MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'based'. Sat, 03 Sep 2011 01:56:59 +0100 http://www.medworm.com/index.php?rid=5174612&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fchinese-study-compares-flu-treatments-prescription-drug-vs-herbal-remedy%2F2011.08.29 During the early days of the 2009 H1N1 influenza A pandemic, the popular herbal formula maxingshigan–yinqiaosan was used widely by TCM practitioners to reduce symptoms. (It’s hard to pronounce and spell, so I’ll refer to it as M-Y.) A new study was done to test whether M-Y worked and to compare it to the prescription drug oseltamivir. It showed that M-Y did not work for the purpose it was being used for: it did not reduce symptoms, although it did reduce the duration of one sign, fever, allowing researchers to claim they had proved that it works as well as oseltamivir. “Oseltamivir Compared With the Chinese Traditional Therapy: Maxingshigan–Yinqiaosan in the Treatment of H1N1 Influenza” by Wang et al. was published in the Annals of Internal Medicine earlier this month. The stu... Better Health blogs http://www.medworm.com/rss/comments.php?id=5174612 Mon, 29 Aug 2011 18:00:51 +0100 5174612 http://www.medworm.com/index.php?rid=5174704&cid=t_152392_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FMJr4_oLHBIQ%2F Time to touch on a few popular topics that I found being discussed on Twitter. First, I’ll put the tweets and then a little but of my own commentary on these hot button issues in healthcare IT. @GovHIT Does a nationwide #EHR lower healthcare costs? Social media reactions | #GovHIT Blog http://ow.ly/64DL1 I always love when people talk about a nationwide EHR. I actually think that it’s a bad title by Government Healthcare IT, but that it’s a very good question. To me a nationwide EHR implies that there is one EHR for the entire nation. I think a number of other countries which are much smaller and less complex than the US have proven quite well that a nationwide government run EHR is a bad idea. I think the Government HIT article actually refers more to widespread adoption... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5174704 Mon, 29 Aug 2011 07:20:12 +0100 5174704 http://www.medworm.com/index.php?rid=5158863&cid=t_152392_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2011%2F08%2F21%2Fpubmeds-higher-sensitivity-than-ovid-medline-other-published-cliches%2F Is it just me, or are biomedical papers about searching for a systematic review often of low quality or just too damn obvious? I’m seldom excited about papers dealing with optimal search strategies or peculiarities of PubMed, even though it is my specialty. It is my impression, that many of the lower quality and/or less relevant papers are [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=5158863 Sun, 21 Aug 2011 19:21:49 +0100 5158863 http://www.medworm.com/index.php?rid=5158864&cid=t_152392_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2011%2F08%2F19%2Ffollowfriday-ff-drjengunter-ebm-sex-health-expert-wielding-the-lasso-of-truth%2F If you’re on Twitter you probably seen the #FF or #FollowFriday phenomenon. FollowFriday is a way to recommend people on Twitter to others. For at least 2 reasons: to acknowledge your favorite tweople and to make it easier for your followers to find new interesting people. However, some #FollowFriday tweet-series are more like a weekly [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=5158864 Thu, 18 Aug 2011 22:12:52 +0100 5158864 http://www.medworm.com/index.php?rid=5139733&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbook-review-food-truths-food-lies%2F2011.08.18 Food Truths, Food Lies, written by family physician Eric Marcotte, M.D., may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods, magical berries, or supplement “must-haves” in the entire book. What you will find is the cold, hard truth about why many Americans are overweight, and what it takes to become a healthy eater. Marcotte writes for the average American – his simple language, matter-of-fact tone, and regular reminders of what the reader has learned, make for a quick and memorable read.  Although it’s clear that Marcotte has carefully distilled his dietary advice from the scientific literature, he refrains from burdening the reader with too many footnotes and references. Instead, he has created ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5139733 Thu, 18 Aug 2011 16:00:45 +0100 5139733 http://www.medworm.com/index.php?rid=5139644&cid=t_152392_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2011%2F08%2F14%2Frip-statistician-paul-meier-foster-parent-not-father-of-the-rct%2F This headline in Boing Boing caught my eye today:  RIP Paul Meier, father of the randomized trial Not surprisingly, I knew that Paul Meier (with Kaplan) introduced the Kaplan-Meier estimator (1958), a very important tool for measuring how many patients survive a medical treatment. But I didn’t know he was “father of the randomized trial”…. But is he really?: [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=5139644 Sun, 14 Aug 2011 21:55:48 +0100 5139644 http://www.medworm.com/index.php?rid=5130671&cid=t_152392_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2011%2F08%2F14%2Frip-statistician-paul-meier-foster-parent-not-father-of-the-rct%2F This headline in Boing Boing caught my eye today:  RIP Paul Meier, father of the randomized trial Not surprisingly, I knew that Paul Meier (with Kaplan) introduced the Kaplan-Meier estimator (1958), a very important tool for measuring how many patients survive a medical treatment. But I didn’t know he was “father of the randomized trial”…. But is he really?: [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=5130671 Sun, 14 Aug 2011 21:55:48 +0100 5130671 http://www.medworm.com/index.php?rid=5107517&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fanonymous-blogger-reviews-the-lack-of-evidence-for-robotic-surgery%2F2011.08.08 The surgeon who blogs as Skeptical Scalpel writes that he (she?) is unable to contain him(her)self any longer and then lunges into a review of evidence (or lack thereof) for robotic surgery. You may disagree with Skeptical Scalpel’s decision to be anonymous, but he/she explains: “I’ve been a surgeon for almost 40 years and a surgical department chairman for over 23 of those years. During much of that time, conforming to the norms, rules and regulations of government agencies, accrediting bodies, hospitals, societies, and social convention was necessary for survival. I was always somewhat outspoken but in a controlled way most of the time. I now have a purely clinical surgery practice with no meetings, site visits or administrative hassles. I am free to speak my mind about... Better Health blogs http://www.medworm.com/rss/comments.php?id=5107517 Mon, 08 Aug 2011 18:00:07 +0100 5107517 http://www.medworm.com/index.php?rid=5096574&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D320 I came across a poll indicating that hospitals plan on increasing their technology spending by up to 37% over the next five years.  This is great news considering the 8% drop in 2009.  But, who is buying what? It’s an interesting discussion considering so much has happened in the last couple of years.   One of the advantages of my position at MD Buyline is that I can see in real time who is buying what and when.  I did some trending and found ultrasound (up 22%), cath labs (up 17%) endoscopy/laparoscopy (up 16%), and nuclear med (14%) technologies will see the most growth.  IT also appears to be growing (12% growth) but not as strong as it did in the last six months.  I also found it interesting that high-end technologies, such as MRI, will see growth (3 to 4%) but not like we hav... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=5096574 Thu, 04 Aug 2011 15:32:22 +0100 5096574 http://www.medworm.com/index.php?rid=5086167&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-we-want-in-health-news-is-often-not-what-we-need%2F2011.08.01 News of the World wasn’t read by 15 percent of the British public because it told people what they should know. It got there by giving them what they wanted: stories about the peccadilloes of the rich and famous, accounts of the gross incompetence of government and of course, pictures of naked ladies. Setting aside the fact that News of the World is no more, its publishers and editors knew how to sell the “news.”  As free online news replaces print, every click, every page view, every second of viewing per page is tracked in the fierce competition for ad dollars, and so the selling of news increasingly influences its reporting.  Titles, format and content are tweaked by editors to “optimize the metrics.” Reporters succeed and fail based on their ability to write articles that a... Better Health blogs http://www.medworm.com/rss/comments.php?id=5086167 Mon, 01 Aug 2011 22:00:46 +0100 5086167 http://www.medworm.com/index.php?rid=5069505&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F07%2Fwhats-wrong-with-performance-measures.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5069505 Tue, 26 Jul 2011 21:12:00 +0100 5069505 http://www.medworm.com/index.php?rid=5062269&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F07%2Ftrends-in-elective-pci-post-courage.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=5062269 Mon, 25 Jul 2011 17:59:00 +0100 5062269 http://www.medworm.com/index.php?rid=5036238&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F1LTHl_vklng%2F Great news LITFLers, Keeping Up with Emergency Medicine is back! Once again, you can stay up to date with the literature in 10 minutes a week, for free! (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5036238 Sun, 17 Jul 2011 03:37:52 +0100 5036238 http://www.medworm.com/index.php?rid=5028220&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmeta-analyses-and-a-capricious-drug-approval-process-the-actos-and-avandia-stories%2F2011.07.13 Both Germany and France have now suspended the marketing of Actos (pioglitazone) due to concerns of a link between Actos and bladder cancer. Though we have known about bladder cancer concerns for some time, these recent concerns about the bladder cancer link stem from a recent report analyzing the FDA’s Adverse Event Reporting System (AERS), which found that 93 cases of cancer were recorded between 2004 and 2009 in patients treated with antidiabetic drugs, of which 31 patients were treated with pioglitazone, representing a statistically significant increased risk of bladder cancer (ROR 4.30, 95% confidence interval, 2.82-6.52; P less than 0.0001). Interestingly, the FDA announced that it was going to look into the link between Actos and bladder cancer only a few days before it made i... Better Health blogs http://www.medworm.com/rss/comments.php?id=5028220 Wed, 13 Jul 2011 19:00:00 +0100 5028220 http://www.medworm.com/index.php?rid=5028610&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D299 Hospitals will spend over $14 billion each year to service medical technology and IT.  But, unlike labor or utilities, the cost of service is negotiable.  Service on medical technology is at least a $1 to $2 million (.5% of the overall budget) line item for a 200-bed hospital.  Larger teaching facilities would see this number easily reach $3 to $5 million.  So, with hospital margins ranging around 4% to 6% and as many as 25% functioning in the red, a couple million dollars is a big deal. I asked Julio Huerta, EE, MPH, director of medical engineering at the University of North Carolina Health Care System in Chapel Hill, NC, about the impact of service costs.  Huerta said, “You buy a piece of equipment and everybody understands about negotiating very tough upfront when you purchase eq... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=5028610 Tue, 12 Jul 2011 14:35:39 +0100 5028610 http://www.medworm.com/index.php?rid=4968938&cid=t_152392_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F06%2Flost-art-of-evaluation-in-pediatric.html This is a topic that is probably long overdue - it is something that I have observed in my geographic area for a long period of time. Based on conversations I have with therapists around the country I know that it is not exclusive to my area.Increasing demands on therapist time, decreasing reimbursements, and dependence on a non-centralized workforce that is not subject to an intense quality improvement process has contributed to significant changes in how occupational therapy 'evaluations' are completed.Our agency made attempts to impact this system while contracted to complete some evaluations, but 'contractor status' did not place us into a position to make broad system changes. Now it seems that the entire community is stuck into a cycle of low expectations based on long history. Unfor... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4968938 Thu, 23 Jun 2011 14:03:00 +0100 4968938 http://www.medworm.com/index.php?rid=4952744&cid=t_152392_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2011%2F06%2F20%2Fhot-topic-does-soy-relieve-hot-flashes%2F The theme of the Upcoming Grand Rounds held at June 21th (1st day of the Summer) at Shrink Rap is “hot”. A bit far-fetched, but aah you know….shrinks“. Of course they hope  assume  that we will express Weiner-like exhibitionism at our blogs. Or go into spicy details of hot sexpectations or other Penis Friday NCBI-ROFL posts. But no, not me, [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=4952744 Sun, 19 Jun 2011 23:37:49 +0100 4952744 http://www.medworm.com/index.php?rid=4934240&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F06%2Fconfusing-cookie-cutter-medicine-with.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4934240 Wed, 15 Jun 2011 10:12:00 +0100 4934240 http://www.medworm.com/index.php?rid=4934401&cid=t_152392_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F06%2Findian-doctors-learning-and-cme.html In reality, all learning is self-learning. We talk about teaching doctors to help them keep uptodate, but in reality, no one can teach anyone else - it's only the student who can learn ! A good teacher will provide as many avenues and opportunities as possible, so that students can learn for themselves.Adult learners are a different breed - and this is especially true for doctors, who are highly qualified and very busy professionals, with major time constraints.Not only is it hard for them to take time out of their busy schedules to learn, it's even more important for us to ensure that whatever techniques we use to teach doctors, these are proven to be effective in helping doctors to improve their knowledgebase.Unfortunately, lectures and presentations at medical conferences are very ineff... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4934401 Mon, 13 Jun 2011 03:25:00 +0100 4934401 http://www.medworm.com/index.php?rid=4921435&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FjkJtnC7xuoA%2F LITFL reviews the June edition of Emergency Medicine Practice on Traumatic Hand Injuries. Are you ready for the Top 10 Review Questions? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4921435 Thu, 09 Jun 2011 09:29:16 +0100 4921435 http://www.medworm.com/index.php?rid=4911634&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D277 First approved in 2008, unattended home sleep studies now have been assigned a permanent CPT code.  Historically, sleep studies have been performed during an overnight stay in a hospital or a lab, but new technology has allowed physicians to prescribe unattended sleep recordings of a patient’s heart rate, oxygen saturation, and respiration in a home environment. This is great news since an estimated 50 to 70 million American have a sleep disorder, and if left untreated, sleep disorders can have serious affects on a patient’s health. In 2011, CMS issued a final rule that assigned home sleep studies to CPT codes 95800 (sleep study, unattended simultaneous recording, heart rate, oxygen saturation, respiratory analysis, and sleep time) and 95801, which monitors the same parameters except ... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4911634 Tue, 07 Jun 2011 14:08:15 +0100 4911634 http://www.medworm.com/index.php?rid=4911493&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FIJ5pagkDJTU%2F We recently featured a video on what could turn out to be the emergency medicine/ critical care 'Trial of the Year'... That's right, the FEAST Trial: (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4911493 Tue, 07 Jun 2011 00:00:18 +0100 4911493 http://www.medworm.com/index.php?rid=4893592&cid=t_152392_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F06%2Fbetter-way-of-making-sure-doctors-learn.html If conferences are such a poor way of teaching doctors, then what can the profession do to ensure that doctors remain updated ? Is it possible to trust that all doctors are responsible professionals who will take the time and trouble to educate themselves on an ongoing continual basis ? Sadly, no. While most doctors are conscientious and will make a concerted effort to learn, not all will do so .So what's a better option which will ensure that doctors learn reliable, updated, accurate evidence based medicine, without wasting time and money ?The answer is surprisingly simple ! In medical college, doctors are used to memorising vast amounts of information from their medical textbooks, so that they can pass their examinations , qualify and start practise. Unfortunately, most of what they lear... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4893592 Fri, 03 Jun 2011 14:13:00 +0100 4893592 http://www.medworm.com/index.php?rid=4893459&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F4KSMp8AaGAU%2F A surprising FEAST: "Fluid boluses significantly increased 48-hour mortality in critically ill children with impaired perfusion in... resource-limited settings in Africa." (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4893459 Thu, 02 Jun 2011 09:23:02 +0100 4893459 http://www.medworm.com/index.php?rid=4852854&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpress-release-contains-ridiculous-health-claim-of-the-week%2F2011.05.23 Every once in a while, a press release comes along that’s worth mocking publically. Here’s one of them. In honor of National Mental Health Month, one PR flack pitched Philip Stein watches. In the flack’s words: “The highlighted element of the watch is the brand’s exclusive wellness technology that helps wearers improve sleep and reduce stress. The watch is embedded with a metal disk that emits natural frequencies into the body wearer and in turn, affects the wearer’s energy field. It’s called ‘Natural Frequency Technology’ and is a new patented technology studies suggest help to improve sleep quality and reduces stress.” Really. That’s what the flack said. Right off the bat, he’s gone from mental health issues to sleep... Better Health blogs http://www.medworm.com/rss/comments.php?id=4852854 Mon, 23 May 2011 20:00:00 +0100 4852854 http://www.medworm.com/index.php?rid=4852823&cid=t_152392_87_f&fid=34591&url=http%3A%2F%2Fwww.badscience.net%2F2011%2F05%2Fwe-should-so-blatantly-do-more-randomised-trials-on-policy%2F Ben Goldacre, The Guardian, Saturday 14 May 2011 Politicians are ignorant about trials, and they’re weird about evidence. It doesn’t need to be this way. In international development work, resources are tight, and people know that good intentions aren’t enough: in fact, good intentions can sometimes do harm. We need to know what works. In [...] (Source: badscience) badscience blogs http://www.medworm.com/rss/comments.php?id=4852823 Mon, 23 May 2011 12:41:38 +0100 4852823 http://www.medworm.com/index.php?rid=4848012&cid=t_152392_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F05%2Flost-in-health-information-maze.html 50 years ago, the major problem was that patients had too little information. All of this was locked up in medical books and journals, and this information asymmetry meant that the patient was often forced to put the doctor on a pedestal, because he had all the knowledge. Patients felt helpless because they did not know enough.Today, there's been a sea change, and patients still feel helpless - but this is because they have access to too much information - most of which is wrong, inaccurate or outdated ! Thanks to google, it's become very easy for patients to unearth thousands of pages of information on any topic - but because this information is badly organised and is not put in context, patients find it easy to get lost.It's very common to find two 2 different websites saying diametrical... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4848012 Fri, 20 May 2011 03:21:00 +0100 4848012 http://www.medworm.com/index.php?rid=4841477&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-review-of-the-most-common-physician-errors-in-thinking-and-judgement%2F2011.05.19 In my recent review of Peter Palmieri’s book Suffer the Children I said I would later try to cover some of the many other important issues he brings up. One of the themes in the book is the process of critical thinking and the various cognitive traps doctors fall into. I will address some of them here. This is not meant to be systematic or comprehensive, but rather a miscellany of things to think about. Some of these overlap. Diagnostic fetishes Everything is attributed to a pet diagnosis. Palmieri gives the example of a colleague of his who thinks everything from septic shock to behavior disorders are due to low levels of HDL, which he treats with high doses of niacin. There is a tendency to widen the criteria so that any collection of symptoms can be seen as evidence of the condition. ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4841477 Thu, 19 May 2011 15:00:33 +0100 4841477 http://www.medworm.com/index.php?rid=4841478&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffrom-spain-drug-prescription-habits-are-often-emotionally-driven%2F2011.05.19 I recently stumbled upon a very interesting editorial opinion in the ‘European Journal of Clinical Pharmacology’: ‘The use of drugs is not as rational as we believe…but it can’t be! The emotional roots of prescribing’, authored by Albert Figueras, from Fundació Institut Català de Farmacologia (Catalonia Institute of Pharmacology Foundation at Vall d’Hebron Hospital, in Barcelona). Since more than 40 years ago when Archie Cochrane said that “there must be solid scientific evidence behind any statement, decision and prescription made by medical staff”, and all the way until today’s WHO promotion of rational medicine utilization, both developing and industrialised countries have been striving to increase sound knowledge about prescription and thus spread the kind of rati... Better Health blogs http://www.medworm.com/rss/comments.php?id=4841478 Thu, 19 May 2011 13:00:18 +0100 4841478 http://www.medworm.com/index.php?rid=4828886&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcutting-healthcare-costs-in-spain-evidence-based-disinvestment%2F2011.05.16 In an economic downturn, two classic cost-reducing solutions come to mind in the healthcare services industry: reduce offerings (give fewer services)  or control demand (limit access to healthcare or increase copayments). There are many more but these two are the most frequently used. Actually, budget cuts in the Spanish region of Catalonia fit in the first type: they will need fewer resources (both human and material) because their services offered will shrink. It’s always controversial to cut healthcare services in Spain. Even talking about it leads to accusations of promoting total privatization, attacking the Welfare State and so on. But there is another way to cut services, drugs or technologies. It’s what Dr. Iñaki Gutierrez-Ibarluzea called ‘Evidenced-based disinvestment’ ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4828886 Mon, 16 May 2011 11:00:10 +0100 4828886 http://www.medworm.com/index.php?rid=4821180&cid=t_152392_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F05%2Forwellian-analysis-of-cse-meetings.html Sometimes when children progress from preschool to school it is determined that they still need to be classified and receive special education services. Sometimes it is determined that they should be declassified. There is a defined process that is supposed to be followed.Patrick is a preschooler who has disabilities and if he enrolled in kindergarten last year he would have either continued his classification and received services OR continued his occupational therapy services in the school under a declassification plan for one year. Given his severity of delay he would have also been a likely participant in a summer readiness program designed to help support children's performance when they are struggling with key developmental skills.The goalposts have been moved again this year. Now th... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4821180 Fri, 13 May 2011 18:52:00 +0100 4821180 http://www.medworm.com/index.php?rid=4813390&cid=t_152392_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F05%2Fhealthwise-patient-education-solution.html The Healthwise Patient Education Solution provides evidence-based patient instructions for virtually any moment in care. The meaningful health content includes instructions on how to prepare for upcoming procedures, after-care instructions, drug leaflets, and guidelines for when to call for help. And the patient instructions include “Go to Web” codes that directly link patients to more health information and interactive decision aids in the Healthwise® Knowledgebase, an online health encyclopedia. The Patient Information Education Trust is the Indian distributor for Healthwise ! (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4813390 Wed, 11 May 2011 12:14:00 +0100 4813390 http://www.medworm.com/index.php?rid=4789332&cid=t_152392_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F05%2F05%2Fhelping-schools-with-their-mental-health-needs%2F May is Mental Health Month (if you hadn’t heard), and in keeping with that theme, it’s good to check in to see where mental health resides in various places in society. One of those places is in our schools. Schools can be a helpful frontline in the identification — through screening programs — of at-risk children and teens who may get a mental disorder. In the past decade, schools have also become a necessary component of ensuring students who need mental health treatment have access to something that can help. But University of Missouri researchers caution that when it comes to mental health programs in schools, one size does not fit all. Just trying to implement research-based solutions without truly understanding what the problem is in a particular school or sch... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4789332 Thu, 05 May 2011 16:45:24 +0100 4789332 http://www.medworm.com/index.php?rid=4789289&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F05%2Fpatient-centered-conversations-about.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4789289 Thu, 05 May 2011 10:54:00 +0100 4789289 http://www.medworm.com/index.php?rid=4753689&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdr-steve-novella-defends-science-and-reason-on-the-dr-oz-show%2F2011.04.26 I must say I was a bit shocked two weeks ago when I was contacted by a producer for The Dr. Oz Show inviting me on to discuss alternative medicine. We have been quite critical of Dr. Mehmet Oz over his promotion of dubious medical treatments and practitioners, and I wondered if they were aware of the extent of our criticism (they were, it turns out). Despite the many cautions I received from friends and colleagues (along with support as well) – I am always willing to engage those with whom I disagree. I knew it was a risk going into a forum completely controlled by someone who does not appear to look kindly upon my point of view, but a risk worth taking. I could only hope I was given the opportunity to make my case (and that it would survive the editing process). The Process Of course, e... Better Health blogs http://www.medworm.com/rss/comments.php?id=4753689 Tue, 26 Apr 2011 22:36:35 +0100 4753689 http://www.medworm.com/index.php?rid=4744817&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysicians-against-dr-ozs-misinformation-a-battle-they-cannot-win%2F2011.04.23 A handful of physicians are collaborating to take Mehmet Oz, MD, to task on what they’re calling outlandish claims and bad medical advice. Their suggestion is to no longer pay attention to that man behind the curtain. David H. Gorski, MD, PhD, at the blog Science-Based Medicine went after Dr. Oz for hosting segments about faith healing and consulting psychics. Dr. Gorski pulls no punches, saying, “Dr. Oz has in some ways imitated Oprah and in some ways gone her one better (one worse, really) in promoting the Oprah-fication of medicine. And this season has been a particularly bad one for science-based medicine on The Dr. Oz Show.” (Dr. Mehmet Oz may be using his “Degree in Thinkology” to come up with some of his show topics.) Val Jones, MD, the woman behind the... Better Health blogs http://www.medworm.com/rss/comments.php?id=4744817 Sat, 23 Apr 2011 22:00:00 +0100 4744817 http://www.medworm.com/index.php?rid=4714750&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FQiqApWaeJFc%2F It's April 2011 and time for @EBMedicineʼs Emergency Medicine Practice. This month the focus on the hottest of hot topics, therapeutic hypothermia. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4714750 Thu, 14 Apr 2011 15:07:15 +0100 4714750 http://www.medworm.com/index.php?rid=4709468&cid=t_152392_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F04%2Fsensory-integration-research-who-is-it.html This article is another factor analysis study that has to be considered in the context of a number of other studies including Ayres (1989) original cluster and factor analyses that went into SIPT standardization, Mulligan's 1998 and 2000 cluster and factor analyses, and the critically appraised topic written by Davies and Tucker (2008). I'm not sure how many street level practitioners read cluster and factor analysis studies but I don't think that most people put this on top of their reading list. I think this is because we don't spend a lot of time educating practitioners on these methods and what they mean. I personally think that these statistical models are interesting but I also understand that they have a serious fundamental flaw in that they are based on heuristic models of interpre... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4709468 Thu, 14 Apr 2011 03:46:00 +0100 4709468 http://www.medworm.com/index.php?rid=4670109&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoes-your-doctor-trust-you%2F2011.04.02 Members of the  American public are frequently surveyed about their trust in various professionals.  Doctors and nurses usually wind up near the top of the list, especially when compared to lawyers, hairdressers and politicians.  Trust in professionals is important to us: they possess expertise we lack but need, to solve problems ranging from the serious (illness) to the relatively trivial (appearance). How much professionals trust us seems irrelevant: our reciprocity is expressed in the form of payment for services rendered or promised, our recommendations to friends and families and repeat appearances. So I was surprised to read an article in the Annals of Family Medicine describing a new scale to measure doctors’ trust in their patients.  This scale, based on input from focus grou... Better Health blogs http://www.medworm.com/rss/comments.php?id=4670109 Sat, 02 Apr 2011 18:00:08 +0100 4670109 http://www.medworm.com/index.php?rid=4653461&cid=t_152392_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2011%2F03%2F29%2Fcelebrate-the-root-canal%2F   What was the dentist doing in Panama? …Looking for the Root Canal  Root Canal Awareness Week The American Association of Endodontists has designated  March 27-April 2 as Root Canal Awareness Week. This event is a national effort to raise awareness of endodontists and to teach the public that root canals should not be [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=4653461 Tue, 29 Mar 2011 16:07:56 +0100 4653461 http://www.medworm.com/index.php?rid=4631485&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fare-urologists-being-seduced-by-robots%2F2011.03.24 Maggie Mahar’s Health Beat blog tipped me off about a Bloomberg opinion piece by an Oregon urologist that begins by stating: “The decision to opt for medical care that relies on the most costly technology is often based on blind faith that newer, elaborate and expensive must be better.” Later, he focuses specifically on robotic surgery devices: “They are costly and require significant re-training for surgeons. Yet consumers hungrily seek out surgeons versed in their use. If a surgeon recommends an older, less expensive technology, many patients will shop for a surgeon willing to use the newest and costliest devices, even if the added benefits are unproven and the risks may be greater. Hospitals do nothing to discourage this and engage in the kind of tawdry marketing... Better Health blogs http://www.medworm.com/rss/comments.php?id=4631485 Thu, 24 Mar 2011 11:00:59 +0100 4631485 http://www.medworm.com/index.php?rid=4626835&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FL1d65XzpRt4%2F Musings on the point of equipoise for investigating and discharging chest pain patients in light of a new paper in the Lancet describing a rapid rule-out protocol for acute coronary syndromes (the ASPECT trial). (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4626835 Wed, 23 Mar 2011 08:55:13 +0100 4626835 http://www.medworm.com/index.php?rid=4622330&cid=t_152392_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F03%2F18%2Fvideo-emr%2F Back in March 2006, I had this great idea about synchronizing video with the EMR. Essentially instead of having to do all these pick lists of information, you’d just record the whole visit with the doctor and that would be all the documentation you’d need. Ok, so that won’t quite work, because you need some things recorded granularly, but the idea of a video EMR was and is really interesting. Thus, you can imagine my interest when I saw this article about a company, CareCam, that’s developing a video based EMR. Here’s a quote from the article: CareCam is developing an EMR system based on video. The idea came to founder and president Shannon Pierce from her days working as a nurse. Data entry distracts clinicians from patient care, she said. … But the bas... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4622330 Fri, 18 Mar 2011 16:02:24 +0100 4622330 http://www.medworm.com/index.php?rid=4600535&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fenough-about-physician-empathy%2F2011.03.16 Is anyone else tired of hearing about how important empathy is in the doctor-patient relationship? Every other day it seems a new study is talking about the therapeutic value of empathy. Enough already! It’s not that I don’t believe that empathy is important — I do. I also believe the data that links physician empathy with improved patient outcomes, increased satisfaction, and better patient experiences. A recent study released in Academic Medicine reported that “patients of physicians with high empathy scores were significantly more likely to have good control over their blood sugar as well as cholesterol, while the inverse was true for patients of physicians with low scores.” Findings from this study by Hojat, et al. are consistent with a 2009 study by Rakel, et al. which f... Better Health blogs http://www.medworm.com/rss/comments.php?id=4600535 Wed, 16 Mar 2011 19:00:36 +0100 4600535 http://www.medworm.com/index.php?rid=4636509&cid=t_152392_112_f&fid=34971&url=http%3A%2F%2Fblog.drmalpani.com%2F2011%2F03%2Fproviding-feedback-to-doctors-to-help.html What makes a good doctor good is the fact that he has good clinical judgment. This is a term which is hard to define, but basically a good doctor is one has seen and treated and learned from lots of patients, each of whom adds to his knowledgebase and clinical wisdom. As the saying goes, "Good judgment comes from experience. Experience comes from bad judgment."However, the mere passage of time does not provide good judgment . After all, 20 years of being a doctor could simply mean 20 years of doing the wrong thing ! It's important that doctors learn from their experience - and the only way they can do so is by tracking the outcomes of the patients they treat.Unfortunately, this rarely happens in real life ! Let's take 2 patients whom a family physician treats for abdominal pain. One gets b... The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=4636509 Wed, 16 Mar 2011 04:42:00 +0100 4636509 http://www.medworm.com/index.php?rid=4592405&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FVkCaN6UfHlU%2F March 2011 sees @EBMedicineʼs Emergency Medicine Practice examine the evidence surrounding the use of Ultrasound in the Emergency Department. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4592405 Wed, 16 Mar 2011 00:00:12 +0100 4592405 http://www.medworm.com/index.php?rid=4592710&cid=t_152392_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F03%2Fcritical-look-at-goal-writing-in-school.html For those who are not aware, IEP Direct is a proprietary Internet-based software package that many school districts use for IEP writing. One value of this kind of tool is that there is more uniformity and subsequent adherence to regulation when IEPs are created in this format. However, a serious negative is that therapists often over-rely on the canned goals that are part of the drop down menus in the software.I am not sure who writes/approves the canned goals in IEP Direct but some of them are rather silly.Being a former full time educator myself I know that academic programs spend quite a bit of time teaching students how to write appropriate goals that are both functional and measurable. Something seems to happen between the classroom and practice because the quality of many goals that ... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4592710 Mon, 14 Mar 2011 20:31:00 +0100 4592710 http://www.medworm.com/index.php?rid=4592699&cid=t_152392_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Fharm-reduction-and-the-12-steps%2F Conclusion: Complementary conceptualizations of harm reduction and 12-step approaches have the potential to broaden the range of options available to people experiencing substance use problems.Posted online on March 11, 2011. (doi:10.3109/10826084.2010.548435) Heather Sophia Lee, Malitta Engstrom, and Scott R. PetersenRelated articlesAA & 12-Step Treatment (twelvestepfacilitation.com)12-Step Treatment More Effective than Alternative (recoveryissexy.com)Women & the 12 Steps of AA (recoveryissexy.com)The 12 Steps and Catholicism (recoveryissexy.com)Alcohol Use and Unsafe Sex by People with HIV (Source: Twelve Step Facilitation.com) Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4592699 Mon, 14 Mar 2011 16:00:00 +0100 4592699 http://www.medworm.com/index.php?rid=4592400&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcoffee-and-stroke-another-study-the-media-got-wrong%2F2011.03.14 Here we go again. Headlines across America blaring lines like, “Coffee may reduce stroke risk.” It was a big study, but an observational study. Not a trial. Not an experiment. And, as we say so many times on this website that you could almost join along with the chorus, observational studies have inherent limitations that should always be mentioned in stories. They can’t prove cause and effect. They can show a strong statistical association, but they can’t prove cause and effect. So you can’t prove benefit or risk reduction. And stories should say that. USA Today, for example, did not explain that in its story. Nor did it include any of the limitations that were included in, for example, a HealthDay story, which stated: “The problem with this type of stu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4592400 Mon, 14 Mar 2011 15:00:45 +0100 4592400 http://www.medworm.com/index.php?rid=4570504&cid=t_152392_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fnew-venue-from-surprising-source-to.html A new blog, entitled the Medical Professionalism Blog, signed on last week with a post emphasizing some themes that should be familiar to Health Care Renewal readers:There is an increasing focus on the sustainability of the U.S. health care system based on current cost trends. Predictions are for the health care system to consume 19% of the GDP by 2019. How did we get here?Some point to the overuse and misuse of health care services, inefficiencies and lack of care coordination. Others blame the lack of clinical evidence, primary care workforce and the external threats to good decision-making, such as a toxic payment system and the influence of pharmaceutical and device companies.While there are many different ideas about what got us here and what should be done, there is wide co... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4570504 Thu, 10 Mar 2011 17:03:00 +0100 4570504 http://www.medworm.com/index.php?rid=4565861&cid=t_152392_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2011%2F03%2F09%2Fmulti-author-medical-blogs-at-the-end-it-is-all-about-credibility%2F Recently, Bertalan Mesko (Berci on Twitter) was asking his twitter followers whether they had a favorite Web 2.0 story.  Berci needed examples for his yearly “Internet in Medicine course” at the university of Debrecen. Doctor Ves (drVes) and Berci discussed various examples of blogs that had grown in a way: a blog that branched from blog [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=4565861 Wed, 09 Mar 2011 17:15:29 +0100 4565861 http://www.medworm.com/index.php?rid=4560440&cid=t_152392_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FQXbljhNuPqU%2F Editor’s Note: We are pleased to bring you this arti­cle by Jason Marsh, thanks to our col­lab­o­ra­tion with the Greater Good Mag­a­zine. ——————- I consider myself something of a prospective meditator—meaning that a serious meditation practice is always something I’m about to start… next week. So for years, I’ve been making a mental note of new studies showing that meditation can literally change our brain structure in ways that might boost concentration, memory, and positive emotions. The results seem enticing enough to make anyone drop into the full lotus position—until you read the fine print: Much of this research involves people who have meditated for thousands of hours over many years; some of it zeroes in on Olympic-level meditators who have clocked 1... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=4560440 Tue, 08 Mar 2011 15:27:50 +0100 4560440 http://www.medworm.com/index.php?rid=4560273&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fibuprofen-parkinsons-study-few-news-organizations-report-on-it-accurately%2F2011.03.08 We’re delighted to see that USA Today, Reuters, and WebMD were among the news organizations that included what an editorial writer said about an observational study linking ibuprofen use with fewer cases of Parkinson’s disease. All three news organizations used some version of what editorial writer Dr. James Bower of the Mayo Clinic wrote or said: “Whenever in epidemiology you find an association, that does not mean causation.” “An association does not prove causation.” “There could be other explanations for the ibuprofen-Parkinson’s connection.” Kudos to those news organizations. And some praise goes to the journal Neurology for publishing Dr. Bower’s editorial to accompany the study. His piece is entitled, “Is the answer... Better Health blogs http://www.medworm.com/rss/comments.php?id=4560273 Tue, 08 Mar 2011 13:00:43 +0100 4560273 http://www.medworm.com/index.php?rid=4560283&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fx2HOtSmjTvQ%2F Jelinek and Brown announce that Emergency Medicine Australasia is taking a stand against drug company advertising. The LITFL team applauds! (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4560283 Tue, 08 Mar 2011 00:00:54 +0100 4560283 http://www.medworm.com/index.php?rid=4552149&cid=t_152392_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Fyouth-alcohol-use-disorders%2F Diagnosis, assessment and management of harmful drinking and alcohol dependence in youthsDescriptionThis clinical guideline offers evidence-based advice on the diagnosis, assessment and management of harmful drinking and alcohol dependence in adults and in young people aged 10–17 years.This is one of three pieces of UK NICE guidance addressing alcohol-related problems and should be read along with:Alcohol-use disorders: preventing the development of hazardous and harmful drinking. NICE public health guidance 24 (2010) – public health guidance on the price, advertising and availability of alcohol, how best to detect alcohol misuse in and outside primary care, and brief interventions to manage it in these settings.Alcohol-use disorders: diagnosis and clinical management of alcohol-re... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4552149 Sat, 05 Mar 2011 17:18:00 +0100 4552149 http://www.medworm.com/index.php?rid=4549765&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F03%2Fnewspeak-of-comparative-effectiveness.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4549765 Sat, 05 Mar 2011 02:30:00 +0100 4549765 http://www.medworm.com/index.php?rid=4540565&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-science-should-override-celebrity%2F2011.03.02 Dr. Barron Lerner has written a book about breast cancer: “The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America.” And he’s written a book about celebrity patients: “When Illness Goes Public: Celebrity Patients and How We Look at Medicine.” He wed the two topics in a blog post on the New York Times health blog entitled “Suzanne Somers, Cancer Expert.” Excerpts: “Earlier this week, NBC’s “Dateline” devoted an entire hour on Sunday evening to allow the actress Suzanne Somers to express her rather unconventional beliefs about cancer. It is not the first time a major media outlet has given air time to Ms. Somers, whose journey into the medical realm has been featured on a variety of news prog... Better Health blogs http://www.medworm.com/rss/comments.php?id=4540565 Wed, 02 Mar 2011 20:00:58 +0100 4540565 http://www.medworm.com/index.php?rid=4517169&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbook-review-tabloid-medicine-how-the-internet-is-being-used-to-hijack-medical-science-for-fear-and-profit%2F2011.02.24 This was the Guest Blog at Scientific American on February 23rd, 2011.  In his new book, “Tabloid Medicine: How The Internet Is Being Used to Hijack Medical Science for Fear and Profit,” Robert Goldberg, PhD, explains why the Internet is a double-edged sword when it comes to health information. On the one hand, the Web can empower people with quality medical information that can help them make informed decisions. On the other hand, the Web is an unfiltered breeding ground for urban legends, fear-mongering and snake oil salesmen. Goldberg uses case studies to expose the sinister side of health misinformation. Perhaps the most compelling example of a medical “manufactroversy” (defined as a manufactured controversy that is motivated by profit or extreme ideology to in... Better Health blogs http://www.medworm.com/rss/comments.php?id=4517169 Thu, 24 Feb 2011 16:00:01 +0100 4517169 http://www.medworm.com/index.php?rid=4501584&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnarrative-medicine-healing-through-storytelling%2F2011.02.21 More in the evolving meme of narrative medicine: Researchers at the University of Massachusetts Medical School (my alma mater) have found that for a select population of individuals, listening to personal narratives helps control blood pressure. While the power of stories is old news, the connection to clinical outcomes is what’s newsworthy here. Read Dr. Pauline Chen’s nice piece in the New York Times. The implications for ongoing work in this area are mind boggling. The Annals of Internal Medicine study authors sum it up nicely: Emerging evidence suggests that storytelling, or narrative communication, may offer a unique opportunity to promote evidence-based choices in a culturally appropriate context.  Stories can help listeners make meaning of their lives, and listeners may be in... Better Health blogs http://www.medworm.com/rss/comments.php?id=4501584 Mon, 21 Feb 2011 16:00:32 +0100 4501584 http://www.medworm.com/index.php?rid=4489998&cid=t_152392_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F02%2Fdismantling-early-intervention-program.html I have recently blogged about the State Plan Amendment that involved a $540 million settlement paid from NY State to the federal government because of Medicaid fraud. In the wake of the settlement, the Office of the Medicaid Inspector General has developed guidelines that municipalities are trying to understand, and in turn these guidelines are trying to be followed by local school districts and providers.The current street level problem is that documentation requirements for services are being applied retroactively - and that causes even greater amounts of ineligible billing. In a mad rush to understand and comply with new requirements (I am hesitant to call them rules or guidelines) the locals are desperately looking for guidance on how they are supposed to provide services, document ser... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4489998 Wed, 16 Feb 2011 20:56:00 +0100 4489998 http://www.medworm.com/index.php?rid=4477767&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FNLPyLS0cFnE%2F The UCEM has today received leaked information that Wakefield is set to open his own research institute to collect evidence that supports his assumptions. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4477767 Tue, 15 Feb 2011 02:30:18 +0100 4477767 http://www.medworm.com/index.php?rid=4464604&cid=t_152392_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2011%2F02%2F11%2Fhave-you-seen-these-recent-systematic-reviews-in-orthodontics%2F Effectiveness of orthodontic treatment with functional appliances on mandibular growth in the short term. Am J Orthod Dentofacial Orthop. 2011 Jan;139(1):24-36.Marsico E, Gatto E, Burrascano M, Matarese G, Cordasco G. INTRODUCTION: The aim of this study was to analyze the current literature for the best evidence (randomized clinical trials) about the efficacy of functional appliances [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=4464604 Fri, 11 Feb 2011 20:54:38 +0100 4464604 http://www.medworm.com/index.php?rid=4450314&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F02%2Fwheels-of-translation-of-evidence-into.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4450314 Tue, 08 Feb 2011 12:34:00 +0100 4450314 http://www.medworm.com/index.php?rid=4441976&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FuA4eO-Nwjls%2F Eight Q-and-As to separate the (wo)men from the amoebae on EBmedicine's Feb 2011 review: An Evidence-Based Review Of Pediatric Pneumonia In The ED. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4441976 Mon, 07 Feb 2011 00:00:53 +0100 4441976 http://www.medworm.com/index.php?rid=4436753&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FgkL_aWmCu_Y%2F 10 Q-and-As to test your knowledge on the key learning points covered in T@EBMedicine's Feb 2001 review: Diagnosis And Management Of Carbon Monoxide Poisoning In The Emergency Department. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4436753 Sat, 05 Feb 2011 00:00:09 +0100 4436753 http://www.medworm.com/index.php?rid=4429024&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F7jp7GibsULo%2F A Q-and-A review of EBMedicine's article titled: Pediatric Sedation In The Emergency Department Procedural Sedation In The Emergency Department (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4429024 Thu, 03 Feb 2011 00:00:29 +0100 4429024 http://www.medworm.com/index.php?rid=4429021&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbook-review-why-we-get-fat-and-what-to-do-about-it%2F2011.02.02 Journalist Gary Taubes created a stir in 2007 with his impressive but daunting 640-page tome Good Calories, Bad Calories. Now he has written a shorter, more accessible book Why We Get Fat: And What to Do About It to take his message to a wider audience. His basic thesis is that: - The calories-in/calories-out model is wrong. - Carbohydrates are the cause of obesity and are also important causes of heart disease, type 2 diabetes, cancer, Alzheimer’s, and most of the so-called diseases of civilization. - A low-fat diet is not healthy. - A low-carb diet is essential both for weight loss and for health. - Dieters can satisfy their hunger pangs and eat as much as they want and still lose weight as long as they restrict carbohydrates. He supports his thesis with data from the scientific litera... Better Health blogs http://www.medworm.com/rss/comments.php?id=4429021 Wed, 02 Feb 2011 14:00:44 +0100 4429021 http://www.medworm.com/index.php?rid=4429033&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F02%2Fhow-many-patients-with-incident-heart.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4429033 Wed, 02 Feb 2011 13:04:00 +0100 4429033 http://www.medworm.com/index.php?rid=4419162&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fmore-evidence-regarding-impact-of.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4419162 Mon, 31 Jan 2011 13:07:00 +0100 4419162 http://www.medworm.com/index.php?rid=4414525&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FxAB9KCkFLYw%2F It’s time for a look at the latest review from EBMedicine: An Evidence-Based Approach to Managing the Anticoagulated Patient in the ED. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4414525 Sun, 30 Jan 2011 00:00:41 +0100 4414525 http://www.medworm.com/index.php?rid=4394476&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fis-deviation-from-practice-guidelines.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4394476 Mon, 24 Jan 2011 15:33:00 +0100 4394476 http://www.medworm.com/index.php?rid=4394482&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fhcap-guideline-adherence-associated.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4394482 Mon, 24 Jan 2011 12:55:00 +0100 4394482 http://www.medworm.com/index.php?rid=4389249&cid=t_152392_125_f&fid=36046&url=http%3A%2F%2Fdentistrylibrary.blogspot.com%2F2011%2F01%2Fsearch-pubmed-on-your-smartphone-and.html Click on this link to Pubmed for Handhelds. When it opens in your browser save it to your home sceen or to your bookmarks. It works fine on the iPhone and iPad. I didn't test it on androids or Blackberry but it should work on those platforms too. You can do a PICO search or a natural language search also knowns as google type search, or a Medline/PubMed search. It automatically invokes the familiar Unikey login screen so even if you are not connected via the Usyd wireless network you would still be able to get to the fulltext. Subscribe in a reader (Source: DentistryLibrary@Sydney) DentistryLibrary@Sydney blogs http://www.medworm.com/rss/comments.php?id=4389249 Sun, 23 Jan 2011 22:50:00 +0100 4389249 http://www.medworm.com/index.php?rid=4382766&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-doctors-feel-about-patients-who-google-their-symptoms%2F2011.01.21 Many doctors roll their eyes whenever patients bring in a stack of research they printed out, stemming from a Google search of their symptoms. A piece by Dr. Zachary Meisel on TIME.com describes a familiar scenario: The medical intern started her presentation with an eye roll. “The patient in Room 3 had some blood in the toilet bowl this morning and is here with a pile of Internet printouts listing all the crazy things she thinks she might have.” The intern continued, “I think she has a hemorrhoid.” “Another case of cyberchondria,” added the nurse behind me. It’s time to stop debating whether patients should research their own symptoms. It’s happening already, and the medical profession would be better served to handle this new reality. According to the Pew Internet and ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4382766 Fri, 21 Jan 2011 14:00:37 +0100 4382766 http://www.medworm.com/index.php?rid=4382768&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FoYO9zFFv5OQ%2F Love is dangerous. If you don't believe me, read on to learn about all the ways amorous acts can threaten life, limb and... other body parts. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4382768 Fri, 21 Jan 2011 05:00:16 +0100 4382768 http://www.medworm.com/index.php?rid=4377589&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fwhats-level-of-evidence-behind-idsa.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4377589 Thu, 20 Jan 2011 11:29:00 +0100 4377589 http://www.medworm.com/index.php?rid=4361318&cid=t_152392_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F01%2Froulette-wheel-of-qualifying-for.html I received a referral today for Trevon, who I initially evaluated eight months ago. His mother was concerned about his development and asked the school system for help when he turned three years old. The initial OT evaluation indicated that he had significant fine motor delays and a speech evaluation indicated that he had significant speech and language delays. The school approved speech therapy and a special education teacher but declined the occupational therapy.Eight months later, I received an authorization to provide services because the motor concerns were impacting his participation in preschool. In the interim months when there was no OT intervention a second OT evaluation was completed which had essentially identical findings to the first evaluation. Apparently, the lobbying effor... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4361318 Tue, 18 Jan 2011 19:56:00 +0100 4361318 http://www.medworm.com/index.php?rid=4361031&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fwhy-professions-adherence-to-evidence.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4361031 Tue, 18 Jan 2011 13:48:00 +0100 4361031 http://www.medworm.com/index.php?rid=4361115&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D148 Over five years ago, I noticed leading-edge hospitals promoting service lines on their websites.  Now, almost 50% of hospitals have adopted some form a service line/product line management.  So, what’s the benefit for the hospital or the patient in this new iteration of healthcare?  An excellent article I read, “The Hospital That Could Cure Healthcare,” discussed the Cleveland Clinics’ 2006 transition to “institutes” organized by disease or organ system.  The institutes focus on coordinating care for better outcomes and reducing costs; in fact, it reduced the cost of treatment by 40% in one year.  Improving outcomes and reducing costs just by reorganizing is something worth paying attention to. Recently, I spoke to Rodger Dix, vice president of finance at Hannibal Regional... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4361115 Mon, 17 Jan 2011 14:43:31 +0100 4361115 http://www.medworm.com/index.php?rid=4361035&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fnon-guideline-based-icd-implantation.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4361035 Mon, 17 Jan 2011 13:11:00 +0100 4361035 http://www.medworm.com/index.php?rid=4355913&cid=t_152392_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F01%2Fnew-study-on-si-effectiveness-but.html Just a quick couple thoughts as I got a few emails asking me to comment on an article in the new AJOT. The study people are interested in is Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. (linked for those of you who have access). The study found that both intervention groups demonstrated significant improvements toward goals on the Goal Attainment Scale, but the SI group demonstrated more significant improvement than the FM group. Also, the SI group displayed significantly fewer autistic mannerisms than the FM group as measured by a sub test of the Social Responsiveness Scale.One of the nicest features of this study is that the researchers completed a series of fidelity measures on the interventions. This is a big step forward... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4355913 Sun, 16 Jan 2011 18:30:00 +0100 4355913 http://www.medworm.com/index.php?rid=4337985&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fjama-commentary-proposes-adding-emotion.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4337985 Wed, 12 Jan 2011 04:33:00 +0100 4337985 http://www.medworm.com/index.php?rid=4331039&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2011%2F01%2Fdecline-effect.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4331039 Tue, 11 Jan 2011 11:24:00 +0100 4331039 http://www.medworm.com/index.php?rid=4322577&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D140 When you have invested $1 million for a new piece of technology, you have to use it to make it pay.  I asked Paula Hennie-Roed, capital administrator at Duke University Medical Center in Durham, NC (an area known for leading-edge medicine), how they select a new piece of technology.  She explained, “The criteria that we use to rank each piece include need, safety, and patient care.  Part of the need portion involves projected utilization since this plays a major factor in revenue.” But, what is reasonable a patient flow?  Five patients a day?  20 patients a day?  A Radiology Business Management Association (RBMA) study that found the national average utilization rate for high-end imaging equipment is 54%.  With The Patient Protection and Affordable Care Act, Congress proposed in... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4322577 Fri, 07 Jan 2011 15:41:25 +0100 4322577 http://www.medworm.com/index.php?rid=4318334&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-autism-vaccine-fraud-the-difference-one-journalist-can-make%2F2011.01.06 The BMJ’s statement this week that the 1998 article by Andrew Wakefield and 12 others “linking MMR vaccine and autism was fraudulent” demonstrates what a difference one journalist can make. Journalist Brian Deer played a key role in uncovering and dismantling the Wakefield story. (Of course, others recently have said something similar about The Daily Show comedian Jon Stewart’s role in focusing on the health problems of 9/11 first responders.) CNN’s Anderson Cooper had a segment worth watching, including a new interview Cooper conducted with Wakefield via Skype: Unfortunately, journalism played a key role in promoting Wakefield’s claims. The “Respectful Insolence” blog referred to one journalist as “CBS’ resident anti-vaccine pro... Better Health blogs http://www.medworm.com/rss/comments.php?id=4318334 Thu, 06 Jan 2011 16:00:16 +0100 4318334 http://www.medworm.com/index.php?rid=4318337&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FbYYKshUIGYU%2F Almost immediately after finishing ‘Time to publish then filter?’ – a post that highlighted a recent editorial in the BMJ outlining the need for an effective system of post-publication peer review — I came across this in the Annals of Emergency Medicine: Millard WB. The Wisdom of Crowds, the Madness of Crowds: Rethinking Peer Review [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4318337 Thu, 06 Jan 2011 12:00:17 +0100 4318337 http://www.medworm.com/index.php?rid=4318339&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F0tiVhrUcz-0%2F An editorial in the BMJ by Schriger and Altman highlights the failings of the peer review process and the need for effective post-publication peer review. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4318339 Wed, 05 Jan 2011 04:40:30 +0100 4318339 http://www.medworm.com/index.php?rid=4309617&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FMLc9Bgh1ERU%2F A look at Cliff Reid's fantastic website: ResusME - Resuscitation Medicine Education. A great way to keep up with cutting edge research and developments in life-saving medicine. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4309617 Tue, 04 Jan 2011 00:00:51 +0100 4309617 http://www.medworm.com/index.php?rid=4309619&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FhIQmwIldM9A%2F A New Year has begun, no doubt many resolutions have been made. Many have probably already been broken! A good place to turn to for some tips on Healthy Living is the Bandolier website. Here are Bandolier's 10 tips on healthy living. What's missing and what needs to be changed? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4309619 Mon, 03 Jan 2011 00:00:00 +0100 4309619 http://www.medworm.com/index.php?rid=4302852&cid=t_152392_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F01%2Fblogscan-wandering-in-wilderness.html On the 1 Boring Old Man blog, "Mickey," the anonymous blogger, a retired academic psychiatrist, posted about how he figured out the extent that health care dysfunction affected psychiatry while wandering the "wildnerness" outside of academic psychiatry.  He proposed that what needs to die is "the shameful mockery many have made of their own rallying cry - 'evidence based medicine'…"  Dr Wally Smith would have called it pseudo-evidence based medicine.   (And thanks for the mention of Health Care Renewal.) (Source: Health Care Renewal) Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4302852 Sat, 01 Jan 2011 21:06:00 +0100 4302852 http://www.medworm.com/index.php?rid=4300552&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-war-against-cancer-a-new-perspective%2F2010.12.30 Myths and misconceptions about cancer abound. Oncologists are frequently criticized for torturing patients by burning, cutting and poisoning without making any real progress in the war against cancer. Siddhartha Mukherjee, an oncologist and cancer researcher, tries to set the record straight with his new book The Emperor of All Maladies: A Biography of Cancer.   It is a unique combination of insightful history, cutting edge science reporting, and vivid stories about the individuals involved: The scientists, the activists, the doctors, and the patients. It is also the story of science itself: How the scientific method works and how it developed, how we learned to randomize, do controlled trials, get informed consent, use statistics appropriately, and how science can go wrong. It is so bea... Better Health blogs http://www.medworm.com/rss/comments.php?id=4300552 Thu, 30 Dec 2010 14:00:43 +0100 4300552 http://www.medworm.com/index.php?rid=4298622&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbecoming-a-savvy-healthcare-consumer-a-difficult-science%2F2010.12.29 Dr. Kent Bottles is in the midst of a very thoughtful multi-part blog post under the heading, “The Difficult Science Behind Becoming a Savvy Healthcare Consumer.” Part I examined “the limitations of science in helping us make wise choices and decisions about our health.” Part II explores “how we all have to change if we are to live wisely in a time of rapid transformation of the American healthcare system that everyone agrees needs to decrease per-capita cost and increase quality.” Both parts so far have addressed important issues about news media coverage of healthcare. (more…) *This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4298622 Wed, 29 Dec 2010 18:00:30 +0100 4298622 http://www.medworm.com/index.php?rid=4298704&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D130 While putting together an article about infection-control technology, I spoke with an administrator who discussed spending over $200,000 on hand washing education.  That doesn’t sound like leading-edge stuff but it’s an important part of the process.  Considering what’s at stake with new legislative directives, providers will have to cover all bases for the changes to come. CMS recently put out a press release about four cost-saving measures that are being implemented: bundling payments, quality reporting, reducing hospital readmissions, and hospital-acquired conditions.  These four measures will amount to $15 billion in savings, with the majority focused on quality improvement, and will require both process and technology changes.  But, what should come first? I spoke with Farro... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4298704 Wed, 29 Dec 2010 15:00:30 +0100 4298704 http://www.medworm.com/index.php?rid=4294641&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FiBl6-3Z31ZE%2F Wouldn't it be great if there was a list of the 100 most important papers published in the emergency medicine literature... with article summaries provided. Now, that's an idea... (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4294641 Tue, 28 Dec 2010 00:00:25 +0100 4294641 http://www.medworm.com/index.php?rid=4285199&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fscienceroll.files.wordpress.com%2F2010%2F12%2Fhealthmash_iphone_app_screen_shot2.png HealthMash, WebLib’s next-generation semantic health search engine, will release an iPhone application in January. It utilizes proprietary natural language processing and semantic technology tools and resources in order to find highly relevant, reliable, and recent health information from the most trusted sources and facilitate user exploration and discovery. *This blog post was originally published at ScienceRoll* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4285199 Thu, 23 Dec 2010 20:00:26 +0100 4285199 http://www.medworm.com/index.php?rid=4277872&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D124 According to the Bureau of Labor Statistics, the consumer price index (CPI) for medical care has risen 3.3% and prescription drug costs rose an average 4.4% last year.  Because of this, pharmaceutical costs are a major focal point for controlling expenses, especially since pharmaceuticals represent the third largest (15%) hospital cost, behind labor (50%) and supplies (20%).  I asked Don Kupper, RPh, MBA, CHE, vice president of supply chain, chief pharmacy officer at University of Louisville Healthcare in Louisville, KY, and a well-published author of pharmacy management, for his thoughts of controlling costs.  He stated, “There are several ways to help lower prescription drug costs in hospitals.  We first focus on moving market share.  In this, we look at moving certain therapeutic... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4277872 Tue, 21 Dec 2010 15:17:54 +0100 4277872 http://www.medworm.com/index.php?rid=4272287&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealth-2-0-is-it-a-threat-to-the-medical-profession%2F2010.12.20 The Internet has threatened journalism. Clay Shirky has said that everyone is a media outlet. An Internet connection and blogging platform makes everyone a publisher. Can the mass professionalization of journalism be applied to medicine or health? Can access to a broadband connection outfit a citizen to think and act like a physician? There are pieces of what physicians do that can be replicated, and other pieces that can’t. The technical things that doctors do can’t be replaced. Removing an appendix or replacing a heart valve, for example. Tough to pull off on CureTogether. But what about the thinking? After all, patients have access to the same information, references, and literature as physicians. Unfettered access to information can create an illusion. It can give us a fals... Better Health blogs http://www.medworm.com/rss/comments.php?id=4272287 Mon, 20 Dec 2010 14:00:04 +0100 4272287 http://www.medworm.com/index.php?rid=4266301&cid=t_152392_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F12%2Fevidence-of-need-for-system-change.html I attended a CSE meeting for a child who has an autism diagnosis. This child previously received EI and CPSE services and was declassified upon entry to kindergarten. The parent called the meeting for CSE consideration because of the severe functional problems the child was having in the classroom. The school wanted to 'give him more time' despite the problems he was having because in their perspective many kindergarten children haven't been exposed to school environments and that is why it is reasonable to expect that there is a wide variation in skill levels of children that age. I suppose that is true, but I guess they forgot to remember that he received EI services and CPSE services and has autism.The school-based occupational therapist presented a boilerplate evaluation that stated th... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4266301 Sat, 18 Dec 2010 14:26:00 +0100 4266301 http://www.medworm.com/index.php?rid=4265798&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2010%2F12%2Finterview-with-david-sackett-one-of-ebm.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4265798 Fri, 17 Dec 2010 14:26:00 +0100 4265798 http://www.medworm.com/index.php?rid=4265802&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2010%2F12%2Febms-blind-spot.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4265802 Thu, 16 Dec 2010 21:39:00 +0100 4265802 http://www.medworm.com/index.php?rid=4265806&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2010%2F12%2Fwhither-evidence-based-medicine.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4265806 Wed, 15 Dec 2010 12:44:00 +0100 4265806 http://www.medworm.com/index.php?rid=4258865&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhrt-no-wonder-women-are-confused%2F2010.12.14 Confused about hormone replacement therapy (HRT)? I can’t imagine why… *This blog post was originally published at tbtam* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4258865 Tue, 14 Dec 2010 19:00:57 +0100 4258865 http://www.medworm.com/index.php?rid=4258866&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fjudge-rules-healthcare-reform-unconstitutional%2F2010.12.14 A federal judge in Virginia has ruled that healthcare reform is unconstitutional and expects the Obama administration to honor that ruling while it’s being appealed. But states and private companies are continuing to plan and budget for it nonetheless. The court ruled that Congress exceeded its constitutional powers in compelling Americans to buy health insurance. Judges elsewhere have ruled the law is valid or dismissed the cases on procedural grounds, while a judge in Florida will hear another case later this week. In the meantime, though, employers and healthcare companies have to continue adjusting to the reform law’s many provisions. States will continue to set up their health insurance exchanges, and they’ve already budgeted for the additional 16 million people who ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4258866 Tue, 14 Dec 2010 17:00:00 +0100 4258866 http://www.medworm.com/index.php?rid=4249062&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FbEUO1LImFsk%2F A question-and-answer review of 'An Evidence-Based Review Of Pediatric Anaphylaxis' from EBMedicine's Pediatric Emergency Medicine Practice. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4249062 Sat, 11 Dec 2010 00:00:01 +0100 4249062 http://www.medworm.com/index.php?rid=4249116&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D115 Although value and quality may be an old cliché that always turns up in car ads, for a patient paying the bill, shouldn’t they have the same mindset for a new knee or hip that costs as much as a car?  Starting Oct. 1, 2012, CMS will institute the national hospital value-based purchasing (VBP) program as mandated by the Patient Protection and Affordable Care Act (PPACA).  It’s amazing how some hospitals really get the connection that technology can have a large impact on value and patients’ outcomes.  I was planning for an emerging technology webinar with the corporate vice president of innovation for a large hospital chain, and one of his concerns was technology and the upcoming value-based purchasing legislation.  So, what is at stake?  Hospitals face a loss of 1% of their Med... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4249116 Fri, 10 Dec 2010 14:32:18 +0100 4249116 http://www.medworm.com/index.php?rid=4241835&cid=t_152392_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FXtT5veL6888%2F My interest in the brain stems from wanting to better understand both how to make school more palatable for students, and professional development more meaningful for faculty. To that end, I began my Neurons Firing blog in April, 2007, have been doing a lot of reading, and been attending workshops and conferences, including Learning & the Brain. If you agree that our brains are designed for learning, then as educators it is incumbent upon us to be looking for ways to maximize the learning process for each of our students, as well as for ourselves. Some of what follows is simply common sense, but I’ve learned that all of it has a scientific basis in our brains. 1. Review and 2. Reflection are two means for thinking about what is being learned. Review can be done in the moments after ... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=4241835 Wed, 08 Dec 2010 19:25:24 +0100 4241835 http://www.medworm.com/index.php?rid=4241800&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D113 Each year, adverse drug events cost an estimated $2 billion a year to treat.  So, how can hospitals achieve the right medication, right dose, right patient, right time, and right route?  According to the Agency for Healthcare Research and Quality, barcoding technology may be the answer.  Over the last few months, I’ve interviewed a long list of hospital CFOs with the goal of determining how they prioritize their capital spending.  Several years ago when I made the same series of interviews, ROI was the determining factor.  Now, as summed up by Debbie Schimerowski, CFO at Provena Covenant Medical Center, Urbana, IL, “Which project takes precedence depends on multiple factors.  Like a lot of hospitals, we have many assets that are at the end of their life cycle right now because mo... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4241800 Wed, 08 Dec 2010 14:17:28 +0100 4241800 http://www.medworm.com/index.php?rid=4225343&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2010%2F12%2Fformulating-clinical-questions-and.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4225343 Fri, 03 Dec 2010 12:03:00 +0100 4225343 http://www.medworm.com/index.php?rid=4225426&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D107 A 200-bed hospital can expect to spend anywhere from $2 to $8 million on healthcare IT over five years.  So can we assume that the $8 million system is four times more effective that the $2 million investment?  Maybe. I spoke with Dr. Diane J. Skiba, PhD, FAAN, FACMI professor, option coordinator, health care informatics and project director, I-Collaboratory: Partnerships for Learning, University of Colorado Denver School of Nursing, Denver, CO, and an authority on innovative technology and healthcare IT.  Dr. Skiba stated, “Healthcare IT, especially electronic medical records, has a definite value on improving patient outcomes, but putting an exact dollar value on it can be difficult.  However, providers must be aware that this direction will guide a whole new field of nursing infor... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4225426 Thu, 02 Dec 2010 14:30:16 +0100 4225426 http://www.medworm.com/index.php?rid=4214111&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedical-journals-do-peer-reviewers-get-worse-with-experience%2F2010.11.29 Interesting post by the Retraction Watch blog, pointing to an interesting paper published last week in the Annals of Emergency Medicine. An excerpt from the blog post: Over 14 years, 84 editors at the journal rated close to 15,000 reviews by about 1,500 reviewers. Highlights of their findings: …92% of peer reviewers deteriorated during 14 years of study in the quality and usefulness of their reviews (as judged by editors at the time of decision), at rates unrelated to the length of their service (but moderately correlated with their mean quality score, with better-than average reviewers decreasing at about half the rate of those below average). Only 8% improved, and those by very small amount. How bad did they get? The reviewers were rated on a scale of 1 to 5 in which a change of ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4214111 Mon, 29 Nov 2010 21:00:30 +0100 4214111 http://www.medworm.com/index.php?rid=4207267&cid=t_152392_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F11%2F29%2Fnursing-times-2010-vol-106-no-44%2F This article outlines the key challenges in sharing and disseminating research findings within NHS organisations. Staff working in joint posts between university and clinical settings are in a unique position to address these challenges. They should encourage the publication of articles, presentations and implementation of recommendations that are locally relevant. An action research approach is suggested to boost the likelihood of findings being implemented and raising awareness of research to clinical staff. Contact the Library for a copy of this article. Filed under: Journals Tagged: Action Research, Evidence Based Practice, Research Dissemination (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4207267 Mon, 29 Nov 2010 08:47:33 +0100 4207267 http://www.medworm.com/index.php?rid=4197075&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FgPdkXrKWmIg%2F SMART EM is part of a network of communication tools designed to offer unbiased translation and summaries of medical evidence mainly pertaining to emergency medicine. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4197075 Wed, 24 Nov 2010 10:07:44 +0100 4197075 http://www.medworm.com/index.php?rid=4197068&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-low-can-oprah-winfrey-go-promoting-faith-healer-john-of-god-to-the-masses%2F2010.11.23 Several of the bloggers on Science-Based Medicine have been — shall we say? — rather critical of Oprah Winfrey. The reason, of course, is quite obvious. Oprah is so famous that if you mention her first name nearly everyone will know exactly of whom you speak. For the last quarter century, Oprah’s daytime TV talk show has been a ratings juggernaut, leading to the building of a media behemoth and making her one of the richest and most famous women in the world. Unfortunately, part of Oprah’s equation for success has involved the promotion of quackery and New Age woo, so much so that last year I lamented about the Oprah-fication of medicine, which scored me a writing gig in the Toronto Star. Whether it be promoting bio-identical hormones, The Secret (complete with a testimonial ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4197068 Tue, 23 Nov 2010 19:00:00 +0100 4197068 http://www.medworm.com/index.php?rid=4197071&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-nnt-quick-summaries-of-evidence-based-medicine%2F2010.11.23 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�... Better Health blogs http://www.medworm.com/rss/comments.php?id=4197071 Tue, 23 Nov 2010 13:00:56 +0100 4197071 http://www.medworm.com/index.php?rid=4190161&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FqGH6TAC-eno%2F Dealing with this exponentially growing information resource can be challenging, especially as we are increasingly want to share our knowledge, and invite comment from our peers....enter Today I Learnt That (TILT) is the brainchild of Jon Brassey of TRIP Database and TRIP Answers fame. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4190161 Tue, 23 Nov 2010 06:41:52 +0100 4190161 http://www.medworm.com/index.php?rid=4190150&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-rationing-of-healthcare%2F2010.11.22 Do you recall the severe rationing of food and water the Chilean miners had to endure to survive? The rationing was done to stretch their limited resources. I would argue the state of Arizona’s new policy to not cover organ transplants for patients on Arizona Health Care Cost Containment System (AHCCCS) or their version of Medicaid is a similar form of rationing. AHCCCS, as many Medicaid programs, is underfunded. They are trying to operate on a limited budget. Something has to give. Sadly in this case, many (NPR reports 98) had already been granted approval for organ transplants which they may not receive. Francisco Felix, 32, who due to hepatitis-C needs a liver transplant, is reported to have made it to the operating room, prepped and ready for his life-saving liver transplant when d... Better Health blogs http://www.medworm.com/rss/comments.php?id=4190150 Mon, 22 Nov 2010 21:00:00 +0100 4190150 http://www.medworm.com/index.php?rid=4190162&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FyUfiO-wWAuU%2F Community Acquired Pneumonia EBM Review (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4190162 Mon, 22 Nov 2010 02:00:00 +0100 4190162 http://www.medworm.com/index.php?rid=4190163&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FYWCGzBtegIM%2F Spontaneous Pneumothorax in the Emergency Department an EBM Review (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4190163 Sun, 21 Nov 2010 02:00:42 +0100 4190163 http://www.medworm.com/index.php?rid=4179403&cid=t_152392_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FbIK4cuhZ8z0%2F Discussions (Members-only links below. To Learn More and Join Council, click Here) Now let’s take a look at the great things going on with the SharpBrains Council. Council Membership 60 Council Members are already active in the Council members-only platform, bringing an excellent cross-sector participation and featuring innovative research, products, services and practices. The Member List available in the Library section includes interests and 2011 priorities, to facilitate connections. We are featuring: 7 most active Council Members: Philip Toman, Jamie Wilson, Luc Beaudoin, Joshua Steinerman, Pascale Michelon, Adam Gazzaley and Sherrie All. 7 Council Members doing great work outside the US: Peter Reiner, Veronika Litinski and David Tal in Canada; Jenny Brockis and Steve Zanon in A... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=4179403 Thu, 18 Nov 2010 17:05:02 +0100 4179403 http://www.medworm.com/index.php?rid=4179326&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FgROxfIp6PKo%2F Evidence based review of acute severe asthma including clinical recognition and management (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4179326 Thu, 18 Nov 2010 02:00:08 +0100 4179326 http://www.medworm.com/index.php?rid=4175735&cid=t_152392_105_f&fid=34896&url=http%3A%2F%2Fdoctorrw.blogspot.com%2F2010%2F11%2Fevidence-based-medicine-science-based.html (Source: Notes from Dr. RW) Notes from Dr. RW blogs http://www.medworm.com/rss/comments.php?id=4175735 Wed, 17 Nov 2010 18:29:00 +0100 4175735 http://www.medworm.com/index.php?rid=4175698&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FWDCNx39-hnc%2F EBM review of Oesophagogastric Varices assessment and management in the emergency department (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4175698 Wed, 17 Nov 2010 02:00:14 +0100 4175698 http://www.medworm.com/index.php?rid=4172165&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D91 EKGs have been a mainstay for assessing a fetus’ health since the early 1900s.  But, due to interference from the maternal EKG signal, physicians are not able to get a true waveform, which is critical in diagnosing arrhythmia or elevated ST segment in a fetus.  According to Dr. Nina Gotteiner, MD, pediatric cardiologist, associate professor of pediatrics, Feinberg School of Medicine, Northwestern University in Chicago, IL, “If we can identify a fetal arrhythmia, it is very treatable and we can affect the outcome.” Currently, fetal EKGs are acquired through a scalp electrode, which limits the technology’s ability to acquire the data in a non-labor setting.  However, evolving noninvasive fetal EKG technology is designed to accurately separate fetal and maternal EKG signals.  Depe... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4172165 Tue, 16 Nov 2010 15:42:00 +0100 4172165 http://www.medworm.com/index.php?rid=4175634&cid=t_152392_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F11%2Fwhen-things-go-bad.html By HERBERT MATHEWSON, MD 1). CELL PHONES DON’T CAUSE CANCER- Despite ample scientific evidence to the contrary much buzz continues about cell phone usage causing brain cancer. Why is that ? A recent review in Scientific American magazine points out... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4175634 Tue, 16 Nov 2010 00:00:00 +0100 4175634 http://www.medworm.com/index.php?rid=4167957&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Flung-cancer-ct-scan-marketing-spreads-across-the-country%2F2010.11.15 Last week, after the National Lung Screening Trial results were released, David Sampson, American Cancer Society director of medical and scientific communications, wrote that “our greatest fear was that forces with an economic interest in the test would sidestep the scientific process and use the release of the data to start promoting CT scans. Frankly, even we are surprised how quickly that has happened.” And, yes, the marketing has even hit fly-over country in the Twin Cities, with this ad appearing in the Sunday Minneapolis Star Tribune in the “A” section: Of course, no where in the ad will you read about the potential harms of such scans, the false positive rate, what happens when you get a false positive (unnecessary followup testing and perhaps unnecessary t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4167957 Mon, 15 Nov 2010 21:00:34 +0100 4167957 http://www.medworm.com/index.php?rid=4164527&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F45wJy3zDE5Q%2F Upper GI Haemorrhage EBM Review. Commonest causes: peptic ulcer (35-50%); oesophagitis (20-30%); duodenitis/gastritis/erosions (10-20%); varices (5-12%); Mallory-Weiss tear (2-5%); tumour (2-5%); angiodysplasia (2-3%); aorto-enteric fistula (<1%). (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4164527 Mon, 15 Nov 2010 02:00:49 +0100 4164527 http://www.medworm.com/index.php?rid=4164529&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FsMX6_NHNJvo%2F Acute Liver Failure in the Emergency Department an EBM Review (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4164529 Sun, 14 Nov 2010 02:00:18 +0100 4164529 http://www.medworm.com/index.php?rid=4159320&cid=t_152392_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D89 Unless you have been living on a deserted island, you are aware of what miniature mechanical systems on silicon (MEMS) have achieved.  Since the first pill camera came out in 1999, scientists have been developing next-generation micro robots, and several interesting designs have appeared, such as self-propelled “spider” and “earthworm” devices that include magnetic remote control.  With these developments comes the promise of noninvasive diagnostic and therapeutic applications never seen before.  The first applications of a micro robotic will be in the GI track.  Dr. Braden Kuo, MD, internist and gastroenterologist, instructor at Harvard Medical School, assistant in medicine, Department of Internal Medicine at Massachusetts General Hospital in Boston, MA, and a leading expert i... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4159320 Fri, 12 Nov 2010 14:13:52 +0100 4159320 http://www.medworm.com/index.php?rid=4159245&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-better-health-blog-partners-with-harvard-health-publications%2F2010.11.11 I’m very pleased to announce that Harvard Health Publications (HHP) is Better Health’s newest content partner. Soon readers of the Better Health blog will enjoy contributions from the HHP team. We believe that their insight and perspectives will be a great addition to our unique collection of healthcare voices online. The Better Health blog is a continuation of “Dr. Val And The Voice Of Reason,” first launched in 2006. At the time, I was inspired to start a blog because of the baffling amount of misinformation that my patients were finding on the Internet. It was a David-versus-Goliath enterprise, but I felt duty-bound to do what I could to provide a counterpoint to media hype, fear mongering, and snake oil salesmen. Over the past four years I’ve been humbled ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4159245 Thu, 11 Nov 2010 17:58:03 +0100 4159245 http://www.medworm.com/index.php?rid=4159247&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fgather-professional-opinions-from-your-medcrowd%2F2010.11.11 medCrowd is the 52nd in my list of biomedical community sites and maybe the first one using crowdsourcing. From medCrowd: Perhaps, you have a patient with a rare condition and you don’t know the best treatment. Or you are treating a patient and you have heard there have been recent developments in the field, but you are not sure how these actually affect your patient’s day-to-day management. The problem is finding the best solution for your patient. What you need is help finding it. medCrowd enables you to find the best solution for your patient by collecting your peers’ professional opinions, simply and in one place. This is called crowdsourcing. *This blog post was originally published at ScienceRoll* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4159247 Thu, 11 Nov 2010 15:00:42 +0100 4159247 http://www.medworm.com/index.php?rid=4155236&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F4XPYG3zxKIE%2F Review of EBM for the assessment and management of Diabetic Ketoacidosis in the emergency department (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4155236 Thu, 11 Nov 2010 02:00:41 +0100 4155236 http://www.medworm.com/index.php?rid=4151800&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FgfGFsKuDWDU%2F Highlights and pearls on toxic alcohol ingestion from the EBMedicine article, "Toxic Alcohols: Not Always A Clear-Cut Diagnosis" (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4151800 Wed, 10 Nov 2010 05:50:28 +0100 4151800 http://www.medworm.com/index.php?rid=4151792&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-doctors-are-paid-less-unnecessary-prescriptions-drop%2F2010.11.09 Take medical uncertainty. Add financial incentive to treat. Voila! Increased utilization. Now take away financial incentive to treat. Guess what you get? MedPageToday explains, in the case of hormone therapy for prostate cancer: Medicare accomplished what clinical guidelines and evidence-based medicine couldn’t: it reduced unnecessary use of androgen deprivation therapy (ADT) in prostate cancer. Inappropriate use decreased by almost 30% from 2003 to 2005, following enactment of the Medicare Modernization Act, which lowered physician reimbursement for ADT. Appropriate use of ADT did not change during the same time period, according to an article in the Nov. 4 issue of the New England Journal of Medicine. “Our findings suggest that reductions in reimbursement may influence the de... Better Health blogs http://www.medworm.com/rss/comments.php?id=4151792 Tue, 09 Nov 2010 19:00:48 +0100 4151792 http://www.medworm.com/index.php?rid=4151687&cid=t_152392_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F11%2F09%2Fnursing-times-2010-vol-106-no-42%2F Fade Fave: How to compile a professional portfolio of practice 2: structure and building evidence Fade Skinny: This is the second in a two-part unit on developing a professional portfolio and what is meant by quality evidence and how to develop it. Contact the Library for a copy of this article. Filed under: Journals Tagged: Nursing, Portfolio. Assessment, Structure, Work-based Learning (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4151687 Tue, 09 Nov 2010 09:10:02 +0100 4151687 http://www.medworm.com/index.php?rid=4151802&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F_s6MkWxUzc4%2F EBM review of the assessment and management of meningitis and Meningococcaemia (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4151802 Tue, 09 Nov 2010 02:00:18 +0100 4151802 http://www.medworm.com/index.php?rid=4142768&cid=t_152392_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2010%2F11%2Fpointless-exam-can-be-just-as-bad-as.html Dr. Abraham Verghese, says the Times, is reviving the lost art of the physical exam. He cuts quite a figure on the wards, with his white coat, his stories, and his diagnostic maneuvers, reminding us of "the doctor who missed nothing and could swiftly diagnose a peculiar walk, sluggish thyroid or leaky heart valve using just keen eyes, practiced hands and a stethoscope." Here's where the definitions of art and science matter, though. The margin here is too narrow to contain a detailed discussion of where these two bugbears embrace and where they face off, fangs bared. The applicable stab of a definition in this case, I think, is this: in a science, we try and apply a community's rigorous professional definition to our individual classifications. In art, we try and apply our own individual c... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=4142768 Mon, 08 Nov 2010 05:01:00 +0100 4142768 http://www.medworm.com/index.php?rid=4142755&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FIzw9vme6a3Q%2F Evidence based review of venous thromboembolism, DVT and pulmonary embolism (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4142755 Mon, 08 Nov 2010 02:00:50 +0100 4142755 http://www.medworm.com/index.php?rid=4139245&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F4PX06cQo3d4%2F Aortic Dissection in review: 3 cases per 100 000 people per year; up to 25% missed diagnosis ante-mortem. ‘Typical’ case is 60-80 years old, M>F 3:1, with hypertension. Overall in-hospital mortality 27%. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4139245 Sat, 06 Nov 2010 02:00:12 +0100 4139245 http://www.medworm.com/index.php?rid=4139188&cid=t_152392_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F11%2F05%2Fresponse-to-the-treasury-committee-inquiry-on-the-spending-review-to-inform-treasury-committee%25e2%2580%2599s-inquiry-on-decision-making-and-other-aspects-of-the-recent-spending-review%2F Title: Response to the Treasury Committee Inquiry on the Spending Review: To inform Treasury Committee’s inquiry on decision-making and other aspects of the recent Spending Review Skinny: Response to the Treasury Committee’s call for evidence on the spending review. The Joseph Rowntree Foundation is committed to informing changes in policy and practice based on evidence from research, from practical demonstration work and from the lives of people directly affected by social issues and problems. The response to the Treasury Committee’s inquiry on the spending review registers their concern that the spending review was not sufficiently based on available evidence about poverty and disadvantage in the UK. Publisher: Joseph Rowntree Foundation Size of Publication: 7 Published: 04/11/201... Fade Library blogs http://www.medworm.com/rss/comments.php?id=4139188 Fri, 05 Nov 2010 15:57:23 +0100 4139188 http://www.medworm.com/index.php?rid=4133707&cid=t_152392_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-e-prescriptions-are-just-like-twitter%2F2010.11.04 I’m surprised I didn’t notice this sooner, but e-prescriptions will only accept 140 characters in their instructions, just like Twitter. If you have longer instructions, you must print the prescription and hand it to the patient for it to be manually filled at their pharmacy. Then again, maybe doctors will start to use some twitter-like abbreviations in their instruction fields, like: “Chk ur BP b4 taking b/c itz K 2 hold if nl. TIA.” Dude. That’d b fab. -WesMusings of a cardiologist and cardiac electrophysiologist. *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4133707 Thu, 04 Nov 2010 20:00:00 +0100 4133707 http://www.medworm.com/index.php?rid=4133719&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fr4rSIn5CGpo%2F Acute heart failure syndrome (AHFS) spectrum can be divided into 5 groups as regards therapeutic management (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4133719 Thu, 04 Nov 2010 02:00:32 +0100 4133719 http://www.medworm.com/index.php?rid=4134023&cid=t_152392_125_f&fid=37825&url=http%3A%2F%2Fbibbynews.wordpress.com%2F2010%2F11%2F03%2F5-things-you-should-do-right-now-with-your-iphone-or-itouch%2F 5 things you should do right now with your iPhone or iTouch! 1. Get the mobile version of the Medical Center Libraries website – In Safari, search for Miner Library – our mobile page will load. To save to your home screen, locate the + sign on the bottom of the screen and select “Add [...] (Source: Bibby Library News and Tips) Bibby Library News and Tips blogs http://www.medworm.com/rss/comments.php?id=4134023 Wed, 03 Nov 2010 20:15:16 +0100 4134023 http://www.medworm.com/index.php?rid=4133721&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FiHTLu6zqsHk%2F Migraine without aura (‘common’ migraine). 66-75% of migraineurs; must have had at least five attacks. Attacks lasting 4-72 hours untreated. At least 2 of headache characteristics: unilateral, pulsating or throbbing, moderate to severe, aggravated by movement. At least 1 associated symptom during headache: nausea and/or vomiting, photophobia and phonophobia. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4133721 Wed, 03 Nov 2010 09:00:49 +0100 4133721 http://www.medworm.com/index.php?rid=4125013&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FVw7FbQmplsc%2F EBM review of Chest Pain Adjunctive Therapies including adjunctive anticoagulant therapy, adjunctive anti-thrombotic therapy and other therapeutic agents (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4125013 Tue, 02 Nov 2010 00:43:24 +0100 4125013 http://www.medworm.com/index.php?rid=4125014&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F8OQ_fLkq61Q%2F including early Management of STEMI or NSTEACS, reperfusion strategies, percutaneous coronary intervention (PCI) and thrombolysis (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4125014 Tue, 02 Nov 2010 00:41:19 +0100 4125014 http://www.medworm.com/index.php?rid=4125015&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fgj2Lssai_Kw%2F Chest Pain and risk stratification - EBM Review. Coronary heart disease single largest cause of death (16% or 27,000) in 2007 in Australia, but down from 22% in 1998. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4125015 Tue, 02 Nov 2010 00:40:25 +0100 4125015 http://www.medworm.com/index.php?rid=4121862&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FpsB0ayXygsc%2F Status Epilepticus: Synonyms: overt, geneneralised tonic-clinic, major motor SE. Defined as a seizure lasting over 5 mins, or two or more seizures without recovery in between. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4121862 Sun, 31 Oct 2010 02:00:27 +0100 4121862 http://www.medworm.com/index.php?rid=4118942&cid=t_152392_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F3jRtI6VX55k%2F Pedagogical disambiguation: Emergency Medicine Lecture Notes and Evidence Based emergency medicine principles from Professor A.F.T Brown and Life in the Fast Lane team. Latest Guidelines International Liaison Committee on Resuscitation (ILCOR). 2010 International Consensus on CPR and ECC Science with Treatment Recommendations (CoSTR). Circulation 2010; 122 (Suppl 2):S250-S581. (12 papers) European Resuscitation Council Guidelines for Resuscitation [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4118942 Fri, 29 Oct 2010 14:23:58 +0100 4118942