Today's News and Commentary

About the public’s health

Assessment of Use, Specificity, and Readability of Written Clinical Informed Consent Forms for Patients With Cancer Undergoing Radiotherapy: “This nationwide study of informed consent practices for cancer treatment with radiotherapy demonstrates that while all US academic radiotherapy departments use written consent forms, it is rare for templates to meet the recommended readability levels for patient materials.” This article is a reminder about communication with patients at the appropriate level of education and literacy.

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Walmart, Sam's Club raise age to buy tobacco to 21; won't sell flavored nicotine to minors: The title is self-explanatory. Walgreens also recently raised its tobacco purchase age to 21. But they still do not match CVS, which stopped selling tobacco products because of health concerns.

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About healthcare technology

Natera Earns Breakthrough Device Designation for Tumor DNA Test: This technology uses genetic markers from the patient’s tumor to check for recurrence by detecting those markers in serial blood samples after treatment. It is a real breakthrough technology because it can detect the recurrence much sooner than other methods.

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Read about the test

Genetically Modified Viruses Help Save A Patient With A 'Superbug' Infection: Knowledge about bacteriophages antedates the antibiotic era. These organisms are viruses with special affinity for bacteria (as opposed to, for example, human cells). Once infected with the phage, the bacteria dies. By administration of special phages, a 17 year old woman has been successfully treated for a drug resistant infection after lung transplant. Until better antibiotics are found, this therapy may be the only hope for such patients.

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About quality

Physician groups voice frustrations with Quality Payment Program: Yesterday, representatives from the American College of Surgeons, American Academy of Family Practice and the American Medical Association testified before a Senate committee hearing their feed back about the MACRA quality programs. The organizations criticized the relevance of criteria and cumbersome reporting process. As well, they wanted an update on meaningful use IT criteria in the face of increasing interoperability requirements.

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MACRA, 2 years later: 9 ways to make it better: Following in the above article, this one summarizes the testimony of AMA president Barbara McAneny, MD about measures to improve MACRA.

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How Johns Hopkins researchers found a way to curb excessive skin cancer surgery: One way to treat skin cancer is to shave off the growth level by level- called Mohs micrographic surgery (MMS). Researchers noted that surgeons “are paid based on the number of stages performed per tumor, ‘creating a perverse incentive… to use an excessive number of staged resections to remove a lesion.’ …In other words, they may cut too much during surgery, quite possibly, because they'll get paid more to do it.” If physicians were provided data on their relative performance, however, 83% of surgeons who were identified as outliers improved their MMS behavior- a sustainable change. The study extrapolated Medicare savings from such an intervention at $11million per year. This research is another case of the benefit of peer data dissemination.

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About pharma

Americans' Prescription Med Use Is Declining:This just-released study from the National Center for Health Statistics (part of the CDC) showed, among other findings, that:

  • In 2015–2016, 45.8% of the U.S. population used prescription drugs in the past 30 days.

  • Prescription drug use increased with age, from 18.0% of children under age 12 years to 85.0% of adults aged 60 and over.

  • Prescription drug use was highest among non-Hispanic white persons followed by non-Hispanic black persons, and lowest among non-Hispanic Asian and Hispanic persons.

  • The most commonly used types of drugs included bronchodilators for ages 0–11 years, central nervous system stimulants for ages 12–19, antidepressants for ages 20–59, and lipid-lowering drugs for ages 60 and over.

  • The percentage of the U.S. population that used prescription drugs decreased over the preceding decade. This finding reversed an previously upward trend.

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Covance: Why biosimilars could be large piece of the drug price puzzle: This article is an interesting review of biosilmilar drugs (biologic generics). One factor impeding their adoption is that the branded versions provide such large rebates that in order to save money from these discounted versions, a health plan will have to drive large volumes to them.

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