Dec 11 1 minute ago, DEagle7 said: A guy who optimized the Beggin Strip formula and a guy who gives out Paw Patrol stickers for a living I would have assumed this was the same person.
December 11, 2024Dec 11 5 minutes ago, DEagle7 said: Yes, comorbidities are a factor. I have fully acknowledged that from the beginning and most of the articles I have posted and looked at identify those as well. However they also specifically identify an overall decrease in those comorbidities across the western world. In other countries this has correlated with improved maternal M&M, but not in the US. Which once again speaks to other issues being afoot. Malpractice is one factor but the most critical factor is poor compensation for OBGYN care. GYN surgeries are compensated at significantly lower rates than comparable male surgeries (eg hysterectomy vs prostatectomy), obstetric care is bundled at a flat rate by insurance companies meaning increasing complexity is not compensated, they are not paid for supervision of midwives/residents/NPs etc. IMO hospital systems have done a poor job of advocating for improved insurance compensation for women's care and insurance companies have taken advantage. That is the largest factor in the worsening access problem They all comment on racism as a factor and for good reason. Racial differences in health outcomes exist in every country and every field, but in OBGYN in the US the gap is significantly wider and widening year by year. This isn't necessarily a "doctors hate black people" kind of racism, but related to factor like increased difficulty detecting clinical anemia in patients with dark skin due to lack of exposure/training, and systems issues like insurance companies not compensating offices for translation services despite the fact that they mandate their use when it comes to yearly health measures. These are systems issues just like any other. Thank you for expanding. And for additional reference, my dissertation was on Melatonin effects on timing of labor/uterine contractility/response to oxytocin in humans.
December 11, 2024Dec 11 14 minutes ago, Paul852 said: Little too nerdy/wordy for my liking. Go with it dude
December 11, 2024Dec 11 18 minutes ago, Paul852 said: Little too nerdy/wordy for my liking. I tried to stick with memes man. I was just here for the memes.
December 11, 2024Dec 11 4 hours ago, xBMTx said: Can someone give me a TLDR summary on what this argument is about *nobody but those two even care*
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