October 14th, 2010 by Steve Novella, M.D. in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research
Tags: Anti-Vaccine Movement, Benefits Vs. Harms, CAM, Complementary And Alternative Medicine, Direct Harm, Dr. Steve Novella, Evidence Based Medicine, Flu Vaccine, Folk Remedies, General Medicine, Normative Beliefs, Placebo Medicine, Public Health, Risk Benefit Ratio, Risk Vs. Harm, SBM, Science and Medicine, Science Based Medicine, Science-Based Evidence, Science-Based Treatments, Unscientific Medical Methods, Unscientific Medicine
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Any promoter of science-based medicine often faces the question: “What’s the harm?” What is the harm if people try treatment modalities that are not based upon good science, that are anecdotal, or provide only a placebo benefit? There are generally two premises to this question. The first is that most “alternative” placebo interventions are directly harmless. The second is that direct harm is the only type worth considering. Both of these premises are wrong.
The pages of Science Based Medicine (SBM) are filled with accounts of direct harm from unscientific treatments: Argyria from colloidal silver, death from chelation therapy, infection or other complications from acupuncture, burns from ear candleing, stroke from chiropractic neck manipulation — the list goes on. You can read anecdotal accounts of such harm on the website, whatstheharm.net.
Of course, as we often point out, harm and risk is only one end of the equation — one must also consider benefit. It is the risk-benefit ratio of an intervention that is important. But generally we are talking about interventions that lack any evidence for benefit, and therefore any risk of harm is arguably unacceptable. Read more »
*This blog post was originally published at Science-Based Medicine*
October 14th, 2010 by Berci in Better Health Network, Medical Art, Research
Tags: Alexandra Pajak, DNA, Emory Vaccine Center, Genetic Code, HIV Genome, HIV Vaccine, Human Immunodeficiency Virus, Medical Art, Musical Translation, Science Roll, Sounds Of HIV, University of Georgia
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A few months ago, Alexandra Pajak, a graduate student at the University of Georgia, contacted me about an album of music based on the DNA of the HIV virus she was about to release. I feel lucky that the album is just on its way to my CD player right now.
You can buy the album on Amazon (release date is October 26.) Note that some of the proceeds will go to the Emory Vaccine Center, which conducts research for an HIV vaccine. If you wonder how it was made, here’s the explanation:
Sounds of HIV is a musical translation of the genetic code of HIV, the human immunodeficiency virus. Every segment of the virus is assigned music pitches that correspond to the segment’s scientific properties. In this way, the sounds reflect the true nature of the virus. When listening from beginning to end, the listener hears the entire genome of HIV.
In English, the nucleotides Adenine, Cytosine, Uracil/Thymine, and Guanine are abbreviated with the letters A, C, T, and G. Since A, C, and G are also musical pitches in the Western melodic scale, these pitches were assigned to the matching nucleotides. To form two perfect fifths (C-G and D-A), “D” was arbitrarily assigned to musically represent Uracil. I assigned the pitches of the A minor scale to the amino acids based on their level of attraction to water.
On Sounds of HIV, depending on the track, only nucleotides and/or amino acids “play” as music. Tracks 1 and 10 are based on the first and last nucleotides of the RNA chain. Tracks 2-9 “play” the proteins and sometimes the nucleotides on top of the proteins.
*This blog post was originally published at ScienceRoll*
October 12th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
Tags: Alarm Fatigue, Diagnosis and treatment, Dr. Kevin Pho, EHR, Electronic Health Record, Electronic Medical Record, Electronic Test Reporting, EMR, General Medicine, Harm Patients, Health IT, KevinMD, Medical Charting, Overwhelm Doctors, Patient, Too Much Data, Tracking of Test Data, VA Doctors, Veterans Administration, Wall Street Journal Health Blog, WSJ
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One of the supposed strengths of electronic medical records is better tracking of test data. In theory, when using more sophisticated digital systems, doctors can better follow the mountains of test results that they encounter daily.
But a recent study, as written in the WSJ Health Blog, says otherwise. Apparently, a study performed in 2007 found:
VA doctors failed to acknowledge receipt of 368 electronically transmitted alerts about abnormal imaging tests, or one third of the total, during the study period. In 4% of the cases, imaging-test results hadn’t been followed up on four weeks after the test was done. Another study, published in March in the American Journal of Medicine, showed only 10.2% of abnormal lab test results were unacknowledged, but timely follow-up was lacking in 6.8% of cases.
Consider that the VA has what is considered the pinnacle of electronic systems — their unified, VistA program that permeates all their hospitals and clinics. Apparently the problem is one of alert overload:
Hardeep Singh, chief of the health policy and quality program at the Houston VA’s health and policy research center, led both studies. He tells the Health Blog that doctors now receive so many electronic alerts and reminders — as many as 50 each day — that the important ones can get lost in the shuffle.
This is not unlike the alarm fatigue issue that I recently wrote about. Too much data — whether it is written or on the screen — can overwhelm physicians and potentially place patients at harm. Curating test results by prioritizing abnormals will really be the true power of electronic test reporting.
*This blog post was originally published at KevinMD.com*
October 12th, 2010 by Medgadget in Better Health Network, News, Research
Tags: Breath Acetone Detection, breath test, Diagnostic Tool, Disease Biomarker Detector, Disease Detection, Exhaled Breath, General Medicine, Medgadget, Nanomedicine, Nanoprobe, Personalized Medicine, Sensor Nanotechnology, Stony Brook University
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A new sensor developed at Stony Brook University may become a clinically useful tool for detecting disease biomarkers in breath. The nanoprobe-based technology is currently able to detect acetone, but should be modifiable to spot other compounds.
From the study abstract:
This paper describes a sensor nanotechnology suitable for non-invasive monitoring of a signaling gas, such as acetone, in exhaled breath. This is a nanomedicine tool comprised of a selective acetone nanoprobe working on the principle of ferroelectric poling sensing, and a microelectronics circuit for comparing the actual sensor signal to a predetermined threshold value, displaying the result using LED signals. This on/off type non-invasive diagnostics platform technology is based on nanotechnology, gives a fast response, it is simple to operate and inexpensive to manufacture, and may truly revolutionize personalized medicine.
Full story: New Sensor Nanotechnology Developed by Stony Brook University Researchers Simplifies Disease Detection…
Abstract in Sensor Letters: Nanosensor Device for Breath Acetone Detection
*This blog post was originally published at Medgadget*
October 11th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News, Research
Tags: ACP Internist, American College Of Physicians, Animal Feed, Animas, Antibiotic Resistance, Biomedical Ethics, Biomedical Research, Doctors In Politics, Doctors Running For Political Office, Dr. Margaret Hamburg, Dr. Val Jones, embryonic stem cells, FDA, Food and Drug Administration, Healthcare Policy, Healthcare Politics, Healthcare reform, Immunology, In Vitro Fertilization, Political Doctors, Ryan DuBosar
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Medical organizations are donating heavily to doctors running for the U.S. House. Dentists, ophthalmologists, radiologists, surgeons, neurologists and ENTs have contributed heavily. The goal is to get doctors onto committees where they can have the most impact. So far, the candidates have trended heavily Republican and have, in at least one campaign, vowed to overturn healthcare reform. The stakes are high if opposing legislators succeed, because they could underfund or block portions of reform to the point that it works poorly or not at all. (Politico, New England Journal of Medicine)
Spurred by antibiotic resistance seen in almost every drug class, FDA Commissioner Margaret Hamburg, FACP, is turning the agency’s attention toward animal feed. With little to no development of new antibiotics in the pipeline, the agency is discussing regulations for animal feed and guidelines for human use. (Wall Street Journal)
Scientists should be able to use stem cells for biomedical research, according to a recent Harris Interactive/HealthDay poll. Almost three quarters of adults surveyed are in favor of using embryonic stem cells left over from in-vitro fertilization. These poll results remain consistent with a similar survey released in 2005. Read more »
*This blog post was originally published at ACP Internist*
