Donanemab doesn't work for alzheimers if you actually read the study. Mammograms should be done every other year and starting at age 50. Blue-blockers don't prevent eye strain on the computer and sleep varies but at this time the evidence doesnt suggest it causes obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2100708 new drug donanemab vs placebo = 257-patient double-blind randomised TRAILBLAZER-ALZ trial. the authors say “In patients with early Alzheimer’s disease, donanemab resulted in a better composite score for cognition and for the ability to perform activities of daily living than placebo at 76 weeks, although results for secondary outcomes were mixed. “ but lets review individuals with a Mini-Mental State Examination (MMSE) score of 20-28 were included in the study The primary outcome was the change in the Integrated Alzheimer’s Disease Rating Scale at 76 weeks. (iADRS; range, 0 to 144, with lower scores indicating greater cognitive and functional impairment) the change in the iADRS score at 76 weeks was -6.86 in the donanemab group and -10.06 in the placebo group (difference, 3.20; 95% confidence interval [CI], 0.12 to 6.27; P=0.04). SADLY--—both groups still got worse just not as worse with donanemab. There was no benefit of donanemab over placebo seen on the secondary outcomes, ((((((Secondary outcomes included the change in scores on the Clinical Dementia Rating Scale–Sum of Boxes (CDR-SB), the 13-item cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS-Cog13), the Alzheimer’s Disease Cooperative Study–Instrumental Activities of Daily Living Inventory (ADCS-iADL), and the Mini–Mental State Examination (MMSE), as well as the change in the amyloid and tau burden on PET.)))))) So you have a 3 point change on a 144 point scale with no other positive findings and you say BAM look at this fantastic drug we have…Although there were no safety concerns I think my listeners will know I think this is a perfect study to question medicine and maybe save in a drawer to give students about the importance of stastical vs clinical significance and how small changes on big scales can give you a positive study but that doesn’t mean it was a positive study clinically speaking.. Recommendations From Breast Cancer Centers for Frequent Screening Mammography in Younger Women May Do More Harm Than Good | Breast Cancer | JAMA Internal Medicine | JAMA Network This is from the “less is more” series and it tackles one of my most favorite discussions—the benefits of mammograms- who should get them?? How often should they get them? What age should we begin? The CDC says-- “Women aged 40 to 44 years should have the choice to start breast cancer screening once a year with mammography if they wish to do so. The risks of screening as well as the potential benefits should be considered. Women aged 45 to 49 years should be screened with mammography annually.” “The most recent (2016) US Preventive Services Task Force (USPSTF) breast cancer screening recommendations for women with average risk advise biennial screening in women aged 50 to 74 years” What about 40-49? Well the USPSTF says they do not recommend it but think it should be dicussed in a shared decision making conversation The AAFP says exactly what the USPSTF says – which is usually a safe and great bet—(rant on what told brian about USPSTF) American cancer society says yearly at age 40, start yearly mammograms at 45, transition to every other year at age 55. ACOG says mammograms every 1-2 years from women 40-49 then annually after that. And when no one agrees that means the evidence is borderline at best OR it is borderline with heavy bias from big pharmat. Every society agrees on the big ticket items like treating blood pressure but when it starts to vary by society then you know that the actual evidence is terrible. So lets talk about risk and b(continued)