New clinical trial approach reduces time and costs of many studies

From an April 8 2011 Science Daily report

ScienceDaily (Apr. 8, 2011) — Doctors at the Veterans Affairs Boston Healthcare System are testing a new kind of clinical trial that’s not only less costly but guides doctors to switch to the best treatment even before the trial is completed. The new approach — called a point-of-care clinical trial — was developed by Stanford University biostatistician Philip Lavori, PhD, and a Boston-based team as an alternative to expensive, lengthy, double-blind, placebo-controlled clinical trials to compare drugs and procedures that are already in regular use.

“The goal of point-of-care clinical trials is to deliver the best care to patients while learning from each experience and redefining that care,” said Lavori, a professor of health research and policy at Stanford’s School of Medicine and the senior author of an article on the method to be published online April 4 in Clinical Trials. “This ‘learning and improving’ loop will enable health-care institutions to more rapidly fold improvements into their medical practices,” he said….

…”The idea of embedding research into clinical care has been around for quite awhile but to my knowledge this is the first time that a randomized trial has been fully integrated into a hospital’s informatics system,” said Fiore. “It demonstrates an effective way to use electronic medical records to improve health care at a local level.”…

Journal Reference:

1. R. A. Rosenheck, J. H. Krystal, R. Lew, P. G. Barnett, S. S. Thwin, L. Fiore, D. Valley, G. D. Huang, C. Neal, J. E. Vertrees, M. H. Liang. Challenges in the design and conduct of controlled clinical effectiveness trials in schizophrenia. Clinical Trials, 2011; DOI:10.1177/1740774510392931

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Report: Hospital Errors May Be Far More Common Than Suspected

New tracking system uncovers 10 times as many medical mistakes

From the April 7 HealthDay news item

THURSDAY, April 7 (HealthDay News) — A new method for identifying medical errors contends that as many as 90 percent of hospital mistakes are overlooked.

The actual error rate is 10 times greater than previously thought, despite a recent focus on reducing error rates and improving patient safety, a new study suggests.

“The more you look for errors, the more you find,” said lead researcher Dr. David C. Classen, an associate professor of medicine at the University of Utah.

“There is a large opportunity for improvement, despite all the work that’s been done,” he said. “And we need better measurement systems to assess how we are doing in patient safety.”

One factor in the high number of errors is that hospital patients tend to be sicker than they were years ago, Classen noted. With the advent of outpatient treatment, “the healthier patients are no longer in hospitals,” he said…..

The report is published in the April issue of Health Affairs.
The abstract is here.
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BioEd Online: Japanese Earthquake and Tsunamis, Before and After

BioEd Online is an online educational resource for teachers, parents, students, and others.

The tool bar at the home page includes links to presentations, slide sets, classroom lessons, teacher resources, hot topics and more.

The current feature (hot topic) focuses on the earthquakes and tsunamis in Japan, particularly the aftermath of the March 11, 2011 natural disasters. Instructional materials include how satellite images are used in recovery efforts, a slide set of “before” and “after” Japanese scenes and news items.

On March 11, 2011, a 9.0 magnitude earthquake struck northeastern Japan. In addition to the destruction caused by the earthquake and aftershocks, related tsunamis devastated miles of the Japanese coastline. Several nuclear power plants were damaged, leading to potentially serious health risks for tens of thousands of people.

source

Links are also given to background information, as

• Discovery School. (2004). Understanding tsunamis. Retrieved 2-25-2005 fromhttp://school.discovery.com/teachers/tsunami/.
• USGS. (2005). Tsunamis and earthquakes. Retrieved 2-21-2005 fromhttp://walrus.wr.usgs.gov/tsunami/srilanka05/index.html#intro

Related Articles

• VIDEOS from Japan and Indonesia show the destructive force of tsunamis (conservationreport.com)
• Discovery Chronicles Japanese Earthquake, Tsunami in April 24 Special, “Megaquake: Hour That Shook Japan” (tvbythenumbers.zap2it.com)

School-based health centers improving access for youth: School settings a boon to student health

From the Nation’s Health ( April 2011, vol. 41 no. 3 , pp 1-20)

During a recent office visit, Robert Wolverton, MD, provided a young woman with emergency contraceptives, helped her restart regular birth control, evaluated a rash she was concerned about and investigated the cause of her ear pain.

Some doctors discourage patients from discussing multiple problems during one appointment, Wolverton said, but that recent patient was like many he sees at the Teen Wellness Center at T.C. Williams High School in Alexandria, Va. She had health concerns and she wanted to handle them quickly and confidentially….

…Nationwide, the number of school-based health centers is climbing, according to Linda Juszczak, DNSc, MPH, MS, CPNP, executive director of the National Assembly on School-Based Health Care. The City of Alexandria has had a wellness center for adolescents for more than a decade, but the previous center was located in a trailer off school property that students had a hard time accessing, Wolverton said….

…

The new center is one of more than 1,900 school-based health centers nationally operating in 48 states and territories. Such centers provide access to primary health care, mental health services, immunizations, sexually transmitted disease testing and a host of other services to about 2 million children and youth, regardless of ability to pay.

The centers are an attractive option for young patients seeking health care, as no patient will be turned away because she or he is not able to pay, said Terri Wright, MPH, director of APHA’s Center for School, Health and Education. In some places, school-based health centers open their doors to adults during non-school hours and bill third-party payers for their care as a way to make ends meet, Wright said.

The growth of school-based health centers such as the one in Alexandria may speed up in the near future, thanks to the health reform law passed last year.

 

Related Articles

• Columbus schools a center for students’ health care (dispatch.com)
• Oakland, L.A. schools to add health centers (sfgate.com)
• Health care part of Columbus schools’ services (dispatch.com)