November 23rd, 2010 by GruntDoc in Better Health Network, Opinion, Research
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I think I blogged this before, but didn’t describe it much. Allow me to rectify that mistake.
The NNT.com (“Number Needed To Treat”) is an ever-expanding website which boils down high-quality reviews of medications and interventions and presents its recommendations in a much more approachable green-yellow-red “warning triangle” format rather than some ratio.
While I won’t use this as a single source to change my practice, I’m going to have to do some more research on some of the [questionables] of our age (i.e. Octreotide for variceal bleeding, PPI infusions for upper GI bleeding, etc.) — just two of the studies that fly in the face of current practice.
An aside: While inhaled corticosteroids for asthma aren’t beneficial in the review, what it doesn’t tell you is that the Feds think they are, and will grade your asthma care on how many of your asthma patients get a prescription for them, so be aware.
Graham Walker, M.D. is behind this, and good for him.
*This blog post was originally published at GruntDoc*
November 15th, 2010 by GruntDoc in Better Health Network, Health Policy, Opinion
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From a recent post of the Retired Doc’s Thoughts blog entitled “What Are the Plans Of Don Berwick’s ‘Leaders With Plans?’“:
“I wonder which is worse: A medical leader recommending price controls out of ignorance of basic economics or being aware of the likely outcomes and mak[ing] that recommendation anyway?”
Wow. I’m speechless. Thanks to Retired Doc for getting this out in a cogent summary.
*This blog post was originally published at GruntDoc*
November 12th, 2010 by GruntDoc in Better Health Network, News, Research
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From The Australian:
Stem cell researchers have found a way to turn a person’s skin into blood, a process that could be used to treat cancer and other ailments, according to a Canadian study published today.
The method uses cells from a patch of a person’s skin and transforms it into blood that is a genetic match, without using human embryonic stem cells, said the study in the journal Nature.
Wow. Very cool. I wonder if hopefully someday this could be a replacement for random blood donation?
*This blog post was originally published at GruntDoc*
November 7th, 2010 by GruntDoc in Better Health Network, Health Policy, News, Opinion
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Via the Texas Tribune:
Some Republican lawmakers — still reveling in Tuesday’s statewide election sweep — are proposing an unprecedented solution to the state’s estimated $25 billion budget shortfall: dropping out of the federal Medicaid program.
Hmmm. Welcome to entitlement reality, Texas-style. Currently 20 billion a year and going to go up with expanded eligibility, the article does say the Feds pay 60 percent, but doesn’t say: 1) It’s temporary, then the Federal contribution goes down or away, and 2) The Federal component doesn’t come from magical money fairies — it’s money taken from taxpayers then funneled back into a particular program.
Medicaid is not loved or respected in medicine. Decreasing reimbursements coupled to increasing requirements mean it’s at a minimum inefficient for both patients and providers.
I’m not against kicking Medicaid to the curb, PROVIDED the state has some kind of replacement program — which I’m not sanguine about.
*This blog post was originally published at GruntDoc*
October 21st, 2010 by GruntDoc in Better Health Network, News, Opinion, Research
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Via USAToday.com:
FREDERICK, Md. — The Army says it has discovered a simple blood test that can diagnose mild traumatic brain damage [TBI] or concussion, a hard-to-detect injury that can affect young athletes, infants with “shaken baby syndrome” and combat troops.
“This is huge,” said Gen. Peter Chiarelli, the Army vice chief of staff.
Yes, it is, if it pans out. There’s so little actual information in this that it’s hard to get excited about it, but let’s say they’ve isolated a “brain injury” protein.
First, it would have uses outside traumatic brain injury (TBI), though that in and of itself might be useful. I don’t want to poo-pooh this test for TBI, but there are already rules for returning to contact sports (and combat has to be the ultimate in contact activities), so what’s the purpose here? (I forsee more Purple Hearts, which is fine.)
Stroke? TIA? Seizure? Pseudotumor cerebri, as a strain indicator? What if this is the test that allows us to diagnose meningitis without doing lumbar punctures? I’m all in on that front. Let’s hope this pans out, for all our sakes.
*This blog post was originally published at GruntDoc*
