Informed Decision Making


CT Scans and Kids: Parents Often Unaware of Risks

CT scan 13 of Clubs_FlickrMary Kathryn Lynch stood next to her young son in a Lake Tahoe emergency room. The Oakland resident had rushed her 9-year-old to the hospital after a ski accident left him groggy, curled up in the fetal position, and speaking incoherently.

Nurses and hospital staff told Lynch that her son needed a CT scan of his head right away, she recalled.

While Lynch and her husband were both worried the accident may have caused brain damage, her husband was also weighing risks of the scan’s radiation.

CT — or computerized tomography — combines a series of x-rays for a sophisticated image. In this case, doctors could use the scan to quickly detect internal bleeding or other injuries.

It is a powerful tool that has saved lives by discovering small problems before they’ve had the chance to get worse, says Andrew Phelps, a pediatric radiologist at UCSF.  But the useful pictures come at a cost: CT scans expose patients to radiation levels that are higher than other types of imaging, like traditional x-rays or MRIs.

And exposure to high levels of radiation has been linked to cancer. Continue reading

Aging is a Part of Life, Not a Disease

(Patrick: Flickr)

(Patrick: Flickr)

Researchers and health advocates have long been encouraging people to make their end-of-life wishes known. While most people say they want to die a natural death at home, few actually put those wishes into writing.

But at least equally important is thinking about how to enjoy quality of life while aging. A new book seeks to help people address these questions. Kaiser Health News interviewed Nortin Hadler, the author of “Rethinking Aging.”

I especially like the book’s tagline: “Growing Old and Living Well in an Overtreated Society.” Hadler is concerned about the medicalization of aging. “We’re taught and marketed that all changes in appearance and in function in older people are forms of disease that demand treatment,” he told Kaiser Health News. “But often, that isn’t true. Much that is termed a disease is a normal aspect of this time of life and needs to be viewed as such.” Continue reading

Getting to Better “Patient-Centered” Healthcare

By Shefali S. Kulkarni, Kaiser Health News

(Photo: U.S. Navy)

(Photo: U.S. Navy)

PCORI is not exactly a household name, but if Dr. Anne Beal has her way, it will be soon. The acronym stands for Patient Centered Outcomes Research Institute—a group of doctors, researchers, statisticians and patient advocates who will commission evidence-based research for the health care system.

The key here is “patient-centered.” Beal says the goal is to provide easy-to-understand information to patients so they can make the most informed health care decisions.

PCORI is yet another part of health care reform that people may not know much about. But while it was created via the Affordable Care Act, but it is an independent, non-profit organization. Continue reading

How Much Do Elderly Patients Want to Know and Should Doctors Tell Them?

(Ryan Wilcox: Flickr)

(Ryan Wilcox: Flickr)

Not so long ago, it was common for doctors to keep sick patients, even terminally ill patients, in the dark about their prognosis. Today, many patients are actively involved in managing their illnesses, in partnership with their doctors. Indeed, one of the tabs on this blog is “You’re the Boss.”

But a “Perspective” in today’s New England Journal of Medicine says doctors have shied away from explicit conversations about prognosis with a group of patients they should engage–the very elderly. The writers recommend doctors discuss “overall prognosis” with elderly patients who have a life expectancy of less than 10 years or who are 85.

Continue reading