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Can
hospital data help catch lousy docs?
BIRMINGHAM, UK
— The use of hospital data to evaluate doctor
performance has a largely bad reputation — and
deservedly so. These benchmarks are often inherently
skewed to make docs who treat the sickest patients look
bad. Bearing this firmly in mind, researchers at the
University of Birmingham used hospital data collected
over a five-year period to compare disgraced gynecologist
Dr Rodney Ledward to 142 of his peers. They found that
the reckless Dr Ledward — self-proclaimed "fastest
gynecologist in the south-east" — stuck out like
a statistical sore thumb in three of those five years.
While the study authors urge caution in using such data
to condemn docs, they conclude that further evaluation
of their method is warranted. The study was posted on
April 14th on BMJ Online First.
Tx
to make patients laugh, or cry, less
BURLINGTON, VT
— Until now, antidepressants were the only
treatment for pseudobulbar affect (PBA), a condition
in which people are unable to control their emotions,
often laughing or crying inappropriately. Another solution
was presented at the American Academy of Neurology 57th
Annual Meeting in Miami Beach this month. A clinical
trial randomized 150 people with multiple sclerosis
and PBA to receive either the drug AVP-293 or a placebo
for 12 weeks. Those taking AVP-293, a combination of
dextromethorphan and quinidine, had 46% fewer emotional
episodes than controls and reported an improved quality
of life.
Don't
go into the light
BODO, NORWAY —
After the long, dark days of winter most people look
forward to a sunny summer. Some migraine sufferers,
however, may be dreading the warm season. Research presented
at the same meeting in Miami revealed that nearly half
of migraine sufferers with aura had more headaches in
the summer than the winter. The study, which interviewed
98 Norwegian women with migraine aura and 71 with migraine
and no aura, concluded that the occipital lobe neurons
of migraine sufferers were hyperexcitable during exposure
to the intense light of summer in the Arctic.
A
death unfit for dogs
MIAMI —
A study appearing in the April 16 Lancet castigates
the US practice of capital punishment by lethal injection.
The researchers, led by Dr Leonidas G Koniaris, looked
at inmates killed in Texas and Virginia, where 45% of
American executions take place. They found a system
in utter shambles where executioners often had no training
in anesthesia. There's typically scant — or no
— medical data collection and no peer review of
the executions themselves. What's more, the authors
found lethal injection often wouldn't even clear low
veterinary standards for putting animals down. An accompanying
editorial adds "repeated studies have shown a pattern
of racial discrimination in the administration of the
death penalty."
Ghostwriters
lurking in the journals
WASHINGTON —
Dr Adriane Fugh-Berman of Georgetown University
delivered a bombshell commentary in the April 14 online
edition of the Journal of General Internal Medicine.
Entitled "The Corporate Coauthor," her commentary details
how she was handed an article, written and paid for
by industry interests, and asked to put her name to
it as the 'author.' She said the study was on herb warfarin
interactions and that the sponsor of the article was
developing an alternative to warfarin — a flagrant
conflict of interest. Fearing this is not an isolated
incident, Dr Fugh-Berman is critical of the current
voluntary conflict of interest declarations. She proposes
more stringent standards coupled with a searchable public
database.
Putting
cancer behind
MINNEAPOLIS —
Prostate cancer may not just be a pain in the behind
as its treatment may also increase the risk of cancer
there. A retrospective study of over 85,000 men in the
Surveillance, Epidemiology and End Results (SEER) Registry
found that those who received radiation therapy for
prostate cancer were 70% more likely to later develop
rectal cancer. However the report, in the April issue
of Gastroenterology, found that the risks of
other types of colon cancer weren't affected by the
therapy.
It's
a boy! And a girl, and another boy...
SAN DIEGO —
In humans, multiple births, like the Dionne quints,
usually make headlines. For the lowly mouse, on the
other hand, they're the norm. A report in the April
4 edition of PNAS explores the genetic factors
that make murine multiple births possible — and
offers an explanation for this rare phenomenon in humans.
Apparently a protein called BMP-15 controls the number
of follicles that can ovulate. In humans, it's produced
normally, resulting in mainly singleton births. In mice,
however, BMP-15 is destroyed before it has a chance
to mature. Researchers hope this finding will impact
infertility and birth control treatments in humans.
Pin
the tail on the bully
SEATTLE —
Researchers may be able to pick out future schoolyard
bullies as early as age four. A study of 1,266 children
in the April issue of the Archives of Pediatric and
Adolescent Medicine found that 13% of the four-year
olds surveyed were considered bullies by their mothers.
These kids were more likely to have watched plenty of
TV at age four, and less likely to have received an
abundance of emotional support and cognitive stimulation
from their parents. Bullying by these kids was later
reported at ages six through 11.
Smokeless
smokes trump addiction
BIRMINGHAM, AL
— We all know that cold turkey is far more
appealing between two slices of bread than as a smoking
cessation method. That's why the authors of a Journal
of Psychoactive Drugs paper came up with the strategy
to replace quitters' cigarettes with a smokeless form
of tobacco. In the January/February issue, they report
that the 75% of subjects who were smoke-free after one
year are still smoke-free seven years later. The smokeless
tobacco carries a 98% lower risk of dying than the real
McCoy.
Tumour-free
chinwag
COPENHAGEN —
The urban legend that cellphone use can cause brain
tumours has at last been debunked. A study in the April
12 issue of Neurology interviewed 427 people
with brain tumours and 822 people without these growths
about their cell phone use. Phone company records indicated
that there was little recall bias, so the finding that
there's no relationship whatsoever between brain tumour
development and frequent cellphone use is a solid one.
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