December 26th, 2011 by PeterWehrwein in Research
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We are fast entering the era of the electronic health record, when it will be possible to call up our medical records on our computers and mobile devices. Medication lists, lab results, appointment schedules—they’ll all be available with clicks of your mouse or taps on the screen of your smartphone or tablet.
But one question that’s far from settled is whether the electronic health record should include the notes that doctors make about them. A doctor’s notes can be straightforward, such as a reminder that an additional test might be needed. But they can also include somewhat speculative observations and hunches about a patient and his or her medical conditions. The Open Notes project is a research program designed to test the consequences of giving patients access to doctors’ notes. Harvard-affiliated Beth Israel Deaconess Medical Center is one of the test sites.
The Open Notes project is far from finished. But results of a survey of the expectations that doctors and patients have for note sharing are being reported in today’s Annals of Internal Medicine.
I don’t think there are any great surprises here. More than half of the primary care physicians Read more »
*This blog post was originally published at Harvard Health Blog*
November 3rd, 2011 by PJSkerrett in Expert Interviews
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Dr. Jerry Avorn
Americans spend more than $300 billion a year on prescription drugs. How we use these drugs, and how effective they are, have become important subjects for public health researchers. A leader in this area is Dr. Jerry Avorn, chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital in Boston and professor of medicine at Harvard Medical School. Avorn is the author of numerous articles and the book Powerful Medicines.
For an article in the Harvard Health Letter, editor Peter Wehrwein spoke with Avorn about generic drugs, the pharmaceutical industry, the high cost of cancer drugs, and more. Here’s an excerpt from their conversation; you can read the complete interview at www.health.harvard.edu. Read more »
*This blog post was originally published at Harvard Health Blog*
March 11th, 2011 by PeterWehrwein in Health Tips, Research
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This month’s Harvard Health Letter has an article about getting shingles a second or even a third time. (Click here to read the full article.) The bottom line is that recurrence is a) certainly possible and b) if some recent research is correct, much more common than previously thought and about as likely as getting shingles in the first place if you’re age 60 or older.
I talked to Barbara Yawn, M.D., director of research at the Olmsted Medical Center in Rochester, Minn., for the article and mentioned results that she and her colleagues first presented at a conference several years ago.
Yawn reported a more complete version of those results in last month’s issue of the Mayo Clinic Proceedings (a favorite journal of mine). Full text of the study isn’t available unless you have a subscription to the journal, but here’s a summary (in medical publishing, such summaries are called abstracts.)
Melinda Beck, a health columnist for the Wall Street Journal, had a column about shingles last week and this how she neatly summed up Yawn’s research:
For the new study on shingles recurrence, researchers at the Olmsted Medical Center in Rochester, Minn., examined medical records of nearly 1,700 patients who had a documented case of shingles between 1996 and 2001. They found that more than 5% of them were treated for a second episode within an average of eight years—about the same rate as would typically experience a first case.
And here is a link to the Journal Watch item of the study and a short comment by the Journal Watch editor. Journal Watch is a monthly newsletter published by the Massachusetts Medical Society that summarizes and comments on recently published research.
In the Mayo Clinic Proceedings paper, Yawn and her colleagues report that 95 of the 1,669 people with an “index” case of shingles got shingles again over the course of a follow-up period that averaged 7.3 years, which works out to about 5.6 percent of the shingles sufferers. Six people had two recurrences and two had three! The timing of recurrence varied from 96 days to 10 years after the initial episode. In 45 percent of those who got shingles again, the site of the recurrence was in a different region of the body than the site of the first case. They also noted that the single biggest risk factor for having a second case of shingles was having pain that lasted 30 days or longer during the first case. Read more »
*This blog post was originally published at Harvard Health Blog*
March 1st, 2011 by PeterWehrwein in Health Tips, Medical Art
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The film “The King’s Speech” won the Academy Award for Best Picture [on Sunday night.] The movie has come in for some criticism for its depiction of the political machinations surrounding the abdication of Edward VIII and Britain’s appeasement of Hitler. The British-born writer Christopher Hitchens, unsparing and deliciously eloquent as always, puts the politics of George VI in a far less favorable light than the movie does.
But “The King’s Speech” has won almost universal praise for its portrayal of the reluctant monarch’s stuttering, a speech pattern that includes involuntary repetition of sounds and syllables and “speech blocks” that cause prolonged pauses. Many young children who stutter grow out of the problem, but perhaps as many as one in every 100 adults are affected by the condition, 80 percent of whom are men. Stuttering clusters in families, so researchers have been searching for inherited genes that might cause the condition. Last year, in The New England Journal of Medicine, NIH researchers reported some success with results showing an association between three mutated genes and stuttering, although those mutations are probably responsible for a very small minority of cases.
It’s been said that “The King’s Speech” will do for stuttering what “Rain Man” did for autism: Plant a sympathetic view of a disability in the public consciousness. One danger of such a quick infusion of awareness, however, is that it can harden into a fixed, if largely favorable, stereotype. We are finding out — or are being reminded — about all the famous people who have stuttered (many of them writers). First-person accounts are popping up all over the place because of the film. The best I’ve come across is by Philip French, a British film critic, who describes vividly what it was like to listen to the radio broadcasts of the real King George VI, wondering if he would make it to the end “like a drunken waiter crossing a polished floor bearing a tray laden with wine glasses.” Read more »
*This blog post was originally published at Harvard Health Blog*
January 5th, 2011 by AnthonyKomaroffMD in Opinion, Research
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When sugar-free beverages first became available, I was skeptical that they could really taste as good as “the real thing.” I quickly changed my mind. In fact, it seemed to me that the sugar-free versions actually tasted better than “the real thing.”
It seemed like a no-brainer. Sugar-free beverages had no calories and tasted better—maybe there is such a thing as a free lunch. Obviously, many people who also wanted to lose weight made the same switch. Were we right about artificial sweeteners?
Although short-term studies suggest that switching from sugar to no-calorie sweeteners can help, other research suggests it may actually promote weight gain. Writing in the December 2011 Harvard Health Letter, noted obesity researcher Dr. David Ludwig explores the possible connection between sugar substitutes and weight gain.
The FDA has approved six calorie-free sweeteners: acesulfame, aspartame, neotame, saccharin, Stevia, and sucralose. They are Read more »
*This blog post was originally published at Harvard Health Blog*
