Tests & Treatments

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

RECENT POSTS

Digital Mammograms: Pricey And Perhaps No Better for Older Women

In the U.S. 95 percent of mammography machine are now digital.(Mychele Daniau/AFP/Getty Images)

In the U.S. 95 percent of mammography machine are now digital.(Mychele Daniau/AFP/Getty Images)

By Kara Manke, NPR

Medicare spending on breast cancer screening for women age 65 and older has jumped nearly 50 percent in recent years. But the rise in price was not associated with an improvement in the early detection of breast cancer.

“We did not see a change in the detection of early or late stage tumors.”

Researchers at the Yale School of Medicine found that Medicare spending on breast cancer screening rose from $666 million in the years 2001-2002 to $962 million in the years 2008-2009.

So why the big increases in costs?

“The way that we screen for breast cancer has changed dramatically,” explains Yale’s Dr. Cary Gross, an internist and a co-author of the study. The study was published this week in the Journal of The National Cancer Institute. Continue reading

Sonoma Co. Supervisor Takes Issue with Kaiser over Mental Health Services

(Ted Eytan/Flickr)

(Ted Eytan/Flickr)

This is Part 1 of a series on issues surrounding Kaiser Permanente’s mental health services.

Sonoma County Supervisor Shirlee Zane is frustrated with Kaiser Permanente.

“Kaiser better change the way they do business when it comes to mental health services.” — Shirlee Zane, Sonoma Co. Supervisor

“I can tell you I have heard a lot of stories within the last few days about these types of incidents over and over again,” she says, “of people who were so wronged by their treatment, by either being referred out of the system or by saying, ‘We don’t have the appointments.’”

She’s referring to allegations of long delays for mental health services at Kaiser Permanente, accusations the health plan has been dealing with for several years. Now, Zane is trying to leverage a very personal tragedy — the suicide of her husband — into pressing Kaiser on reforming its mental health practices. Continue reading

New Guidelines Say Many Women Can Skip Pelvic Exam

(Maigh/Flickr)

If this picture makes you shudder, you’ll want to understand the new guideline. (Maigh/Flickr)

No more dreaded pelvic exam? New guidelines say most healthy women can skip the yearly ritual.

Routine pelvic exams don’t benefit women who have no symptoms of disease and who aren’t pregnant, and they can cause harm, the American College of Physicians said Monday as it recommended that doctors quit using them as a screening tool.

It’s part of a growing movement to evaluate whether many longtime medical practices are done more out of habit than necessity, and the guideline is sure to be controversial.

Scientific evidence “just doesn’t support the benefit of having a pelvic exam every year,” said guideline coauthor Dr. Linda Humphrey of the Portland Veterans Affairs Medical Center and Oregon Health & Science University. Continue reading

At Stanford, Using Rodin’s Sculpted Hands to Teach Anatomy

Photo of Auguste Rodin’s “Left Hand of Eustache de St. Pierre” druing the 3D scanning process. (Photo: Matthew Hasel, © Division of Clinical Anatomy, Stanford University School of Medicine)

Photo of Auguste Rodin’s “Left Hand of Eustache de St. Pierre” druing the 3D scanning process. (Photo: Matthew Hasel, © Division of Clinical Anatomy, Stanford University School of Medicine)

By Laura Sydell, NPR

Auguste Rodin is known for his realistic, unflinching depiction of the human form. Some of the French sculptor’s work even shows the ravages of disease and disfigurement. A Stanford University professor and surgeon who noticed these realistic details was inspired to incorporate Rodin into his teaching using a curriculum that combines Rodin’s sculpture with medical science and computer technology.

Superimposing scans of patients’ hands into Rodin’s hands to show 3-D anatomy.

Dr. James Chang first noticed certain details of Rodin’s sculptures when he was a medical resident at Stanford studying hand surgery. He used to relax on the grass at the sculpture garden of the school’s Cantor Arts Center. “The more I looked at the Rodin sculptures … and I focused on the hands, and if you look at each hand … they’re exactly like the actual medical conditions I was treating.”

The works include some of Rodin’s most famous pieces, like the Burghers of Calais, a group of defeated noblemen. Chang noticed that one of the Burghers had fused fingers. “We have children with Apert syndrome that have a similar fusion of the fingers and an open thumb, and we release the fingers to put [them] into a more natural condition,” he says. Continue reading

Stanford Tests Artificial Pancreas on Children with Diabetes

Study participant Tia Geri explains how this artificial pancreas works. (April Laissle/KQED)

Study participant Tia Geri explains how her artificial pancreas works. (April Laissle/KQED)

By April Laissle

This week seven children are participating in a Stanford research study in a somewhat unusual setting — a hotel in Newark, outside San Francisco. Researchers are testing an “artificial pancreas” on these children who all have Type 1 diabetes. The device is the latest advance in diabetes management technology.

“We’re trying to push this system to the limit by having the kids eat a lot and get out and run.”

The artificial pancreas is an android phone loaded with software mimicking the function of a real pancreas. Using bluetooth, the device communicates with two monitors attached to the patient’s body; one that keeps track of blood sugar levels and another that pumps insulin into the body when those sugar levels are too high. It determines when and how much insulin to release and sends that information to the insulin pump without patient intervention.

Researchers say the device could simplify the lives of those with diabetes by taking the guesswork out of treating the disease.  Continue reading

Another Step Closer to Autism Therapy as Medi-Cal Benefit?

(Getty Images)

(Getty Images)

By David Gorn, California Healthline

CMS officials last week approved a state plan amendment for the state of Washington that includes autism therapy as a Medicaid benefit.

It’s the second state in a month to receive that go-ahead from the federal government, and it means autism coverage should be a Medi-Cal benefit in California, as well, according to Kristin Jacobson, president of Autism Deserves Equal Coverage, a not-for-profit autism advocacy group.

The budget passed this week by the California Legislature omitted autism therapy as a Medi-Cal benefit.

Autism advocates hope one day soon CMS will make it clear that applied behavior analysis treatment — known as ABA therapy — should be a required benefit for all states receiving Medicaid, including California. Continue reading

People from Mexico Show Vast Genetic Diversity

Mexico City, Mexico (Alex Torres/Flickr)

Mexico City, Mexico. (Alex Torres/Flickr)

The genetic diversity of the Mexican population is so vast that two people of Mexican descent can be as genetically different from each other as a European and a Chinese person. That’s the finding of researchers from UC San Francisco, Stanford, and the Mexican National Institute of Genomic Medicine. It’s considered the first, large-scale analysis of its kind,  and the study could change the way health care is delivered to Mexican-Americans. It helps drive forward the move toward personalized medicine.

KQED News anchor Mina Kim spoke with UCSF Professor Esteban Burchard, one of the co-authors of the study, during a Thursday evening newscast. Burchard described that because of “historical factors, geographical factors, linguistic factors,” the researchers identified that indigenous populations in Mexico are genetically distinct. The genetic ancestry mirrors the geography of Mexico.” Continue reading

New Device Brings Price Drop in Diabetes Test Strips

The iHealth mobile blood glucose monitor. (Courtesy: iHealth Lab)

The iHealth mobile blood glucose monitor. (Courtesy: iHealth Lab)

iHealth Labs, a Mountain View company focused on mobile personal health technology has received FDA approval for what the company says is the world’s smallest mobile blood glucose monitor, called iHealth Align.

But for people with diabetes, the bigger news is likely to be the cost of the test strips that the device will use. People with diabetes often check their blood sugar one or more times a day. The test strips that users fit into a monitor list at a dollar each, for some of the larger brands. The strips for the new device will run 25 cents each. The device itself is $16.95.

“It’s probably more of a known secret in the marketplace that the real margins is within the strips,” Adam Lin, president of iHealth Labs, told MobiHealthNews. “We (wanted) to pass on all that savings to the end users. It’s got to be simple to understand. You don’t have to go through all these issues for reimbursement. We brought it down to pretty much co-pay.” Continue reading

Doctors Say They Would Forego Aggressive Treatment When Near Death

(Getty Images)

(Getty Images)

By Katherine Hobson, NPR

Everybody dies.

But when doctors’ time is up, they are different from the rest of us. They “go gently” rather than opt for aggressive end-of-life treatments, as one physician wrote a few years ago. They have seen the suffering of their patients at the end of life and want no part of it.

In fact, nearly 9 in 10 young physicians just finishing up their residencies or fellowships wouldn’t want to receive life-prolonging CPR or cardiac life support if they were terminally ill and their heart or breathing stopped, a Stanford University School of Medicine survey finds.

The report, published Wednesday in the journal PLOS ONE, notes the disconnect between the aggressive care the average person receives — an average of about $7,000 worth for Medicare beneficiaries in their last month of life — and what doctors would want for themselves. Continue reading

California Doctors Among Those Charging Medicare the Most for Office Visits

Caption will go here. (John Moore/Getty Images)

More complicated office visits are billed at a higher reimbursement level and can cost patients more in higher copays. (John Moore/Getty Images)

By Lisa Aliferis, April Dembosky and Lisa Pickoff-White

When people think of seeing a doctor, generally the first thing that comes to mind is an office visit. But not all visits are the same. Frequently, patients have minor problems, which can be dispensed with quickly. Other problems are much more complex and require more of a doctor’s time and expertise. Not surprisingly, doctors get paid more for these more complex visits. Office visits for established patients are billed across five levels.

Three California doctors are among the top five nationally in billing for the most complex office visits.

Most doctors’ billing patterns to the Medicare program fall in the middle ground between simple and complex.

In California, only 5 percent of doctors’ office visits for Medicare patients were billed at the highest level in 2012. It is unusual for doctors to determine — and bill — a large proportion of their office visits as complex.

Now an analysis of Medicare billing data — which was made public for the first time last month — shows that three California doctors are among the top five nationally in billing for the highest number of the most complex office visits. In addition, they tended to bill at the highest level significantly more frequently than peers in their specialty. Continue reading