A Look at the ASA Puzzle

We saw in the article on the AHA (American Heart Association) that the medical science puzzle is not a single puzzle, but a puzzle made of other puzzles. As such, our analysis lead us to look at the ASA (American Stroke Association) and the ADA (American Diabetes Association) which will will examine in the next article. Our examinations, at this point, are only preliminary, just enough to get a general picture.

The place to begin, is where we found the best in formation about the AHA, on the website under about us. Here we find a history, and find two points of interest.

1.

1997. The Stroke Division was formed as a result of a recommendation made by the Stroke Positioning Task Force. The Stroke Division is a cross-functional work group with representatives from all of the key work process groups operating throughout the American Heart Association National Center. (i.e., Consumer Health Marketing, Communications, Advocacy, Scientific Meetings, and Research)

The purpose of the Stroke Division was to help the American Heart Association increase its strategic focus in stroke and maximize and integrate stroke messages through all appropriate American Heart Association programs, products and services.

Next, the American Heart Association's national Board of Directors considered changing the corporate name to include stroke, but chose instead to change the name of the newly created Stroke Division. American Heart Association volunteers and market research supported this decision.

1998. The Stroke Division was renamed the American Stroke Association, a division of the American Heart Association. This change was made to:

• Elevate the name to match the organizational commitment to stroke.
• More closely align the Stroke Division?s programming activities with the American Heart Association?s newly established goals and strategies hierarchy.
• Reinforce stroke as a priority among the general public, internal staff and volunteers.
• Increase recognition among the general public that the American Heart Association is the organization to turn to for information about stroke.
• Increase the American Heart Association?s ability to marshal resources at all levels to achieve of the long-range stroke impact goal.

2.

1999. The Bugher Foundation made a major commitment to stroke research with the American Stroke Association by committing $7.5 million over an eight-year period. The American Stroke Association focused its energy on developing or revising more than 40 programs, products and services relating to stroke. One such product, the Acute Stroke Treatment Program, was launched to give hospitals the tools needed to implement primary stroke centers.

The first point tells us that the ASA is a division of the AHA and how it emerged from the AHA and became the ASA. The second tells us it's function, from which the last line causes my the most problems. As with the AHA, we see a large chunk of their work (and expenses) goes into these professional services. What troubles me, and is the primary question that comes to mind. Why aren't the MDs learning (being trained) in medical school? Further, it calls into question the standard(s) of licensing for MDs. The reason being, it seems to be falling to the AHA, the ASA and other such organizations to properly train MDs.

The next issue comes from the fact the 2004 annual report reviewed for the AHA, is also for the ASA, this means that the research funds are (with all things being equal) just 50% of the total for each area. The minimal 20% of the income that is used for research must be shared between both cardiology research and stroke research - leaving only 10% for each. This is actually a substantial decrease in the total funding available. This creates the environment described in the journal Science and in the past article (in this journal) Science is noPlace for Fudge that produces the problematic "forward-looking" research. Research that produces favorable reports for those who provide the funding. This is demonstrated by the recent concerns about the drug Crestor. Richard H. Karas, M.D., Ph.D., director of preventive cardiology and the Woman's Heart Center at Tuft-New England Medical Center, wrote a paper issuing a warning about the safety of the drug Crestor The paper, was published in the AHA journal Circulation, by Elliott Antman, M.D., of Harvard Medical School, director of the coronary care unit at Brigham and Woman's Hospital in Boston and a Circulation senior associate editor. Who admitted "fast tracking" the paper to publication. Further, the author was found, on CNBC, to have been funded by a group with interests in a class action lawsuit against AstraZeneca, the maker of Crestor. Who, promptly produced medically backed arguments of itsown.