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Developing Priorities In The Field Of Genomics And Public Health

Text: 2012-2017 Priorities for Public Health Genomics Stakeholder Consultation|Priorities Conference Report|September 2011  In June 2011, the CDC Office of Public Health Genomics launched a community wide consultation process to develop priorities for the field of public health genomics in the next 5 years. This process was initiated as part of strategic visioning for integrating the emerging tools of genomics into practice and assuring the success of these new tools in improving population health. The process was conducted at a time of a widening gap between the rapid scientific advances in genomics and their impact on improving population health.   The University of Michigan Center for Public Health and Community Genomics and Genetic Alliance spearheaded an effort to seek, collate and synthesize advice and recommendations from numerous stakeholders and constituents. The effort culminated in a workshop conducted on September 14, 2011 in Bethesda, Maryland. The results of the consultation, discussions and deliberations are summarized in a report published by the University of Michigan. Highlights of the recommendations are summarized here but readers should consult the full report.  Some of the recommendations include:

To improve public health genomics education: Read more »

*This blog post was originally published at Genomics and Health Impact Blog*

Study Hopes To Help Those Seeking Breast Reconstruction Surgery

Jeffrey A. Ascherman, MD, FACS

Jeffrey A. Ascherman, MD, FACS

After the jubilation of beating cancer, many women who seek breast reconstruction have another journey to complete. Before they can receive a permanent breast implant, they must first undergo a process to create the space to house the new implant – a process which can be uncomfortable at times and may take many months.

“Traditionally, women undergoing breast reconstruction have had to endure a long process of inconvenient and sometimes uncomfortable saline injections every 2 to 3 weeks to create a pocket for the permanent implant following a mastectomy,” said Jeffrey Ascherman, MD, Site Chief, Division of Plastic Surgery, NewYork-Presbyterian/Columbia. According to some women, this process can also involve a significant time burden, since they must visit their doctor’s office every few weeks for an average of four to six months.

Dr. Ascherman is now the first physician in the United States to be enrolling patients in a study of a new, Read more »

*This blog post was originally published at Columbia University Department of Surgery Blog*

Avastin’s Approval Revoked: Harvard Health Publications Uncovers The FDA’s Process

Last week, the FDA revoked its 2008 approval of the drug Avastin to treat breast cancer, concluding that the drug does little to help women with breast cancer while putting them at risk for potentially life-threatening side effects. Avastin will remain on the market (and so be potentially available to women with breast cancer) because it has also been approved to treat other types of cancer.

In a statement, FDA Commissioner Margaret A. Hamburg said this:

FDA recognizes how hard it is for patients and their families to cope with metastatic breast cancer and how great a need there is for more effective treatments. But patients must have confidence that the drugs they take are both safe and effective for their intended use. After reviewing the available studies it is clear that women who take Avastin for metastatic breast cancer risk potentially life-threatening side effects without proof that the use of Avastin will provide a benefit, in terms of delay in tumor growth, that would justify those risks. Nor is there evidence that use of Avastin will either help them live longer or improve their quality of life.

Why does this happen? Read more »

*This blog post was originally published at Harvard Health Blog*

Convincing The Public Of The Importance Of Evidence-Based Medicine

On October 4th, 2011, I delivered the Alex Drapos Memorial Lecture at Clark University as part of their ongoing President’s Lecture Series.  Here’s what Jim Keogh, Director of News and Editorial Services, reported about my talk:

Gruman said American health care treads a fine line between trying to serve the good of the many and the interests of the individual. But no one has yet figured out a cost-effective, yet humane, way to do both. She asserted that the skyrocketing expense of health care — expected to rise to $4.64 trillion by 2020 — isn’t reflected in the quality of treatment people receive.

“Should we be able to choose whatever medicine we want, even if there’s no evidence it’s effective?” ~ Jessie Gruman

“There is much ineffective, extra, inappropriate care being delivered,” Gruman said. As an example she cited Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

NPR Addresses Upcoming Final Decision On Avastin’s Fate

On the NPR Shots blog, Scott Hensley addresses, “Avastin For Breast Cancer: Hope Versus False Hope.” Excerpt:

Any day now FDA Commissioner Margaret Hamburg is expected to make a final decision on Avastin’s fate. Women who said Avastin helped their breast cancer were out in force at a June hearing of an appeal of FDA’s proposal. At this point, it would be a big surprise if the agency let the approval, granted on an accelerated basis back in 2008, stand.

Now, one of the cancer specialists on the expert panel, which Read more »

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

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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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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