Two most common pediatric migraine medications no more effective than placebo

Neither of the two drugs used most frequently to prevent migraines in children–amitriptyline and topiramate–is more effective than a placebo, according to results of the Childhood and Adolescent Migraine Prevention (CHAMP) trial published this week in The New England Journal of Medicine. The investigators found no significant differences in reduction in headache frequency or headache-related disability in childhood and adolescent migraineContinue reading “Two most common pediatric migraine medications no more effective than placebo”

AHRQ and CMS Public Reporting Measures Fail to Describe the True Safety of Hospitals

A new study from the Johns Hopkins Armstrong Institute for Patient Safety and Quality, published in the journal Medical Care, performed a systematic review and meta-analysis of two sets of safety measures used for pay-for-performance and public reporting The measures evaluated in the study are used by several public rating systems, including U.S. News and World Report’s Best Hospitals, Leapfrog’s Hospital Safety Score,Continue reading “AHRQ and CMS Public Reporting Measures Fail to Describe the True Safety of Hospitals”

Medical ecology: tending the microbiome

Today, the Obama administration announces the new National Microbiome Initiative, intended to create scientific tools, discoveries and training techniques related to the human microbiome, the 100 trillion microbes that live in the human body. Tending the human microbiome may help in the treatment of infections, as well as disorders that would seem unrelated to microbes, including obesity andContinue reading “Medical ecology: tending the microbiome”

Should Doctors Undergo Opioid Prescribing Risk Training?

Earlier this week, an advisory panel recommended that the Food and Drug Administration require doctors who prescribe painkillers s to undergo training aimed at reducing misuse and abuse of the medications. The New York Times notes: It is the second time since 2010 that an F.D.A. panel has recommended expanding safety measures for painkillers. But the trainingContinue reading “Should Doctors Undergo Opioid Prescribing Risk Training?”

What are the priority Emergency Department (ED) presenting conditions for which ED-based Shared Decision-Making should be most urgently developed?

An article in this week’s Wall Street Journal focused on the development and use of shared decision-making (SDM) tools in the emergency department (ED).  Decision tools can help engage patients in making decisions about their care, including decisions about which tests and treatments to pursue.  In the ED, relevant decisions are (1) decisions involving two similarly reasonable optionsContinue reading “What are the priority Emergency Department (ED) presenting conditions for which ED-based Shared Decision-Making should be most urgently developed?”

Fall in life expectancy for white Americans

Newly released 2014 data from the National Center for Health Statistics on life expectancy showed a worrisome decline in life expectancy for whites in the US, to 78.8 years in 2014 from 78.9 in 2013. The good news is that, in contrast, life expectancy increased by 0.2 years for the Hispanic population (from 81.6 toContinue reading “Fall in life expectancy for white Americans”

April no-fooling!

This week’s NY Times science section debunks several common misconceptions.  All are interesting reads: Misconception: Baby teeth don’t matter. I am leading with the one I hear most often at work. Dental caries (cavities) is the most common chronic illness of childhood, and this misconception is one reason why. (Actually: Neglecting baby teeth can set a childContinue reading “April no-fooling!”

Sitting is killing us, again

As an addendum to my last post related to the health hazards of excess sitting, a study in the American Journal of Preventive Medicine added more evidence that excessive sitting is a risk factor for mortality. Using survey data from 54 countries, the researchers analyzed the association between time spent sitting more than three hours a day and mortality.  They found thatContinue reading “Sitting is killing us, again”

Sitting is the new smoking

Alternatives to the traditional desk chair have become popular as increasing evidence shows that prolonged sitting increases heart failure risk and disability risk and shortens life expectancy. A review found that sitting time was independently associated with poor health outcomes regardless of physical activity. Alternatives to sitting have become a new industry: A new Cochrane review of 20 studies of sitting-alternatives showedContinue reading “Sitting is the new smoking”