September 27th, 2011 by StevenWilkinsMPH in Research
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Turns out there is an unintended consequence of many of the current efforts to standardize the way doctor’s practice medicine. It is called de-skilling. De-skilling can occur when physicians and other providers try to adapt to standardized, new ways of doing things. Examples of such standardization include clinical based care guidelines, electronic medical records (EMRs), Pay for Performance (P4P), Patient Centered Medical Home (PCMH) requirements and so on.
Examples of physician de-skilling were revealed in a recent study which consisted of in-depth interviews with 78 primary care physicians regarding EMR use. EMRs are all about standardization – what data is captured and recorded, how data is reported, how data is used, and so on.
Over the course of the interviews, physicians in the study described significant examples of de-skilling behavior. Most indicated that Read more »
*This blog post was originally published at Mind The Gap*
September 27th, 2011 by RyanDuBosar in Research
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Intranasal insulin stabilized or improved cognition and function and preserved cerebral metabolic rate of glucose in brain regions affected by Alzheimer’s disease, concluded researchers from a phase II trial. But more and larger trials are needed before any conclusions can be drawn, they also cautioned.
Insulin is important to normal brain function, and reduced insulin levels may contribute to Alzheimer’s disease, researchers noted. To examine the effects of intranasal insulin in adults with amnestic mild cognitive impairment or Alzheimer’s disease, researchers conducted a randomized, double-blind, placebo-controlled trial in a VA medical center.
The intent-to-treat sample consisted of 104 adults with amnestic mild cognitive impairment (n=64) or mild to moderate Alzheimer’s disease (n=40) defined as Clinical Dementia Rating scores of 0.5-1 and Mini-Mental State Examination scores greater than 15.
Participants received Read more »
*This blog post was originally published at ACP Internist*
September 26th, 2011 by Steve Novella, M.D. in Health Policy, Opinion
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It is an unfortunate truth that there is money in pseudoscience, particularly medical pseudoscience. Money both attracts charlatans and also funds their activities, which includes marketing pseudoscience and defending their claims from scientific scrutiny. In this way the game is rigged in favor of pseudoscience.
With0ut effective regulation, sites like ours are forced to play whack-a-mole with the medical pseudoscience du jour. The latest case in point is Titanium Ion Bands – which are just another version of the Power Balance bands that have been previously exposed as nonsense. The idea is that by wearing a small bracelet on one wrist you will experience improved athletic performance. This sounds impossible – because it is. But companies have successfully bamboozled enough of the public to rake in millions.
The marketing strategy is three-fold. First, Read more »
*This blog post was originally published at Science-Based Medicine*
September 26th, 2011 by Medgadget in News, Research
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A couple years ago, a team of researchers from the University of Utah managed to create a wireless network made from standard home automation devices to “see” through walls.
Now, the engineers are using the same technology to monitor breathing in patients with sleep apnea, post surgery, and babies at risk for SIDS. The system consists of Read more »
*This blog post was originally published at Medgadget*
September 26th, 2011 by PJSkerrett in Health Tips
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The death of Kara Kennedy, the only daughter of the late Senator Edward M. Kennedy, at age 51 from an apparent heart attack while exercising, was yet another tragedy for one of the country’s most prominent political families. It also offers a reminder of the possible long-term effects of cancer and its treatment.
In 2002, Kennedy was diagnosed with lung cancer that her doctors initially said was inoperable. Her father refused to accept that diagnosis, according to an article in the Boston Globe. He found doctors at Brigham and Women’s Hospital in Boston who thought they could treat the cancer. They removed a portion of Ms. Kennedy’s right lung and then administered radiation and chemotherapy. She lived for another nine years, in apparently good health.
While the cause of Kennedy’s death has not yet been confirmed, the long-term effects of her lung cancer treatment could have played a role. Cancer survivors are often at increased risk of heart disease. That’s because the treatments used to fight cancer—drugs, radiation, and hormones—can damage the heart and arteries. (These are detailed in a Harvard Heart Letter article on cancer therapy and heart disease.)
If life were completely fair, cancer survivors would be exempt from future health problems. Sadly, that isn’t the case. Read more »
*This blog post was originally published at Harvard Health Blog*
