Articles Posted in Research Studies

Collinslab-150x150Mukamal-144x150The National Institutes of Health, perhaps the world’s leading medical research institution, has moved fast to try to fix self-inflicted damage to its reputation caused by a controversial $100-million study on alcohol and its harms.

NIH Director Francis Collins halted the study, and an advisory group backed his action, lambasting researchers for soliciting funding and counsel from the alcohol industry for a work that purported to answer key and fundamental questions about booze but from its outset leaned toward seeing benefit in moderate drinking.

The New York Times deserves credit for digging into the dubious  actions by researchers supported by the National Institute on Alcohol Abuse and Alcoholism, an arm of NIH.

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Breast cancer patients may get a welcome respite from one of the disease’s dreaded aspects — its aggressive and costly treatments. New research suggests that thousands of women with early-stage breast cancer who now are told to get chemotherapy don’t need it, while a larger, significant number of patients can benefit by halving the time they’re told to take an expensive drug with harsh side-effects, especially for the heart.

Although this information should be taken in a positive light, patients should consult with their doctors about appropriate treatment for their individual case.

The prospective shifts in breast cancer treatment, based on new findings, may add to rumblings and criticisms about over-treatment and whether doctors have taken too lightly the toll — physically, mentally, and financially — that this and other forms of cancer inflict on patients.

cdc-3suicide-300x117Uncle Sam’s sobering new report about suicide rates rising in all but one state between 1999 and 2016, with fatal increases across age, gender, race and ethnicity, became even more somber and urgent with the shock and grief expressed widely over the self-inflicted deaths of chef-raconteur Anthony Bourdain in France and fashion designer-entrepreneur Kate Spade in Manhattan.

Suicide no longer should be viewed solely as a personal mental health problem but also now as a public health crisis, the federal Centers for Disease Control and Prevention warned.  Anne Schuchat, the CDC’s principal deputy director, told the Washington Post: “The data are disturbing. The widespread nature of the [suicide rate] increase, in every state but one, really suggests that this is a national problem hitting most communities.”

The suicides of Bourdain, 61, and Spade, 55, hit many hard, as was reflected in the extensive media coverage and social media reactions. Both Bourdain and Spade rose from modest circumstances, with abundant hard work, talent, personality, and ambition, to lead lives in the spotlight, and with an economic comfort that others would envy and consider glamorous. They were “successes.”

mentalnyt-300x142Although Americans keep making progress toward ending the stigma associated with mental disorders, including trying to put public funding for the diseases’ treatment on a more even footing, patients with serious mental illness suffer unfairly and harshly still due to their conditions.

Dhruv Khullar, a doctor at NewYork-Presbyterian Hospital and a researcher at the Weill Cornell Department of Healthcare Policy and Research, has written a painful piece for the “Upshot,” an evidence-based column for the New York Times. His article, “The Largest Health Disparity We Don’t Talk About,” reports that:

Americans with depression, bipolar disorder or other serious mental illnesses die 15 to 30 years younger than those without mental illness — a disparity larger than for race, ethnicity, geography or socioeconomic status. It’s a gap, unlike many others, that has been growing, but it receives considerably less academic study or public attention. The extraordinary life expectancy gains of the past half-century [for most in this country] have left these patients behind, with the result that Americans with serious mental illness live shorter lives than those in many of the world’s poorest countries.

salty-200x300If you’ve got a shaker of salt, you may want to empty it on recent news coverage of the American Cancer Society’s announcement about its new guidelines on the age to start colorectal screening. That’s because the organization’s advisory and more than a few health journalists show a shaky grasp of basic disease statistical math.

Cancer specialists, correctly, are concerned because they say they are seeing the disease in younger people, with more colon and rectum cancers detected in patients in their 20s and even in their teens. They’re unsure what’s causing this. But just how many diagnosed cases have there been — and do the numbers mean there’s enough hard science to support a new recommendation that patients get colorectal screening five years earlier than they do now, at age 45 instead of 50?

As Kevin Lomangino, managing editor of Healthnewsreview.org, a health news watchdog site, points out, too many reporters became too accepting of experts’ fuzzy math when describing a screening change that could result in patient harms. The society, and specialists contacted by many reporters, spoke often of “doubled risks,” or impressive seeming percentage increases in colorectal cancer diagnoses — but without providing actual numbers of cases.

MarijuanaOpioids-300x150There’s been a deadly side to the nation’s opioid drug abuse crisis and increasing number of states’ legalization of marijuana: A leading safety group says the number of drugged drivers killed in car crashes is rising dramatically.

The Governors Highway Safety Association reported that 44 percent of fatally injured drivers tested for drugs had positive results in 2016, which is up more than 50 percent compared with a decade ago, according to a blog post by the nonprofit, nonpartisan Pew Trusts, which added that, “more than half the drivers tested positive for marijuana, opioids or a combination of the two.”

As Pew reported, the District of Columbia and nine states “allow marijuana to be sold for recreational and medical use, and 21 others allow it to be sold for medical use. Opioid addiction and overdoses have become a national crisis, with an estimated 115 deaths a day. States are struggling to get a handle on drugged driving. Traffic safety experts say that while it’s easy for police to test drivers for alcohol impairment using a breathalyzer, it’s much harder to detect and screen them for drug impairment. There is no nationally accepted method for testing drivers, and the number of drugs to test for is large. Different drugs also have different effects on drivers. And there is no definitive data linking drugged driving to crashes.”

alzheimers-300x168As many as five million Americans already have Alzheimer’s and other dementia-related conditions, and their resulting loss of cognitive capacity and personal control rank among the top causes for health dread among those 55 and older, polls show.  So it’s worth noting that new studies are showing that seniors 65 and older get on average a dozen years of good cognitive health ── and that span is expanding.

Further, the onset of problems typically may occur in relatively mild fashion, with the most serious cognitive decline occurring in a short but late period of 18 months or so, Judith Graham reported for the independent, nonpartisan Kaiser Health News Service.

In her story for the KHNS feature “Navigating Aging,” Graham looks at an array of the latest and reliable research on seniors and cognitive decline, finding glimmers of optimism in what has been increasingly gloomy, evidence-based studies on how huge a challenge may be posed for our fast-graying nation by dementia, Alzheimer’s and their care.

catheterablation-300x193It’s one thing when modern medicine becomes so hidebound that it struggles over shedding a bit of traditional doctors’ garb. But new information emerging about cardiology’s entrenched reliance on maverick surgeons and evidence-light therapies in treating heart problems raises real questions: Exactly what’s going on in this costly area of care?

Haider Warraich ── a cardiology fellow at Duke and author of “Modern Death,” a book exploring how technology and modern mores are changing patients’ end-of-life experiences ── deserves praise for raising major concerns about the too easy acceptance by doctors and surgeons of existing, device-based treatments for heart conditions. The headline on his Op-Ed in the New York Times summarizes well his tough point: Don’t Put That in My Heart Until You’re Sure It Really Works.

He, of course, points to recent challenges about the effectiveness of cardiac stents. They have been commonly used for years now ── in hundreds of thousands of surgeries ── supposedly to relieve blockages in patients with stable chest pain. But recent research has started to show they provide no benefit over drugs, and it was only after further study showed that a new kind of dissolving stent contributed to increased heart attack risks that the device maker pulled the already in-use product, Warrich notes.

suicide-300x154Moms, dads, grandparents, teachers, and coaches all may need to increase even more the attention and concern they devote to teen-agers, especially young women, as hospitals and emergency rooms report dramatic increases in their treatment of youthful suicides.

Multiple news organizations reported that, as the New York Times noted, “the proportion of emergency room and hospital encounters for …  suicide-related diagnoses almost tripled, from 0.66 percent in 2008 to 1.82 percent in 2015. And the rate of increase was highest among adolescent girls.”

NPR reported: “Children ages 5 to 17 visited children’s hospitals for suicidal thoughts or attempts about twice as often in 2015 as in 2008.”

nags-300x166If you can get your favorite sports fans peeled away from the latest broadcast pro event  ─ whether it’s the basketball playoffs, hockey championship series, golf tourneys, or the heating up baseball season ─  a conversation of sorts could be sparked by dropping numbers on them. See what kind of rise you can get by telling them their data-driven obsession with improving their own athletic performance may be built on shoddy calculation.

In the “Moneyball,” statistics’ crazy world of contemporary sports and athletic fandom, that statement could be heretical. But the numbers-driven folks at the web site “528” deserve credit for digging into a popular but dubious approach employed by researchers in sports medical science: Magnitude-based inference, aka MBI. Their article’s worth a read, especially for wonks and the numerically inclined. For those who are less so, here’s a taste of what’s at stake, as 528 reported:

At first blush, the studies look reasonable enough. Low-intensity stretching seems to reduce muscle soreness. Beta-alanine supplements may boost performance in water polo players. Isokinetic strength training could improve swing kinematics in golfers. Foam rollers can reduce muscle soreness after exercise. The problem: All of these studies shared a statistical analysis method unique to sports science. And that method is severely flawed.

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