Tests & Treatments

Information and new research about advances in discovering and treating diseases and conditions.

RECENT POSTS

The Cost of Mammograms: Is A Picture Worth $7 Billion?

(Getty Images)

(Getty Images)

The issue of how often a woman should be screened for breast cancer has been a topic of hot debate for years. But of the many different issues that are closely examined, cost is rarely among them.

Even mentioning cost typically gets patients somewhat understandably up in arms — no one wants her life to be determined by mere dollars.

But what if those dollars are being spent poorly? The harms of mammograms are well-known — false positives and overtreatment among them. What if reconsidering what we’re doing and how we’re doing it could actually lead to more lives saved?

Into the fray comes an analysis from several researchers, including Dr. Laura Esserman, a breast cancer surgeon with UCSF. They calculated the costs for screening mammography in the U.S. under different scenarios. Continue reading

At-Home Test Good Alternative to Colonoscopy, Study Confirms

If you’re like most of my colleagues in the newsroom, you read that headline and thought, “GREAT! What is the alternative test?!”

Here’s the quick background: Colorectal cancer is the third most common cancer killer in the U.S. A colonoscopy is an excellent screening tool. But more than one-third of people who are supposed to get it (that’s people ages 50-75) don’t.

Why? I think you can guess.

A colonoscopy is an invasive screening test that can involve missing one to two days of work, an inconvenient preparation process and then a “colonoscope is gently eased inside the colon and sends pictures to a TV screen,” the American Cancer Society says. Continue reading

New Cholesterol Guidelines Will Lead to Overprescribing Statins, Critics Say

A prescription label for the cholesterol-lowering drug Lipitor, a brand name statin medicine. (Tim Boyle/Getty Images)

A prescription label for the cholesterol-lowering drug Lipitor, a brand name statin medicine. (Tim Boyle/Getty Images)

Last Monday two major groups released a set of new guidelines designed to lower cholesterol. Now, it appears a major component of the guidelines — an online risk calculator — may be flawed, the New York Times reports.

Since the publication of the guidelines, two Harvard Medical School professors “evaluated the guidelines using three large studies that involved thousands of people and continued for at least a decade,” the Times reported. They knew the patients’ health status at the start and then they looked to see how many had had a heart attack or stroke in the next decade. How accurate was the new calculator in predicting risk? From the Times:

The answer was that the calculator overpredicted risk by 75 to 150 percent, depending on the population. A man whose risk was 4 percent, for example, might show up as having an 8 percent risk. With a 4 percent risk, he would not warrant treatment — the guidelines that say treatment is advised for those with at least a 7.5 percent risk and that treatment can be considered for those whose risk is 5 percent.

Continue reading

FDA Seeks to Tighten Control on Hydrocodone Painkillers Like Vicodin

(futurowoman/Flickr)

(futurowoman/Flickr)

By Rob Stein, NPR

The Food and Drug Administration Thursday announced that it wants the federal government to impose tough new restrictions on some of the most widely used prescription painkillers.

The FDA said it planned to recommend that Vicodin and other prescription painkillers containing the powerful opioid hydrocodone be reclassified from a “Schedule III” drug to a “Schedule II” drug, which would impose new restrictions on how they are prescribed and used.

OxyContin, another opioid painkiller, is already a Schedule II drug, defined by the Drug Enforcement Administration as “potentially leading to severe psychological or physical dependence”.

In a statement posted on its website, the agency said it was taking the step after becoming “increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States.” Continue reading

Vitamin D Not So Great for Building Bones in Middle Aged Adults After All

Most people can save their money and skip the Vitamin D supplements. (Getty Images)

Most people can save their money and skip the Vitamin D supplements. (Getty Images)

By Nancy Shute, NPR

It’s not easy being a wonder vitamin these days. Just when it looks like you’re the solution to every health problem, some doctors come along and burst your bubble. Now it’s happening to vitamin D.

The supplement has been widely promoted to prevent osteoporosis and fight a host of other ills. But recent studies haven’t found much benefit, for bones or for general health.

This latest review looks at 23 randomized controlled trials involving more than 4,000 people to study vitamin D’s effect on bones. Vitamin D, which is converted into a hormone by the body, makes it easier for us absorb calcium in the intestines. So it’s easy to presume that more “D” would lead to stronger bones.

But this review found that for middle-aged people, taking vitamin D supplements for two years didn’t affect bone mineral density in the spine, hip, arm bone and skeleton overall. They did find increased bone density in the neck of the femur bone, where it often breaks in the elderly. The review also found no relation between bone density and taking calcium supplements, people’s overall vitamin D levels, length of treatment or age. Continue reading

It’s Time to Rediscover the IUD, Women’s Health Advocates Say

Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States.(Spike Mafford/Getty Images)

Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States.(Spike Mafford/Getty Images)

By Dana Farrington, NPR

What will it take to make intrauterine devices sexy?

IUDs are highly effective forms of contraception, but fear of side effects, lack of training for doctors and costs can keep women away. Health organizations and private companies are trying to change that by breaking down misconceptions and broadening access.

The contraceptives are inserted into the uterus and can prevent pregnancy for years. And they’re reversible. Shortly after they’re taken out, a woman can become pregnant.

IUDs are more than 99 percent effective. The World Health Organization reports they are “the most widely used reversible contraceptive method globally.” But few women in the U.S. use them; the percentage is only in the single digits, in part because IUDs have a checkered past. The Dalkon Shield IUD, marketed nationwide beginning in 1971, was found to raise the risk of pelvic inflammatory disease. Medical complications and deaths sparked lawsuits with thousands of claimants. Continue reading

Federal Health Officials to Launch Study of Valley Fever

A bull kicks up dust on a farm south of Bakersfield. Valley fever spores are carried by the wind in the dry, desert southwest, including California's Central Valley. (David McNew/Getty Images)

A bull kicks up dust on a farm south of Bakersfield. Valley fever spores are carried by the wind in the dry, desert southwest, including California’s Central Valley. (David McNew/Getty Images)

By Rachel Cook, Reporting on Health Collaborative

The leaders of the Centers for Disease Control and the National Institutes of Health announced they will launch a clinical trial to get a better understanding of how to treat valley fever. The announcement was made Monday as part of a two-day symposium on valley fever being held in Bakersfield.

The randomized control trial will cost millions of dollars and involve roughly 1,000 patients, and it could help determine the best practices for treating the fungal infection.

“It will take some time to mount this trial, to plan it, to put it forward,” said Dr. Francis Collins, director of the NIH. “But I just want to assure all of you from this part of California that we’re serious about trying to get some of those answers even in the face of difficult budget times,” Collins said.

California’s San Joaquin Valley is a valley fever hot spot.

“What we’ve seen is a steady increase in the number of diagnosed cases of valley fever, or coccidioidomycosis,” said Dr. Thomas Frieden, director of the CDC. “We don’t know why that’s happened and there’s a lot that we need to learn.”

Continue reading

How Many Die From Medical Mistakes In U.S. Hospitals?

An updated estimate says at least 210,000 patients die from medical mistakes in U.S. hospitals a year. (Getty Images)

An updated estimate says at least 210,000 patients die from medical mistakes in U.S. hospitals a year. (Getty Images)

By Marshall Allen, Pro Publica

It seems that every time researchers estimate how often a medical mistake contributes to a hospital patient’s death, the numbers come out worse.

In 1999, the Institute of Medicine published the famous “To Err Is Human” report, which dropped a bombshell on the medical community by reporting that up to 98,000 people a year die because of mistakes in hospitals. The number was initially disputed, but is now widely accepted by doctors and hospital officials — and quoted ubiquitously in the media.

In 2010, the Office of Inspector General for the Department of Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.

Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death.

That would make medical errors the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second.

The new estimates were developed by John T. James, a toxicologist at NASA‘s space center in Houston who runs an advocacy organization called Patient Safety America. James has also written a book about the death of his 19-year-old son after what James maintains was negligent hospital care.

Continue reading

Money May Be Motivating Doctors To Do More C-Sections

(Getty Images)

(Getty Images)

By Shankar Vedantam, NPR

Obstetricians perform more cesarean sections when there are financial incentives to do so, according to a new study that explores links between economic incentives and medical decision-making during childbirth.

About 1 in 3 babies born today is delivered via C-section, compared to 1 in 5 babies delivered via the surgical procedure in 1996. During the same time period, the annual medical costs of childbirth in the U.S. have grown by $3 billion annually. There are significant variations in the rate of cesarean deliveries in different parts of the country — in Louisiana, for example, the C-section rate is nearly twice as high as in Alaska.

Obstetricians in many medical settings are paid more for C-sections. In a new working paper published by the National Bureau of Economic Research, health care economists Erin Johnson and M. Marit Rehavi calculated that doctors might make a few hundred dollars more for a C-section compared to a vaginal delivery, and a hospital might make a few thousand dollars more. Continue reading

New Method to Predict Dementia Risk for Type 2 Diabetics

Abel

Abel Corona of Watsonville pours piña colada from a pitcher at his home. He is more careful about his diet since he was diagnosed with diabetes. He is a student in a diabetes self-management education class at a local health clinic, Salud Para la Gente, or Health for the People. (Vinnee Tong/KQED)

An international team of researchers says it’s developed a tool that predicts the risk that a senior with type 2 diabetes will develop dementia in the next 10 years.

People with type 2 diabetes are known to be at a high risk of developing dementia – a range of problems that hinder memory, language, and problem solving. In fact, type 2 diabetics are two times more likely to develop dementia later in life than people without the disease.

According to a paper published today in the new journal The Lancet Diabetes & Endocrinology, researchers have created a 20-point “risk score,” which they assign to patients based on their personal history and health issues. With each point on the scale, a person’s risk for developing dementia within 10 years grows. It’s the first risk score to be developed specifically for people with type 2 diabetes.

“[The risk score] puts these patients on the radar of clinicians to know they are at high risk,” said Rachel Whitmer, a scientist with Kaiser Permanente Division of Research in Oakland, Calif. With this score in hand “the clinician could be especially attentive to looking out for memory or cognitive problems.”

Continue reading