More evidence-concordant FDA guidelines increase access to mifepristone

As covered in the New York Times, this week the Food and Drug Administration relaxed the guidelines for taking mifepristone (Mifiprex, formerly RU-486), a pill that induces abortion, reviving one of the most contentious issues of the abortion debate. The change brings the directions for taking the drug, mifepristone, in line with what has become standard medical practice in most states: reducing the dosageContinue reading “More evidence-concordant FDA guidelines increase access to mifepristone”

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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”

The difference between the parties’ health care proposals boils down to how they distribute risk

In a Health Affairs blog post today, two Urban Institute scholars–economist Linda Blumberg and policy fellow John Holahan–state that the fundamental difference between the two parties’ health care proposals is how they propose to share health care expenditures between those currently healthy and those with costly health care needs. The health policies of the two political parties and theirContinue reading “The difference between the parties’ health care proposals boils down to how they distribute risk”

Talking with children about political bullies

Columns on “talking to your children about XXX” appear after mass shootings, natural disasters and other disturbing news events. This election cycle’s extreme levels of bullying have inspired columns on talking with your children about Trump. These include The Parent-Child Discussion That So Many Dread: Donald Trump (New York Times) Telling our kids not toContinue reading “Talking with children about political bullies”

Emergency Department Return Visits as a Quality Metric

A recent JAMA publication lead-authored by Dr. Amber Sabbatini examined the scientific soundness of emergency department (ED) return visits as a measure of the ED’s quality of care. Emergency department return visits have been considered for wider adoption as a quality metric, especially for those patients who are hospitalized during the return ED visit. The “quality”Continue reading “Emergency Department Return Visits as a Quality Metric”

Avoid peanut allergy by early introduction of peanuts

A study released today in the New England Journal of Medicine showed that giving infants small amounts of peanut butter in their first year of life substantially reduced the prevalence of peanut allergy when compared to infants who avoided peanuts for their first year. The investigators found that the safeguard lasted for a year after the children stoppedContinue reading “Avoid peanut allergy by early introduction of peanuts”

Robots vs. doctors?

Although I agree with the basic premise of this week’s Washington Post article “The Robot Doctor Will See You Now“–namely, that computers can augment medical care–the article misses the art-science balance so central to physician’s practice.  He states: If you’ve ever gone to a doctor with an odd set of symptoms and realized that your doctor has no clue what theyContinue reading “Robots vs. doctors?”

Coffee: to drink or not to drink

According to the U.S. Food and Drug Administration, 90% of people worldwide, and 80% in the US, consume caffeine in some form every day. The average adult has an intake of about 200 milligrams, or roughly one cup of coffee per day. As one of those few non-coffee-drinking adults–probably rarer still among emergency medicine providers–I was intrigued by  today’s New YorkContinue reading “Coffee: to drink or not to drink”

Social determinants of health and pay-for-performance readmissions measures

In an article released by JAMA Pediatrics today, my co-authors and I show that social determinants of health (patient factors such as health insurance, poverty and other sociodemographic measures) are risk factors for readmissions-related penalties for children’s hospitals. Without adjusting pay-for-performance (P4P) measures for social determinants of health (SDH), hospitals may receive penalties partially related to patient SDH factors beyondContinue reading “Social determinants of health and pay-for-performance readmissions measures”

Readmissions revisited

I am reposting  a post by Garret Johnson and Zoe Lyon, both research assistants for Dr. Ashish Jha at the Harvard T.H. Chan School of Public Health (who also has a great post on risk-adjustment for readmissions.  The post eloquently explores an issue I’ve visited in a recent post: the importance of understanding the diverseContinue reading “Readmissions revisited”