Episodes
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The Babies Who Died of Early Detection
What follows is a summary of the transcript, written by Claude. Let me know what you think, please. RT is fully reader-supported. Please become a paid subscriber—and spread the word, yo. My sons, 11 and 13, inform me that when I say something like “cancer screening can kill you,” the phrase I’m...
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The Early Detection Cancer Test That Doesn’t Detect Early
In college our physics teacher, Professor McGinnis, held an annual competition. Using a container made only of glue and toothpicks, we had to keep an egg from cracking when dropped out of the classroom’s first-story window. My team built a geometric lattice, buttressed with layers of internal...
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Deconstructing the Alcohol-Cancer Obsession
Below is a summary of the audio transcript, written by Gemini AI with some heavy editing by me. Let me know if you like or hate these, I’m still experimenting! “STROLLERS THAT KILL! At eleven.” RT is reader-supported. To help, PLEASE become a paid subscriber. For the price of a cappucino once a...
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The Cardiologist Contorting To Compliment the STAREE Trial
Below is a summary of the transcribed audio, brought to you by Gemini. I’m trying different AI options for these summaries, please feel free to let me know which ones you like. For an additional note answering one subscriber’s excellent question about statins, check out the audio. Enjoy! RT is…
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The Single Most Important Trick in Medical Research
Today’s episode explains the broader theme that ran through our episode from earlier this week. I wasn’t sure if I was clear enough, so here it is. Since it was just a quick audio I had ChatGPT turn the transcript into a written piece for the many written word addicts in our group (respect!)....
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The New Adult RSV Vaccine, the Death Star, and Promises Broken
Apologies to my paid subscribers, who are getting this for the second time. I sent it out as a paid-only post, which was a mistake. I will be having paid subscriber-only content fairly soon, but I do try to make most of my content available to everyone, so I’m re-sending to all. Sorry for the…
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The New Adult RSV Vaccine, the Death Star, and Promises Broken
In third grade Marc Diaz explained to me, very earnestly, that if one’s hand was larger than their face, that person was technically deformed. Concerned, I held my palm to my face, carefully comparing. At which point he cracked the back of my hand with his own palm, sending my hand into my face…
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What If Medicine’s Most Trusted Journal Can’t Be Trusted?
Jeffrey Flier, former dean of Harvard Medical School, recently accused the New England Journal of Medicine of editorial failure. Flier and others were responding to an essay from the Journal’s new Voices section about Jason Arday, a Cambridge professor who committed suicide after being outed for...
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Two New Statin Trials the AHA Won’t Want to Talk About
Once again the audio this week is for people who enjoy a bit more wonkiness. Below is what ChatGPT wrote when I pasted in the transcript and asked for a piece emulating my voice. And as always, I still couldn’t stop myself from editing pretty heavily. Enjoy! RT is fully reader-supported. To help…
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Do Black Doctors Save More Black Babies?
Today’s post, for efficiency reasons, is another freestyle audio. For my devoted readers who are strongly allergic to audio, I’ve asked ChatGPT to write a short summary piece in my style, which I’ve lightly edited. That’s what you see below. Enjoy! RT is totally reader-supported. To support its...
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The Bonkers Theory Driving The New Cholesterol Guideline
This week is the culmination of months of research and data review, so it’s longer than usual. Obviously, the big question we all should be asking about the new AHA guideline is, what changed? With no new trials, what led the committee to believe more young and healthy people need to take pills…
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The Statin Hazard Hidden for Twelve Years
In the coming episodes I’ll be explaining the AHA’s rationale for their new guidelines, which call for aggressive expansion in cholesterol testing and treatment. Obviously, that means walking through the data that form the basis for any claim that cholesterol is currently under-treated. But to...
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The Cholesterol Study the AHA Is Afraid to Discuss
When I do a public-facing summary and critical appraisal of a study I typically do it verbally and free-form. No script, no notes. After years of journal clubbing and presenting lectures and talks, that’s how I feel most comfortable. I’m trying something new this week and I'd like your feedback.…
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The Cholesterol Charade: How Statins Debunked the Lipid Hypothesis
I originally posted this in 2024 and there have been major, relevant study publications since then. I hate seeing my material out of date, so I’ve added the findings into this new updated version, and tried to polish things. It’s a big piece to take in, more like a chapter than my bite-size…
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The Failure of Cardiology's Plumbing Theory
“Sandy,” I called over my shoulder. “Back in two!” I pressed the metal square on the ER’s back wall and strode into the hall toward the lounge, where lunch awaited. Behind me I heard a grunt. A well-dressed man lay face down, a pool of blood spreading from his midsection. He wore a hospital...
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Is Your Doctor A Cholesterol Bully?
A friend of mine has a cholesterol of 258. Recently, when his new doctor saw this for the first time, she flipped. In addition to scolding him for not being on drugs, visibly shaken, she threatened to send him to the ER. For what, exactly, I cannot say. Emergency cholesterol-ectomy?…
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Tamiflu, and the Fatal Mistake of Doing Something
As a long time critic of Tamiflu and its brethren, I have often heard defenders make the following last ditch plea to justify its use: “What about people in the ICU with the flu?? Without it they could die!.” The unspoken insanity behind this claim is a powerful, almost gravity-like bias in…
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Is Moderate Alcohol Consumption Dangerous?
Last month the Journal of Studies on Alcohol and Drugs (‘JSAD’) published a large data review comparing mortality rates in light-to-moderate drinkers with mortality among people who don’t drink alcohol. The NY Times and others gleefully picked up the story, trumpeting the most provocative…
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Alzheimer's and Amyloid, A Summary
What you see below is not grape soda. It is urine from a human being—Purple Urinary Bag Syndrome, as it’s called, is quite something to behold. But it is brief, and happens when bacteria interact with the plastic of a urinary bag. Treating the underlying infection (typically mild, if there is…
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Alzheimer's and Amyloid 5: The Big Mistake
In part 2 of this series I described a trial in which researchers developed a novel vaccine for Alzheimer’s patients, designed to rid the brain of amyloid. The vaccine worked, clearing amyloid—but their dementia progressed, unabated. This was, in other words, a full debunking of any notion that...
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Alzheimer's and Amyloid 4: The Long Mistake
Over the first three parts in this series we followed the rise and fall of the Amyloid Hypothesis. The plaques failed. The idea of toxic precursors failed. The most influential oligomer paper in the field was ultimately retracted. By any ordinary standard of scientific reasoning, this should have...
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Alzheimer's and Amyloid 3: The Mistake of the Invisible Friend
Neuroscientists are not famous for being dumb. So when the following timeline unfolded, they should have understood exactly what it meant: First, autopsy studies in 1991 and 1992 found that amyloid plaques—supposedly the cause of Alzheimer’s, as the centerpiece of the Amyloid Hypothesis—did not...
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Alzheimer’s and Amyloid 2: Mistakes Of Mice and Men
Last week we reviewed two seminal studies from the 1990s, both showing mathematically that amyloid plaques are, at best, an inconsistent bystander in Alzheimer’s Disease. Plainly, they are not the driving cause. Hardcore believers may have ignored or rationalized the findings from these small but...
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Alzheimer's and Amyloid Part 1: The First Mistake
Note: If you haven’t, please read Jeanne Lenzer’s recent piece, “The Campaign to Turn Healthy People into Alzheimer’s Patients.” Jeanne is a brilliant and ferocious journalist, and her piece prompted me to dig into the research history behind it. The next few weeks will be like the Cholesterol...
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The Ghost On the Balance Sheet of Cancer Screening
Cancer screening has always hidden its dark side. Behind the simple messaging and pink ribbons is a long history of complicated truths, failed trials, and titanic spending. Now, with a novel blood test flooding the market and media misrepresenting new data, it’s a good time to clarify the…
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Surgery To Treat Knee Degeneration Increased Knee Degeneration
Dr. Katz, the attending ER doctor, walked ahead of me as we left the bedside of a woman with abdominal pain and vomiting. “What’s the most common reason for emergency surgical admission to the hospital?” Wanting to impress him, I stumbled. “Um, appendicitis?” “In the top three, but no.” Dr. Katz...
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Paxlovid: A Requiem
Paxlovid is dead. Again. Last month Pfizer’s pill for Covid failed in two large trials published together in the New England Journal of Medicine. The bigger one, with roughly 1,700 participants per group, found 14 people assigned to Paxlovid were hospitalized versus 11 in the control group. No...
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Cholesterol 5: The Power at Your End of the Stethoscope
During the Cholesterol Mistake series, we’ve walked through the unraveling of a medical dogma. First, we saw how the Lipid Hypothesis violates the seminal rule of risk factors. Next, we watched the goalposts shift from extending life to chasing non-fatal laboratory endpoints. Then, in trial...
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Checking The Math in New Statin Guidelines
Today’s piece is an interlude in the Cholesterol Mistake series (parts 1, 2, 3, and 4) which was inspired by the new AHA lipid guidelines. I got sidetracked by the figure below from those guidelines, and ended up in the weeds—deep enough to go much longer than normal. Apologies for length, hope…
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Cholesterol 4: What Went Wrong
Readers: What follows is part 4 of a series intended to defog the strange misunderstanding that is cholesterol in modern medicine. Part 1 explains a mistake that birthed the Lipid Hypothesis, part 2 explains how we failed in measuring success, part 3 walks through the data, which reveals a…
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Cholesterol 3b: A Study Straight Out Of Central Casting
I hope you will forgive the mini-barrage. I don’t usually clutter inboxes, but the timely publication of a trial that fits, hand-in-glove, with the current series was too much temptation. To understand what’s gone wrong in cholesterol research, and what my 4-part series is about, you don’t need a...
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Cholesterol 3: The Big Mistake
The AHA’s cholesterol guideline cites a large review of trials from 2012 as the principal evidence for treating cholesterol in healthy people. The following table is from that review, webfigure 9, in the supplement. It’s okay for your eyes to glaze over, I’ll summarize the important parts. People...
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Cholesterol 2: Cardiology's Nonfatal Mistake
Author note: What follows is part 2 of a series intended to summarize and explain just how, historically, we went off the rails with cholesterol. Check out part 1 here. In the early 1990s, Eugene Braunwald and the cardiology community had a problem. In the throes of a major heart attack new...
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Cholesterol 1: The First Mistake
The AHA’s new cholesterol guideline is asking professionals to start earlier, screen more, and treat cholesterol more aggressively, decades before any heart or vascular disease could plausibly occur. What follows, therefore, is the first of a series in which I will attempt to show how doctors…
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Cholesterol and Bloodletting
In the early 19th century, the French physician Pierre-Charles-Alexandre Louis did something medicine had rarely done before: he counted. At the time, bloodletting was standard. It was elegant, logical, and universally accepted. If an imbalance of humors caused disease, removing blood should fix...
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A Curious Surgery
Earlier this week media reported that Robert F. Kennedy Jr., the Secretary of Health and Human Services, had surgery to repair a torn rotator cuff. That’s interesting. Not just because I wrote about rotator cuff surgery last week. Kennedy has spent years arguing that medical treatments should be...
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Orthopedic Surgery’s Big Problem
I used to do a lot of push-ups. Then, one day, my right shoulder abruptly said no más. Coincidentally, days later I saw my doctor. To be clear, I live by “See doctors, not too much, only when sick,” but my insurance policy insists on an annual visit. So once a year I skulk into the office and…
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How to Spot a Misleading Cancer Screening Study —Before It’s Even Published
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The Case of the Missing Heart Attack
When Arthur Conan Doyle wanted Sherlock Holmes to show off, he didn’t give him a bloody fingerprint or a dropped monocle. He gave him a dog that didn’t bark. In Silver Blaze, the silence was the clue. The horse didn’t vanish because of a stranger—the stable dog knew the intruder. The absence of...
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Selling the Newest Flu Drug: A Masterclass in Distraction
When readers sent me media articles touting baloxavir (‘Xofluza’), I started looking. In the interim, Sensible Medicine, a wonderful Substack by evidence-based doctors, published a podcast, and today a written piece, recommending the drug. I believe they have it deeply wrong. Fun! Check it out,...
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Autism, Tylenol, and the FDA
Below marks my first critique of politics, and you’ll see why. For background: I have no political affiliation and do not care for party politics. Years ago I became deeply disenchanted with parties of all stripes. I do not seek a packaged bundle of beliefs or positions—I have my own. I care what...
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Vitamins, Vaccines, Alcohol, and the Flu—HodgePodge 2026
This week is an audio hodgepodge—lagniappe, if you will—a chance to discuss and explore recent headlines. Enjoy! Here are some of the relevant RT and news links. WSJ on vitamins -Vitamins piece on RT NYT on recent vaccine changes -Vaccines piece on RT (Covid for children, and related discussion)…
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Aspirin and Donald Trump: Schadenfreude Alert
“Meet Virginia” is, I believe, one of the great rock singles of recent decades. It opens with a blue-sy, core-bending bassline and a thirsty guitar riff, as Pat Monahan etches a fantasy vamp. You will not forget Virginia. “Train” is the band’s eponymous first album, and with other tracks like...
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Flu Vaccine and Dog Park Etiquette
I wrote and posted this last year, but with the respiratory season now gripping local and national stats—and me spending time with my family, including two boys with the flu—I thought I’d repost this for anyone interested. Turns out no new flu research has changed anything below. And for a list…
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Does Reducing Blood Sugar Prevent Heart Disease?
More than a decade ago, large data reviews found that using drugs to tightly control blood sugar in people with type 2 diabetes does more harm than good. In careful studies, it didn’t save lives, reduce heart problems, or prevent kidney failure. And while on rare occasions it helped to avoid or...
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The Deception of Absolute vs Relative: Once You Get It, You Can't Unget It
Get full access to Research Translation at researchtranslation.substack.com/subscribe
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The Arterial Line and the Illusion of Knowing
Every generation of medicine has its totems—high-tech gizmos that measure, promising mastery over the human form if we can just capture the numbers precisely, continuously, and in triplicate. For my teachers the Swan–Ganz, a fancy catheter snaked into the hearts of ICU patients, held this role.…
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Masks, Crocodiles, and Meds: How a Prestigious Journal Launders Research For Profits
During the pandemic we were treated to a common, but curious site in traffic: A driver gliding by, alone in the car, windows up—wearing a mask. Like Covid was hiding in the glove compartment. It’s tough to count the things that went wrong to make such a moment possible. For starters, masking…
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The Elaborate, Expensive Act We Call Cancer Screening
As you can probably tell I’m frustrated with modern medicine’s apparent immunity to evidence, so I hope you’ll suffer my rant-y, short essay this week. Research Translation is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber....
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The Myth of Early Detection
Imagine a weatherman who’s wrong 97% of the time he predicts rain. Picnics and ballgames canceled, flights rerouted, bikes garaged. Yet somehow, he has fans—devout ones—who revel in warning their neighbors about coming storms. “Stock up!” they cry, taping their windows. “Oh my! Thank you!” the...