SF bro "unleashes AI agents on his genome" and finds "the most useful medical advice he's ever received". 🤯
The advice: he has a predisposition to melanoma
The SF bro's skin:
That’s a compliment.
These are organizations built on groupthink and protecting the status quo. They steer biomedical research down very narrow paths, ignore a lot of the more promising directions, and then close ranks when anyone points it out.
They operate as large nonprofit corporations, with six and seven figure executive compensation and active lobbying in Washington, while using patients as cover to protect their own financial interests.
Trump's pick to head the CDC, Erica Schwartz, would likely be a disaster.
Schwartz led nationwide Covid-19 vaccine deployment and her long track record of directly issuing rights-crushing civilian and military vaccine mandates, including mandating injection of smallpox, anthrax, and flu vaccines into U.S. Forces, and discipling those that refused, reflects she lacks the basic ethics and morals to lead the CDC.
This agency does not need another cheerleader for industry; it needs a regulator over industry.
Her prior promotion, let alone mandates, of nearly a dozen different vaccines leave little hope she will objectively oversee CDC’s vaccine program which has, between 1986 and the 2026, gone from 3 injections to 29 injections, including in utero, by an infant’s first birthday, while chronic childhood disease has gone from under 10% to over 40% of children, most related to immune system dysregulation.
SOURCES:
For examples of Schwartz mandating vaccines, see:
https://media.defense.gov/2019/Feb/25/2002092737/-1/-1/0/CI_6230_10B.PDF
https://media.defense.gov/2019/Feb/19/2002090711/-1/-1/0/CI_6230_3D.PDF
https://www.dcms.uscg.mil/Portals/10/CG-1/cg112/cg1121/docs/aig/2015/R%20211759Z%20JUL%2015.pdf
For increase in vaccine schedule, see:
https://www.cdc.gov/vaccines/schedules/images/schedule1983s.jpg(https://perma.cc/E74A-WT3U); https://www.cdc.gov/vaccines-pregnancy/hcp/vaccination-guidelines/index.html (https://perma.cc/DAX5-MKSW); https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-age.html (https://perma.cc/TM2U-2HBQ). The 29 injections in 2026 only include routine vaccines and the Covid-19 vaccine. Also see table on page 37 of Vacines, Amen.
For rise in chronic health, see:
https://pubmed.ncbi.nlm.nih.gov/3944229/ (https://perma.cc/NGA9-93KW)(“According to data from the National Health Interview Survey (NHIS) [1979-1981] over two million children under 17 years (3.8%) are afflicted by chronic conditions that cause some limitation of activ-ity.”); https://pmc.ncbi.nlm.nih.gov/articles/PMC1646496/ (https://perma.cc/KN4A-94TV) (“Data from the National Health Interview Survey indicate that the prevalence of activity-lim-iting chronic conditions among children under age 17 years doubled between 1960 and 1981, from 1.8 to 3.8 per cent.”); https://pubmed.ncbi.nlm.nih.gov/9551003/ (https://perma.cc/JTZ5-JBNK) (Among “children younger than 18 years who were included in the 1992-1994 National Health Interview Survey … [a] significant proportion of children, estimated at 6.5% of all US children, experienced some degree of disability.”); https://www.cdc.gov/chronic-dis-ease/about/index.html (https://perma.cc/N4GT-38L2) (“Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both.”); https://pubmed.ncbi.nlm.nih.gov/21570014/ (https://perma.cc/62JZ-SRY4) (The 2007 National Survey of Children’s Health found that: “An estimated 43% of US children (32 million) currently have at least 1 of 20 chronic health conditions assessed, increasing to 54.1% when overweight, obesity, or being at risk for developmental delays are included.”); https://pubmed.ncbi.nlm.nih.gov/40058728/ (https://perma.cc/3VHC-L7H2) (Only considering a “condition that is typically pediatric-onset and expected to be persistent or severe” or a “functional/ activity limitation related to a condition that is typically pediatric-onset and expected to be persistent or severe” from the National Health Interview Survey data it found that children falling into this category “has risen from 22.57% in 1999/2000 to 30.21% in 2017/2018”); https://www.cdc. gov/school-health-conditions/chronic-conditions/index.html (https://perma.cc/298V-C59B) (“In the United States, more than 40% of school-aged children and adolescents have at least one chronic health condition”); See Part IV of Vaccines, Amen for additional sources.
For relationship of chronic health issues to immune system dysregulation, see among other sources:
https://pubmed.ncbi.nlm.nih.gov/30741719/(https://perma.cc/P4L2-9KPZ); https://pubmed.ncbi.nlm.nih.gov/28849096/ (https://perma.cc/HZ8E-ETE5); https://pub-med.ncbi.nlm.nih.gov/39426507/ (https://perma.cc/BTM6-HFF8); https://pmc.ncbi.nlm.nih.gov/articles/PMC5373490/ (https://perma.cc/KZS3-5ERS); https://pubmed.ncbi.nlm.nih.gov/39481220/ (https://perma.cc/H9QN-U2E7); https://pmc.ncbi.nlm.nih.gov/articles/PMC10906461/ (https://perma.cc/LV9U-GQKE); https://pubmed.ncbi.nlm.nih.gov/39681901/ (https://perma.cc/LN7W-ZAX8). See Part IV of Vaccines, Amen for additional sources.
https://www.cnn.com/2026/04/16/health/erica-schwartz-cdc-director
Love this. I continue to be amazed that we are afraid of self-driving cars because they are not perfect, even though they are so much better than we are.
If you thought I was hard on the Hi-PEITHO trial of ultrasound-fibrinolytic therapy of PE https://www.sensible-med.com/p/at-acc26-the-hi-peitho-trial-is-in
Then do listen to the next Fortnight In Medicine podcast on @Sensible__Med OMG
Firstly, this is a pretty mean and negative take. I’d invite you to level up your discourse.
Secondly, since you won’t say it, I will. The reason you hate Endpoint Arena is that it makes predictions measurable. People like you have built careers as gatekeepers of biotech without being consistently scored or held accountable. A system that tracks forecasts publicly challenges your authority and reduces your control.
Thirdly, let’s just test it. We can backtest and forward test your predictions vs the “degenerates” who “log your web site[sic]” on a public scoreboard. Accuracy over time settles this better than tweets. We’ll put the scoreboard on the site so anyone can keep track.
Pretty sure that reading this article shortened my life.
https://www.nytimes.com/2026/04/07/well/longevity-medicine-definition.html
In our new paper, w/ Sunny Kim and @VPrasadMDMPH, we explain why observation should remain the standard of care in high-risk Smoldering Myeloma
What is Smoldering Myeloma?
How OpenEvidence failed?
How key data lacking from NEJM were made available by the german HTA agency?
🧵1/
This is exactly the kind of hype and misrepresentation that has defined cancer research and oncology for decades.
After 40+ years of work and well over $100B in taxpayer funding, what’s being presented as a revolution is a survival improvement of about 6–7 months.
Patients don’t even get an additional birthday.
This is now being hyped by the biotech industry and amplified by academic scientists as if it represents some fundamental breakthrough. It doesn’t.
What’s even more concerning is that almost no one is calling this out. The same narrative gets repeated, the same approaches get reinforced, and the same cycle continues.
Billions of taxpayer dollars will continue to fund this. Venture capital will continue to flow into biotech companies built around these claims. Pharma will continue to allocate time and resources here. Healthcare expenses for the public will continue to be greater than ever.
Meanwhile, entire areas of cancer research and oncology practice—particularly early detection and prevention—remain neglected.
People freaking out about this are acting like hedge funds and other quant firms aren't already implicitly betting on clinical trials
Honestly it's a messed up system, but perhaps it is better to be open about it than closed.
Quick run down of the features on Endpoint Arena, the prediction market for clinical trials.
the home page has all the trials:
Kevin Hall made a big public show including a media tour through CNN and NY Times about resigning from the NIH. He greatly exaggerated and resorted to hyperbole about a purported loss of freedom under HHS.
His freedom appears to have been on sale for the price of a pharma compensation package.
This fellow made a big public show of leaving the @NIH over "academic freedom" and "censorship." A year later, he is working for Big Pharma. I wonder how much academic freedom is allowed at AstraZenica?
It is his right to do so, of course. But a few apologies are owed. Perhaps @nytimes could do a follow-up story. @alicegcallahan
How was this published? You gave this vaccine to 46 immunosuppressed patients and determined it was safe?
Safety of MMR vaccination in patients with myeloma receiving daratumumab after autologous stem cell transplantation | https://ashpublications.org/bloodneoplasia/article/doi/10.1016/j.bneo.2026.100220/567198/Safety-of-MMR-vaccination-in-patients-with-myeloma
They did not do themselves any favors with this one: https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm
Guidelines are like dinosaurs. They get bigger and bigger until they go extinct.
Median age 71. The risk of non colorectal cancer death at 10 years was not 9x but 96x the risk of colorectal cancer death
What a fabulous study! They should follow this up w 55-70 year olds next
Hubris. Risk illiteracy. Main reasons to have a healthy body probed or imaged
Then vs now: from “hardened stance under Vinay Prasad” to “don’t blame him.”
Please stop making me do this! Assuming she fully defers all loan payments 3 years, she’d be at $471,098. That’s a big number but is very doable given that it entails making interest payments of $27,677 per year while making an average of $650k per year.
Let’s just say, there’s a lot not to like in the new lipid guidelines.
https://open.substack.com/pub/sensiblemed/p/guidelines-evidence-based-medicine?r=n8zko&utm_medium=ios
Excellent Friday post from @adamcifu on @Sensible__Med
Guidelines have indeed run amok
If this is the best that computers can do reading ECGs in 2026, I am not too worried about being replaced by them . . . @drjohnm @anish_koka @AndrewFoy82
Appreciate that perspective, but the MMWR is not an independent scientific journal, it is effectively a govt agency newsletter. Ensuring that information published within it is accurate and reliable seems within the purview of the CDC director. I would assume that CDC scientists are free to submit and publish anything they like in the peer-reviewed scientific literature, just as NIH scientists are.
Ex-Sen. Ben Sasse on the 'nasty drug' for Stage 4 cancer that makes him 'bleed out of a whole bunch of parts' https://trib.al/F3digJ7
R² = 24.31% with genetics
R² = 24.17% without genetics
(supp table 22, wt)
The finding is mechanistically interesting, but its incremental predictive value is very small. Practically sex, drug type, dose, treatment duration, T2DM or not, and ancestry are much stronger predictors
The average physician has an NPV of around $10M, and neurosurgeons make way more than the average. Neurosurgeons work a ton of hours and undergo many years of training. However, they are extremely well compensated for that, as they earn nearly $1 million/year on average.
nothing is learned
Sample size of alternative therapy are implausibly very tiny
Such info is poorly captured in these databases
Way too much unmeasured confounding
Perfect example of how this should NOT influence clinical practice & is NOT hypothesis generating
See my AAOx2 post
https://open.substack.com/pub/aaox2/p/flawed-research-is-not-hypothesis?r=771z0v&utm_campaign=post&utm_medium=web
The illusion of PFS explained for @Sensible__Med https://open.substack.com/pub/sensiblemed/p/the-illusion-of-progression-free?r=4uml45&utm_medium=ios
This is a fascinating. I, naively, assumed all pts on thyroid replacement needed it. Gosh, 1 in 4 pts could stop the med
I bet if you used a proper placebo the discontinuation rate would be even higher
I also wonder how many other meds such a process would be feasible for
Please help David Sinclair find the parties responsible for circulating exaggerated out-of-context age-reversal clips on the internet.
🔥 “The influx of these patients to the medical services was resisted by the medical residents and interns. On June 30th, 1981, the entire medical training program signed a resolution denouncing liver transplantation as an unrealistic objective and an “unethical pursuit.” Starzl shrugged, and from that point on admitted all these patients to his own surgical service, which at the time consisted of two surgical residents and two attendings.”
Sometimes (maybe lost of times..🫣) the one giving the podium presentation or the first NEJM author didn’t even enroll a single pt! So, they didn’t even have to think about the problem your are stating. 😢
Cancer drugs are often approved on the basis of surrogate endpoints: variables that are proposed to predict survival or quality of life
These surrogates accelerate approvals and get drugs on the market, but they're poorly vetted
In oncology, most surrogate-based approvals fail:
The Moderna mRNA flu shot is an extreme example of regulatory capture. The shot doesn't work but Blackstone CEO & GOP megadonor Stephen Scharzman called the White House and told them to 'get 'er done.' Marty Makary knows he will be fired if he doesn't approve it. Dems are silent.
Must be nice to be a medical journal editor and publish your own research in your own journal.
Academic medicine awards trialists with promotions, papers, podium speeches for conducting trials they would not enroll their loved one in due to the poor quality of the control arm. A quick glance at http://clinicaltrials.gov shows many such trials are still enrolling in the US
The NIH Office of Science Policy has ~50 employees.
So why has this office been unable to generate a simple policy on publication fees?
Thousands of iterations of this policy could be drafted in seconds using ChatGPT, at no cost—yet this office, which operates at a cost of millions per year, has still not delivered one.
An essay that I hope the next generation of applicants will read.
https://open.substack.com/pub/sensiblemed/p/a-referendum-on-the-self-on-entering?r=n8zko&utm_medium=ios
Vinay Prasad’s exit from the FDA isn’t the “good riddance” story some media coverage has painted. In the wake of it, there’s real concern among many about what it means that someone with his background and approach to evidence standards wasn’t retained, and many came away from the media coverage of his tenure feeling cynically enlightened by it.
I saw him as a once-in-a-lifetime opportunity for FDA reform that was squandered. This isn’t fawning. I can admire someone and stay analytically grounded. This is about regulatory direction and evidence standards.
I wrote more about this earlier, and I still think it’s worth revisiting.
US ID community, ACP, and AAP continue to insist on necessity of universal annual covid boosters. Meanwhile, public demand has fallen so low that manufacturers cannot enroll trials.