2007-05-09 00:00:00

Asprin Risks Compare to Driving a Car

Taking an aspirin every day may help prevent heart disease and stroke but, for a middle-aged man, it is nearly as risky as driving a car or working as a firefighter, researchers said Tuesday.While people are poor at assessing true risks, they are often willing to take on those risks in exchange for the benefits — which can include simply having fun, said Joshua Cohen and Peter Neumann of Tufts-New England Medical Center.

Writing in the journal Health Affairs, they said federal regulators must take the true risks into account, and balance them against thebenefits, when deciding whether to approve or withdraw drugs.

People are bad at estimating risk, the researchers said.

“In general, they tend to overestimate the probability of small and especially dreaded risks while underestimating the probability of large risks,” Cohen and Neumann wrote.

They calculated the risks of various voluntary actions, starting with deaths associated with taking drugs.

“We included selected drugs for which we could develop a reasonable annual mortality risk estimate,” they wrote.

For 50-year-old men, taking a full-sized, 325 mg aspirin every day to prevent heart disease and stroke carries a risk of 10.4 deaths per 100,000 men per year over and above their overall death risk.

Using Vioxx for arthritis pain carried a risk of 76 deaths per 100,000 people per year. Merck and Co withdrew Vioxx in September 2004 after it was shown to double the risk of heart attack and stroke.

“The finding that taking Vioxx for a year is much more risky than a year of car travel, swimming or being a firefighter suggests that greater scrutiny of drug risks may be warranted,” the researchers wrote.

Using Tysabri, known generically as natalizumab, to treat multiple sclerosis raises the death rate by 65 per 100,000 people a year.

Biogen Idec’s and Elan Corp’s Tysabri was withdrawn from the U.S. market in 2005 afterthree patients contracted a rare brain disease, but the Food and Drug Administration re-approved it after many patients said they would use it despite the risks.

Cutting trees risky

As for job-related deaths, the riskiest profession was being a tree-feller, with 55 deaths per year or a risk of 357 deaths per 100,000 people a year.

Firefighters have a risk of 10.6 deaths per 100,000 people per year, compared with 3.9 for all occupations and 0.4 for office workers.

Being a truck driver is risker than being a firefighter, with 44.8 deaths per 100,000 people per year.

Bicycling is more dangerous than skiing, the researchers found — bicyclists face a death rate of 2.1 per 100,000 people a year, compared with 0.49 for skiers.

Swimming has a death risk of 0.88 per 100,000 people a year but climbing mountains in the Himalayas carries a 13,000 per 100,000 climbers per year risk.

For transport, the researchers estimated risks both in terms of 100,000 people per year and per 100 million miles traveled.

Traveling by commercial airliner carries a risk of 0.03 deaths per 100 million miles or 0.15 deaths per 100,000 people a year.

Car and light truck travel has a 0.7 fatality risk per 100 million miles or 11 per 100,000 people per year, compared to 450 for motorcycle travel and 1.3 for using a cell phone while driving.

Filed under: — @ 2007-05-09 00:00:00
2007-05-08 00:00:00

Free tool to help identify iPods, USB sticks on the network

I’ve written previously about PodSlurping and portable storage devices being a security hazard on our healthcare networks.

I ran across this tool called EndPointScan. GFI have just released this online scanner, which is basically a free tool that can show which portable storage devices have been and are being used on an organization???s network, where on the network they???re used and by whom. If you’re in the information assurance or security group in your department or enterprise you owe it to yourself to get a tool like this so you’re not caught off guard. If users know you’re watching (you can send them nice e-mails telling them when they’ve tripped an alarm) they are less likely to carelessly use portable devices on the network.

I ran the tool on a few computers in my office and the scanning worked but reports weren’t properly generated. I think it might have to do with me running Vista instead of Windows XP (but to be fair, Windows Vista is not on their “supported” list). If you give it a shot, drop me a comment here to tell me whether you find it of value or not.

Filed under: — @ 2007-05-08 00:00:00
2007-05-08 00:00:00

Free tool to help identify iPods, USB sticks on the network

I’ve written previously about PodSlurping and portable storage devices being a security hazard on our healthcare networks.

I ran across this tool called EndPointScan. GFI have just released this online scanner, which is basically a free tool that can show which portable storage devices have been and are being used on an organization???s network, where on the network they???re used and by whom. If you’re in the information assurance or security group in your department or enterprise you owe it to yourself to get a tool like this so you’re not caught off guard. If users know you’re watching (you can send them nice e-mails telling them when they’ve tripped an alarm) they are less likely to carelessly use portable devices on the network.

I ran the tool on a few computers in my office and the scanning worked but reports weren’t properly generated. I think it might have to do with me running Vista instead of Windows XP (but to be fair, Windows Vista is not on their “supported” list). If you give it a shot, drop me a comment here to tell me whether you find it of value or not.

Filed under: — @ 2007-05-08 00:00:00
2007-05-06 00:00:00

EHRs Fix Everything - and Nine Other Myths

I read this article recently published by American Academy of Family Physicians and found it quite useful. As a health IT professional, I also talk about many of the ideas written up in the article but perhaps coming from a fellow physician (the author an MD), it will mean more to other physicians considering EMRs and EHRs. Here are myths the article debunks (along with some of my own comments):

  • Myth 1 - A new EHR system will fix everything. Fact - moving to a new system will create new problems at the same time that it solved old problems. Be ready to adapt.
  • Myth 2 - Brand A is the best. Fact - no single software package fits all practices equally.
  • Myth 3 - Our software needs to work the way we currently work. Fact - commercial software is not malleable enough to suit your needs. You’ll have to change your workflows to conform to the new technology.
  • Myth 4 - Software will eliminate errors. Fact - software can eliminate some rudimentary errors but in fact can propagate real errors even faster.
  • Myth 5 - Discrete data is always best. Fact - start with free text and add discrete data where you know you can make use of it. Having tons of data you “could analyze” has a low ROI.
  • Myth 6 - The more templates, the better. Fact — maintaining templates is hard work, only do it because it has clinical or business value. Less is more in this case.
  • Myth 7 - Electronic records are more legible than paper records. Fact - when you have electronic data, you have a lot more “noise” in the chart (because it’s easier to capture).
  • Myth 8 - Mobile is best. Fact - don’t be fooled by fancy gadgets. Mobile is fine but you’ll trade value for convenience and since you don’t really need all the features in your hip pocket go for “minimal mobile” features and “maximal desktop” features.
  • Myth 9 - You must have a detailed plan, and stick to it.
  • Myth 10 - You can stop planning.

The article is worth reading if you’re considering automating your practice on the clinical side.

Filed under: — @ 2007-05-06 00:00:00
2007-05-06 00:00:00

EHRs Fix Everything - and Nine Other Myths

I read this article recently published by American Academy of Family Physicians and found it quite useful. As a health IT professional, I also talk about many of the ideas written up in the article but perhaps coming from a fellow physician (the author an MD), it will mean more to other physicians considering EMRs and EHRs. Here are myths the article debunks (along with some of my own comments):

  • Myth 1 - A new EHR system will fix everything. Fact - moving to a new system will create new problems at the same time that it solved old problems. Be ready to adapt.
  • Myth 2 - Brand A is the best. Fact - no single software package fits all practices equally.
  • Myth 3 - Our software needs to work the way we currently work. Fact - commercial software is not malleable enough to suit your needs. You’ll have to change your workflows to conform to the new technology.
  • Myth 4 - Software will eliminate errors. Fact - software can eliminate some rudimentary errors but in fact can propagate real errors even faster.
  • Myth 5 - Discrete data is always best. Fact - start with free text and add discrete data where you know you can make use of it. Having tons of data you “could analyze” has a low ROI.
  • Myth 6 - The more templates, the better. Fact — maintaining templates is hard work, only do it because it has clinical or business value. Less is more in this case.
  • Myth 7 - Electronic records are more legible than paper records. Fact - when you have electronic data, you have a lot more “noise” in the chart (because it’s easier to capture).
  • Myth 8 - Mobile is best. Fact - don’t be fooled by fancy gadgets. Mobile is fine but you’ll trade value for convenience and since you don’t really need all the features in your hip pocket go for “minimal mobile” features and “maximal desktop” features.
  • Myth 9 - You must have a detailed plan, and stick to it.
  • Myth 10 - You can stop planning.

The article is worth reading if you’re considering automating your practice on the clinical side.

Filed under: — @ 2007-05-06 00:00:00
2007-05-01 00:00:00

Mental Stimulation Brings Back Memories for Alzheimer’s Suffers.

Research has shown us that mental stimulation can prevent disorders such at dementia and Alzheimer’s, but new research shows us how living in a stimulating environment can bring back thoughts that were lost.

“We show, I believe, the first evidence that even if the brain suffered some very severe neurodegeneration and the individual exhibits very severe learning impairment and memory loss, there is still the possibility to improve learning ability and recover to a certain extent lost long-term memories,” according to Neuroscientist Li-Huei Tsai of the Howard Hughes Medical Institute and the Massachusetts Institute of Technology.

Tsai said if apparently lost long-term memories could be retrieved, this suggested the memories had not been actually erased from the brain.

The researchers used genetically engineered elderly mice in which they were able to activate a protein that triggered brain pathology very much like that of people with Alzheimer’s, with atrophy and loss of nerve cells.
Mice with Alzheimer’s-like brain damage put in the stimulating environment could remember that shock test far better than similar animals kept in standard cages. The playground mice also were better at learning new things than those kept in standard cages.

So, if you are feeling like your memory is slipping, it is time to break out the crossword puzzles and the trivial pursuit.?? Yet another example of “use it or lose it.”

Filed under: — @ 2007-05-01 00:00:00
2007-05-01 00:00:00

WorldVistA EHR CCHIT Certified

I wanted to thank Fred Trotter for sending me this note yesterday:

Now you can download and use an FOSS EHR under the GPL that is CCHIT certified. The days of the proprietary EHR systems are OVER.

I love Fred’s enthusiasm about open source software in healthcare, it’s definitely the direction of the future. While CCHIT certification doesn’t actually improve a product or make it any more applicable to a particular client, it’s great to see that a free and open source solution can no longer be derided as “not being certified” by other vendors.

Filed under: — @ 2007-05-01 00:00:00
2007-05-01 00:00:00

WorldVistA EHR CCHIT Certified

I wanted to thank Fred Trotter for sending me this note yesterday:

Now you can download and use an FOSS EHR under the GPL that is CCHIT certified. The days of the proprietary EHR systems are OVER.

I love Fred’s enthusiasm about open source software in healthcare, it’s definitely the direction of the future. While CCHIT certification doesn’t actually improve a product or make it any more applicable to a particular client, it’s great to see that a free and open source solution can no longer be derided as “not being certified” by other vendors.

Filed under: — @ 2007-05-01 00:00:00
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