New IOM Reports

To Err is Human: Building A Safer Health System

5/24/2012

This report lays out a comprehensive strategy by which government, health care providers, industry, and consumers can reduce preventable medical errors. Concluding that the know-how already exists to prevent many of these mistakes, the report sets as a minimum goal a 50 percent reduction in errors over the next five years.

Public Engagement on Facilitating Access to Antiviral Medications and Information in an Influenza Pandemic - Workshop Series Summary

5/17/2012

Influenza pandemics overwhelm health care systems with thousands or hundreds of thousands of sick patients, as well as those worried they may be sick. In order to ensure a successful response to the patient swell caused by a pandemic, robust planning is essential. Distribution and dispensing of antiviral medications will need to occur within a potentially limited timeframe, and persist over a period of time to treat multiple waves of the pandemic. In response to a request from the CDC, the IOM held a series of workshops that explored the public’s perception of potential alternative strategies for facilitating access to antiviral medications and treatment during an influenza pandemic.

Ranking Vaccines: A Prioritization Framework - Phase I: Demonstration of Concept and a Software Blueprint

5/17/2012

Ranking Vaccines: A Prioritization Framework describes a decision-support model and the blueprint of a software called Strategic Multi-Attribute Ranking Tool for Vaccines, or SMART Vaccines, that should help decision makers prioritize new vaccines by accounting for demographic, economic, health, scientific, business, programmatic, social, policy and related factors.

Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation

5/11/2012

Two-thirds of adults and one-third of children are overweight or obese. Left unchecked, obesity’s effects on health, health care costs, and our productivity as a nation could become catastrophic. The staggering human toll of obesity-related chronic disease and disability and an annual cost of $190.2 billion for treating obesity-related illness underscore the urgent need to strengthen obesity prevention efforts in the United States. The IOM evaluated prior obesity-prevention strategies and identified recommendations to accelerate progress. The IOM’s recommendations, when implemented together, could profoundly reshape the environments where people live, learn, work, and play.

The Future of Nursing: Leading Change, Advancing Health

5/11/2012

The United States has the opportunity to transform its health care system, and nurses, as the largest segment of the nation’s health care workforce, can and should play a fundamental role in this transformation. In this report the IOM makes recommendations for an action-oriented blueprint for the future of nursing.

Alliances for Obesity Prevention: Finding Common Ground - Workshop Summary

5/11/2012

Many organizations are making focused efforts to prevent obesity. To achieve their goals, accelerate their progress, and sustain their success, the assistance of many other individuals and groups—not all of them with a singular focus on obesity prevention—will be essential. In October 2011 the Institute of Medicine held a workshop that provided an opportunity for obesity prevention groups to hear from and hold discussions with many of these potential allies in obesity prevention. They explored common ground for joint activities and mutual successes, and lessons learned from efforts at aligning diverse groups with goals in common.

Ethical and Scientific Issues in Studying the Safety of Approved Drugs

5/1/2012

Prescription drugs are crucial for preventing and treating diseases and improving the public’s health, but they can also have unintended harmful effects. Often, their benefits and risks cannot be fully identified until after a drug has been used by a large, diverse group of patients over time. The passage of the Food and Drug Administration Act in 2007 provides the Food and Drug Administration (FDA) with additional postmarketing regulatory tools to better protect the health of the public, including the authority to require manufacturers to continue studying drugs that are being marketed. The FDA asked the IOM to evaluate the scientific and ethical aspects of conducting safety studies for approved drugs. The IOM recommends implementing a life cycle approach to drug safety oversight that could allow the FDA to better anticipate post-approval research needs and improve drug safety for all Americans.

Facing the Reality of Drug-Resistant Tuberculosis: Challenges and Potential Solutions in India - Summary of a Joint Workshop by the Institute of Medicine, the Indian National Science Academy, and the Indian Council of Medical Research

4/27/2012

An estimated 8.8 million people fell ill with tuberculosis (TB) in 2010 and 1.4 million died from the disease. Although antibiotics to treat TB were developed in the 1950s and are effective against a large percentage of TB cases, resistance to these antibiotics has emerged over the years, resulting in the growing spread of multi-drug resistant (MDR) TB. The IOM held a workshop April 18-19, 2011, in New Delhi, India, in collaboration with the Indian National Science Academy and the Indian Council of Medical Research, to highlight key challenges to controlling the spread of drug-resistant strains of TB in India and to discuss strategies for advancing and integrating local and international efforts to prevent and treat drug-resistant TB.

Innovations in Health Literacy Research - Workshop Summary

4/24/2012

Nearly nine out of 10 adults have difficulty using everyday health information to make good health decisions. The IOM Roundtable on Health Literacy held a meeting on May 27, 2010, to explore areas for research in health literacy, the relationship between health literacy and health disparities, and ways to apply information technology to improve health literacy.

Child Maltreatment Research, Policy, and Practice for the Next Decade - Workshop Summary

4/23/2012

In 1993, the National Research Council (NRC) released its report, Understanding Child Abuse and Neglect, which identified child maltreatment as a devastating social problem in America. The report noted that abuse and neglect were the cause of thousands of child deaths each year, and research in the field of child maltreatment was relatively undeveloped. Nearly 20 years later, child maltreatment research has greatly expanded, however, many critical gaps in knowledge remain. The IOM and NRC held a workshop to review the accomplishments of the past two decades of research related to child maltreatment, identify remaining gaps, and consider potential research priorities.

Preventing Violence Against Women and Children - Workshop Summary

4/23/2012

Across the world, violence against women and children poses a high burden on global health. Women and children are particularly susceptible to violence because they often have fewer rights or lack legal protection. Over the last decade, researchers have gathered data on the growing magnitude of this violence, but many research gaps still remain. January 27-28, 2011, the Forum on Global Violence Prevention held its first workshop to explore the prevention of violence against women and children. The workshop opened the discussion on violence-prevention strategies, as well as ways to prevent the spread of violence from one generation to the next.

The Early Childhood Care and Education Workforce: Challenges and Opportunities - A Workshop Report

4/23/2012

Early childhood care and education (ECCE) settings offer an opportunity to provide children with a solid beginning in all areas of their development. The quality and efficacy of these settings depend largely on the individuals within the ECCE workforce. Policy makers need a complete picture of ECCE teachers and caregivers in order to tackle the persistent challenges facing this workforce. The IOM and the National Research Council hosted a workshop to describe the ECCE workforce and outline its parameters. Speakers explored issues in defining and describing the workforce, the marketplace of ECCE, the effects of the workforce on children, the contextual factors that shape the workforce, and opportunities for strengthening ECCE as a profession.

Safe and Effective Medicines for Children: Pediatric Studies Conducted Under BPCA and PREA

4/23/2012

The Best Pharmaceuticals for Children Act (BPCA) and the Pediatric Research Equity Act (PREA) were designed to encourage more pediatric studies of drugs used for children. The FDA asked the IOM to review aspects of pediatric studies and changes in product labeling that resulted from BPCA and PREA and their predecessor policies, as well as assess the incentives for pediatric studies of biologics and the extent to which biologics have been studied in children. The IOM committee concludes that these policies have helped provide clinicians who care for children with better information about the efficacy, safety, and appropriate prescribing of drugs. The IOM suggests that more can be done to increase knowledge about drugs used by children and thereby improve the clinical care, health, and well-being of the nation’s children.

Assessing the Effects of the Gulf of Mexico Oil Spill on Human Health - Workshop Summary

4/21/2012

The 2010 Gulf of Mexico oil spill is unprecedented, and its effects on the overall health of individuals remain uncertain. The IOM held a public workshop June 22-23 to examine many factors that could impact how public health officials choose to monitor the potential health effects of the Gulf oil spill and related clean-up activities.

Genome-Based Diagnostics: Clarifying Pathways to Clinical Use - Workshop Report

4/13/2012

New technologies are improving our ability to provide personalized treatment catered to an individual patient. Based on findings from the sequencing of the human genome, genome-based diagnostic tests have the potential to direct therapeutic interventions, predict risk or onset of disease, or detect residual disease. However, because evidence is lacking to show that these tests lead to an improved outcome, adoption has been limited. On November 15, 2011, the IOM held a workshop to discuss the differences in evidence required for clinical use, regulatory oversight, guideline inclusion, coverage, and reimbursement of genome-based diagnostics with the goal of clarifying a pathway for using these tests in clinical settings.

Integrating Large-Scale Genomic Information into Clinical Practice - Workshop Summary

4/13/2012

As the technology and affordability of genomic sequencing continues to evolve and the clinical applications for genomics-based research increase, it is important to address how genomics data can best be integrated into the clinical setting. On July 19, 2011, the IOM’s Roundtable on Translating Genomic-Based Research for Health hosted a workshop to highlight and identify the challenges and opportunities in integrating large-scale genomic information into clinical practice. Challenges for realizing genomic medicine range from the analysis, interpretation, and delivery of genetic information to associated workforce, ethical, and legal issues.

Generating Evidence for Genomic Diagnostic Test Development – Workshop Summary

4/13/2012

Ten years after the sequencing of the human genome, scientists have developed genetic tests that can predict a person’s response to certain drugs, estimate the risk of developing Alzheimer’s disease, and make other predictions based on known links between genes and diseases. However, genetic tests have yet to become a routine part of medical care, in part because there is not enough evidence to show they help improve patients’ health. The IOM held a workshop to explore how researchers can gather better evidence more efficiently on the clinical utility of genetic tests.

Establishing Precompetitive Collaborations to Stimulate Genomics-Driven Product Development - Workshop Summary

4/13/2012

Despite the many basic research discoveries in genetics, relatively few gene-based treatments, drugs, or preventative measures have been developed. One way to bridge this gap may be for industry, academia, and government to develop partnerships that share resources while distributing risk. However, intellectual property protections and other barriers can inhibit collaborative efforts. The IOM held a workshop on July 22, 2010, to explore these issues and develop solutions.

Challenges and Opportunities in Using Residual Newborn Screening Samples for Translational Research - Workshop Summary

4/13/2012

Newborn screening samples are used to test more than 4 million infants each year for life-threatening diseases that are treatable if found at birth. These specimens also represent a potentially invaluable resource for public health and biomedical research. The IOM held a workshop to examine issues surrounding the use of blood samples for translational research.

The Value of Genetic and Genomic Technologies - Workshop Summary

4/13/2012

Knowing one’s genetic disposition to a variety of diseases, including common chronic diseases, can benefit both the individual and society at large. The IOM’s Roundtable on Translating Genomic-Based Research for Health held a workshop on March 22, 2010, to bring together diverse perspectives on the value of genetic testing, and to discuss its use in clinical practice.

Systems for Research and Evaluation for Translating Genome-Based Discoveries for Health. Workshop Summary

4/13/2012

The correlation between genetic variations and variations in disease risk has been a subject of study for more than 100 years. Initially, research focused on single genes that give rise to rare genetic diseases such as cystic fibrosis or Huntington’s disease. With new studies, however, numerous associations have been found between genes and more common diseases, for example breast cancer, type II diabetes, coronary artery disease, asthma, and bipolar disorder. This rapidly advancing field of genomics has stirred great interest in “personalized” health care. The hope is that using genomic information in care will lead to reduced health care costs and improved health results, as preventive measures and treatments are tailored to patients’ genetic susceptibilities. On February 12, 2009, the Institute of Medicine’s Roundtable on Translating Genomic-Based Research for Health hosted a workshop to examine how to evaluate the clinical use of genomic information and the impact of genetic information in caring for patients.

Innovations in Service Delivery in the Age of Genomics. Workshop Summary

4/13/2012

New discoveries in genomics—that is, the study of the entire human genome—are changing how we diagnose and treat diseases. As the trend shifts from genetic testing largely being undertaken for rare genetic disorders to, increasingly, individuals being screened for common diseases, general practitioners, pediatricians, obstetricians/gynecologists, and other providers need to be knowledgeable about and comfortable using genetic information to improve their patients’ health. To address these changes, the Roundtable on Translating Genomic-Based Research for Health held the public workshop “Innovations in Service Delivery in the Age of Genomics” on July 27, 2008.

Diffusion and Use of Genomic Innovations in Health and Medicine. Workshop Summary

4/13/2012

The Institute of Medicine’s Roundtable on Translating Genomic-Based Research for Health, established in 2007, held its first workshop to address the following questions: (1) Are there different pathways by which new scientific findings move from the research setting into health care? (2) If so, what are the implications of those different pathways for genomics? (3) What can we learn from the translation of other new technologies as we seek to understand the translation of genome science into health care?

Conflict of Interest in Medical Research, Education, and Practice

4/13/2012

Collaborations between physicians or medical researchers and pharmaceutical, medical device, and biotechnology companies can benefit society—most notably by promoting the discovery and development of new medications and medical devices that improve individual and public health. However, relationships between medicine and industry may create conflicts of interest, potentially resulting in undue influence on professional judgments. In 2007, the Institute of Medicine (IOM) appointed the Committee on Conflict of Interest in Medical Research, Education, and Practice to examine conflicts of interest in medicine and to recommend steps to identify, limit, and manage conflicts of interest without negatively affecting constructive collaborations.

Envisioning a Transformed Clinical Trials Enterprise in the United States: Establishing an Agenda for 2020 - Workshop Summary

4/13/2012

There is growing recognition that the United States’ clinical trials enterprise (CTE) faces great challenges. There is a gap between what is desired – where medical care is provided solely based on high quality evidence – and the reality – where there is limited capacity to generate timely and practical evidence for drug development and to support medical treatment decisions. With the need for transforming the CTE in the U.S. becoming more pressing, the IOM held a two-day workshop in November 2011, bringing together leaders in research and health care.

Building a Resilient Workforce: Opportunities for the Department of Homeland Security - Workshop Summary

4/12/2012

Every job can lead to stress for a variety of reasons. How a person responds to stress in the workplace can be determined by the workplace environment. The Department of Homeland Security (DHS) has raised concerns that long-term exposures to stressors may reduce individual resilience and negatively affect employee’s physical and mental well-being. To explore DHS workforce resiliency, the IOM hosted two workshops in 2011 focused on DHS’s operational and law enforcement personnel and its policy and program personnel with top secret security clearances.

For the Public's Health: Investing in a Healthier Future

4/10/2012

The poor performance of the United States in life expectancy and other major health outcomes, as compared with its global peers reflects what the nation prioritizes in its health investments. The health system’s failure to develop and deliver effective preventive strategies continues to take a growing toll on the economy and society. In this report, the IOM assesses both the sources and adequacy of current government public health funding and identifies approaches to building a sustainable and sufficient public health presence going forward.

Ensuring Safe Foods and Medical Products Through Stronger Regulatory Systems Abroad

4/10/2012

Whether it’s suspect scallions from Mexico or contaminated ingredients from China used in the blood thinner heparin, the FDA is intimately familiar with the daunting task of policing the safety of food and medical products faced by regulators abroad. The FDA is responsible for protecting American consumers from unsafe food, medicines, biologics, and medical products that originate from many different countries and are transported through complex supply chains. The IOM formed a committee to identify the core elements of food, medicine, medical product, and biologics regulatory systems in developing countries; to pin-point the main gaps in these systems; and to design a strategy to leverage the expertise of the FDA and other stakeholders to strengthen regulatory systems abroad.

Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research

4/5/2012

Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. At the request of HHS, the IOM assessed the state of the science regarding pain research, care, and education. The IOM recommends that HHS develop population-level strategies to increase awareness about pain and its treatments. In addition, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America.

The Role of Obesity in Cancer Survival and Recurrence - Workshop Summary

4/3/2012

Recent research suggests that obesity and excess weight can influence cancer survival and recurrence. Given the increasing rate of obesity and an aging population more susceptible to cancer, there is mounting concern about obesity’s role in fueling tumor growth. At an IOM workshop, experts presented the latest evidence on the obesity-cancer link and the possible mechanisms underlying that link, as well as potential interventions to mitigate the effects of obesity on cancer, and research and policy measures needed to counter the expected rise of cancer incidence and mortality due to an increasingly overweight and older population.