Articles Posted in Research Studies

mal200x267In the battles between lawyers and doctors over malpractice lawsuits filed by patients harmed while seeking medical services, it may be worth heeding economists’ prescription for caregivers: Physicians, heal thy selves.

Aaron Carroll, a pediatrician and health policy expert at Indiana University, has written in the “Upshot” column of the New York Times that research shows that so-called tort “reforms”—including current initiatives on medical malpractice by the Republican-controlled Congress—may be misguided.

That’s because advocates committed to greater patient safety and improved care may find more impressive results on the medical not the legal side of “reforms,” Carroll argues. He points to persuasive data from Florida and Texas hospitals and how they fare with lawsuits and their rankings with Patient Safety Indicators (PSIs).

D-vitaminsThe health care pendulum appears to have taken a bad swing to the extreme with vitamin D.  Too many Americans may be taking unnecessary tests to see if they’re deficient of this important nutrient. Too many of us are taking unneeded amounts of it.

Federal experts report that blood tests for vitamin D among Medicare beneficiaries, most 65 and older, increased 83-fold from 2000 to 2010. Testing rates rose 2.5-fold from 2009 to 2014 among those with commercial insurance.  Among a recent sample of 800,000 patients in Maine, nearly one in five had at least one test for blood levels of the vitamin over a three-year period. More than a third got two or more tests, often for vague complaints like malaise or fatigue. Labs and doctors are telling patients who have undergone tests and who have readings in the normal range of 20 to 30 nanograms of the vitamin per milliliter of blood that they suffer a deficiency.

This all is leading to what some experts are terming a “pandemic” of over-testing, faulty diagnosis, and excess consumption of a nutrient, based on sparse evidence and misplaced belief that, as the New York Times reports, “vitamin D can help turn back depression, fatigue, and muscle weakness, even heart disease or cancer. In fact, there has never been widely accepted evidence that vitamin D is helpful in preventing or treating any of those conditions.”

http://www.protectpatientsblog.com/wp-content/uploads/sites/69/2017/04/hpv-vaccine-uptake-infographic.__v100248120-216x300.jpgMore Americans ages 18 to 59 may be infected with the human papilloma virus (HPV) than previously had been known, with 1 in 4 men and 1 in 5 women carrying high-risk strains, federal experts say.

The new findings from the Centers for Disease Control and Prevention may become a key part of campaigns to get more parents to vaccinate youngsters against HPV infections. They have been found to cause cervical cancer and have been tied to cancers of the throat, anus, and male and female reproductive organs.

HPV-related cancers are on the rise, and it is concerning that the CDC found that almost half of Americans’ are infected. But public health leaders have confronted ignorance and adult prudery—by physicians, public officials, and parents—as they try to get boys and girls, ages 11 and 12, inoculated and protected against the virus.

popularOcareRepublicans in Congress are heading home to their districts for a spring break. Will they hear again from angry constituents—but this time from zealous supporters angry that they failed to fulfill their seven-year promise to repeal and replace the Affordable Care Act aka Obamacare?

Maybe, maybe not. It seems the House GOP, especially, has remedied one of President Obama’s notable shortcomings: Republicans have churned through the ACA so thoroughly and publicly that they have convinced Americans that Obamacare’s pretty good.

It’s polling more strongly than ever, hitting a peak 55 percent approval rating. Americans say they want politicians to improve the existing ACA, not replace it with the failed American Health Care Act, aka Trumpcare.

Tom_Price_official_Transition_portrait-240x300Doctors should hold the prime role in the nation’s medical policy making, Tom Price, the orthopedist who is the Trump Administration’s top health expert, has insisted. But will the U.S. Health and Human Services Secretary heed top experts in his field, writing in some of medicine’s leading journals, that he and GOP partisans lack real evidence for their assault on patients’ rights to seek legal redress when injured by medical care?

Experts from the Stanford University’s medical and law schools have just written in The New England Journal of Medicine that “this an odd time for [Price and] Congress to be considering malpractice reform.” Why? As they noted:

Malpractice environments are currently stable: the incidence of paid claims has shrunk by half in the past decade, indemnity-payment levels have declined or plateaued, and many physicians pay less for liability insurance than they did a decade ago. Price has claimed that defensive medicine is responsible for a quarter of U.S. health care spending — about $650 billion — but the best estimates are closer to $50 billion. So is a push for liability reform at this moment inappropriate? We don’t think so.”

cybertrollOnline trolls who have wreaked havoc on traditional news sources also are bedeviling scientific and medical publications. Although experts have benefited from much greater access to information about studies and key developments in their field, they’re also struggling to ensure the articles they get on the Internet are accurate, fair, and responsible. This  battle over the credibility of information is critical not just to academics in ivy towers. It could affect science, medicine, and the public’s health care. Some recent reports illustrate why.

Let’s start with some Polish researchers’ light-hearted way to lance, in deadly serious fashion, a nasty boil in medical-scientific publication—the viral spread of “predatory” journals. These online outlets have proliferated partly in response to an imperative in academia (including in medical-scientific research) to “publish or perish.” Rising PhDs  and even many MDs are under incredible pressure to build their credentials and institutional standing by showing they can get their studies disseminated in professional journals.

But gone are the days when these publications were scarce, based often in elite institutions, and engaged in glacial peer reviews, which often were back-scratching exercises among cadres of medical or scientific good ol’ guys, all familiar with each other dating, perhaps, from their days in prep schools.

1-Britax-B-Agile-stroller-in-travel-system-mode-256x300Despite years of public and regulatory pressure, manufacturers continue to dump risky nursery products into the market, sending tens of thousands of children each year to emergency rooms for treatment. These injuries also increased markedly during the last years of a newly published study.

In a study published in the journal Pediatrics, researchers from the Nationwide Children’s Hospital said they scrutinized records on more than a million injuries of youngsters in emergency care for more than two decades (from 1991 to 2011), finding that 66,000 youngsters each year require treatment—almost an incident every eight minutes—due to issues with baby walkers, bouncers and changing tables.

Baby carriers, cribs and mattresses, and strollers caused the preponderance of injuries requiring ER attention, with 81 percent of the injuries affecting youngsters’ head, face, or neck. Most of the injuries were not major and were caused by toddlers falling from nursery products, which the researchers wrote are all too common:

repatha®-evolocumab-product-shot-5-HR-300x189With all the public attention now focused on soaring drug costs, Big Pharma just can’t seem to stay out of the spotlight. Drug makers are keeping up their eyebrow-raising actions, as are purveyors of so-called “stem cell” treatments, and it’s worth noting some of what’s happening with these:

Will insurers, MDs, patients pay for $14,000-a-year cholesterol fighting drug?

doc-sleep-300x225Must doctors be absolutely impervious to common sense improvements in the way they train their own? Their bullheadedness has reemerged with the revisited decision by a major academic credentialing group to allow medical residents yet again to work 24-hour shifts.

The Accreditation Council for Graduate Medical Education clearly was on the defensive when it issued its memo on residents’ learning and working hours, guidance that academic medical centers and hospitals nationwide will rely on in setting workplace standards for the young doctors in whose hands so many patients will put their lives. The council noted that it had established a high-level task force to reconsider criticisms of residents’ stress and overwork and how this might imperil patient care, responding to an early rollback of shift hours:

“… The Task Force has determined that the hypothesized benefits associated with the changes made to first-year resident scheduled hours in 2011 have not been realized, and the disruption of team-based care and supervisory systems has had a significant negative impact on the professional education of the first-year resident, and effectiveness of care delivery of the team as a whole. It is important to note that 24 hours is a ceiling, not a floor. Residents in many specialties may never experience a 24-hour clinical work period. Individual specialties have the flexibility to modify these requirements to make them more restrictive as appropriate, and in fact, some already do. As in the past, it is expected that emergency medicine and internal medicine will make individual requirements more restrictive.”

rheumatoid-arthritis-hands-2-300x200More than 50 million Americans struggle with arthritis: Three in 10 of them find that stooping, bending, or kneeling can be “very difficult.” One in five can’t or find it tough to walk three blocks, or to push or pull large objects. Grown-ups with arthritis are more than twice as likely to report fall injuries.  Arthritics have lower employment rates, and a third of them 45 and older experience anxiety or depression. So what to do about this leading cause of disability, a painful condition whose woes will only grow as the nation ages and already is responsible for $81 billion in direct annual medical costs?

Experts from the Centers for Disease Control and Prevention recommend that those with the most common arthritis forms—osteoarthritis, rheumatoid arthritis, gout, lupus, and fibromyalgia—avoid a reflexive reach for pain-killing pills. Instead, they must keep moving. “Physical activity,” CDC experts said in a new study, “is a proven strategy for managing arthritis. …” It also “has known benefits for the management of many other chronic conditions” that also afflict those with arthritis—including heart disease, diabetes, and obesity.

Although arthritis commonly is associated with seniors, the majority of adults with the condition, more than 32.2 million Americans, are younger than 65. Arthritis is much more common among women than men, and much less so among Hispanics and those of Asian descent that among whites. It afflicts those with a high school or less education more than those who completed college or higher.

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