Health and Medical News and Resources

General interest items edited by Janice Flahiff

Surgical metrics do not provide a clear path to improvement

Surgical metrics do not provide a clear path to improvement 

From the 4 February 2015 Mayo Clinic press release

PHOENIX – While surgical outcomes have improved nationally over time, surgical outcome reporting does not necessarily lead to better outcomes, according to a Mayo Clinic study published this week in the Journal of the American Medical Association.

Systems that capture, analyze, and report surgical outcomes are an increasingly important part of the quality improvement movement in health care in the United States.  Within the U.S., the most widely used surgical outcomes reporting system is the National Surgical Quality Improvement Program (NSQIP), which is coordinated through the American College of Surgeons.

The study analyzed data regarding surgical outcomes — complications, serious complications, and mortality — in over 345,000 patients treated between 2009 and 2013 at academic hospitals throughout the United States.  Of these patients, approximately half were treated at hospitals that participated in the NSQIP.  The study showed that surgical outcomes significantly improved overall in both study groups during the period of analysis.

“In our study we weren’t interested in whether patients had better outcomes in NSQIP vs. non-NSQIP hospitals,” says David Etzioni, M.D., chair of Colorectal Surgery at Mayo Clinic in Arizona and the study author. “We wanted to know whether the outcomes experienced by patients treated at NSQIP hospitals improved, over time, in a way that was different from patients treated at non-NSQIP hospitals.”

The study found no association between hospital-based participation in the NSQIP and improvements in postoperative outcomes over time, suggesting that a surgical outcomes reporting system does not provide a clear mechanism for quality improvement.  According to the research team, the failure of these types of outcomes monitoring systems to produce measurable improvements in outcomes may be related to difficulties in identifying mechanisms that translate reports into changes in how surgical care is provided.

“I think if there is one lesson that we have learned at Mayo Clinic; real quality is achieved through a system — not just a doctor, not just a nurse or other staff,” Dr. Etzioni says. “All of these elements of care have to work together closely to provide patients with the best possible outcomes.”

February 5, 2015 Posted by | health care | , , , , | Leave a comment

[Press release] Taking statins to lower cholesterol? New guidelines

From the 4 February 2014 Mayo Clinic Press Release

ROCHESTER, Minn. — Feb. 4, 2014 — Clinicians and patients should use shared decision-making to select individualized treatments based on the new guidelines to prevent cardiovascular disease, according to a commentary by three Mayo Clinic physicians published in this week’s Journal of the American Medical Association.

Journalists:  Sound bites with Dr. Montori are available in the downloads.

Shared decision-making is a collaborative process that allows patients and their clinicians to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values and preferences.

In 2013, the American College of Cardiology and the American Heart Association issued new cholesterol guidelines, replacing previous guidelines that had been in place for more than a decade. The new guidelines recommend that caregivers prescribe statins to healthy patients if their 10-year cardiovascular risk is 7.5 percent or higher.

“The new cholesterol guidelines are a major improvement from the old ones, which lacked scientific rigor,” says primary author Victor Montori, M.D., Mayo Clinic endocrinologist and lead researcher in the Knowledge and Evaluation Research Unit. “The new guidelines are based upon calculating a patient’s 10-year cardiovascular risk and prescribing proven cholesterol-lowering drugs — statins — if that risk is high.”

However, Dr. Montori cautions that the risk threshold established by the guideline panel is somewhat arbitrary. Instead he recommends that patients and their clinicians use a decision-making tool to discuss the risks and benefits of treatment with statins.

“Rather than routinely prescribing statins to the millions of adults who have at least a 7.5 percent risk of having a heart attack or stroke within 10 years, there is an opportunity for clinicians and patients to discuss the potential benefits, harm and burdens of statins in order to arrive at a choice that reflects the existing research and the values and context of each patient,” he says.

“We’re creating a much more sophisticated, patient-centered practice of medicine in which we move the decision-making from the scientist to the patient who is going to experience the consequences of these treatments and the burdens of these interventions,” Dr. Montori explains. “Decision-making tools can democratize this approach and put it in the hands of millions of Americans who have their own goals front and center in the decision-making process.”

Additional authors of the commentary include Henry Ting, M.D., and Juan Pablo Brito Campana, M.B.B.S., both of Mayo Clinic.

 

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February 5, 2014 Posted by | health care | , , , , , , , , | Leave a comment

What Should You Know About E-Cigarettes?

Electronic Cigarette Model

Electronic Cigarette Model (Photo credit: planetc1)

On a personal note, my husband is very sensitive to e-cigarette vapors.
He finds he has to leave any room where they are being “smoked”.

 

From the 23 October 2013 ScienceDaily article

 E-cigarettes are becoming increasingly popular and widely available as the use of regular cigarettes drops. Recently, the Centers for Disease Control and Prevention (CDC) reported that e-cigarette use by children doubled from 2011 and 2012. The health effects of e-cigarettes have not been effectively studied and the ingredients have little or no regulation. Mayo Clinic’s Nicotine Dependence Center experts are available to discuss what people should know before trying e-cigarettes

Electronic cigarettes, often called e-cigarettes, are battery-operated devices that provide inhaled doses of a vaporized solution of either propylene glycol or vegetable glycerin along with liquid nicotine. An atomizer heats the solution into a vapor that can be inhaled. The process, referred to as “vaping,” creates a vapor cloud that resembles cigarette smoke. Some liquids contain flavoring, making them more appealing to users.

“As of right now, there is no long-term safety data showing the impact of repeated inhalation of propylene glycol or vegetable glycerin on lung tissue,” cautions Jon Ebbert, M.D., associate director at Mayo Clinic’s Nicotine Dependence Center. “There is some short-term data suggesting that e-cigarettes may cause airway irritation, but until we have long-term safety data, we are not recommending e-cigarettes for use among cigarette smokers to help people stop smoking.”

So, what is known about electronic cigarettes?

*Manufacturers claim that electronic cigarettes are a safe alternative to conventional cigarettes.

*The Food and Drug Administration (FDA) has questioned the safety of these products.

*FDA analysis of two popular brands found variable amounts of nicotine and traces of toxic chemicals, including known cancer-causing substances (carcinogens).

*The FDA has issued a warning about potential health risks associated with electronic cigarettes, but is not yet regulating their use or standards of manufacture.

“It’s an amazing thing to watch a new product like that just kind of appear. There’s no quality control,” says Richard Hurt, M.D., director of Mayo Clinic’s Nicotine Dependence Center. “Many of them are manufactured in China under no control conditions, so the story is yet to be completely told.”

October 24, 2013 Posted by | Consumer Health, Health News Items | , , , , | Leave a comment

Mayo Clinic plans to sequence patients’ genomes to personalise care

 

Mayo Clinic

Image via Wikipedia

Mayo Clinic plans to sequence patients’ genomes to personalise care [The Guardian]

Project will give doctors the genetic information they need to choose drugs that work best and minimise side effects

Excerpt from the 27 December article

Doctors have drawn up plans to sequence the full genetic code of thousands of people in a landmark project to personalise their medical care.

Volunteers will have all six billion letters of their genome read, stored and linked to their medical records to help doctors prescribe more effective drugs and other therapies.

The prestigious Mayo Clinic in the US will launch the pilot study early next year as part of an ambitious move towards an era of “proactive genomics” that puts modern genetics at the centre of patient care.

The trial reflects a growing trend in medicine to use genetic information to identify those patients who will benefit most from a drug and those who will respond better to an alternative.

Other medical centres around the world that are thinking of introducing their own whole genome tests will be watching the trial with interest.

The wealth of information locked up in the human genome can help doctors advise patients on lifestyle changes to stave off diseases they are at risk of developing, but in many cases that advice is familiar and generic – for example focusing on healthy eating, regular exercise, drinking in moderation and not smoking.

The Mayo Clinic trial goes further by giving doctors all the genetic information they need to choose drugs that will work best for a particular patient while minimising side effects.

 Read the entire article

 

 

January 9, 2012 Posted by | health care | , , , , , | Leave a comment

Mayo Clinic Community And Additional Online Health Communities/Support Groups

Mayo Clinic currently uses social media tools as YouTube, Facebook, and Twitter.
Blogs include Podcast Blog , News Blog, and Sharing Mayo Clinic blog for patients and employees to share their Mayo Clinic stories.

Connect with others who've been there. Welcome to Mayo Clinic's free online health community.

Mayo Clinic’s Center for Social Media has recently launched the Mayo Clinic Community  to connect people who have been through the Mayo Clinic experience with others facing a similar health concern.

The Mayo Clinic Community is free and open to all, whether or not one is or was a Mayo Clinic patient.

This online community includes content from various Mayo Clinic blogs,health and medical videos from Mayo’s YouTube channel and links to news articlesabout Mayo Clinic research and treatment advances. It also features a discussion forum where members can connect with others who have similar interests or concerns.

 

Additional Online Health Communities/Support Groups

  • Self-Help Group SourceBook Online
    A starting point for finding every type of national, international, model and online self-help support group that is available starting point for finding every type of national, international, model and online self-help support group that is available. (MentalHelp.net)
  • MedlinePlus 
    Search with a phrase as “support groups” cancer or select a Health topic and select an organization.
  • Medpedia communities
    This site allows people with common health interests to share information and communicate. Anyone may create a community of interest and anyone may join.Medpedia is an open platform connecting people and information to advance medicine. Users include health care professionals, health care organizations, expert lay persons, students, and scientists.
  • MedHelp International
         This online health community which not only provides health information but helps patients actively manage their health through online personal health records andMedhelp trackers (iphone friendly options).
    The People option allows one to search by a disease or condition to find related information (including symptoms, treatments, resources). One can also view postings and blogs by other members and interact with them.
    Medical experts helps users by answering questions in Ask-an-Expert forums, participating in conversations with members in free live health chats, and sharing their knowledge and the latest news in blogs

July 14, 2011 Posted by | Uncategorized | , , , , | Leave a comment

   

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