Health and Medical News and Resources

General interest items edited by Janice Flahiff

Guidelines Panellists’ Conflict Of Interest Raises Concern

From the 13 October 2011 Medical News Today article

An investigation published on bmj.com today showed that members of guideline panels in the U.S. and Canada have a high prevalence of conflicts and high numbers of under-reporting conflicts of interest (COI).

The problem of incomplete disclosure is exposed in the investigation, which also underlines the crucial relationship between presence of COI and sponsorship guidelines.

For over 20 years the incidence of COI among industry and clinicians has been a concern for the medical profession.

Because freedom from bias is important, the development of clinical practical guidelines is one area of particular concern for the presence of COI.

Even though the majority of companies that create guidelines have adopted conflict on interest disclosure policies, they are not usually clear, and might not be enough to stop members of guideline panels bias from influencing recommendations. …

Read the entire article

October 15, 2011 Posted by | Medical and Health Research News | , , , | Leave a comment

PubMed Clinical Queries Page Updated

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From the 11 August 2011 National Library of Medicine (NLM) Technical Bulletin

The PubMed® Clinical Queries homepage will be slightly modified to provide users with a more straightforward understanding of how to enter a search (see Figure 1).

Screen capture of PubMed Clinical Queries homepage.
Figure 1: PubMed Clinical Queries homepage.

After running a search, the category/scope limits for the Clinical Query Study Categories secion and topic limits for the Medical Genetics section will be available on the preview results page (see Figure 2).

Screen capture of PubMed Clinical Queries preview results page.
Figure 2: PubMed Clinical Queries preview results page.

The clinical queries search strategies will not be changed.

By Kathi Canese
National Center for Biotechnology Information

 

[From http://medlib.bu.edu/busdm/content.cfm/content/pubmedclinicalqueries.cfm]

PubMed Clinical Queries provides access to specialized PubMed searches designed to quickly connect clinicians with evidence-based clinical literature.

There are two EBM search options:

    • Search by Clinical Study Category
    • Find Systematic Reviews
For more information on how PubMed can help you find biomedical articles (PubMed is the largest indexer of biomedical literature) please go to
               Many academic and medical librarians give at least limited assistance to the public.
               Call ahead and ask for a reference librarian

 

August 12, 2011 Posted by | Biomedical Research Resources, Educational Resources (High School/Early College(, Finding Aids/Directories, Librarian Resources, Professional Health Care Resources | , , , , , , , , , | Leave a comment

Updated heart disease prevention guidelines for women focus more on ‘real-world’ recommendations

Updated heart disease prevention guidelines for women focus more on ‘real-world’ recommendations

From the February 15 2011 Eureka news alert

Updated cardiovascular prevention guidelines for women [link goes to free full text of the article] focus on what works best in the “real world” vs. clinical research settings and consider personal and socioeconomic factors that can keep women from following medical advice and treatment. The guidelines also incorporate illnesses that increase heart disease risk in women, such as lupus, rheumatoid arthritis and pregnancy complications Helping women — and their doctors — understand risks and take practical steps can be most effective in preventing heart disease and stroke.

 

The 2011 update identifies barriers that hinder both patients and doctors from following guidelines, while outlining key strategies for addressing those obstacles.

“Awareness continues to be a key driver to optimal care,” said Mosca, director of preventive cardiology at New York-Presbyterian Hospital and professor of Medicine at Columbia University Medical Center. “Cause initiatives such as Go Red for Women and provider compliance programs such as Get With The Guidelines® are strong components in our efforts to broaden awareness and improve adherence among patients and providers.”

She said getting a dialogue started between a woman and her doctor is a critical first step.

“If the doctor doesn’t ask the woman if she’s taking her medicine regularly, if she’s having any side effects or if she’s following recommended lifestyle behaviors, the problems may remain undetected,” she said. “Improving adherence to preventive medications and lifestyle behaviors is one of the best strategies we have to lower the burden of heart disease in women.”

To evaluate patient risk, the guidelines incorporate illnesses linked to higher risk of cardiovascular disease in women, including lupus and rheumatoid arthritis, and pregnancy complications such as preeclampsia, gestational diabetes or pregnancy-induced hypertension. Mosca said women with a history of preeclampsia face double the risk of stroke, heart disease and dangerous clotting in veins during the five to 15 years after pregnancy. Essentially, having pregnancy complications can now be considered equivalent to having failed a stress test.

“These have not traditionally been top of mind as risk factors for heart disease,” she said. “But if your doctor doesn’t bring it up, you should ask if you’re at risk for heart disease because of pregnancy complications or other medical conditions you’ve experienced.”

The updated guidelines also emphasize the importance of recognizing racial and ethnic diversity and its impact on cardiovascular disease. For example, hypertension is a particular problem among African-American women and diabetes among Hispanic women.

Although putting clinical research into practical, everyday adherence can be challenging, solid scientific evidence is still the basis for many of the guidelines, Mosca said. Some commonly considered therapies for women are specifically noted in the guidelines as lacking strong clinical evidence in their effectiveness for preventing cardiovascular disease and, in fact, may be harmful to some women. Those include the use of hormone replacement therapy, antioxidants and folic acid.

The update includes depression screening as part of an overall evaluation of women for cardiovascular risk, because while treating depression has not been shown to directly improve cardiovascular health, depression might affect whether women follow their doctor’s advice.

Despite a growing body of clinical evidence to fight heart disease and stroke in women, more is needed, Mosca said. Coronary heart disease death rates in women dropped by two-thirds from 1980 to 2007, due to both effective treatment and risk factor reduction, according to the American Heart Association, but cardiovascular disease still kills about one woman every minute in the United States.

In future studies, researchers should look at interventions during specific times throughout a woman’s lifespan ― including puberty, pregnancy and menopause ― to identify risks and determine effective prevention opportunities during those critical times, Mosca said. More cost-effective analyses and clinical trial research with male- and female-specific results are also needed, especially regarding risks posed by preventive therapies.

“Now that science has shown the benefits are often similar for men and women, there is a need to understand if the risks are also similar and acceptable,” she said.

“These guidelines are a critical weapon in the war against heart disease, the leading killer of women,” Mosca said. “They are an important evolution in our understanding of women and heart disease. And I cannot stress personal awareness and education enough. Initiatives such as Go Red For Women give women access to the latest information and real-life solutions to lower their risk of heart disease.”

 

 

February 15, 2011 Posted by | Consumer Health | , , , , , , , | Leave a comment

   

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