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Medical-evidence giant Cochrane battles funding cuts and closures

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41–50 of 73 posts

Re: Medical-evidence giant Cochrane battles funding cuts and closures

#41

This may seem like bad news, but as a grad student studying evidence synthesis I can say that there is a silver lining here. The quality of studies in systematic inputs is low and even Cochrane's reviews have been critiqued for missing things. It's a big factory that hasn't fundamentally innovated how research is synthesized. There are newer forms of synthesis like realist reviews, meta-modeling, and model-driven met…

Totally agree. Cochrane is a dinosaur and can do more harm than good.

Re: Medical-evidence giant Cochrane battles funding cuts and closures

#42

This may seem like bad news, but as a grad student studying evidence synthesis I can say that there is a silver lining here. The quality of studies in systematic inputs is low and even Cochrane's reviews have been critiqued for missing things. It's a big factory that hasn't fundamentally innovated how research is synthesized. There are newer forms of synthesis like realist reviews, meta-modeling, and model-driven met…

I don't remember hearing anything about Cochrane in mainstream news until they put out an unfavorable review on the effectiveness of mask usage during covid 19.

Re: Medical-evidence giant Cochrane battles funding cuts and closures

#43

Earlier quoted context omitted.

https://www.salary.com/research/salary/benchmark/physician-i... $230k, which when indexed by median household income, is comparable to the UK at 100k (I assume you used dollars? If not that’s $126k). Edit: I’m not making any tax statements because taxes are unavoidable and applied to everyone in the nation, so are part of the indexing. That said US taxes sound comparable or more in some areas (taxes in NYC for instan…

> taxes in NYC for instance can exceed 50% Is that a marginal rate or total tax burden?

Total, it’s a combination of federal, state, and city income tax plus social security etc.

Re: Medical-evidence giant Cochrane battles funding cuts and closures

#44

Earlier quoted context omitted.

Except this sort of funding has multiplicative effects. Funding for a single doctor helps only that doctor and their patients. Funding for this sort of work helps all doctors and all patients. When austerity cannibalizes your force multiplying efforts, that’s truly the end. Edit: For context the thing you linked says UK medical residents (in US language) make $36k/year, and the median household income is also $36k/y[…

What's the difference in pay between a "full doctor" as you put it consultant (UK) or attending (US)? UK a consultant earns £100k pretax and pays approximately 30% net tax rate and 60% marginal rate. What about US? Apparently family medicine in the US brings in 130% more than the equivalent in the UK (GP which makes up half of all UK doctors). https://revisingrubies.com/us-vs-uk-doctors-salary/ That's truly astoundin…

However the median household income is half the US. You can’t compare nominal values.

Re: Medical-evidence giant Cochrane battles funding cuts and closures

#45

Earlier quoted context omitted.

Except this sort of funding has multiplicative effects. Funding for a single doctor helps only that doctor and their patients. Funding for this sort of work helps all doctors and all patients. When austerity cannibalizes your force multiplying efforts, that’s truly the end. Edit: For context the thing you linked says UK medical residents (in US language) make $36k/year, and the median household income is also $36k/y[…

What's the difference in pay between a "full doctor" as you put it consultant (UK) or attending (US)? UK a consultant earns £100k pretax and pays approximately 30% net tax rate and 60% marginal rate. What about US? Apparently family medicine in the US brings in 130% more than the equivalent in the UK (GP which makes up half of all UK doctors). https://revisingrubies.com/us-vs-uk-doctors-salary/ That's truly astoundin…

> UK a consultant earns £100k pretax

While it depends on the specialty, in Australia it is not uncommon for consultants to be on AUD 300-400K (= 150-200K GBP, 200-250K USD). I don't understand why salaries in the UK are so low, even for highly educated professionals.

My grandfather was a GP. He hated the NHS so much, he left the UK and never went back. Pay was likely a factor, but he also viewed the NHS as a denial of his professional freedom. While Australia eventually adopted something akin to the NHS (Medicare), I don't think he objected so much to that, since it involved less government control over the how of his job.

Re: Medical-evidence giant Cochrane battles funding cuts and closures

#46

This may seem like bad news, but as a grad student studying evidence synthesis I can say that there is a silver lining here. The quality of studies in systematic inputs is low and even Cochrane's reviews have been critiqued for missing things. It's a big factory that hasn't fundamentally innovated how research is synthesized. There are newer forms of synthesis like realist reviews, meta-modeling, and model-driven met…

I don't remember hearing anything about Cochrane in mainstream news until they put out an unfavorable review on the effectiveness of mask usage during covid 19.

A very unfortunate, badly run meta analysis as I understand it which fundamentally undermined trust in their governance because it was so easily critiqued. I haven't seen a robust defence of that one.

Re: Medical-evidence giant Cochrane battles funding cuts and closures

#47

> Cochrane says that the lost NIHR funding — around £4.2 million (US$5.3 million) — does not affect its core income, which was £8.9 million in 2022. However, a more existential threat looms. Around £6.8 million of that core income came from subscriptions to the Cochrane Library, but Cochrane aims to make all its reviews open access by 2025 What the actual fuck, those are peanuts for any single country or health care…

A lot of folks are now angry that Cochrane went slightly against masks. There is a religious war unfortunately. There is even one comment here along that line. https://www.forbes.com/sites/brucelee/2023/03/11/cochrane-sa...

As I've said above it was subject to pretty hefty critique and I've never seen a robust defence. They meta combined papers which were not well grounded and it was unlike its RCT normal approach.

Re: Medical-evidence giant Cochrane battles funding cuts and closures

#48

Earlier quoted context omitted.

What's the difference in pay between a "full doctor" as you put it consultant (UK) or attending (US)? UK a consultant earns £100k pretax and pays approximately 30% net tax rate and 60% marginal rate. What about US? Apparently family medicine in the US brings in 130% more than the equivalent in the UK (GP which makes up half of all UK doctors). https://revisingrubies.com/us-vs-uk-doctors-salary/ That's truly astoundin…

However the median household income is half the US. You can’t compare nominal values.

My brother has lived in all three of the US, UK and Australia, doing non-professional jobs (construction, agriculture, gardening, cellar hand in the wine industry).

He didn't last long in London – he was working as an unskilled labourer in the construction industry, the pay was terrible, and the basic necessities of life were so expensive, he could hardly afford to eat. He'd worked similar jobs in Australia and got paid a lot more, and found life more bearable.

Some countries pay high because everything is expensive. Some countries pay low because everything is cheap. The UK seems to be a place where people get paid low because everything is expensive.

Re: Medical-evidence giant Cochrane battles funding cuts and closures

#49

Earlier quoted context omitted.

However the median household income is half the US. You can’t compare nominal values.

My brother has lived in all three of the US, UK and Australia, doing non-professional jobs (construction, agriculture, gardening, cellar hand in the wine industry). He didn't last long in London – he was working as an unskilled labourer in the construction industry, the pay was terrible, and the basic necessities of life were so expensive, he could hardly afford to eat. He'd worked similar jobs in Australia and got p…

Absolutely true. But saying UK doctors are underpaid because they’re paid half of a US doctor while ignoring everyone is paid half of a US person for everything is disingenuous. Everyone in the UK is inexplicably underpaid, and everything is expensive.

What was your brothers take on the US?

Re: Medical-evidence giant Cochrane battles funding cuts and closures

#50
post #10

Earlier quoted context omitted.

>misleading review on mask effectiveness (with Tom Jefferson)? Can you provide more context for this? What was the study? Why was it misleading?

As the sibling in the thread detailed: https://www.factcheck.org/2023/03/scicheck-what-the-cochrane... The misleading part was done by Tom during an interview with a major media organization with a similar established narrative.

To be honest, that "factcheck" demonstrates the value of performing well-constructed systematic reviews, i.e. a clear and unbiased assessment of what the pertinent studies do and do not support.
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