“Operational failures in the transportation, food and nuclear energy industries have motivated substantial improvements. Why don’t widespread clinical quality problems in health care elicit a similar response?” study authors Arnold Milstein, M.D., M.P.H. and Nancy E. Adler, Ph.D., ask.

Using an applied social psychology approach, Milstein and Adler apply research findings from cognitive and motivational psychology to discuss why clinical failures go unnoticed. They suggest that the problem is an example of “signal detection,” or the task of deciding whether a perceived “signal” represents a true event.

Some obstacles to signal detection are strong enough to make it “highly unlikely that appropriately vigorous corrective action will naturally occur,” the researchers conclude.

To read the full study, go to http://www.healthaffairs.org/1130_abstract_c.php? ID=http://www.healthaffairs.org/Library/v22n2/s21.pdf (subscription or pay-per-view required).

* The Journal of the American Medical Association is launching a new section on translational medical research, containing studies that reflect a “bedside to bench and back to bedside approach,” say JAMA editors Phil B. Fontanarosa, M.D. and Catherine D. DeAngelis, M.D., M.P.H., in the April 23/30 issue of the journal. The section will provide a forum where clinicians can learn about basic disease mechanisms that may lead to better patient care, according to the editors.

A major study in the same issue reports the success of two behavioral interventions to lower blood pressure. Researchers found that a lifestyle modification intervention among people with hypertension led to weight loss, improved fitness and less salt consumption. When the lifestyle intervention was combined with the DASH diet, which is designed to lower blood pressure, people also increased their vegetable, fruit and dairy consumption.

To read more, go to http://jama.ama-assn.org/cgi/ content/abstract/289/16/2083 (hypertension study) and http://jama.ama-assn.org/cgi/content/full/289/16/2133 (translational medical research).