My latest books....

5/15/09:  Influenza A/H1N1 2009 I have received a number of requests for an analysis of the novel H1N1 Influenza that appears (emphasize "appears") to have begun in Mexico, probably in early to mid-March of 2009.  You can find a complication of data along with a stratightforward statistical analysis and what I believe is a concise compendium of special concerns and problems this strain of influenza here.  While it was not hard to see early on that it was unlikely that disease severity was going to be much different from seasonal influenza A/H1N1,  public health officials are understandably worried about recombination or reasssortment events that could take place with other influneza viruses as flu season begins in the Southern hemisphere.  I take full responsibility for any erros (either in transcription of the data or in my statistical claculations).  Comments are welcome. 5/5/08:  New Book released More Harm than Good, my latest book, co-authored with my colleague Michael Bellomo, has just been released.  With the hope of enhancing the debate over health care, we review the core reasons for the very high cost, yet relatively poor performance of the US healthcare system when compared to other western countries.  We believe that improvements come from both systemic changes, well described at the end of the book, and a better educated consumer who, in collaboration with her/his physician weigh treatment choices; indeed, in a few recent studies so-called "shared decision-making" has resulted in patients often expressing preferences for less agressive (and certainly less expensive) care for a wide variety of conditions.  Thus, we provide a clear understanding of the common chronic diseases in the US (those that will affect most of us at one time or another in our lives) so that patient-centered (rather than phyisician-preferred) choices can more easily become part of one's dialogue.  Science-based evidence can further enhance such decision-making if physicians are provided with incentives to to report outcomes in their practices, which are, in reality, natural experiments whose valuable data currently goes unexploited. More Harm than Good was just reviewed by the Library Journal, not exactly an easy sell when it comes to new books as this publication is one that most libraries depend on in deciding how to allocate limited resources for purchasing items for their collections.  Their review follows. Zelicoff, Alan, M.D., & Michael Bellomo. More Harm Than Good: What Your Doctor May Not Tell You About Common Treatments and Procedures. AMACOM: American Management Assn. May 2008. c.256p. index. ISBN 978-0-8144-0027-2. $24. "As the costs of U.S. health care continue to surge and quality remains both highly variable and unevenly distributed, Zelicoff and Bellomo (coauthors, Microbe) attempt to pinpoint the problems and offer some solutions. They identify four key issues: consumers know too little about the most common health problems; doctors often treat more by habit than by applying evidence; evidence is often inadequate for good decision making; and the financing of health care and the lack of electronic records lead to excessive costs and less-than-optimum care. They cite such examples as the inappropriate use of some screening tests, which lead to the overtreatment of prostate cancer and cardiovascular disease. Better understanding of statistics and evidence by physicians and a national electronic database of treatment records would provide a stronger evidence base and, in turn, result in a reduction of costs and inappropriate treatment, their argument goes. Clearly written and well documented, this book covers the same ground as Shannon Brownlee's Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer but with more emphasis on the need for better use of evidence. Recommended for all public libraries".—Dick Maxwell, Porter Adventist Hosp. Lib.,

Microbe: Are We Ready for the  Next Plague? Alan Zelicoff  and Michael Bellomo ISBN: 0-8144-0865-6 Amacom, New York, NY, 2005 Excerpt from a review published in the journal Emergining Infectious Diseases, Vol 11(11): 2005, pg 1807 by Dr. Peter Jahrling. "Microbe: Are We Ready for the  Next Plague? by Alan Zelicoff and Michael Bellomo is a comprehensive,  yet succinct, account of the threat to public health posed by microbial  pathogens. What distinguishes this  book from the surfeit of recent books  hyping the threat of bioterrorism are its balanced perspective and elucidation of naturally emerging disease  threats, such as severe acute respiratory syndrome (SARS) or West Nile virus, as exotic entities requiring a  rapid and effective response; Mother Nature is quite the bioterrorist herself.  Early recognition that an event has  occurred is key to containment of the nascent epidemic. The unifying theme of the book is the  importance of syndrome-based surveillance in achieving this goal. This book  is the best of its genre and is recommended for anyone interested in  understanding and managing the risks  associated with emerging microbial threats." Peter B. Jahrling National Institutes of Health, Bethesda, Maryland, USA

• why does the use of new medical technology vary by a factor of 10 or more across the country, while producing no evident differences in outcome for the most common diseases?
• what can be done to make modern medicine much more cost-effective while at the same time taking into account patient preferences?  We believe that simple practice changes -- perhaps informed by a single-payer systems' database of practice patterns -- would easily save hundreds of billions of dollars in our existing, wasteful healthcare system.  As the population ages, public policy decisions that follow the carefully gathered data of the past 4 decades will become ever more important in wisely spending our medical resources.