Testing

August 8, 2018

Shift-and-shaft: Why is it always patients’ burden to hunt for affordable care?

The health policy wonks and those who purport to “reform” the U.S. health care system may be long on academic and other fancy credentials. But they also persist in demonstrating they can be short on old-fashioned common sense, especially about the way most of us lead our lives.

That’s a point emphasized in a recent column in the evidence-based “Upshot” feature of the New York Times, written by Austin Frakt. He directs the Partnered Evidence-Based Policy Resource Center at the VA Boston Healthcare System and is an associate professor with Boston University’s School of Public Health and an adjunct associate professor with the Harvard T.H. Chan School of Public Health.

Frakt looked at some recent research to dissect a question that occupies many experts: Could Americans cut their health care costs by shopping around more for medical services? This is a fond notion held by a slice of health care “reformers,” whom Frankt proceeds to disabuse.

August 1, 2018

Colonoscopies carry higher infection risks than previously believed

by Patrick A. Malone

More than 15 million Americans each year undergo an invasive medical test, roughly once a decade and starting at age 50. If some medical experts had their way, more patients would get this cancer checkup, beginning at an even younger age. But as Emily Bazar, a senior editor and consumer columnist (Ask Emily) for the independent, nonprofit Kaiser Health News service, points out, physicians may want to heal themselves and their hygiene practices before pushing even more patients to get colonoscopies and endoscopies (procedures to examine the upper gastrointestinal tract).

That’s because a growing body of research shows that the switch by doctors, hospitals, and specialty centers to reusable scopes to peer into various parts of the body have resulted in rising infection rates among colonoscopy and endoscopy patients, among others.

Inspections show that the reused scopes don’t get cleaned properly and all the time. The more complex the medical device, the greater the risk, as clinicians and patients learned when complex and dirty duodenoscopes were tied to the deaths of 35 patients since 2013 and the sickening of dozens of others, leading to congressional investigations, lawsuits, and product recalls.

July 31, 2018

Patients? We’re just profitable bit$ and byte$ to Big Pharma and insurers

by Patrick A. Malone

Big Data may be a business buzzword that puts most consumers into a big sleep, but big alarms are sounding for Americans about Big Brother intrusions into their lives via the collection and analysis of vast amounts of highly personal information. Of course, Big Pharma and medical insurers are at the fore of invasive practices — some of which patient-consumers themselves are helping, likely without knowing they’re doing so.

Millions of Americans may be little aware, for example, that they’re now working for GlaxoSmithKline, a global pharmaceutical conglomerate with $9 billion in revenues in just the most recent quarter. GSK just struck a $300-million deal with 23andMe, the company that has persuaded roughly 5 million consumers to spit in a test tube to get a glimpse of their genetic information, notably information about their ancestry and purportedly some of their genomic health risks.

Firms like 23andMe, with promotions at events like Baltimore Ravens pro football games, also have amassed highly personal genetic and medical data on millions of patient-consumers, promising to protect the information but also offering, casually and by the way, that this vital information could be shared — ostensibly for the betterment of public health.

July 15, 2018

Wilting in the summer’s heat: Food safety, water hygiene, and officials’ ethics

by Patrick A. Malone

Americans hoping for relaxed, healthful summer days, instead may be getting steady and unwelcome reminders that, despite much publicized claims about regulators’ protective programs, the safeguarding of the nation’s food and water supplies remains a flawed work in progress.

The list only keeps growing of well-known commercial brands affected by tainted food claims, now including:

McDonald’s, with more than 100 reported cyclosporiasis infections, mostly in Illinois with some in Iowa, and linked to eating the fast-food chain’s salads. McDonald’s has said it will stop selling salads in 3,000 or so of its Midwestern outlets, and will resume sales only after restocking supplies and ensuring their safety.

July 1, 2018

A billion reasons to worry that rushed FDA approvals put patient safety at risk

by Patrick A. Malone

Big Pharma has thrown a billion-dollar biscuit at the nation’s prescription drug watchdog, and with the admirable goal of possibly getting sick Americans faster pharmaceutical help, the federal Food and Drug Administration may be rushing risky, unsafe medications to market.

ProPublica, the Pulitzer Prize-winning investigative site, has posted a deep dig into the increasing warning signs that the FDA may be on a dangerous track with its plan to answer rightful criticisms that the agency for too long was too pokey in reviewing and approving prescription drugs for sale in the United States.

But the agency may be putting patients at grave risk with its plans to step on the gas, including allowing drug makers to pay for costs of reviews in exchange for ensuring they will be speedy. Big Pharma has forked over $905 million in 2017 — 75 percent of the agency budget for scientific reviews of branded and generic drugs — as compared with 27 percent funding in 1993.

June 13, 2018

For early-stage breast cancer patients, dreaded chemo may be unneeded

by Patrick A. Malone

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.

February 21, 2018

FDA approves a blood test to diagnose severity of traumatic brain injury

by Patrick A. Malone

Federal officials offer a glimmer of hope in caring for head injuries, especially the sharp, repeated, and often damaging blows that afflict athletes and which millions worldwide are witnessing, yes, as part of the Winter Olympic Games.

The federal Food and Drug Administration has announced that it has approved a long-awaited blood test that can help doctors determine the severity of traumatic brain injuries. This test will provide a cheaper, easier, more convenient, and likely faster way to handle the rising health bane of concussions, rather than relying on computed tomography or CT scans using big machines and a form of X-rays.

As the New York Times reported:

January 18, 2018

President O? Let’s first look hard at her role in hyping health humbug

by Patrick A. Malone

Oprah Winfrey’s recent rousing broadcast speech — both in accepting an entertainment industry group’s lifetime achievement award and denouncing sexism and sexual harassment in Hollywood — also opened the door to a reconsideration of how this talented, smart, accomplished, powerful, and wealthy celebrity icon long has helped to foster a barrage of health and medical humbug, spreading it far and wide in popular culture.

As Stat, a health and information site, recapped about Winfrey:

She connected a cancer patient to ‘junk science,’ a Washington Post analysis says. She promoted charlatans on her show, according to Slate. Former Arkansas governor Mike Huckabee put out a statement … attacking Winfrey for ‘giving a platform to anti-vaccination campaigners and other dangerous health quackery.’

January 10, 2018

Over-screening skews disease research and puts harsh burdens on seniors

by Patrick A. Malone

Medical over-screening and over-testing not only adds hundreds of billions of dollars in unnecessary costs to U.S. health care, it also may be skewing researchers’ understanding of what causes disease and imposing harsh burdens on older Americans.

Stat, an online health and medical news service, has highlighted an intriguing study from the Dartmouth Institute for Health Policy and Clinical Practice, whose researchers are well-respected for their work on their Atlas Project, which “documents glaring variations in how medical resources are distributed and used in the United States.”

Dartmouth researchers recently examined screening, especially for breast, prostate, and thyroid cancers, and found that over-testing, as Stat reported, may be “misleading doctors and the public about what increases people’s risk of developing cancers,” especially “the types of cancer that matter.”

January 9, 2018

Experts fret over how precise key basics may be in ‘precision medicine’

by Patrick A. Malone

Although billions of dollars and lots of positive public attention have been lavished on the promise of genetic-based “precision medicine,” this therapeutic approach to treating cancer and other serious diseases may need more scrutiny for basics of quality control.

National Public Radio deserves credit for airing some less-heard experts’ worries about the roles of at least two groups of little-seen and often-ignored medical specialists — pathologists and med techs — and how their common practices may undercut the potential of efforts to target disease treatments to individual patients based on maps of their genes.

Despite its powerful and progress-promising name, precision medicine relies on some old-fashioned, unchanged, and possibly problematic medical techniques, experts told NPR. Blood and tissue samples, which later will be analyzed with costly and supposedly state-of-the-art equipment, still get taken by med techs with limited training. Little attention typically gets paid to how they collect samples and how carefully they get handled before arriving in labs. They may sit on carts for hours, and they may be dragged through different parts of hospitals where temperatures vary widely and can hit extremes.