Your Weekly Update of News and Reviews
September 6, 2012
Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., with help from William M. London, Ed.D., M.P.H. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.
IOM publishes health-care system critique. A new report from the Institute of Medicine has noted that America’s healthcare system is too complex and costly to continue business as usual and represents a threat to the nation’s economic stability and global competitiveness. The report concluded:
- About 30% of health spending in 2009—roughly $750 billion—was wasted on unnecessary services, excessive administrative costs, fraud, and other problems.
- Achieving higher quality care at lower cost will require an across-the-board commitment to transform the U.S. health system into a “learning” system that continuously improves by systematically capturing and broadly disseminating lessons from every care experience and new research discovery.
- Mobile technologies and electronic health records offer significant potential to capture and share health data better. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care.
- Health care costs have increased at a greater rate than the economy as a whole for 31 of the past 40 years. Most payment systems emphasize volume over quality and value by reimbursing providers for individual procedures and tests rather than paying a flat rate or reimbursing based on patients’ outcomes, the report notes.
- Health economists, researchers, professional societies, and insurance providers should work together on ways to measure quality performance and design new payment models and incentives that reward high-value care.
- Health care product developers should create better tools to help people to manage their health and communicate with their providers.
The report—Best Care at Lower Cost: The Path to Continuously Learning Health Care in America—can be downloaded free of charge or purchased from the National Academies Press Web site.
Ginkgo flunks another big Alzheimer’s prevention trial. A 5-year study has found that administering ginkgo biloba did not appear to influence the development or progression of Alzheimer’s disease among adults age 70 or older who had reported memory complaints to their primary physician. The study followed 2854 participants age 70 or older about half of whom received at last one daily dose of a ginkgo extract and half who received an inert placebo. [Vellas B and others Long-term use of standardized ginkgo biloba extract for the prevention of Alzheimer’s disease (GuidAge): a randomized placebo-controlled trial. Lancet Neurology, Sept 6, 2012] A similar large trial (the Gingko Evaluation of Memory trial) published in 2008 sponsored by the National Institutes of Health found similar results. [DeKosky ST and others. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA 300:2253-2262, 2008] An editorial that accompanied the recent article concluded:
The GuidAge trial adds to the substantial evidence . . . that ginkgo biloba does not prevent dementia in elderly individuals with or without memory complaints or cognitive impairment and is not effective for prevention of Alzheimer’s disease. It would be unfortunate if users of ginkgo biloba, nevertheless, are led to believe that the extract prevents the dementia. Some users will rationalize that, in the absence of effective treatments, ginkgo biloba could still possibly help and, appearing safe, will not harm them. Other users of ginkgo biloba, however, might now consider letting it go. [Schneider LS. Gingko and AD: Key negatives and lessons from GuidAge. Lancet Neurology Sept 6, 2012]
AMA specialty journals will be renamed in 2013. The American Medical Association has announced that on January 1, 2013, its nine specialty Archives journals will be renamed JAMA Dermatology, JAMA Facial Plastic Surgery, JAMA Internal Medicine, JAMA Neurology, JAMA Ophthalmology, JAMA Otolaryngology-Head & Neck Surgery, JAMA Pediatrics, JAMA Psychiatry, and JAMA Surgery.
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