December 3rd, 2010 by StevenWilkinsMPH in Better Health Network, Health Tips, Opinion, Research
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“I recommend.” These are two word which, when spoken by a physician to a patient have tremendous power to change behavior. That assumes of course a trusting relationship between patient and physician (but that’s a topic for another day.)
Take the colonoscopy. The U.S. Preventive Services Task Force (USPSTF) recommends that adults aged ≥50 years get a colonoscopy every 10 years. In 2005, 50 percent of adults aged ≥50 years in the U.S. had been screened according to these recommendations. Not surprisingly, the rate of colonoscopy screening is much lower than that of other recommended adult preventive services. I was curious: Why?
Here are two interesting facts:
1. Studies show that patients cite “physician recommendation” as the most important motivator of colorectal screening. In one study, 75 to 90 percent of patients who had not had a colonoscopy, said that their doctor’s recommendation would motivate them to undergo screening.
2. In that same study, in 50 percent of patients where a colonoscopy was appropriate but not done, the reason given was that the physician simply did not “bring up” the subject during the visit. Reasons included lack of time, visit was for acute problem, patient had previously declined or forget. Read more »
*This blog post was originally published at Mind The Gap*
November 29th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News, Research
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By 2020, an estimated 15 percent of adults will have diabetes and 37 percent will have prediabetes, a total of 39 million people, compared with rates of 12 percent and 28 percent today, respectively.
Today, more than 90 percent of people with prediabetes, and about a quarter of people with diabetes, are unaware of it, according to a report from UnitedHealth Group, the provider of insurance and other health care services.
The health savings alone of preventing diabetes would bend the cost curve of health care spending in the country. Health spending associated with diabetes and prediabetes is about $194 billion this year, or 7 percent of U.S. health spending, the report said. That cost is projected to rise to $500 billion by 2020, or a total of almost $3.4 trillion on diabetes-related care.
Engaging the at-risk population could save up to $250 billion, or 7.5 percent of estimated spending on diabetes and prediabetes, in the next decade. Of that money, $144 billion, or about 58 percent, would come from savings in Medicare, Medicaid and health care exchange subsidies. Read more »
*This blog post was originally published at ACP Internist*
October 5th, 2010 by GarySchwitzer in Better Health Network, Health Policy, Health Tips, News, Opinion, Research, Video
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We reviewed four stories on the Swedish mammography study that appeared in the journal Cancer last week. Three of the four stories gave a pretty clear indication that there were methodological concerns about the Swedish research (of the four reviewed, only HealthDay offered no such hint):
• 4th paragraph of AP story: “The new study has major limitations and cannot account for possibly big differences in the groups of women it compares.”
• 1st paragraph of LA Times blog story: “Critics charged that the study was poorly designed and potentially vastly misleading.”
• 2nd sentence of NY Times story: “Results were greeted with skepticism by some experts who say they may have overestimated the benefit.”
But none of the stories did a very complete job of explaining those potential limitations. Because of the confusion that must be occurring in the minds of women — especially those in their 40s — this is a time in which journalism must rise to the need and do a better job of evaluating evidence and helping readers make sense of what appear to be conflicting findings.
I was in Chapel Hill, North Carolina, when the study was published and had the chance to talk about it with former U.S. Preventive Services Task Force member, and a recognized thought leader on issues of prevention and especially of screening tests, Dr. Russell Harris, Professor and Director of the Health Care and Prevention Concentration of the University of North Carolina (UNC) School of Public Health. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
September 12th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Research
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This is a thoughtful “sounding board” piece in the New England Journal of Medicine this week: Lessons from the Mammography Wars.
It is so important to keep this discussion alive. The miscommunication that took place last November of what the U.S. Preventive Services Task Force tried to convey, and the complicity of some news organizations in adding to that confusion, provide lessons from which we simply must learn to do better.
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
May 25th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Health Tips, Opinion, Quackery Exposed, Research
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A patient brought in a flyer for Life Line Screening, where for $129 an individual can have their carotid (neck) and peripheral (leg) arteries screened for blockage, their abdominal aorta screened for aneurysm (swelling), and be tested for osteoporosis. The advertisement claims that “we can help you avoid a stroke,” and their logo notes “Life Line Screening: The Power of Prevention.”
Are these tests worth your money? Short answer: No.
Although the flyer correctly indicates that 80 percent of stokes can be prevented, the National Stroke Assocation does not recommend ultrasound as a screening test. Preventing stroke includes quitting smoking, knowing your blood pressure and cholesterol numbers, drinking alcohol in moderation (if already doing so), exercising regularly, and eating a low-sodium diet. Their is no mention of an ultrasound test. Why? Because there is NO evidence that it helps save lives in individuals who are healthy and have no symptoms (except for the following situations). Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
