Lou Gehrig's Disease - Motor Neuron Disease - Amyotrophic Lateral Sclerosis
Thought it had been cured by now? Still no known cause. Still no cure. Still quickly fatal. Still outrageous.

Friday, March 16, 2012

What Is A Microbrewery?

There was a Jeopardy! clue this week about an operation that produces fewer than 15,000 barrels of beer per year.

The correct response was, "What is a microbrewery?

Do we measure breweries by the number of barrels in inventory? Of course not. It's a matter of production.

A very significant and large-production brewery could have a relatively small warehouse. The warehouse alone doesn't define the impact. You need to understand input and output.

Think about the way we measure the relative impacts of diseases. It has always been the number of patients in our midst at any moment.

The ALS factory makes a similar number of new patients every year as the MS factory; however, the ALS warehouse isn't very big. We have very few patients in our midst at any moment in time. For every new patient, another patient dies to make room in that tiny "warehouse" for the newly diagnosed. The MS warehouse simply accommodates more people, and therefore we don't perceive it as "rare" as ALS.

The conventional definitions of disease impact (prevalence) look solely at the size of the warehouse. We need to look at the number of people trying to pour into a very small warehouse. The small size of the warehouse is exactly the problem that makes ALS a hugely significant disease.

We're stuck in a prevalence rut that only looks at the warehouse.

The disease with the tiny warehouse and the big production needs to make some noise. The micro warehouse doesn't mean that ALS is a small problem. It means that ALS is a huge problem relative to ALS production figures. ALS is a Budweiser disease trying to cram into a pole-barn warehouse.

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