April 6, 2011

No Experience Needed

The infamous Washington State 'No Strips For Kids' idea was the subject of a post I read today. The gist was that in part this may have been the result of a system that considers it a conflict of interest to have specialist with clinical experience in a given field participate in how that field get managed. So no endos when considering strip use for effective diabetes management. I would love to know if these assertions are accurate. If so:


That is Moronic.

Now in all fairness I read this on the Internet so there is a fair shot that it is not entirely accurate. The dude who wrote it flat out says he didn't have time to fact check it. Here is the bit from Forbes.

This gets me to a recent pair of Wall Street Journal editorials on the Washington state health panel, called the Health Technology Assessment committee, which was considering denying reimbursement for test strips that help diabetic children self-monitor their blood sugar levels. (Coincidentally, last September, Leah Hole-Curry, director of HTAC, was appointed to the governing board of President Obama’s comparative effectiveness research program, the Patient-Centered Outcomes Research institute.)
The HTAC had previously suggested that there wasn’t enough evidence that self-monitoring was clinically beneficial. But this was, in part, an unfair criticism: it’s difficult to conduct a trial in which you ask diabetic children not to monitor their blood sugar levels. The idea that poorly monitoring one’s blood sugar levels is a good thing defies decades of understanding.
So why would the HTAC consider denying reimbursement for test strips? “One reason that the panel chose to prosecute this case,” suggests the WSJ, “may be that its strict conflict-of-interest rules prevent specialists from setting priorities. The 11-member Health Technology Assessement [committee], naturally, does not include an endocrinologist or any other physician with relevant clinical experience whose expertise might pollute the findings.”
I don’t have time to dig into HTAC’s conflict-of-interest rules myself to see whether or not this is the case.