November 30th, 2010 by PeterWehrwein in Better Health Network, Health Tips, News, Research
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Vitamin D has been talked about as the vitamin — the one that might help fend off everything from cancer to heart disease to autoimmune disorders, if only we were to get enough of it.
“Whoa!” is the message from a committee of experts assembled by the Institute of Medicine (IOM) to update recommendations for vitamin D (and for calcium).
The IOM committee’s report, released this morning, says evidence for many of the health claims for vitamin D is “inconsistent and/or conflicting or did not demonstrate causality.” The exception is the vitamin’s well-documented (and noncontroversial) benefits on bone growth and maintenance.
The IOM panel’s report also says most North Americans (Canadians as well as Americans) have more than enough vitamin D in their blood to achieve the desired effect on bone. The committee said a blood level of 20 nanograms per milliliter (ng/mL) is sufficient for most people.
The panel set 600 International Units (IU) as the recommended daily intake for children and for adults ages 19 to 70. People ages 71 and older are supposed to get an additional 200 IU, or 800 IU a day.
That’s a fairly sizable increase over the previous recommendations of 200 IU per day through age 50, 400 IU for people ages 51 to 70, and 600 IU for people ages 71 and older. Read more »
*This blog post was originally published at Harvard Health Blog*
November 30th, 2010 by Elaine Schattner, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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Over the long weekend I caught up on some reading. One article* stands out. It’s on informed consent, and the stunning disconnect between physicians’ and patients’ understanding of a procedure’s value.
The study, published in the Sept 7th Annals of Internal Medicine, used survey methods to evaluate 153 cardiology patients’ understanding of the potential benefit of percutaneous coronary intervention (PCI or angioplasty). The investigators, at Baystate Medical Center in Massachusetts, compared patients’ responses to those of cardiologists who obtained consent and who performed the procedure. As outlined in the article’s introduction, PCI reduces heart attacks in patients with acute coronary syndrome — a more unstable situation than is chronic stable angina, in which case PCI relieves pain and improves quality of life but has no benefit in terms of recurrent myocardial infarction (MI) or survival.
The main result was that, after discussing the procedure with a cardiologist and signing the form, 88 percent of the patients, who almost all had chronic stable angina, believed that PCI would reduce their personal risk for having a heart attack. Only 17 percent of the cardiologists, who completed surveys about these particular patients and the potential benefit of PCI for patients facing similar scenarios, indicated that PCI would reduce the likelihood of MI.
This striking difference in patients’ and doctors’ perceptions is all the more significant because 96 percent of the patients “felt that they knew why they might undergo PCI, and more than half stated that they were actively involved in the decision-making.” Read more »
*This blog post was originally published at Medical Lessons*
November 30th, 2010 by Medgadget in Better Health Network, News, Research
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E. coli is a Gram negative rod-shaped bacterium that is a regular inhabitant of the human gastrointestinal tract and certain strains can cause a lot of trouble. A team from the University of Tokyo in Japan, however, have manipulated the bacterium to perform a more noble task: Solving Sudoku.
The bacterium managed to solve 4×4 grid Sudoku puzzles, and in theory the more common 9×9 grid puzzles should be solvable as well. Read more »
*This blog post was originally published at Medgadget*
November 29th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, News, Opinion
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Have you ever wondered how hospitals get paid by Medicare? The New York Times has an excellent and simple explanation of this highly complicated process. It’s simple really.
First the hospital labor component is adjusted for geographic location and then added to the capital depreciation expenditures adjusted for geographic location and then a medical severity adjusted diagnosis related group multiplier is added (MS-DRG).
Once this adjusted payment rate is calculated, the hospital is given a bonus to cover the costs incurred if they are a teaching hospital, through the indirect medical education payment. Added to that is the disproportionate share payment for hospitals that see a lot of uninsured or Medicaid patients (strange that Medicare subsidizes Medicaid, isn’t it?) If you have a patient that is extremely sick or spends mulitple extra days in the hospital, they may get an extra outlier payment. Read more »
*This blog post was originally published at The Happy Hospitalist*
November 29th, 2010 by GarySchwitzer in Better Health Network, News, Opinion, Research
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Interesting post by the Retraction Watch blog, pointing to an interesting paper published last week in the Annals of Emergency Medicine. An excerpt from the blog post:
Over 14 years, 84 editors at the journal rated close to 15,000 reviews by about 1,500 reviewers. Highlights of their findings:
…92% of peer reviewers deteriorated during 14 years of study in the quality and usefulness of their reviews (as judged by editors at the time of decision), at rates unrelated to the length of their service (but moderately correlated with their mean quality score, with better-than average reviewers decreasing at about half the rate of those below average). Only 8% improved, and those by very small amount.
How bad did they get? The reviewers were rated on a scale of 1 to 5 in which a change of 0.5 (10%) had been earlier shown to be “clinically” important to an editor. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
