Person: Jones, David
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Jones, David
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Publication Inherently Limited by our Imaginations: Health Anxieties, Politics, and the History of the Climate Crisis(2024-09-19) Jones, David; Satin, DavidPublication Coronary artery disease and the contours of pharmaceuticalization(Elsevier BV, 2015) Pollock, Anne; Jones, DavidCoronary artery disease (CAD) has dominated mortality for most of the past century, not just in Europe and North America but worldwide. Treatments for CAD, both pharmaceutical and surgical, have become leading sectors of the healthcare economy. This paper focuses on the therapeutic landscape for CAD in the United States. We hope to add texture to the broader conversation of pharmaceuticalization explored in this issue by situating pharmaceutical therapies as just one element in the broader therapeutic terrain, alongside cardiac surgery and interventional cardiology. Patients with CAD must navigate a therapeutic landscape with three intersecting paths: lifestyle change, pharmaceuticals, and surgery. While pharmaceuticals are often seen as a quick fix, a way of avoiding more difficult lifestyle changes, it is surgery and angioplasty that promise patients the quickest fix of all. There also is another option, often overlooked by analysts but popular among physicians and patients: inaction. The U.S. context is often critiqued as a site of excessive treatment with respect to both drugs and procedures, and yet there is deep stratification within it – over-treatment in many populations and under-treatment in others. People who experience the serious risks of CAD do so in a racialized terrain of durable preoccupations with difference and unequal access to care. While the pharmaceuticalization literature disproportionately attends to lifestyle drugs, which some observers consider to be medically inappropriate or unnecessary, CAD does remain the leading cause of death. Thus, the stakes are high. Examination of the pharmaceuticalization of CAD in light of surgical treatments and racial disparities offers a window into the pervasiveness and persuasiveness of pharmaceuticals in an increasingly consumer-driven medicine, as well as the limits of their appeal and their reach.Publication Therapeutic Evolution or Revolution? Metaphors and Their Consequences(University of Chicago Press, 2016) Jones, DavidEvolution and revolution are both models of change over time. It is easy to see the appeal of a claim of revolution for scientists and for their historians: it pronounces a radical break from the past, confident and triumphant. Progress is implied by the decisiveness of the rupture. Such rhetoric is good for marketing, especially when contrasted against the cautious gradualism of evolution. But evolution has its own appeals, especially its reassuring connotations of progressive improvement. It is not enough simply to debate what counts, or not, as revolution or evolution. Instead, much can be gained through serious engagement with the theory and language of revolution and evolution in pursuit of the best possible accounts of scientific change.Publication Doctors and the Dangers of Driving(New England Journal of Medicine (NEJM/MMS), 2014) Jones, DavidPublication Olympic Medicine(New England Journal of Medicine (NEJM/MMS), 2012) Jones, DavidPublication The Burden of Disease and the Changing Task of Medicine(New England Journal of Medicine (NEJM/MMS), 2012) Jones, David; Podolsky, Scott; Greene, JeremyPublication How much CABG is good for us?(Elsevier, 2012) Jones, DavidPublication Is an Ounce of Prevention Worth an Ounce of Cure? Explaining the Decline in Cardiovascular Mortality, 1964-2010(2011) Greene, Jeremy; Jones, DavidMortality from coronary heart disease in the United States has fallen 60% from its peak. Cardiologists and epidemiologists have debated whether this decline reflects risk factor control or the power of medical therapeutics. Attempts to resolve this debate and guide health policy have generated sophisticated datasets and techniques for modeling cardiovascular mortality. Neither effort, however, has provided specific guidance for health policy. Historical analysis of the decline debate and the development of cardiovascular modeling offers valuable lessons for policymakers about tensions between medical and public health strategies, the changing meanings of disease prevention, and ability of evidence-based research and models to guide health policy. Policymakers must learn to open up the black box of epidemiological models -- and of their own decision making processes -- to produce the best evidence-informed policy.Publication How Personalized Medicine Became Genetic, and Racial: Werner Kalow and the Formations of Pharmacogenetics(Oxford University Press (OUP), 2013) Jones, DavidPhysicians have long puzzled over a well-known phenomenon: different patients respond differently to the same treatment. Although many explanations exist, pharmacogenetics has now captured the medical imagination. While this might seem part of the broader interest in all things genetic, the early history of pharmacogenetics reveals the specific factors that contributed to the emergence of genetics within pharmacology. This paper examines the work of one pioneering pharmacologist, Werner Kalow, to trace the evolving intellectual formations of pharmacogenetics and, in particular, the focus on race. Working in the 1950s and 1960s, Kalow made three arguments to demonstrate the relevance of genetics to pharmacology, based on laboratory techniques, analogies to differences between other animal species, and appeals to the logic of natural selection. After contributing to the emergence of the field, Kalow maintained his advocacy for pharmacogenetics for four decades, collecting more evidence for its relevance, navigating controversies about race and science, and balancing genetics against other possible explanations of patient variability. Kalow's work demonstrates the deep roots of the genetic and racial preoccupations in pharmacology. Understanding this history can restore attention to other explanations of individuality in medical practice, something of increasing importance given the current interest in personalized medicine.Publication Detection and characterization of translational research in cancer and cardiovascular medicine(BioMed Central, 2011) Jones, David; Cambrosio, Alberto; Mogoutov, AndreiBackground Scientists and experts in science policy have become increasingly interested in strengthening translational research. Efforts to understand the nature of translational research and monitor policy interventions face an obstacle: how can translational research be defined in order to facilitate analysis of it? We describe methods of scientometric analysis that can do this. Methods We downloaded bibliographic and citation data from all articles published in 2009 in the 75 leading journals in cancer and in cardiovascular medicine (roughly 15,000 articles for each field). We calculated citation relationships between journals and between articles and we extracted the most prevalent natural language concepts. Results Network analysis and mapping revealed polarization between basic and clinical research, but with translational links between these poles. The structure of the translational research in cancer and cardiac medicine is, however, quite different. In the cancer literature the translational interface is composed of different techniques (e.g., gene expression analysis) that are used across the various subspecialties (e.g., specific tumor types) within cancer research and medicine. In the cardiac literature, the clinical problems are more disparate (i.e., from congenital anomalies to coronary artery disease); although no distinctive translational interface links these fields, translational research does occur in certain subdomains, especially in research on atherosclerosis and hypertension. Conclusions These techniques can be used to monitor the continuing evolution of translational research in medicine and the impact of interventions designed to enhance it.