Laboratory Science, Policy and Practice Program Office
Healthcare News
A Weekly Compilation of Clinical Laboratory and Related Information
from The Division of Laboratory Science and Standards
February 28, 2013
News Highlights
- Cuts Could Harm Health Emergency Preparedness
- FDA Regulation of Laboratory Developed Tests: Benefit or Unnecessary Burden?
- Steep Climb to Suitable Reference Standards
- Test the Children
- 'Choosing Wisely' Targets 90 More Dubious Tests, Therapies
- Attitudes on PSA Hinge on How Test is Described
- Do-It-Yourself Health Test Market Expanding 20 Percent Annually
- EHR Users Unhappy, Many Switching
View Previous Issues - Healthcare News Archive
Cuts Could Harm Health Emergency Preparedness
The Centers for Disease Control and Prevention has put out a new game called Solve the Outbreak that allows would-be medical sleuths to track dangerous diseases in a frightening cyber world. But if the sequester takes effect, CDC’s actual disease detectives may be a lot less prepared for an epidemic in the real world.
“Fundamentally, CDC’s ability to protect the health of Americans would be severely compromised,” CDC Director Tom Frieden told POLITICO. “It would impact every CDC program. It would make us less able to find and stop outbreaks.”
Frieden and other experts say that even before the automatic budget cuts that are set to go into effect Friday, the nation’s public health system was stretched dangerously thin. Recession-driven cuts in federal, state and local spending since 2008 have culled the ranks of public health workers nationwide by about a fifth — 46,000 fewer positions.
More than two-thirds of the CDC’s core budget of about $6 billion goes to state and local health departments to fund positions and programs that extend a network of public health partnerships that can deliver early warnings of emergencies and a coordinated, rapid response.
Source: http://www.politico.com/
White House Moves to Make Federally Funded Research Open to the Public
The White House moved to make nearly all federally funded research freely available to the public, the latest advance in a long-running battle over access to research that exploded into view last month after the suicide of free-information activist Aaron Swartz. In a memo, White House science adviser John P. Holdren directed agency leaders to develop rules for releasing federally backed research within a year of publication in scientific or technical journals. “These policies will accelerate scientific breakthroughs and innovation, promote entrepreneurship, and enhance economic growth and job creation,” Holdren wrote.
Source: http://www.washingtonpost.com/
Feds Outline What Insurers Must Cover, Down to Polyp Removal
The Obama administration released its final rule on essential health benefits, which sets out what benefits insurers must offer starting in 2014. Insurers must cover 10 broad categories of care, including emergency services, maternity care, hospital and doctors’ services, mental health and substance abuse care and prescription drugs.
Limits on the maximum out-of-pocket costs a consumer would face each year, for example, would apply to all policies. That amount would be $6,250 for a single policyholder and $12,500 for a family based on this year’s rate.
Source: http://capsules.kaiserhealthnews.org/
Bill Seeking Greater Genetic Privacy Protection Reintroduced in California
Democratic State Sen. Alex Padilla reintroduced a bill to establish the California Genetic Information Privacy Act, which would make it illegal to collect, analyze, transfer, or store an individual's genetic information without that person's approval. Padilla introduced the same bill last year, but it stalled at the committee level.
Federal legislation, called the Genetic Information Nondiscrimination Act, prohibits the use of genetic information in health insurance and employment matters, and in 2011 California augmented GINA by passing legislation to prohibit genetic-based discrimination in life insurance, housing, education, and other areas.
Source: http://www.genomeweb.com/
Doctors, Lawyers Support Medical Errors Bill
Usually staunch adversaries, doctors and trial lawyers have both gotten behind an Oregon bill creating a new mediation process for patients injured by medical mistakes. Gov. John Kitzhaber, a doctor, called their agreement "the holy grail of medical and legal politics," something he never thought he'd live to see. "This is a foundation," Kitzhaber told a Senate committee. "It will definitely benefit the practice of medicine. It will benefit hundreds if not thousands of individuals." The Senate Judiciary Committee approved the measure, advancing it to a budget committee. The bill is aimed at reducing medical liability claims, but it doesn't put any restrictions on the amount of money a jury can award to punish doctors or hospitals for medical errors. Critics say it won't do anything to reduce the sky-high premiums for medical liability insurance.
Source: http://www.katu.com/
“Sunshine” Regulation Published Requiring Reporting of Payment or Transfer of Values to Physicians and Teaching Hospitals
Payments and transfer of anything of value to physicians and teaching hospitals by most manufacturers of drugs, devices, biological and medical supplies covered by Medicare, Medicaid and the Childrens’ Health Insurance Program (CHIP) will have to be reported to CMS (Final rule, 78 FR 9458, February 8, 2013). Group purchasing organization (GPOs) as well as manufacturers will have to report certain physician ownership or investment interests as well. The first report will be due March 31, 2014, and will cover all payments and transfers of value from August 1, 2013 to December 31, 2013. Reports will be due on March 31 of subsequent years for all payments and transfers made during the previous year
Source: http://health.wolterskluwerlb.com/
AMA, McKesson Team up on Genetic-Test Codes
The American Medical Association and McKesson Corp. struck a licensing agreement that they say will bring order to diagnostic codes in molecular testing, an area that AMA CEO Dr. James Madara says “has grown somewhat dicey.” The agreement calls for grouping and indexing the “Z-Code Identifiers” in the McKesson Diagnostic Exchange software—used by labs and test manufacturers—to the AMA Current Procedural Terminology, or “CPT,” code set used by physicians to report healthcare services delivered and by payers to reimburse for them.
Source: http://www.modernhealthcare.com/
'Choosing Wisely' Targets 90 More Dubious Tests, Therapies
No fewer than 12 of the guidelines issued as part of the "Choosing Wisely" campaign of the American Board of Internal Medicine Foundation
caution physicians that asymptomatic patients probably do not need a given treatment. A few examples follow, along with the society that recommended them:- Don't screen for carotid artery stenosis in asymptomatic adult patients (American Academy of Family Physicians).
- Don't automatically use computed tomography scans to evaluate children's minor head injuries (American Academy of Pediatrics).
- When prescribing medication for most people aged 65 years and older who have type 2 diabetes, avoid attempting to achieve tight glycemic control (American Geriatrics Society).
- Don't routinely order imaging tests for patients without symptoms or signs of significant eye disease (American Academy of Ophthalmology).
- Don't screen for ovarian cancer in asymptomatic women at average risk (American College of Obstetricians and Gynecologists).
- Avoid using stress echocardiograms on asymptomatic patients who meet "low-risk" scoring criteria for coronary disease (American Society of Echocardiography).
Source: http://www.medscape.com/
Diagnostic Tests May Not Ease Anxious Minds
Doctors overestimate the reassurance value of diagnostic testing when the probability of serious disease is low, researchers reported. In a systematic review and meta-analysis, testing did not allay nonspecific anxiety, the worry that symptoms might represent serious illness, or persistence of the symptoms, according to Alexandra Rolfe, MBChB, of the University of Edinburgh, and Christopher Burton, MD, of the University of Aberdeen, both in Scotland.
On the other hand, testing did reduce the number of subsequent primary care visits in some situations, albeit with a high number needed to investigate to prevent one extra visit, Rolfe and Burton reported online in JAMA Internal Medicine. The finding that diagnostic testing did little to reassure patients is "inconsistent with beliefs expressed by physicians," the researchers concluded.
Source: http://www.medpagetoday.com/
FDA Regulation of Laboratory Developed Tests: Benefit or Unnecessary Burden?
The U.S. Department of Food and Drug Administration (“FDA”) has previously announced an interest in regulating diagnostic tests used in providing personalized medicine clinical care. Interested stakeholders such as the American Clinical Laboratory Association, the College of American Pathologists, and the Association for Molecular Pathology, have weighed in on whether the FDA can and should expand its jurisdiction to laboratory developed tests (“LDTs) performed by clinical laboratories.
To the end of understanding the issues and concerns of stakeholders and the public, the Personalized Medicine Coalition (“PMC”) recently issued a white paper reporting on the regulatory landscape for personalized medicine tests and services in U.S. clinical practice. The report “Personalized Medicine Regulation: Pathways for Oversight of Diagnostics” (“PMC Report”, available here - PMC Report
[PDF 248.92KB]) explains the current regulatory oversight of diagnostic tests, and in particular LDTs and contrasts their regulation with regulation of certain diagnostic tests by the FDA.Current Regulatory Framework
The Report notes that two separate agencies in the U.S. Department of Health and Human Services (“HHS”) oversee personalized medicine products and services in the United States. The FDA regulates pharmaceutical products, biological products and medical devices used in patient care, including care that is considered personalized medicine. Clinical laboratories that perform diagnostic medicine such as genetic analysis (typically called “Laboratory Developed Tests or “LDTs”) are under the jurisdiction of the Centers for Medicare and Medicaid Services (“CMS”) pursuant to the Clinical Laboratory Improvement Amendments (“CLIA”). CMS certification currently is required before clinical laboratories can generally perform diagnostic tests and interpret and report results to health care providers.
Comparison of FDA and CMS Regulation of Diagnostic Tests
The PMC Report reviews in detail the structure of the FDA and CMS and the current oversight of LDTs by each agency. The PMC Report notes five key ways the FDA’s approach to regulating the manufacture and distribution of diagnostic medical devices differs from CMS’s approach to regulating diagnostic test services performed by laboratories:
Source: http://www.jdsupra.com/
Updating the HIV-Testing Guidelines — A Modest Change With Major Consequences
The U.S. Preventive Services Task Force (USPSTF) recently released a draft statement assigning a grade A recommendation to screening for human immunodeficiency virus (HIV) in the general population 15 to 65 years of age. The proposed guidelines cite an updated systematic evidence review of the benefits and potential harms of HIV screening. Since the previous evidence review was published in 2005, new studies have shown that antiretroviral therapy can reduce transmission by HIV-infected persons and that earlier initiation of such therapy can reduce morbidity and mortality and improve quality of life.
On the surface, the proposed guidelines of the USPSTF appear to represent a modest change, since they resemble the 2006 CDC recommendations regarding general-population screening. In practice, they have large implications for the way HIV testing is financed in the era of national health care reform. In addition, moving testing into routine care affects both the resources required for HIV treatment in future years and the costs that will be borne by various public and private payers.
Source: http://www.nejm.org/
NIH Launches Study of Long-Term Effects of Blood Glucose During Pregnancy
Researchers funded by the National Institutes of Health plan to determine whether elevated blood sugar during pregnancy, a less-severe condition than gestational diabetes, influences later levels of body fat in children and development of diabetes in mothers after giving birth.
The original study, the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO), looked at 23,316 mother-child pairs and found that a mother's blood sugar levels, even short of diabetes, were associated with her newborn's birth weight and body fat. The HAPO-Follow-up Study (HAPO-FUS) seeks to recruit 7,000 of the original HAPO mother-child pairs for a single visit to one of 10 of the original HAPO clinical centers. Mothers and children (now ages 8 to 12 years), will have their height, weight, blood pressure, body fat, blood sugar, insulin, and blood fats measured. "The goal of this study is to determine the levels of blood sugar during pregnancy that are linked to increased body fat in the child, and to a mother's chances of developing diabetes 8 to12 years after her pregnancy," said Mary Horlick, M.D., project scientist
Source: http://www.nih.gov/
Test the Children
Two big advisory groups have updated their stance on genetic testing and screening of children for the first time in more than a decade. The American College of Medical Genetics and Genomics and the American Academy of Pediatrics released a joint policy statement in the journal Pediatrics and a scientific paper backing up their recommendations in Genetics in Medicine. The new advice hinges less on the potential harms of genetic information to the psyches of kids and their parents than the groups' earlier positions, and encourages testing that is in children's best interest.
Source: http://www.genomeweb.com/
Advocacy Groups Urge Reauthorization of HHS Newborn Screening Committee as Charter Nears Expiration
The committee that advises the US Department of Health and Human Services on matters related to newborn screening for genetic diseases, and sets the newborn screening standards followed by many states, is set to expire in April and advocates are pressing to get it reauthorized. The 10-year-old Secretary's Advisory Committee on Heritable Disorders in Newborns and Children advises the HHS on ways to address newborn and childhood genetic disorders, and its domain now involves issues left behind by the now-defunct Secretary's Advisory Committee on Genetics, Health, and Society.
Source: http://www.genomeweb.com/
Geneticists Question Balance of Media Coverage of the Value of Gene Sequencing and Personalized Medicine
Pathologists and medical laboratory managers will want to stay informed about how genome sequencing data is being translated into clinical applications there is a vigorous debate unfolding about the ability of personal genome sequencing to reliably predict disease. That is not news to pathologists and clinical laboratory managers. What is a novel twist in the arguments by both sides is whether media coverage has the potential to undermine public support for genomics and personalized medicine.
For example, one media story on a study of the power of personal genome sequencing to predict disease drew fire from some genomics experts on two counts. First, they questioned the validity of the study. Second, they fear that such coverage by the media could weaken public support for genomics and personalized medicine.
Source: http://darkdaily.com/
Personalized Medicine Experts Call on Pathology Profession to Create a New Breed of Pathologist
‘National Agenda’ seeks to marshal efforts to sharpen the clinical impact of pathology in the genomics era Pathologists are being urged to seize the high ground as the unfolding revolutions in genomics and bioinformatics create unprecedented capabilities to more accurately diagnose patients and guide the selection of appropriate therapies.
Two experts in these fields have come together to issue a call to action for the pathology profession, stating that pathologists need to be prepared for the sequencing revolution. “Revolution is not too strong a word; this is not incremental change,” declared Dennis P. Wall, Ph.D. and Peter J. Tonellato, Ph.D., in a recent story published in The Scientist. “The use of whole-genome analysis (WGA) can, should, and will replace many current standard pathology practices of diagnosis and prognosis on which proper therapy and disease management rely,” the co-authors asserted.
Source: http://darkdaily.com/
AP Tracking: an Eagle Eye on Blocks and Slides
A high-tech blend of hall monitor, bloodhound, and lost and found, tracking systems to manage tissue specimens, blocks, and slides have gradually been taking root as part of an automated workflow in some anatomic pathology laboratories. As manual labeling, logging, and data capture give way to bar coding and even radio frequency identification, it’s a revolution of sorts, but a quiet one.
“Tracking systems have been in the clinical laboratory for at least a decade and AP has been really slow to catch up, largely because the volume was never quite there and AP is very much a manual process,” says John H. Sinard, MD, PhD, professor of pathology and director of pathology informatics at Yale University School of Medicine. “There’s still an art to getting a good histologic section. It’s something that requires skill and training.” Now, however, the volume has increased along with the need for efficiency and patient safety, and tracking technology has matured.
Source: http://www.cap.org/
Steep Climb to Suitable Reference Standards
For a laboratory test to produce true results reliably, reference materials are required that are well-characterized, homogeneous, stable, traceable, and commutable, Lawrence J. Jennings, MD, PhD, D(ABHI), noted. He was speaking at a plenary session on the lack of laboratory reference materials at the Association for Molecular Pathology 2012 Annual Meeting on Genomic Medicine. The talks of the plenary’s three speakers were intended to be complementary, he told CAP TODAY. David [Barton, PhD] and Lisa [Kalman, PhD] spent most of their time talking about the work they do characterizing [genetic] reference materials and what is available.” “It can cost thousands of dollars for them to run these samples.... They do it because they feel these materials are necessary," says CDC’s Lisa Kalman, PhD,
Source: http://captodayonline.us2.list-manage1.com/
Attitudes on PSA Hinge on How Test is Described
Three approaches to explaining the screening resulted in varying percentages of patients who identified reduced risk of prostate cancer death as its most important aspect. Men’s preferences and values about prostate cancer screenings are influenced by the way physicians present information on the prostate-specific antigen test, according to a team of scientists led by the University of North Carolina.
Fifty-four percent of men who were asked to rate and rank PSA test attributes as part of what’s known as a values clarification task said reducing the chance of prostate cancer death was the most important aspect of the screening, according to a study published online Feb. 11 in JAMA Internal Medicine, formerly Archives of Internal Medicine. In contrast, only 35% of men who examined a balance sheet and 33% who participated in a discrete choice experiment considered reduction in the chance of prostate cancer mortality to be the most important screening attribute, the data show.
Source: http://www.ama-assn.org/
Genomic Test Predicts Metastasis Risk in Prostate Cancer
A new test used after prostatectomy can indicate whether a man is at high risk or low risk for metastases, and therefore whether or not he is a candidate for additional treatment. The test, known as Decipher (developed by GenomeDx Biosciences), could help prevent overtreatment, according to Ketan Badani, MD, urologic oncologist at Columbia University in New York City.
Source: http://www.medscape.com/
Testing for Huntington Disease Streamlined by Novel Test
High level of sensitivity and specificity reduces need for additional testing, reported in the Journal of Molecular Diagnostics. A new test may help to streamline genetic testing for Huntington Disease (HD) by generating accurate results, avoiding unnecessary additional testing, and improving turnaround time. The test, which uses chimeric or triplet repeat primed PCR (TP PCR) methodology, yielded results that were 100% concordant with standard genotyping methods in an analysis of 246 samples.
Source: http://www.medicalnewstoday.com/
TED 2013: Uchek App Tests Urine for Medical Issues
A smartphone app that uses a phone's camera to analyse urine and check for a range of medical conditions has been shown off at the TED (Technology, Education and Design) conference in Los Angeles. Uchek tests for 25 different health issues and could help diagnose and treat diseases in the developing world. Increasingly mobile health is being talked up as a lifesaver in such areas.
The app is the brainchild of TED fellow Myshkin Ingawale. "I wanted to get medical health checks into users' hands," he told the BBC. Urine can be tested for the presence of 10 elements - including glucose, proteins and nitrites. These can be used to pinpoint a range of conditions including diabetes, urinary tract infects, cancers, liver problems as well as being used to keep track of general health. Users need to collect their urine and dip a standard test strip into it. Colour chart The strip is placed on a mat - supplied with the app and intended to normalise the colours on the stick regardless of lighting conditions where the photo is taken. Once the photo is taken the app will analyse which, if any, condition, the colour applies to. The app will be available from Apple's app store from the end of March for $20 (£13), which includes the cost of the mat and five dipsticks. As well as being used by individuals, the app will be put through its paces in the King Edward Memorial hospital in Mumbai, India. There, its accuracy will be tested against the laboratory machines more normally used to test urine." If it does well we can make it available to mobile clinics. Instead of buying a $10,000 machine they can use their existing smartphones," he said. Currently Uchek is only available for iPhones but versions for Android will be coming soon, Mr. Ingawale told the BBC.
Source: http://www.bbc.co.uk/
Building a Biochemistry Lab on a Chip
Miniaturized laboratory-on-chip systems promise rapid, sensitive, and multiplexed detection of biological samples for medical diagnostics, drug discovery, and high-throughput screening. Using micro-fabrication techniques and incorporating a unique design of transistor-based heating, researchers at the University of Illinois at Urbana-Champaign are further advancing the use of silicon transistor and electronics into chemistry and biology for point-of-care diagnostics. Lab-on-a-chip technologies are attractive as they require fewer reagents, have lower detection limits, allow for parallel analyses, and can have a smaller footprint.
Source: http://www.sciencedaily.com/
Huge Therapeutic and Diagnostic Potential Offered by Noncoding RNAs
As scientists continue to unravel the complexity of the human genome and to uncover vital elements that play a role in both, normal physiology and disease, one particular class of elements called noncoding RNAs is gaining a lot of attention. Guest Editor Tom Cech, PhD and Executive Editor Fintan Steele, PhD explore the enormous potential value of this rapidly advancing research area in their Editorial "The (Noncoding) RNA World." * The authors introduce a special research section on noncoding RNAs published in the current issue of Nucleic Acid Therapeutics
Source: http://www.medicalnewstoday.com/
Quest Selling HemoCue to Danaher's Radiometer
Quest announced a definitive agreement to sell its HemoCue business to Danaher's Radiometer Medical for about $300 million. Based in Cypress, Calif., HemoCue develops hemoglobin, glucose, and other point-of-care testing systems.
Source: http://www.genomeweb.com/
Do-It-Yourself Health Test Market Expanding 20 Percent Annually
The do-it-yourself test market, estimated at $2 billion to $3 billion globally, is expanding 20 percent a year as new checks for colon and prostate cancer, HIV, chlamydia, stomach ulcer, sperm count and drug abuse take their place on pharmacy shelves alongside standards such as blood-sugar monitors for diabetics and pregnancy tests, according to Alan Hirzel, a London-based partner at consulting company Bain & Co.
Source: http://www.bloomberg.com/
Clinical Screening Program Developed for No.1 Genetic Cause of Colon Cancer
Cleveland Clinic researchers have found that colorectal cancer outcomes could be improved with regular genetic screening for Lynch syndrome, the most common hereditary, adult-onset cause of colorectal cancer, as published in the online version of the Journal of Clinical Oncology.
Lynch syndrome is the most common genetic cause of colon cancer in adults. The study found that a universal screening program of all colorectal cancers surgically removed at Cleveland Clinic resulted in increased identification of Lynch syndrome patients by successfully referring individuals whose tumors screen positive to genetics professionals. Identification of Lynch syndrome will lead to significantly improved outcomes for colorectal cancer patients and their family members. With four million Americans having Lynch syndrome each year, and most going unrecognized, a systematic manner of screening for this condition presented a challenge.
Source: http://www.medicalnewstoday.com/
Studies of H5N1 Bird Flu to Require Strict Reviews
U.S. health officials announced plans for scientists to move forward with controversial research on the deadly H5N1 bird flu and said that any discoveries about how the virus might gain the ability to spread easily among humans should be shared with other scientists and the public.
The new policy, released by the National Institutes of Health, requires that studies aimed at making the virus more dangerous would now be subject to a heightened level of review. Effective immediately, researchers will have to explicitly delineate the potential science and health benefits — as well as safety risks — involved in their work before they can get government funding, said Dr. Amy Patterson, NIH associate director for science policy.
Source: http://www.latimes.com/
In U.S., Flu Vaccine Worked in Just Over Half of Those Who Got It
A U.S. government analysis of this season's flu vaccine suggests it was effective in only 56 percent of people who got the shot, and it largely failed to protect the elderly against an especially deadly strain circulating during flu season. The U.S. Centers for Disease Control and Prevention said the findings underscore the need for more effective weapons in the fight against influenza, which kills between 3,000 and 50,000 people in the United States each year depending on the severity of the flu season. "We simply need a better vaccine against influenza, one that works better and lasts longer," CDC Director Dr. Thomas Frieden said in a statement.
Source: http://www.reuters.com/
High Cystatin C Boosts Likelihood of Prediabetes
Elevated levels of serum cystatin C are associated with prediabetes in non-obese adults in the U.S., a study found. Compared with individuals in the lowest quartile of serum cystatin C, those in the highest quartile had a twofold increased likelihood of prediabetes, after adjusting for body mass index (BMI), blood pressure, C-reactve protein and cholesterol levels, and other potential confounders, researchers reported online ahead of print in the European Journal of Epidemiology.
The investigators defined prediabetes as a two-hour glucose concentration of 140-199 mg/dL, a fasting glucose concentration of 110-125 mg/dL, or a hemoglobin A1C value of 5.7%-6.4%. Prediabetes is an early stage in the hyperglycemic continuum associated with increased future risk of developing diabetes and cardiovascular disease, the authors explained.
Source: http://www.renalandurologynews.com/
Bad Sleep 'Dramatically' Alters Body
A run of poor sleep can have a potentially profound effect on the internal workings of the human body, say UK researchers. The activity of hundreds of genes was altered when people's sleep was cut to less than six hours a day for a week. Writing in the journal PNAS, the researchers said the results helped explain how poor sleep damaged health. Heart disease, diabetes, obesity and poor brain function have all been linked to substandard sleep.
What missing hours in bed actually does to alter health, however, is unknown. So researchers at the University of Surrey analysed the blood of 26 people after they had had plenty of sleep, up to 10 hours each night for a week, and compared the results with samples after a week of fewer than six hours a night. More than 700 genes were altered by the shift. Each contains the instructions for building a protein, so those that became more active produced more proteins - changing the chemistry of the body.
Source: http://www.bbc.co.uk/
Deadly Breast Cancers are Rising in Young Women
At a time when the USA is making progress overall against cancer, a new study suggests a worrisome rise in the number of young women diagnosed with advanced, incurable breast cancer. The number of American women ages 25 to 39 diagnosed with metastatic breast cancer — which has already spread to other organs by the time it's found — rose about 3.6% a year from 2000 to 2009, according to a study in today's Journal of the American Medical Association. The trend began in the 1970s, although the most rapid increases occurred in about the last decade, the study says. The study doesn't provide any clues about what might be driving the increase, says study author Rebecca Johnson, a pediatric and adolescent oncologist at Seattle Children's Hospital.
Source: http://www.usatoday.com/
FDA Approves a New Drug for Advanced Breast Cancer
The Food and Drug Administration approved a new type of drug that combines the widely used breast cancer medicine Herceptin with a powerful toxin to more effectively kill cancer cells while potentially reducing side effects. The drug, which will be called Kadcyla but was known as T-DM1 during its development, extended the median survival of women with advanced breast cancer by nearly half a year in a clinical trial.
Genentech, which developed the drug, said it would cost about $9,800 a month, or $94,000 for a typical course of treatment. That is about twice the price of Herceptin itself, which is also made by Genentech, but it is similar to the price of some other new cancer drugs.
Source: http://www.nytimes.com/
Computer Simulations Set to Save Health Care
New research from Indiana University has found that machine learning -- the same computer science discipline that helped create voice recognition systems, self-driving cars and credit card fraud detection systems -- can drastically improve both the cost and quality of health care in the United States. Using an artificial intelligence framework combining Markov Decision Processes and Dynamic Decision Networks, IU School of Informatics and Computing researchers Casey Bennett and Kris Hauser show how simulation modeling that understands and predicts the outcomes of treatment could reduce health care costs by over 50 percent while also improving patient outcomes by nearly 50 percent.
The work by Hauser, an assistant professor of computer science, and Ph.D. student Bennett improves upon their earlier work that showed how machine learning could determine the best treatment at a single point in time for an individual patient.
Source: http://www.medicalnewstoday.com/
EHR Users Unhappy, Many Switching
With more electronic health record systems continuing to fall short of providers' expectations, a new report by Black Book Rankings suggests that 2013 may indeed be the "year of the great EHR vendor switch." After polling some 17,000 active EHR adopters, report officials found that as many as 17 percent of medical practices could be switching out their first choice EHR by the end of the year. “The high performance vendors emerging as viable past 2015 are those dedicating responsive teams to address customers’ current demands,” said Black Book’s managing partner Doug Brown, in a news release.
Source: http://www.healthcareitnews.com/
Computerized Provider Order Entry Reduces Medication Errors in Hospitals
Processing a prescription through an electronic ordering system can reduce the likelihood of a drug error by half and potentially avoid more than 17 million such incidents in U.S. hospitals in one year alone, according to a new study supported by the Agency for Healthcare Research and Quality. The authors evaluated published evidence on the impact of computerized provider order entry (CPOE) on hospital drug errors and combined this information with data on the adoption of CPOE and the volume of medication orders processed annually. The results estimated the reduction in drug errors for one year, finding that widespread adoption of CPOE could substantially reduce drug errors. “Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems” appears online in the Journal of the American Medical Informatics Association. To access the abstract, select http://jamia.bmj.com/content/early/2013/01/27/amiajnl-2012-001241.full
.Source: Agency for Healthcare Research and Quality (AHRQ) Weekly Digest Bulletin
Regulation of Hospitals Supported by Study
Hospital beds tend to get used simply because they're available - not necessarily because they're needed; according to a first-of-its-kind study that supports continued regulation of new hospitals. Michigan State University researchers examined all 1.1 million admissions at Michigan's 169 acute-care hospitals in 2010 and found a strong correlation between bed availability and use, even when accounting for myriad factors that may lead to hospitalization. These factors include nature of the ailment, health insurance coverage, access to primary care and patient mobility. In other words, the simple fact the beds were available led to higher use, said Paul Delamater, lead author and a researcher in MSU's Department of Geography. The study appears in the journal PLOS ONE. "The findings support the regulation of hospital beds - of keeping the number of hospital beds aligned with the health care needs of the population," Delamater said.
Source: http://www.medicalnewstoday.com/
Black Men Increasingly Hard to Find in Medical Schools
A dwindling share of students pursuing physician careers are African-American men. Experts warn that the trend could exacerbate racial health disparities and doctor shortages.
Black men are notable in that their numbers are lagging even as other minorities and women are continuing a long-term trend of gaining greater representation among medical school applicants and students, according to the most recent Assn. of American Medical Colleges report on medical education diversity. The report said 2.5% of medical school applicants were black men in 2011, a drop from 2.6% in 2002. That compares with 9% and 11% increases in the share of Asian and Hispanic male applicants, respectively, during the same period. A 10% greater share of matriculating students were Asian men in 2011 than in 2002, and Hispanic men made up a 24% larger proportion of new medical students. The share of white male applicants and matriculants was stable.
The underrepresentation of black men in medicine is problematic for multiple reasons, experts say.
Source: http://www.ama-assn.org/
Koop, Who Transformed Surgeon General Post, Dies
With his striking beard and starched uniform, former Surgeon General Dr. C. Everett Koop became one of the most recognizable figures of the Reagan era — and one of the most unexpectedly enduring.
Koop was born in the New York City borough of Brooklyn, the only son of a Manhattan banker and the nephew of a doctor. He said by age 5 he knew he wanted to be a surgeon and at age 13 he practiced his skills on neighborhood cats. He attended Dartmouth, where he received the nickname Chick, short for "chicken Koop." It stuck for life. Koop received his medical degree at Cornell Medical College, choosing pediatric surgery because so few surgeons practiced it. Koop was appointed surgeon-in-chief at Children's Hospital in Philadelphia and served as a professor at the University Of Pennsylvania School Of Medicine.
Source: http://www.ajc.com/
Major Health Benefits Expected From Low-Arsenic Rice Discovered in Bangladesh
Millions of people worldwide are regularly exposed to arsenic through drinking water and eating rice grown in soil and water containing high amounts of arsenic. Long-term exposure can lead to the development of different types of cancer as well as serious cardiovascular, neurological, and other health problems. Scientists have now identified aromatic rice from Bangladesh that has far lower arsenic concentrations than found in non-aromatic rice. The other important benefit is that it contains higher amounts of selenium and zinc. The discovery is reported in Biomedical Spectroscopy and Imaging.
Source: http://www.medicalnewstoday.com/
Disclaimer- The information provided in this news digest is intended only to be general summary information. It does not represent the official position of the Centers for Disease Control and Prevention and is not intended to take the place of applicable laws or regulations.
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