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How The Swedish Mammography Study Should’ve Been Analyzed

We reviewed four stories on the Swedish mammography study that appeared in the journal Cancer last week. Three of the four stories gave a pretty clear indication that there were methodological concerns about the Swedish research (of the four reviewed, only HealthDay offered no such hint):

• 4th paragraph of AP story: “The new study has major limitations and cannot account for possibly big differences in the groups of women it compares.”

• 1st paragraph of LA Times blog story: “Critics charged that the study was poorly designed and potentially vastly misleading.”
• 2nd sentence of NY Times story: “Results were greeted with skepticism by some experts who say they may have overestimated the benefit.”

But none of the stories did a very complete job of explaining those potential limitations. Because of the confusion that must be occurring in the minds of women — especially those in their 40s — this is a time in which journalism must rise to the need and do a better job of evaluating evidence and helping readers make sense of what appear to be conflicting findings.

I was in Chapel Hill, North Carolina, when the study was published and had the chance to talk about it with former U.S. Preventive Services Task Force member, and a recognized thought leader on issues of prevention and especially of screening tests, Dr. Russell Harris, Professor and Director of the Health Care and Prevention Concentration of the University of North Carolina (UNC) School of Public Health. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

An Obesity-Causing Virus?

Finally, the answer to the obesity epidemic. [According to the LA Times], it’s a virus:

New evidence indicates that children who are exposed to a virus called adenovirus-36 are more likely to be obese than those who are not exposed to it, and to be heavier than other obese kids who were not exposed to it, researchers said this week. The virus…is one of 10 bacteria and viruses that have been associated with a propensity for putting on plural poundage.

Maybe this explains why I and two of my sisters all became fat in the same year. Well, that — combined with the fact that we had just moved to a new neighborhood where there were no kids we knew to play outside with, and we started taking a bus to school instead of walking, and “Dark Shadows” had just started, leading us to spend every afternoon after school snacking in front of the TV. But I like to think it was a virus.

*This blog post was originally published at tbtam*

Debunking Fake Diseases

Ever heard of adrenal fatigue? Wilson’s temperature syndrome? If not, there’s a good reason: They exist only on the Internet.

The Hormone Foundation, an affiliate of the Endocrine Society, recently issued two fact sheets for patients debunking these so-called conditions, which were “apparently conceived only in an effort to sell products promoted to treat them,” the LA Times reported. No medical evidence supports either faux disease and there are no tests or treatments for them, but patients still try to alleviate them with supplements, some of them potentially dangerous, the Times said.

Adrenal fatigue is characterized by such “symptoms” as having salt and sugar cravings and needing coffee to get you through the day, while the man who discovered Wilson’s temperature syndrome also coincidentally promotes a product to treat it, according to the Times. (Hormone Foundation, LA Times)

*This blog post was originally published at ACP Internist*

Rectal Cancer Becoming More Common In Younger People

Rates of rectal cancer in those younger than 40 have been increasing, the LA Times reported recently.

Researchers studied data from the Surveillance, Epidemiology and End Results (SEER) Registry and looked at the change in rectal and colon cancer incidence in those under 40 from 1973 to 2005. Overall rates were low, but while colon cancer incidence remained constant, rectal cancer incidence increased by an average of 3.8 percent annually, the authors reported in the journal Cancer.

The authors didn’t advocate routine screening in those under 40, but did recommend that physicians be more alert to the possibility of rectal cancer in those presenting with symptoms such as rectal bleeding, according to the Times. (LA Times)

*This blog post was originally published at ACP Internist*

Facebook: Should Hospitals Block It?

A recent piece in the LA Times created quite a kerfuffle in the social health infosphere. The article When Facebook goes to the hospital, patients may suffer detailed some of the issues facing hospitals that have chosen to flirt with Facebook. Stories of nurses posting images of dead patients. Lawsuits and employee rights. An interesting read. It offered up a serving of fresh red meat for those health professionals looking to keep their heads squarely in the sand.

A few thoughts:

Blocking Facebook won’t stop stupidity. Read Paul Levy’s most recent post on the issue. He reminds us that administrative legislation will not stop ignorance. It’s the messenger, not the medium. As healthcare administration’s most vocal advocate for social adoption, I’d recommend you check out Paul Levy. His point of view is remarkable.

Good employees may not understand privacy. We need to go to the next step and address the fact that many hospitals have employees who don’t understand the privacy laws. We still have a responsibility to protect patients from the misinformed. While it’s suggested that you “can’t stop the conversation,” it’s important that hospitals take responsibility and educate their employees regarding what’s appropriate and what isn’t. Many health professionals I know innocently believe that by simply excluding an individuals name you’ve protected their privacy. We have work to do. Read more »

*This blog post was originally published at 33 Charts*

Latest Interviews

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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How Do Hospital Executives Feel About Locum Tenens Agencies And Traveling Physicians?

I recently wrote about my experiences as a traveling physician and how to navigate locum tenens work. Today I want to talk about the client in this case hospital side of the equation. I ve had the chance to speak with several executives some were physicians themselves about the overall…

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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