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Top 6 articles by James T.

Science Policy

A Diabetes Group Fought for Editorial Independence in 2015. Now It's Suppressing Its Own. The Difference Is Who It Costs.

Defending a principle when it costs nothing reveals little. The ADA's reversal from defender to suppressor of editorial independence shows what happens when upholding it would cost something real.

By James T.·9 min read
Pharma Regulation

The FDA Halted Every Trial Using One Vector and Restored Only One. The Inconsistency Is More Defensible Than It Looks.

Safety risk from a shared vector genuinely aggregates across programs while disease-specific benefit does not. The real grievance isn't the inconsistency, it's a process that counts the harm of acting and ignores the harm of waiting.

By James T.·9 min read
Clinical Trials

Novo Nordisk's Drug Lowered Inflammation Perfectly. It Prevented Zero Heart Attacks. That Gap Is Why Outcomes Trials Exist.

A hazard ratio of 0.99 sitting under a perfect-looking set of inflammation numbers is the cleanest possible demonstration that moving a biomarker and helping a patient are not the same thing.

By James T.·8 min read
Public Health

Syphilis Is Curable With a Cheap, 80-Year-Old Shot. Every Reason It's Spreading Is a System Failure.

Nothing about syphilis got harder to treat. What decayed is everything around the cure: manufacturing resilience, the one drug pregnant patients have no substitute for, and the surveillance that finds hidden cases.

By James T.·9 min read
Clinical Trials

The FDA's Advisers Backed a Drug They Couldn't Fully Interpret and Rejected One They Called a "Mirage." The Difference Is Trust.

An honest design limitation is forgivable. A benefit that appears only after the analysis plan changed after the fact is not. That distinction, not data quality alone, explains why one panel voted 10-3 to endorse and the other 3-9 to reject.

By James T.·8 min read
Health Policy

Cassidy Traded His Vote for Assurances Once Before. Those Reportedly Broke. He Just Did It Again.

A confirmation vote is a one-time, irreversible payment. A private promise is a revocable one. Cassidy has now made that exact trade twice with the same department, and the first round reportedly did not hold.

By James T.·8 min read