Content tagged with 'Evidence-Based Medicine'
Targeting Prescribers Can Reduce Excessive Use of Antibiotics in Hospitals
HBNS STORY | April 30, 2013
Giving prescribers access to education and advice or imposing restrictions on use can curb overuse or inappropriate use of antibiotics in hospitals, according to a new Cochrane systematic review.
What Do I Tweet – and Why?
PREPARED PATIENT BLOG | April 3, 2013 | Jessie Gruman
Who would have thought that Twitter, this tiny aperture – a mere 140 characters – could connect me with so many smart, feisty, tough people who share, amplify, and improve on my efforts to spread carefully chosen health and health care content through their responses, retweets, modified tweets and acknowledgements?
Here’s why I tweet what I tweet...
Whatever Happened to Underuse of Medical Services?
PREPARED PATIENT BLOG | April 2, 2013 | Trudy Lieberman
Twelve years ago, in its landmark study Crossing the Quality Chasm, the Institute of Medicine (IOM) found that “the health care industry is plagued with overutilization of services, underutilization of services, and errors in health care practice.” In simple English, the IOM reported that health care was riddled with overuse, underuse and misuse of medical services.
Prebiotics: Do Supplements In Baby Formula Help Prevent Allergies?
HBNS STORY | March 28, 2013
Prebiotic supplements in infant formula may help to prevent eczema, according to a systematic review published in The Cochrane Library.
Diabetes: Computer Based Interventions Provide Limited Support
HBNS STORY | March 28, 2013
Self-management interventions delivered by computer and mobile phone currently provide limited benefits for people with diabetes, according to a systematic review published in The Cochrane Library.
False Alarms and Unrealistic Expectations in Preventive Care
PREPARED PATIENT BLOG | March 28, 2013 | Kenny Lin
Shortly after we moved to Washington, DC, my wife and I purchased a basic home security system, the kind with a programmable keypad, multiple door alarms and a motion sensor. All things considered, it's hard to argue that the benefits of this preventive measure have outweighed its cumulative harms.
Comparative Effectiveness Research: Louise Vetter, CEO of the Huntington’s Disease Society of America
PREPARED PATIENT BLOG | March 27, 2013 | Louise Vetter
There are 30,000 Americans alive today with symptoms of HD, and an additional 200,000 are at risk...Generally, we see CER as an important priority to inform clinician decision making.
School Grades Go Down When Health Risks Go Up
HBNS STORY | March 26, 2013
Academic performance is linked to risky health behaviors in children and teens, reports a new review in the Journal of Adolescent Health.
Comparative Effectiveness Research: Marty Tenenbaum, Founder & Chairman of Cancer Commons
PREPARED PATIENT BLOG | March 13, 2013 | Marty Tenenbaum
There is a large disparity of information across the medical world. If you consult 6 doctors, you’ll likely get 6 opinions about how to treat your cancer. And 5-year survivals may vary as much as 50%. This is inexcusable.
Too Much Medical Care: Do We Know It When We See It?
PREPARED PATIENT BLOG | March 11, 2013 | Kenny Lin
If I didn't object to receiving what I recognized as too much medical care, it should not be a surprise that, according to one study, many inappropriate tests and treatments are being provided more often, not less.
True Informed Consent Is Elusive
PREPARED PATIENT BLOG | November 26, 2012 | Harriet Hall
Most of us would agree that doctors should not treat patients without their consent, except in special cases like emergency care for an unconscious patient. It’s not enough for doctors to ask “Is it OK with you if I do this?”
Respiratory Exercises Before Heart Surgery Can Prevent Pneumonia
HBNS STORY | November 14, 2012
Patients who practice respiratory physical therapy exercises before elective cardiac surgery may reduce serious pulmonary complications later, finds a new evidence review from The Cochrane Library.
Review Confirms Value of Combined Approach to Quitting Smoking
HBNS STORY | October 17, 2012
Smokers who try to quit would be more successful if they combined medication or nicotine-replacement therapy with behavioral counseling, finds a new review in The Cochrane Library.
Diagnostic Confidence Key for Prompt Treatment for Women with Heart Symptoms
HBNS STORY | August 29, 2012
Doctors who believe that women have “atypical” coronary heart disease symptoms are less certain when diagnosing heart disease in women. As a result, women are less likely than men to receive treatments for an urgent cardiac event, finds a new study in the Journal of Health and Social Behavior.
Using Press Releases for Preliminary Pilot Data
PREPARED PATIENT BLOG | July 24, 2012 | Conversation Continues
Steven Novella of the Science Based Medicine blog asks, 'If this is a pilot study only and we should not base any firm conclusions on the results, then why the press release?''
Research that Incorporates the Patient's Perspective
PREPARED PATIENT BLOG | July 17, 2012 | Conversation Continues
Josh Freeman, M.D., argues for research that looks at the patient as a whole. CFAH President Jessie Gruman cautions that if researchers are not advised, supported, and required to include the patient's perspective, it will not occur.
No Evidence to Support Removing Impacted Wisdom Teeth
HBNS STORY | June 13, 2012
Little evidence exists to support removing impacted wisdom teeth that are not causing pain and swelling, aren’t negatively affecting other teeth, and that are disease-free, finds a new review in The Cochrane Library.
Use of Patient Centered Medical Home Features Not Related to Patients' Experience of Care
HBNS STORY | June 6, 2012
Providing patient care using key features of a Patient-Centered Medical Home (PCMH), a model of health care delivery promoted by major physician groups, may not influence what patients think about the care they receive, reports a new study in Health Services Research.
Caffeine Gives a Small Boost to Painkillers’ Effectiveness
HBNS STORY | March 15, 2012
Caffeine improves the effectiveness of over-the-counter pain relieving drugs, but only by a small margin, according to a new evidence review in The Cochrane Library.
No Support Shown for the Use of Pycnogenol® for Chronic Disorders
HBNS STORY | February 15, 2012
The manufacturer of a dietary supplement made from French pine bark, Pycnogenol®, markets it widely for the prevention or treatment of many chronic disorders, ranging from asthma to erectile dysfunction, but a recent systematic review found no sound basis for the claims.
Tweetchat with Jessie Gruman Today at 2PM on Overtesting and Overtreating in Health Care
PREPARED PATIENT BLOG | February 1, 2012 | CFAH Staff
Join @jessiegruman, Otis Brawley MD, Executive VP of ACS and other experts on Twitter today at 2PM with ABC's @DrRichardBesser for a Tweetchat about overtesting and overtreating in health care. Use hash tag #abcdrbchat.
Guest Blog: How People's Stories Support Evidence-Based Care
PREPARED PATIENT BLOG | December 5, 2011 | Kenny Lin
I was recently asked how evidence from clinical trials can possibly overcome powerful emotional stories of "saved lives." My answer: evidence-based medicine's supporters must fight anecdotes with anecdotes. Statistics show that, while some are saved, many people are temporarily or permanently injured as a result of screenings/testings - and their stories matter too.
Conflicts of Interest and the FDA
PREPARED PATIENT BLOG | November 17, 2011 | Inside Health Care
Patients rely on panels of experts to review and approve new treatments and products. The hope is that these experts are unbiased in their evaluations. Here, health care insiders debate whether there are enough conflict-free panelists to go around.
The Rocky Adolescence of Public Reporting on Health Care Quality: It's Not Useful Yet, and We're Not Ready
PREPARED PATIENT BLOG | November 9, 2011 | Jessie Gruman
The American people, long protected from the price of health care by insurance, are now forced to act as consumers. This situation is a free marketer's dream.
Guest Blog: When Patients Demand Treatments That Won't Work
PREPARED PATIENT BLOG | November 4, 2011 | Carolyn Thomas
When my son Ben came down with a sore throat this past summer, he went to his doctor for antibiotics. Both agreed it sure sounded like strep, so without having to wait for the throat swab test results, Ben left the office with a prescription for antibiotics. But were they the appropriate treatment? Do all bugs need drugs?
Getting the Patient's Perspective in Research: Will PCORI Deliver on its Promise?
PREPARED PATIENT BLOG | November 2, 2011 | Jessie Gruman
One major challenge for the new Patient Centered Outcomes Research Institute (PCORI) is to make good on its stated mission to improve health care by producing evidence 'that comes from research guided by patients, caregivers and the broader health care community.'
"That's Not What I Wanted to Hear!": Evidence-Based Medicine and Our Hard Choices
PREPARED PATIENT BLOG | October 19, 2011 | Jessie Gruman
American health care treads a fine line between trying to serve the good of the many and the interests of the individual. But no one has yet figured out a cost-effective, yet humane, way to do both.
Why Patient Care Needs To Get Personal
PREPARED PATIENT BLOG | October 19, 2011 | David L. Katz
Evidence-based medicine, in other words, is population-based medicine. The care of any individual patient is based on the experiences of patients who have come before. And while to some extent that is unavoidable, it is also a great peril.
Contagion: Action! Adventure! The Value of Science?
PREPARED PATIENT BLOG | October 12, 2011 | Jessie Gruman
Our country is politically polarized. The economy is teetering. Distrust of government and its employees is at an all-time high. Scientists are criticized as biased money-grubbers.
Excluding Hypertension, Review Finds Calcium Supplements Have No Benefit During Pregnancy
HBNS STORY | October 5, 2011
Most physicians instruct pregnant women to increase their calcium intake, but a new evidence review of potential benefits of calcium supplementation for mom and baby found none, except for the treatment of pregnancy-related hypertension.
Review: Taking Blood Pressure Drugs at Night Slightly Improves Control
HBNS STORY | October 5, 2011
Patients who take certain popular types of blood pressure medication once a day are able to achieve somewhat better control of their hypertension if they take their daily dose at bedtime, according to a new systematic review.
Patient Engagement: Expert Molly Mettler Talks about Challenges
PREPARED PATIENT BLOG | September 26, 2011 | Molly Mettler
This interview with Molly Mettler is the third in a series of brief chats between CFAH president and founder, Jessie Gruman and experts - our CFAH William Ziff Fellows - who have devoted their careers to understanding and encouraging people's engagement in their health and health care.
Review: Probiotics Have Slight Preventive Effect on Colds
HBNS STORY | September 15, 2011
Taking probiotics seems to provide both children and adults with a mild degree of protection against many upper respiratory tract infections including the common cold, according to a new systematic review.
Guest Blog: We Interrupt This State Fair for a Little Prostate Cancer Screening
PREPARED PATIENT BLOG | September 7, 2011 | Gary Schwitzer
There are a few things a man should think about seriously before rolling up his sleeve for the supposedly "simple" blood test. 'But here, prostate cancer screening is hawked in the same setting as the modern-day carnies pitching their slice-'em-and-dice-'em devices and inventions you only see at the state fair - "only at this price today!"
Guest Blog: Laurel & Hardy and Prostate Cancer Chemoprevention
PREPARED PATIENT BLOG | August 10, 2011 | Gary Schwitzer
A drug currently used for benign prostate problems is now being pushed for prostate cancer prevention. But the FDA warns there's evidence it may actually result in more advanced cancers.
Premature Ejaculation Therapy Not Supported by Evidence
HBNS STORY | August 9, 2011
A new review finds little reliable research to support treating premature ejaculation by teaching men how to control their bodies with their minds.
Guest Blog: Evidenced-based Medicine or Easy-bake Oven: Tension Between Evidence and Reality
PREPARED PATIENT BLOG | August 8, 2011 | Kelly Young
This post was inspired by the article "Patient Advocates: Flies in the Ointment of Evidenced Based Care" at the Health Affairs Blog. Patient advocacy and evidenced-based medicine are both intimately entwined with several matters in rheumatological care, but first a word about flies. Patient advocates probably are flies in the ointment, and there would certainly be no flies in a perfect world. But in a perfect world, we wouldn't be sick. In a perfect world, doctors could comprehend our pain.
Guest Blog: NIH to Drop Requirement for Websites Disclosing Researchers' Ties to Industry
PREPARED PATIENT BLOG | August 5, 2011 | Elaine Schattner
Word comes from Nature News that the NIH is dropping a proposed requirement for universities to disclose researchers' financial ties to industry on websites. This is a loss for patients, who may not be aware of their doctors' relationships with pharmaceutical companies and others who fund clinical trials, fellowships, conference junkets and other perks for physicians.
Guest Blog: The Confusing Morass of Medical Evidence
PREPARED PATIENT BLOG | July 28, 2011 | Ken Covinsky
Practitioners of evidence-based medicine use published evidence from the medical literature to guide them as they try to provide the best care for each patient. But sometimes the medical literature just feels like a big morass.
Our Preference in Health News: Uncertainty or Naked Ladies?
PREPARED PATIENT BLOG | July 27, 2011 | Jessie Gruman
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.
Guest Blog: Niseritide, the 'Lost Decade', and the Pinto
PREPARED PATIENT BLOG | July 21, 2011 | Patricia Salber
Eric Topol, MD wrote an interesting commentary in the July 7, 2011 issue of the New England Journal of Medicine, titled 'The Lost Decade of Nesiritide.' Nesiritide is a drug for heart failure symptoms (e.g., shortness of breath) that was approved by the FDA in 2001. Since that time, according to Dr. Topol, 'well more than $1 Billion was wasted on purchasing the drug.'
Patient Advocates: Flies In The Ointment Of Evidence-Based Care
PREPARED PATIENT BLOG | July 18, 2011 | Jessie Gruman
The women recounted how their lives had been saved as they pleaded for the Food and Drug Administration not to withdraw approval for Avastin as a treatment for advanced breast cancer. They did so even without evidence that it provides benefit and with evidence that it confers risks.
The Hidden Secrets of Evidence
PREPARED PATIENT BLOG | July 15, 2011 | Connie Davis
I have a fear. My fear is that the public has an unrealistic view of medicine and the science behind it.
Inside Health Care: Show Me the Evidence
PREPARED PATIENT BLOG | June 2, 2011 | CFAH Staff
Being actively engaged in your health care means understanding how the care you are receiving will benefit you. We expect the care we receive and the health advice we are offered to be evidence based, using the best research available. Journalists, a researcher, and a doctor call attention to common practices where evidence is lacking.
The Cognitive Traps We All Fall Into
PREPARED PATIENT BLOG | May 26, 2011 | Harriet Hall
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.
Guest Blog: The Role of Experience in Science-Based Medicine
PREPARED PATIENT BLOG | April 21, 2011 | Harriet Hall
Before we had EBM (evidence-based medicine) we had another kind of EBM: experience-based medicine. Mark Crislip has said that the three most dangerous words in medicine are 'In my experience.' I agree wholeheartedly.
Guest Blog: Death Panels and Decision Making: A Radio Interview
PREPARED PATIENT BLOG | April 15, 2011 | Amy Berman
Diana Mason, former editor-in-chief of the American Journal of Nursing, interviews Program Officer at The John A. Hartford Foundation, Amy Berman, and The New York Times blogger and nurse, Theresa Brown. Amy Berman was diagnosed with Stage IV breast cancer earlier this year, and in this interview, she says, 'Nothing was off limits.'
For a Less Biased Study, Try Randomization
HBNS STORY | April 12, 2011
If you’re interested in the finer points of medical research, this story’s for you.
Guest Blog: Quality or Value? A Measure for the 21st Century
PREPARED PATIENT BLOG | March 24, 2011 | Marya Zilberberg
Fascinating, how in the same week two giants of evidence-based medicine have given such divergent views on the future of quality improvement. Donald Berwick, the CMS administrator and founder and former head of the Institute for Health Care Improvement, emphasizes the need for quality as the strategy for success in our healthcare system. But one of the fathers of EBM, Muir Gray, states that quality is so 20th century, and we need instead to shine the light on value. So, who is right?
Pacifiers Don’t Interfere With Established Breastfeeding, Review Finds
HBNS STORY | March 15, 2011
A new review finds no association between pacifier use and early cessation of nursing.
Guest Blog: The Beautiful Uncertainty of Science
PREPARED PATIENT BLOG | February 2, 2011 | Marya Zilberberg
I am so tired of this all-or-nothing discussion about science! On the one hand there is a chorus singing praises to science and calling people who are skeptical of certain ideas unscientific idiots. On the other, with equal penchant for eminence-based thinking, are the masses convinced of conspiracies and nefarious motives of science and its perpetrators. And neither will stop and listen to the other side's objections, and neither will stop the name-calling. So, is it any wonder we are not getting any closer to the common ground?
Prevention Magazine Pushes High-tech, Non-Evidence-based Heart Screenings More Than Basic Prevention
PREPARED PATIENT BLOG | January 26, 2011 | Gary Schwitzer
The February issue of Prevention magazine has an article, "Surprising Faces of Heart Attack" profiling "three women (who) didn't think they were at high risk. Their stories are proof that you could be in danger without even knowing it." No, their stories are not proof of that.
A Fighting Spirit Won't Save Your Life
PREPARED PATIENT BLOG | January 26, 2011 | Richard Sloan
Dr. Sloan's piece 'A Fighting Spirit Won't Save Your Life', that recently ran in The Opinion Pages of the New York Times, calls into question our belief that we can affect our health through optimism and positive thinking.
Mechanical Versus Manual CPR—Too Close to Call
HBNS STORY | January 18, 2011
Makers say that mechanical devices perform CPR more effectively than human efforts alone. However, a new review comparing mechanical to manual chest compressions has failed to demonstrate that one is superior to the other.
Prepared Patient: Sorting Out Medical Opinion Overload
PREPARED PATIENT BLOG | December 28, 2010 | Health Behavior News Service
When her grandmother experienced a sudden onset of dizziness, slurred speech and facial drooping, Kafi Grigsby found herself in an emergency department waiting room, surrounded by five doctors with four different opinions on what had occurred and how to treat it.
“White-Noise” Therapy Alone Not Enough to Curb Tinnitus
HBNS STORY | December 9, 2010
Tinnitus — what many think of as “ringing in the ears” — is the perception of sound without any real acoustic stimulation. Sound masking therapy, a common component of tinnitus treatment, is of uncertain benefit when used on its own, a new evidence review finds.
Ginseng Might Boost Brain Power, but Evidence Is Weak
HBNS STORY | December 7, 2010
Many people believe that the popular herb ginseng can improve thinking ability and prevent or even treat dementia. However, a comprehensive review of research failed to find convincing evidence of these benefits.
More Can Also Be Less: We Need a More Complete Public Discussion about Comparative Effectiveness
PREPARED PATIENT BLOG | December 1, 2010 | Jessie Gruman
Media coverage of the government's new investment in comparative effectiveness research leans heavily toward the effects of such research on new drugs and technologies: Will such evaluations lead to restricted access to the latest innovations? Will insurance no longer cover a drug that might give my aunt another year to live? Will such research hinder the development of a drug that could cure my nephew of type 1 diabetes?
Book Review: Bad Science by Ben Goldacre
PREPARED PATIENT BLOG | November 29, 2010 | Connie Davis
I've been following evidence-based medicine for many years and I've been appalled by the way it is playing out. We have pay-for-performance that does not understand that the reliability we are after is not in reliably (read blindly) applying a guideline to a patient population, but rather reliably considering how the evidence applies to the individual in a health care interaction. We have guidelines that are based on expert opinion, often influenced by drug company funding, or based on bad science. And we have a news media that seems unable to present medical findings in a balanced and understandable way.
Integrating Patient Experience into Research and Clinical Medicine: Towards True Personalized Medicine
PREPARED PATIENT BLOG | November 12, 2010 | David Gorski
We advocate science-based medicine (SBM) on the Science-Based Medicine blog. However, from time to time, I feel it necessary to point out that science-based medicine is not the same thing as turning medicine into a science. Rather, we argue that what we do as clinicians should be based in science. This is not a distinction without a difference. If we were practicing pure science, we would be theoretically able to create algorithms and flowcharts telling us how to care for patients with any given condition, and we would never deviate from them.
Inside Health Care: Trusted Sources?
PREPARED PATIENT BLOG | October 29, 2010 | Inside Health Care
The increasing presence (sometime hidden) of advertisers in health care websites - including the new Sharecare - was discussed this week by healthcare journalists Gary Schwitzer and Pia Christensen, Dr. Elaine Schattner, M.D. and marketer and advertiser Dan Dunlop
Atlantic: Lies, Damned Lies, and Medical Science
PREPARED PATIENT BLOG | October 18, 2010 | Society for Participatory Medicine
There's an extraordinary new article in The Atlantic, 'Lies, Damned Lies, and Medical Science.' It echoes the excellent article in our Journal of Participatory Medicine (JoPM) one year ago this week, by Richard W. Smith, 25 year editor of the British Medical Journal: In Search Of an Optimal Peer Review System.
Do Scientists Understand the Public? And Does It Matter?
PREPARED PATIENT BLOG | September 16, 2010 | Jessie Gruman
Exploring these questions is relevant to all who are working to support people's engagement in their health and health care. They are also relevant to the debate about the value of comparative effectiveness research. Science journalist Chris Mooney reports a couple of provocative points in this account of four meetings on the topic sponsored by the American Academy of Arts and Sciences over the past year.
The People and Evidence-Based Medicine: We are All Above Average
PREPARED PATIENT BLOG | September 1, 2010 | Jessie Gruman
Problems with evidence-based guidelines and comparative effectiveness research all have at their core the conflict between averages and individuals.
Antibiotic Resistance, Evidence-Based Medicine and the End of the World as We Know It
PREPARED PATIENT BLOG | August 24, 2010 | Jessie Gruman
Delivering evidence-based medicine is a deceptively elegant and simple goal.' But new findings about the increase in antibiotic resistance challenge us to consider just how complicated and challenging it is to actually define and deliver evidence-based care.'
Who's Got My Back?
PREPARED PATIENT BLOG | July 27, 2010 | Jessie Gruman
Last week The New York Times published a front-page feature about how diagnosing breast cancer can be surprisingly difficult, prone to both outright error and case-by-case disagreement over whether a cluster of cells is benign or malignant.
Risky Treatment Decisions: The Devil and the Deep Blue Sea
PREPARED PATIENT BLOG | April 22, 2010 | Jessie Gruman
Tuesday's New York Times ran a story about the unreliability of the tests and the variation among laboratory standards that determine the potential effectiveness of new targeted cancer treatments. Linda Griffin, a physician with breast cancer, described the series of treatment decisions she made with her doctors about whether or not to take the very expensive, fairly disruptive and potentially very effective drug, Herceptin, based on a genetic test that was inconclusive and further, which produced different findings when the same material was retested.
Evidence and Trustworthy Intermediaries
PREPARED PATIENT BLOG | April 20, 2010 | Jessie Gruman
2009 was not a good year for the public's understanding of evidence.
Zinc Supplements to Prevent Middle Ear Infections: Evidence Is Weak
HBNS STORY | February 16, 2010
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