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 'england journal of medicine'. Sat, 03 Sep 2011 02:04:48 +0100 http://www.medworm.com/index.php?rid=5181801&cid=t_162946_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fapixaban-finally-showing-superiority-over-warfarin-in-clinical-trial%2F2011.09.01 With the publication of “Apixaban versus Warfarin in Patients with Atrial Fibrillation” (the ARISTOTLE trial) in the New England Journal of Medicine, the third drug in a series of medications designed to attack thrombin in the clotting cascade. The study was announced with quite a fanfare in Europe as cardiologists, financial analysts and reporters gushed forth with ‘mega-blockbuster’ praise this past weekend. And for good reason. This is the first trial to conclude that (more…) *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5181801 Thu, 01 Sep 2011 14:00:00 +0100 5181801 http://www.medworm.com/index.php?rid=5174616&cid=t_162946_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fweaknesses-of-the-current-malpractice-system%2F2011.08.28 Medical malpractice reform is in the news again. Of course, for the medical profession, the medical malpractice system is the wound that simply will not heal. For the plaintiffs bar, in contrast, the medical liability system is the gift that keeps on giving. I have argued that the current system fails on four important fronts. Efficiency Cost Fairness Quality Improvement I admit readily that my profession has not been as diligent as it should be in holding ourselves accountable. We have not been forthright in admitting our medical errors, although can you blame us under the current medical liability construct? (more…) *This blog post was originally published at MD Whistleblower* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5174616 Sun, 28 Aug 2011 21:30:00 +0100 5174616 http://www.medworm.com/index.php?rid=4852943&cid=t_162946_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F05%2F21%2F6-steps-to-get-anyone-yourself-included-to-do-anything%2F I am not promising these things. A motivational coach, consultant, therapist, and award-winning faculty member at Yale School of Medicine is. A guy named Michael V. Pantalon. He has a bunch of credentials like publishing articles in the New England Journal of Medicine and the Journal of the American Medical Association, so I read though his book, Instant Influence: How to Get Anyone to Do Anything—FAST with curiosity. I have a lot of projects that I was hoping he could help me with. I have not had enough time to accurately test-drive his recipe of influence; however, I think I’m coming with a bit of a handicap considering my strong urge to want to please people. I only have to hear a vague “I don’t really see it that way,” to abandon my way and go with someone else’s. However,... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4852943 Sat, 21 May 2011 10:36:08 +0100 4852943 http://www.medworm.com/index.php?rid=4460182&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FcNF2uULPpF8%2F According to legend, academic researchers are good at discovering underlying mechanisms and pathways of disease, but less so at applied research for discovering drugs that can treat disease. Now, though, a new study in the New England Journal of Medicine debunks this myth - public sector research institutions were involved in developing more than 20 percent of new, innovative drugs approved between 1990 and 2007. This figure was derived by examining a newly constructed patent database for meds approved by the FDA after 1962 and identifying pertinent patents filed by PSRIs - defined as universities, research hospitals, nonprofit research institutes, and federal labs. From there, the researchers determined whether patents were for applied research. They found that PSRIs contributed to the di... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4460182 Thu, 10 Feb 2011 15:31:55 +0100 4460182 http://www.medworm.com/index.php?rid=4433105&cid=t_162946_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-link-between-oral-sex-and-head-and-neck-cancer%2F2011.02.03 USA Today published a pretty accurate article regarding the rise of certain head and neck cancers with the increased popularity of oral sex and number of sexual partners. The factor that creates this link is the human papillomavirus (HPV) which is associated with tonsil and tongue cancer. Alcohol and tobacco use is more highly linked with such oral cancers, but HPV does appear to be an independent risk factor. A 2007 study in the New England Journal of Medicine found that younger people with head and neck cancers who tested positive for oral HPV infection were more likely to have had multiple vaginal and oral sex partners in their lifetime. Having six or more oral sex partners over a lifetime was associated with a 3.4 times higher risk for oropharyngeal cancer — cancers of the base ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4433105 Thu, 03 Feb 2011 14:00:00 +0100 4433105 http://www.medworm.com/index.php?rid=4414522&cid=t_162946_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fabortion-doesnt-cause-mental-illness%2F2011.01.29 Here’s yet another study showing that abortion does NOT lead to future psychiatric problems. From The New York Times: The New England Journal of Medicine has taken on one of the pillar arguments in the abortion debate, asking whether having the procedure increases a woman’s risk of mental-health problems and concluding that it doesn’t. In fact, researchers found, having a baby brings a far higher risk. The study, by Danish scientists (and financed in part by the Susan Thompson Buffett Foundation, which supports research on abortion rights), is the most extensive of its kind to date. It studied 365,550 Danish women who had an abortion or gave birth for the first time between 1995 and 2007. Of those, 84,620 terminated their pregnancies and 280,930 gave birth. In the year after an a... Better Health blogs http://www.medworm.com/rss/comments.php?id=4414522 Sat, 29 Jan 2011 14:00:53 +0100 4414522 http://www.medworm.com/index.php?rid=4377789&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FaVe4cHW2HSM%2F In a move that some may consider long overdue, more than a dozen of the most prestigious medical journals will consider requiring doctors who submit studies to disclose any payments received from hedge funds and other large investors. The proposal is expected to be discussed at the next annual meeting of The International Committee of Medical Journal Editors, which is scheduled for June, according to a spokeswoman for the New England Journal of Medicine. The possibility follows ongoing concerns about conflicts of interest between researchers and the pharmaceutical industry and the extent to which undisclosed financial relationships may unduly influence medical research and, from there, medical practice. But the issue is also encompassing financial ties to large investors, given the growing... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4377789 Thu, 20 Jan 2011 15:21:05 +0100 4377789 http://www.medworm.com/index.php?rid=4298589&cid=t_162946_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F12%2Fnejm-editorial-proposes-surgeons-disclose-sleepwork-hours-patients%2F An editorial published in this week’s New England Journal of Medicine is proposing that surgeons not be allowed to perform elective cases if they are sleep-deprived or, at minimum, they must disclose to their patient that they are such. Lead author Dr. Charles A. Czeisler comments. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4298589 Thu, 30 Dec 2010 01:39:41 +0100 4298589 http://www.medworm.com/index.php?rid=4281314&cid=t_162946_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fabout-weightlifting-and-breast-cancer%2F2010.12.22 Last August, Kathryn Schmitz, PhD, MPH and colleagues published the results of their study Weightlifting in Women with Breast-Cancer–Related Lymphedema (BCRL) in the New England Journal of Medicine. They have now published a similar study in the Archives of Internal Medicine (see full reference below). While the NEJM article focused on breast cancer survivors with lymphedema, the Archives article focuses on breast cancer survivors without lymphedema. The new study adds weight for the need to change historic dogma which cautions breast cancer patients to avoid weight training after a mastectomy and or axillary dissection. (more…) *This blog post was originally published at Suture for a Living* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4281314 Wed, 22 Dec 2010 17:00:00 +0100 4281314 http://www.medworm.com/index.php?rid=4207255&cid=t_162946_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F11%2Fstudy-reports-1-6-patients-harmed-hospital-medical-mistakes%2F In a new study reported this week in the New England Journal of Medicine one in six patients are harmed by medical mistakes in the hospital.The lead researcher was Dr. Christopher P. Landrigan of Harvard Medical School. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4207255 Sun, 28 Nov 2010 19:51:47 +0100 4207255 http://www.medworm.com/index.php?rid=3965702&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FxylflFXqUYo%2F For the past three years, the reliability of the meta-analysis has been widely debated thanks to such a review that was published in The New England Journal of Medicine about the cardiovascular risks of GlaxoSmithKline’s Avandia diabetes pill (back story). At issue, of course, is whether a meta-analysis can sufficiently capture the sort of specific information needed to make a solid judgment about risks. Although such concerns have cropped up concerning other drugs, the FDA has largely avoided taking a position. The other day, however, three FDA staffers - one from the Division of Pulmonary, Allergey and Rheumatology Products in the Office of New Drugs, and two from the Division of Epidemiology in the Office of Surveillance - offered a cautionary word about the utility of the meta-an... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3965702 Mon, 13 Sep 2010 12:05:25 +0100 3965702 http://www.medworm.com/index.php?rid=3833405&cid=t_162946_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F08%2Fmedical-oncologist-dr-alan-venook-reports-patient-longer-afford-lifesaving-meds%2F Medical oncologist Dr. Alan P. Venook of the University of California, San Francisco Medical Center reports in the New England Journal of Medicine that some patients of his can no longer afford medications to keep their cancer at bay. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=3833405 Sun, 08 Aug 2010 05:46:25 +0100 3833405 http://www.medworm.com/index.php?rid=3795062&cid=t_162946_151_f&fid=35818&url=http%3A%2F%2Frecoveryissexy.com%2Freview-of-the-book-alcoholics-anonymous-2%2F From; The NEW ENGLAND JOURNAL OF MEDICINE, Vol. 221(15), October 12, 1939. ALCOHOLICS ANONYMOUS: The story of how more than one hundred men have recovered from alcoholism. 400 pp. New York Works Publishing Co., 1939, $3.50. The psychological aspect of alcoholism taxes the entire skill and intuition of the therapist, and the authors of this book claim that in the long run the ex-alcoholic patient who is properly trained in psychological method is an extremely effective person to bring about the cure of the neurotic alcoholic individual. The first part of the book discusses methods, with particular stress on twelve steps in the recovery program. This program includes the general principles of psychotherapy found in such books as those by Durfee and Peabody. There is, however, an essentially ... Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=3795062 Tue, 27 Jul 2010 18:13:00 +0100 3795062 http://www.medworm.com/index.php?rid=3753739&cid=t_162946_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F07%2Fexperimental-diet-pill-shows-promise%2F The experimental diet pill lorcaserin was shown to be beneficial in helping patients lose weight and did not show major serious side effects in a article published in the July 15, 2010 issue of the New England Journal of Medicine. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=3753739 Thu, 15 Jul 2010 02:12:40 +0100 3753739 http://www.medworm.com/index.php?rid=3737292&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FwY1IvDS3ltw%2F For clinical trials to be overseen correctly, a Data Safety Monitoring Board should be apprised of any changes or circumstances that may effect the outcome and, of course, should not be compromised by outreach from the drugmaker. But that’s not what happened in two high-profile trials involving Vytorin and Avandia, both of which were later published in The New England Journal of Medicine. However, the journal was unaware the DSMBs in both instances were manipulated by the companies, according to an editorial in this week’s edition that was written by Jeff Drazen, the journal’s editor, and Alastair Wood of Vanderbilt University. In both examples, they write, “a commercial entity decided to unblind aspects of trial data rather than let the DSMBs exercise their importa... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3737292 Thu, 08 Jul 2010 14:49:27 +0100 3737292 http://www.medworm.com/index.php?rid=3699453&cid=t_162946_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F06%2Fprofessional-integrity-for-sale-sure.html Some chiropractors also practice homeopathy. According to Frank King, D.C., many more should be doing just that:Homeopathy is an energetic form of natural medicine that corrects nerve interferences, absent nerve reflexes, and pathological nerve response patterns that the chiropractic adjustment alone does not correct. The appropriate homeopathic remedies will eliminate aberrant nerve reflexes and pathological nerve responses which cause recurrent subluxation complexes.Not only does homeopathy correct nerve interferences, it empowers the doctor of chiropractic to reach the entire nervous system. What this means is that we can now better affect the whole person, and all of the maladies that affect us. Homeopathy’s energetic approach reaches deep within the nervous system, correcting nerve ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3699453 Fri, 25 Jun 2010 12:35:00 +0100 3699453 http://www.medworm.com/index.php?rid=3671696&cid=t_162946_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-nejm-iphone-app%2F2010.06.17 Apparently the New England Journal of Medicine was listening yesterday when I suggested to an audience in Chicago that the way to a doctor’s heart is through his smartphone. The NEJM This Week iPhone App went live this morning on iTunes and it’s worth a look. The App offers four pages covering articles, images, audio and video. According to Toby Plewak, NEJM’s Manager of Product Development, the article page covers most everything available through the print/web version as well as all of the “online first” (early release) articles for the current week. The only articles excluded are those that can’t be delivered effectively on the iPhone.   I just listened to the NEJM This Week audio summary and it’s beautiful (I know what I’ll be doing during my drives to the Texa... Better Health blogs http://www.medworm.com/rss/comments.php?id=3671696 Thu, 17 Jun 2010 12:00:31 +0100 3671696 http://www.medworm.com/index.php?rid=3614689&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F-9oZqoepvd8%2F Richard Page thinks Multaq is an excellent new drug for treating atrial fibrillation, and the chairman of the department of medicine at the University of Wisconsin School of Medicine and Public Health, last year authored a large study in The New England Journal of Medicine that led to FDA approval. But his involvement allowed Sanofi-Aventis to dictate the terms, according to The Milwaukee Journal-Sentinel. Although he vouched for the accuracy and completeness, he never saw the raw data. The drugmaker, which paid for the study, collected that info and performed the analysis without an external audit. “These companies, if they were falsifying data, wouldn’t be kept in business if that were found out,” Page tells the paper. “I was satisfied and remain satisfied that th... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3614689 Mon, 31 May 2010 12:16:05 +0100 3614689 http://www.medworm.com/index.php?rid=3556093&cid=t_162946_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-primary-care-doctors-are-so-busy%2F2010.05.12 There’s been a lot of commentary on a recent article from the New England Journal of Medicine, detailing the undocumented tasks that a typical primary care physician performs. For those who haven’t read the piece, entitled, What’s Keeping Us So Busy in Primary Care? A Snapshot from One Practice, it’s available free at the NEJM website. I highly recommend it. To summarize, primary care doctors are responsible for much more than seeing patients in the exam room. In the cited practice, which has a fairly typical makeup, physicians were responsible for an average of over 23 telephone calls and 16 e-mails per day. Many practices don’t engage their patients over e-mail, so it’s conceivable that the number of telephone calls is lower than average here. (more…) *This blog... Better Health blogs http://www.medworm.com/rss/comments.php?id=3556093 Wed, 12 May 2010 14:00:26 +0100 3556093 http://www.medworm.com/index.php?rid=3502831&cid=t_162946_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F04%2F25%2Fultrawellness-or-ultra-hype-antidepressant-as-demagogue%2F Mark Hyman, MD, is a “practicing physician and pioneer in functional medicine,” according to his bio on the Huffington Post where he recently penned the nonsensical, “Why Antidepressants Don’t Work for Treating Depression.” I say “nonsensical” because this article is based upon a study that came out 3 years ago, so writing this article to educate the public seems not to be its primary purpose. Exhibiting sound reasoning and logic also doesn’t seem apparent in this article, since generally a scientist or doctor would not dismiss an entire class of medications — antidepressants — based upon a single study. Or when there are many different types of antidepressants and sub-classes — SSRIs, tricyclics, MAOIs, SRNIs, etc. The stud... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3502831 Sun, 25 Apr 2010 15:45:16 +0100 3502831 http://www.medworm.com/index.php?rid=3350270&cid=t_162946_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FORzKd2YOkW0%2F Editor’s note: The Disruptive Women in Health Care blog recently compiled an ebook exploring the issue of Comparative Effectiveness Research (CER) from a variety of viewpoints and perspective. We invite you to download the ebook or read the original posts. By Liz Scherer. Comparative effectiveness research (CER): it’s the buzzword of the new decade.  In fact, Congress recently passed legislation to provide more than $1B to support CER  in hopes of improving utilization of existing therapies while simultaneously holding down healthcare costs. The ultimate goal of CER goes even further and paints a rosy vision of patient-centered care and personalized medicine. However, perhaps these goals are loftier than originally imagined.  Newly- published data appearing in this week’s JAMA... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3350270 Wed, 10 Mar 2010 13:31:25 +0100 3350270 http://www.medworm.com/index.php?rid=3302351&cid=t_162946_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F02%2Fjacc-to-appear-on-kindle.html This Christmas, I bought my wife, an unmitigated book-lover, a new Kindle 2 from Amazon. While she's a bit of a Luddite when it comes to technology, she has quickly become a believer - uploading three books at a time to bring with her on weekend trips. (She's even one of my three subscribers to this blog on the Kindle!) My only regret is hearing the soft "*click* ... (pause) ... *click*" in bed as she turns electronic pages at bedtime.While hard copy books will still be great permanent reference sources, the plethora of fast-moving printed journals seem ripe for electronic disruption. I wouldn't be surprised to find that most journals as we know them eventually go the way of the dinosaur. As proof comes this from the ACC: The Journal of the American College of Cardiology (JACC) will be ava... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3302351 Tue, 23 Feb 2010 22:38:00 +0100 3302351 http://www.medworm.com/index.php?rid=2999484&cid=t_162946_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F11%2Feditorial-that-wasnt-evidence-for.html Woe to those of us who have been advocates for evidence-based medicine.  A short description of the evidence-based medicine is medicine whose practice is informed by critical, rigorous review of the best available evidence from clinical research as revealed by systematic search of the published research literature, as well as by the clinician's understanding of biology and the medical and biopsychosocial context, and by the patient's own values. Evidence-based medicine is based on some key assumptions.  One is that a systematic review will reveal all the results of research studies that are relevant to the issue at hand.  A second is that while the research studies may be flawed and imperfect, they are reported honestly.Unfortunately, as we have repeatedly discusse... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2999484 Mon, 16 Nov 2009 21:55:00 +0100 2999484 http://www.medworm.com/index.php?rid=2262111&cid=t_162946_167_f&fid=38271&url=http%3A%2F%2Frebeccascritchfield.wordpress.com%2F2009%2F03%2F12%2Ftalk-of-the-nation-on-npr-calories-and-weight-loss-2yr-study%2F I found this radio interview on the NPR website’s show Talk of the Nation…. listen, learn and discuss. Here’s what I found most interesting: 1. exercise discussion - long term weight management 2. total lifestyle change - portion control, calories matter I disagree with the overall message that it doesn’t matter what kind of calories. If you only eat 1500 calories a day of food and you need 2000 sure you are creating a calorie deficit. But if those calories are from a high sugar cereal with milk, a frozen meal at lunch, and a slice of pizza at dinner, you aren’t getting enough fiber, vitamins, minerals, and all the antioxidants and phytochemicals that come with eating whole grains, vegetables, and fruits. (Source: Balanced Health and Nutrition Rebecca Scritchf... Balanced Health and Nutrition Rebecca Scritchfield's Blog blogs http://www.medworm.com/rss/comments.php?id=2262111 Thu, 12 Mar 2009 15:30:04 +0100 2262111 http://www.medworm.com/index.php?rid=2228347&cid=t_162946_167_f&fid=37833&url=http%3A%2F%2Fnutrition.edublogs.org%2F2009%2F02%2F27%2Fweight-loss-is-eating-fewer-calories%2F This study also found that attendance at group sessions was strongly associated with weight loss. Resources: Sacks FM, Bray GA. Feburary 26, 2009. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates. New England Journal of Medicine. 360:859-873 Parker-Pope T. February 25, 2009. Study Zeroes In on Calories, Not Diet, for Loss: Fewer Calories (Carbs, Protein or Fat ) Are Called Weight Loss Key. New York Times. Image: Modified Microsoft Clipart. Authored by Dr.Dyer. Hosted by Edublogs. (Source: Nutrition and Wellness Biology 50) Nutrition and Wellness Biology 50 blogs http://www.medworm.com/rss/comments.php?id=2228347 Tue, 03 Mar 2009 03:03:30 +0100 2228347 http://www.medworm.com/index.php?rid=2654073&cid=t_162946_167_f&fid=37833&url=http%3A%2F%2Fnutrition.edublogs.org%2F2009%2F02%2F27%2Fweight-loss-is-eating-fewer-calories%2F This study also found that attendance at group sessions was strongly associated with weight loss. Resources: Sacks FM, Bray GA. Feburary 26, 2009. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates. New England Journal of Medicine. 360:859-873 Parker-Pope T. February 25, 2009. Study Zeroes In on Calories, Not Diet, for Loss: Fewer Calories (Carbs, Protein or Fat ) Are Called Weight Loss Key. New York Times. Image: Modified Microsoft Clipart. Authored by Dr.Dyer. Hosted by Edublogs. (Source: Nutrition and Wellness Biology 50) Nutrition and Wellness Biology 50 blogs http://www.medworm.com/rss/comments.php?id=2654073 Fri, 27 Feb 2009 18:18:37 +0100 2654073 http://www.medworm.com/index.php?rid=2144434&cid=t_162946_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F01%2F29%2Fobama-and-congressional-leaders-cant-overlook-emr-failure-rates%2F “If it’s [EMR investment and implementation] too hasty, you can create so many bad experiences that people say…’My data’s a mess and my patients are angry,’” Mr. Glaser said in a recent Wall Street Journal article on the possible wasted investment in EMR.  The scary thing is that John Glaser, chief information officer for Partners Healthcare, is probably right.  I know that President Barack Obama wants to “wield technology’s wonders to raise health care’s quality and lower its costs.”  I want to do that too.  In fact, I think we’d all like for that to happen.  Unfortunately, I think we have to seriously ask ourselves if the current electronic medical records offerings can raise health care’s quality and lowe... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2144434 Fri, 30 Jan 2009 07:22:11 +0100 2144434 http://www.medworm.com/index.php?rid=2011057&cid=t_162946_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2008%2F12%2Fno-such-ruc-new-england-journal-takes.html The vast amounts spent globally on health care do not seem to translate into access for many patients, quality care, and improved outcomes. The US, in particular, spends huge amounts, now more than $2 trillion a year, without getting universal access, or superb quality and outcomes. While we spend all this money, the primary care and generalist practitioners on the front lines of care are paid less and less, are increasingly embattled and disgruntled, and their numbers are rapidly thinning.Although these problems are huge, there is not much clear discussion of them.Thus, it was encouraging to see the vaunted New England Journal of Medicine, the premier US journal of medicine, take up the issue of the "future of primary care." A few weeks ago, the journal published a series of commentaries ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2011057 Wed, 03 Dec 2008 15:59:00 +0100 2011057 http://www.medworm.com/index.php?rid=1709718&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F365651139%2F This is a new twist on summer reading. Now that the key parties have filed their briefs with the US Supreme Court, which will review a case involving Wyeth on November 3, a host of interested parties - including 47 state attorneys general, former FDA commissioners, members of Congress, constitutional experts and editors of The New England Journal of Medicine - have just filed their own briefs arguing against preemption. What is all the fuss about? The background: During an emergency room hospital visit, Diana Levine was given a Wyeth nausea med called Phenergan, which was administered improperly and caused the Vermont musician to lose her right arm below the elbow. She successfully argued that, even though labeling complied with FDA requirements, the adequacy of the warning still wasn’t ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1709718 Fri, 15 Aug 2008 23:42:31 +0100 1709718 http://www.medworm.com/index.php?rid=1575641&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F325806062%2F Not surprisingly, the editors of The New England Journal of Medicine say ‘yes.’ Preemption, you may recall, is the notion that FDA approval supercedes state law claims challenging safety, efficacy, or labeling. Drugmakers and the FDA argue that preemption exists by maintaining the agency’s actions are the final word on safety and effectiveness. This fall, the US Supreme Court will hear a case that could determine whether patients can sue a drugmaker through state law when a product has already been approved by the FDA. And in an editorial, the NEJM editors offer a cautionary note. “Drug and device companies have chosen an inauspicious moment to attack the right of patients to seek redress,” they write. “A series of pivotal reports on patient safety from the ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1575641 Thu, 03 Jul 2008 13:53:33 +0100 1575641 http://www.medworm.com/index.php?rid=1344614&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F262163176%2F A federal judge in Boston has denied a motion by the drugmaker to compel The New England Journal of Medicine to hand over confidential peer reviews and editorial notes, The Chronicle of Higher Education reports. The decision comes two weeks after a federal judge in Chicago agreed with two other journals - including the Journal of the American Medical Association and the Archives of Internal Medicine - that Pfizer couldn’t force them to reveal confidential info. In January, Pfizer filed a motion asking for peer-review documents it had subpoenaed from 11 studies on the drugs published by the various journals, including the NEJM, and also sought rejected studies, arguing the manuscripts might contain data that could be useful for its defense. The drugmaker is currently being sued in fed... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1344614 Tue, 01 Apr 2008 19:34:13 +0100 1344614 http://www.medworm.com/index.php?rid=1307873&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F253188495%2F A federal judge in Chicago last Friday denied Pfizer’s efforts to obtain confidential peer review documents related to Celebrex and Bextra from the New England Journal of Medicine, according to Science magazine. In January, Pfizer filed a motion asking for peer-review documents it had subpoenaed from 11 studies on the drugs published by the NEJM, and also sought rejected studies, arguing the manuscripts might contain data that could be useful for its defense. The drugmaker is currently being sued in federal court in San Francisco by patients who claim the painkillers caused heart problems and wants the material for its defense. NEJM argued that releasing the info would compromise its anonyous peer review process, a position supported in an affidavit by the editor-in-chief of Science,... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1307873 Mon, 17 Mar 2008 19:35:24 +0100 1307873 http://www.medworm.com/index.php?rid=1250428&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F239394691%2F In a blistering editorial in Science magazine,* editor-in-chief Donald Kennedy notes that Pfizer has issued subpoenas to the New England Journal of Medicine in order to wade through confidential reviews of published studies of its Celebrex and Bextra painkillers, which are the subject of numerous product-liability lawsuits. As he sees it, Pfizer wants it both ways - an opportunity to defend itself against litigation that involves dismissing the same confidential system that validates industry research. To Kennedy, it’s a ‘fishing expedition’ that will undermine journal integrity. “At Science, we editors love our reviewers and know that our editorial colleagues elsewhere do, too. After all, the process of scientific publication depends on the volunteer services of th... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1250428 Fri, 22 Feb 2008 13:14:25 +0100 1250428 http://www.medworm.com/index.php?rid=1246631&cid=t_162946_145_f&fid=35710&url=http%3A%2F%2Fstoryofhealing.com%2F2008%2F02%2F20%2Fmedia-in-medicine-i-love-film%2F This New England Journal of Medicine article is another one worth sharing about the use of media in medicine. Today’s plate is film. This medium of communication is a personal favorite of mine. It is also my favorite learning tool. It is not uncommon to use video as a medium to communicate medicine, to educate, to share knowledge, to present theories, report breakthroughs. Though most commonly, the point of view is that of the professional, student, or authority on health issues. But this time Dr. Gretchen Berland of the Yale University School of Medicine aptly rotated the camera sharing with all of us a stark portrait, “The View from the Other Side—Patients, Doctors, and the Power of a Camera.” As an internist, I was disturbed by the contrast between those two scenes,... the story of healing blogs http://www.medworm.com/rss/comments.php?id=1246631 Thu, 21 Feb 2008 05:42:08 +0100 1246631 http://www.medworm.com/index.php?rid=1188763&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F226026684%2F Ever wonder how Glaxo was able to respond so quickly and authoritatively to the controversial meta-analysis published last May in The New England Journal of Medicine? This was the study linking the Avandia diabetes pill to a 43 percent increased risk in heart attacks and strokes. Well, it turns out that a peer reviewer for the journal broke confidentiality and leaked the damaging analysis to Glaxo ahead of publication, according to Nature (subscription required). Exactly 17 days earlier, Steven Haffner of the University of Texas Health Science Center at San Antonio faxed his copy of the article to Alexander Cobitz, a Glaxo employee who Haffner knew from working on an earlier Avandia clinical trial. “Why I sent it is a mystery,” Haffner told Nature. “I don’t really understan... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1188763 Wed, 30 Jan 2008 19:26:19 +0100 1188763 http://www.medworm.com/index.php?rid=1143509&cid=t_162946_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F01%2Fnavigenics-who-was-that.html So after the New England Journal of Medicine has given Personal Genome Sequencing the thumbs down, I ask you...."What will happen to these personal genome companies?"I have several ideas....1. They all morph into non-health related information tools. Every bell and whistle that can be marketed that will not face the scrutiny of physicians will come out of the wood works. 2. They will begin to say "The medical field has no sense of what the promise of genomic medicine is" They will attack physicians' lack of genomic knowledge. This is the tactic which nutraceutical companies use. The 'Ol "We have a secret....most physicians don't know or won't share......because they want you to have disease"3. They will disappear, like the dinosaurs. A neat phenomenon that gave us something to write about ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1143509 Fri, 11 Jan 2008 00:10:00 +0100 1143509 http://www.medworm.com/index.php?rid=1131141&cid=t_162946_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2F211296968%2F Suffering from cardiac arrest while staying in a hospital might be more deadly than receiving such a fit at a crowded airport, according to a new study. Being a nurse, I find this hard to believe. I would think that we would respond quicker and get CPR and an ET tube in place quicker than an innocent bystander looking for the AED on the wall. I can not remember more than a 3-4 minute lag or down time for any code situation that I have ever personally been involved in. And what if the person needs to be trached or a balloon pump inserted for concractility of a mushy heart? I don’t see that happening on a mall floor. The study published by the New England Journal of Medicine stated that in 1/3 of all hospital cardiac arrests, nurses and doctors did not move quickly enough resulting in ... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=1131141 Sat, 05 Jan 2008 01:47:15 +0100 1131141 http://www.medworm.com/index.php?rid=1126410&cid=t_162946_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F01%2F2008-here-we-come.html This study is a neat expression of this unique technology. By identifying patients with a "Genetic Disorder" (What disease isn't genetic?) researchers have created a new piece of nucleic acid that will actually tell the machinery in the cell to do something other than it was coded to do.Say Wha? Ok. Muscular Dystrophy is caused by absence of a certain protein called Dystrophin. If muscle cells can't make this protein, then they cannot function. Children often are wheelchair bound before 10. Why can't they make the protein? Usually, the gene which codes for the protein is defective. Its defect causes the gene to protein machinery to stop making the protein very early in its production. This results in a non-functioning protein. This new product PRO051 tells the machinery to pay no attention... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1126410 Wed, 02 Jan 2008 16:16:00 +0100 1126410 http://www.medworm.com/index.php?rid=771757&cid=t_162946_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2007%2F07%2Fms-genes-and-gwas.html Today I want to once again cool the hype from the media. There recently was a study in the New England Journal of Medicine as well as a candidate gene study in the journal Nature Genetics which identify new risk factors for Multiple Sclerosis.First what we knowCandidate-gene studies have validated associations between multiple sclerosis and polymorphic variants within the major histocompatibility complex (MHC), but no other loci with a definitive association with the disease have been found. 30 years ago scientists found that immune system proteins called HLAs (human leukocyte antigens) are partly responsible for the genetic factor. HLAs are like identity tags, all cells of the body carry them and the immune system "inspects" them so it knows not to attack them when it's seeking out foreig... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=771757 Tue, 31 Jul 2007 14:44:00 +0100 771757 http://www.medworm.com/index.php?rid=763023&cid=t_162946_107_f&fid=35762&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fscienceblogs%2Fgrrlscientist%2F%7E3%2F138081700%2Fcan_animals_predict_impending.php tags: animals, predict death, Oscar the cat, New England Journal of Medicine Oscar the cat provides comfort to the dying. According to an article that was just published in the New England Journal of Medicine, a two-year-old cat that lives in Steere House Nursing and Rehabilitation Center in Providence, Rhode Island, can correctly predict impending death among the residents. Oscar the cat has a habit of curling up next to patients who are in their final hours, and so far, he has been observed to be correct in 25 cases. Read the rest of this post... | Read the comments on this post... (Source: Living the Scientific Life (Scientist, Interrupted)) Living the Scientific Life (Scientist, Interrupted) blogs http://www.medworm.com/rss/comments.php?id=763023 Fri, 27 Jul 2007 21:54:43 +0100 763023 http://www.medworm.com/index.php?rid=745642&cid=t_162946_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F135615626%2F In an editorial this week, The New England Journal of Medicine editors urge Congress to pass PDUFA, calling it “the most important drug-safety legislation in a century,” despite expressing misgivings about the relationship created between the FDA and drugmakers by increased user fees. The editors then list what they say a final bill must contain… - The FDA needs authority to mandate postmarketing safety trials with specific results timetables and to conduct annual safety reviews for the first 3 years after a drug’s approval and again at 7 years; Drug ads and labels must include a toll-free telephone number and an Internet address; Substantial penalties for drug ads that overstate efficacy or understate adverse effects; The FDA must be able to mandate changes to labe... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=745642 Fri, 20 Jul 2007 12:33:18 +0100 745642 http://www.medworm.com/index.php?rid=658842&cid=t_162946_87_f&fid=34867&url=http%3A%2F%2Fwww.thediabetesblog.com%2F2007%2F06%2F05%2Favandia-latest-glaxo-fights-back%2F This article also notes that weekly prescriptions for Avandia have fallen by sixteen percent since the recent publication of a damaging article by Dr. Steven Nissen in the New England Journal of Medicine. Nissen asserted that Avandia could increase the risk of heart attack by forty-three percent and the risk of cardiac-related death by sixty-four percent.By the way, it is worth checking out the Wikipedia entry on Glaxo for a brief rundown of the company's history, including previous wrangles with the media and the law over its products. Note, though, the entry has not yet been updated in the wake of the Avandia scandal.Read | Permalink | Email this | Linking Blogs | Comments (Source: The Diabetes Blog) The Diabetes Blog blogs http://www.medworm.com/rss/comments.php?id=658842 Tue, 05 Jun 2007 04:00:00 +0100 658842 http://www.medworm.com/index.php?rid=611608&cid=t_162946_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2007%2F05%2Fblogscan-anechoic-effect-and-hpv.html MedPundit notes that the New England Journal of Medicine's editorial on the HPV vaccine, which accompanied multiple original articles and commentaries on this topic, omitted any mention of how the manufacturer of the vaccine lobbied state legislatures to make administration of the vaccine mandatory. The anechoic effect lives (in medical journals, but not in blogs). (Source: Health Care Renewal) Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=611608 Thu, 10 May 2007 16:56:00 +0100 611608 http://www.medworm.com/index.php?rid=568121&cid=t_162946_87_f&fid=34867&url=http%3A%2F%2Fwww.thediabetesblog.com%2F2007%2F04%2F24%2Ffitness-for-sale-dont-buy-it%2F Filed under: Type 2, Diet, Lifestyle, ExerciseI don't really spend all that much time watching TV, but even in the limited amount of time that I do, I always happen upon the so-called latest and greatest diet and exercise fad. Last night I just so happened to see an advert for yet another ab rolling type machine, with this one claiming to help you lose your abdominal fat in, like, eight seconds. TV is not the only media outlet to blame, however. Just as guilty, if not even more so, is the internet -- also known as the place where faulty claims run amok and unsupported data is pretty much the norm. Yes, I'm well aware of the fact that this is an internet-based platform, too. You take the good, you take the bad (you take them both and then you have the facts of life -- and here it is I clai... The Diabetes Blog blogs http://www.medworm.com/rss/comments.php?id=568121 Tue, 24 Apr 2007 04:00:00 +0100 568121 http://www.medworm.com/index.php?rid=486515&cid=t_162946_131_f&fid=34996&url=http%3A%2F%2Ftalk.genesanddrugs.com%2F2006%2F12%2F15%2Fcolon-cancer-screening-in-a-conservative-town%2F Many years ago Uncle Sam sent me to Rockford Illinois to repay my National Health Service Corps scholarship by providing medical services to the medically indigent population of Winnebago County. Rockford population about 150,000 was the second largest city in Illinois and, to this California boy, rather provincial. At the time I arrived, the HIV epidemic was raging. In Rockford, most of the victims were iv drug users, their partners, and their children. HIV wasn’t really a gay thing in Rockford because when a gay Rockfordian was old enough to leave town, he did—usually for Chicago. Faced with the epidemic, I asked my Rockford colleagues why no one had started a needle exchange program. “Oh,” I was told, “we can’t do that here. Rockford is a conservative town…” But I digres... Genes & Drugs Blog blogs http://www.medworm.com/rss/comments.php?id=486515 Sat, 16 Dec 2006 01:55:26 +0100 486515