In Context

How Much Would You Pay

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Mon, 18 Feb 2008 13:30:00 -0600

Would you pay $10 to detect or avoid cancer? Commenting on the New England Journal of Medicine's January 24, 2008 article, "Effect of Cost Sharing on Screening Mammography in Medicare Health Plans", Dr. Dacso discusses a study done by the Brown University Medical School that found some interesting and surprising results as to how little value we place in preventative care when it comes to making decisions around managing our health. Is the remedy to offer these services for free? Listen as Dr. Dacso weighs in on this question.

The Positives of Negative Studies

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Thu, 15 Nov 2007 13:50:00 -0600

Sometimes discovering what doesn't work is just as important as discovering what does. In this episode Dr. Dacso discusses the bias of publication of positive results. Articles cited in this podcast: Cardiac-Resynchronization Therapy in Heart Failure with Narrow QRS Complexes and Publication bias against negative results from clinical trials: three of the seven deadly sins

Frankenbugs

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Mon, 22 Oct 2007 15:15:00 -0600

With sensational headlines like Experts: Drug-resistant staph deaths may surpass AIDS toll and, Bacteria that killed Virginia teen found in other schools it's easy to feel overwhelmed and a bit helpless in the face of such daunting news. However, the simple truth is that doctors have been dealing with these drug resistant "superbugs" throughout history [New York Times, 1946: Drop in Efficacy of 2 Drugs Noted]. Drug resistant bacteria may be an unpleasant reality in medicine but we can all take solace in the simple fact that hand washing is enough to mitigate the spread of MRSA and other diseases [Science, 2004: "Hand washing lessens MRSA risk"].

Vitamins and Wishful Thinking are Not Enough

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Fri, 21 Sep 2007 12:00:00 -0600

Medical hypotheses are often generated from observational studies. These studies collect vast amounts of data across large populations in an attempt to identify underlying correlations. However correlation does not imply causation and sometimes these circumstantial relationships are dispelled when subjected to more rigorous clinical trials. In this episode Dr. Dacso discusses a report from the Journal of the American Medical Association which suggests there is insufficient evidence to support B vitamins as prevention for vascular disease. [Abstract]

Considerations and Reservations About Electronic Medical Records

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Tue, 28 Aug 2007 22:20:00 -0600

When it is possible for anyone to logon and read their e-mail while away from home, why is it impossible to have the same kind of access to your personal medical information? Despite the huge advances in information exchange personal Electronic Medical Records have not yet become the norm. In this episode Dr. Dacso and Bob Teague, MD the CEO of Practice IT discuss why EMRs have yet to be adopted by physicians.

The Impact of Advertising on Prescription Drugs

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Wed, 22 Aug 2007 05:00:00 -0600

Ads for prescription drugs have permeated the media since the FDA issued a three page draft guidance document in August of 1997 that opened the doors to direct-to-consumer advertising. Since then spending on advertising has sky-rocketed from $11.4 billion in 1996 to $29.9 in 2005. Despite the criticisms that have been levied against the pervasive advertising some contend that the increase in information has let to more informed patients. A recent article in the New England Journal of Medicine titled "A Decade of Direct-to-Consumer Advertising of Prescription Drugs" [Abstract] explores this very issue and served as inspiration for this episode.

Experience Does Matter

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Fri, 10 Aug 2007 07:55:00 -0600

Practice makes perfect even in medicine. In this episode Dr. Dacso discusses the importance of clinical experience to the practice of medicine. The current standard of residency training allows new doctors to treat patients under tight controls and strict supervision. However a new paradigm of medical education is on the horizon which will incorporate sophisticated medical simulators to augment the training of medical students.

"The Menace of Daily Life"

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Thu, 26 Jul 2007 17:00:00 -0600

A recent study published in the American Heart Association journal Circulation linked soft drink consumption to an increased risk for metabolic syndrome. It's common to see reports like this where investigators armed with large data sets and sophisticated statistical techniques find correlations which imply prolonged exposure to seemingly harmless every day items can be hazardous to one's health. In this episode, Dr. Dacso discusses why a little bit of common sense can help put into perspective the risks asserted by these studies.

Limiting Residents' Work Hours

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Fri, 20 Jul 2007 19:00:00 -0600

In recent years the Accreditation Council for Graduate Medical Education has placed restrictions on the number of hours that residents can work. The effects of these restrictions have been uncertain. A study recently published in the Annals of Internal Medicine sought to determine whether these regulations had an affect on mortality in hospitalized patients. In this episode, Dr. Dacso discusses the motivation for these restrictions and their potential implication on the future of the medical profession.

Reflections on Michael Moore's Sicko

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Thu, 12 Jul 2007 12:00:00 -0600

In this episode, Dr. Dacso and Finger Fellow Jonathon Carrasco discuss the recent Michael Moore flim Sicko.

Physician Self-Disclosure

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Thu, 12 Jul 2007 12:00:00 -0600

A recent study published by the Archives of Internal Medicine concludes that Physician Self-Disclosure has no evidence of positive effects and may, in fact, be disruptive. In this episode of In Context, Dr. Dacso discusses how clinicians must balance between being too clinical versus being too personal.

Emerging Infectious Disease

jetrocket@gmail.com (The Abramson Center for the Future of Health) — Fri, 08 Jun 2007 12:00:00 -0600

A brief history of the evolution of multi-drug resistant diseases and its implications in a highly mobile modern world.