How to Determine If a Clinical Practice Guideline is Trustworthy

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An interesting article titled “How to Decide Whether a Clinical Practice Guideline Is Trustworthy,” written by David F. Ransohoff, MD Michael Pignone, MD, MPH, and Harold C. Sox, MD appears in JAMA, January 9, 2013,Vol 309, No. 2, pp. 139 -140. The article mentions how many controversies have arose recently over cancer screening guidelines. The article mentions how in 2008 Congress gave the Institute of Medicine (IOM) of the National Academies with developing standards for objective, scientifically valid, and consistent approaches to developing practice guidelines. Well as I mentioned in this blog post Tips to Prevent Medical Errors – AHRQ Congress actually gave the Agency for Health Care Policy and Research (AHCPR) in 1989 evidence-based, clinical-practice guidelines. However, the medical device industry and several doctors organizations opposed this as it was threatening to limit their profits and found a sympathetic ear … Read more

Dental Amalgam Mercury Poisoning: Why Is It Still an Issue?

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This is a guest post written by Harmon Pearson who is currently pursing a post graduate degree in dental science. He  spends time blogging about his pursuits and writing on dental care. When he is not studying, he enjoys restoring antique pendulum timepieces. How is it that in the 21st century we continue to put a known toxic element—mercury—into our mouths?  The question may seem straightforward, but the answer, curiously, is not.  Mercury remains a primary ingredient in dental amalgam, also known as silver fillings.  Other ingredients include copper, silver, tin, and zinc.  These elements when bound with mercury form what’s typically referred to as a stable compound.  It’s hard and resilient to degradation in the mouth environment making it a seemingly ideal compound for replacing small amounts of decayed or removed tooth material.  Because of this, it’s remained a … Read more

Anti Affordable Care Act (Anti ObamaCare) Ads with Uncle Sam

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In the United States, with the ObamaCare exchanges set to go live on Tuesday and the looming government shutdown also set for Tuesday, I wanted to draw your attention to some recent ads you may have missed. Now I came across these ads watching Real time with Bill Maher last week, where Bill plays one of the ads on his program and discusses it. The videos are designed to deter young people from signing up for the ObamaCare exchanges and do so by featuring a young man and a young woman about to undergo prostate and pelvic exams. The ads are from from Generation Opportunity, a Virginia-based group with ties to the Koch brothers. I have embedded the two ads below and they both show two young college age students who have their first doctors appointment using the new ObamaCare … Read more

Unsafe Injection Practices Plaque U.S. Outpatient Facilities

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In a post last year I discussed how an Oral Surgeon Investigated for Reusing Needles and Syringes. In a recent article in JAMA titled “Unsafe Injection Practices Plague US Outpatient Facilities, Harm Patients,” Bridget M. Kuehn discusses many problems with injection practices (December 26, 2012,Vol 308, No. 24, pp. 2551-2552). She describes how hepatitis C virus was contracted by 2 patients who received an epidural injection from a pain management clinic. “During the visit, they observed the physician who treated both patients withdrawing medication from a multiple-dose vial with a previously used syringe topped with a new needle, a breach of safe injection practices that may have contaminated the vial and exposed subsequent patients to potential blood-borne infections.” This led to 8,000 patients who were treated at the clinic to be tested and 8 additional cases of hepatis C to … Read more

How does the U.S. Health Care System Differ From Other OECD Countries

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An interesting article written by Victor R. Fuchs titled “How and Why US Health Care Differs From That in Other OECD Countries” appears in JAMA, January 2, 2013,Vol 309, No. 1, pp. 33-34.  The article attempts to discuss the difference between the U.S. Healthcare system and other countries in the  Organization for Economic Co-operation and Development (OECD). One way they differ is that the healthcare expenditures in the U.S. are twice as high. A second way they differ is that the share of expenditures funded by the U.S. government is lower. Most OECD countries have a tax-supported system healthcare system that is able to have lower administrative costs and is able to negotiate costs more aggressively with drug companies and physicians. Thirdly, there are differences in care with the U.S. being more technology intensive such as with MRIs. The author … Read more