Swine Flu: It’s everywhere!
With 71 cases out of nearly 900 in the U.S., Massachusetts has been relatively hard-hit by the Swine Flu. But the H1N1 virus hasn’t killed anyone in the region so far — despite being carted around by Boston dental students and two Lowell Little Leaguers. The two U.S. deaths were in Texas.
The flu cases that did turn up here were not as severe as feared and didn’t spread as fast as expected. So some of the urgency is gone.
The state public health blog is the best place to get up-to-date local information.
On Wednesday, Lauren Smith, the state Dept. of Public Health’s medical director, posted a letter to “concerned parents” urging them NOT to keep their kids home from school — even if another student there tests positive for the H1N1 flu:
“There are a couple of reasons for this:
“1) Whether or not there is a confirmed case in your community or in your school, it is most likely already there. You should assume you could be exposed to this new flu at school, at work or at the grocery store (in other words, anywhere you go)…
“2) Another reason we don’t feel it’s necessary to close schools, even with a confirmed case of H1N1, is that it doesn’t seem to be any more severe than a regular seasonal flu.”
One thing the flu did do was test our medical readiness to handle a pandemic. WBUR had an interview with epidemiologist David Ozonoff of Boston University’s School of Public Health, who says hospital ERs are not ready for — new pandemic jargon alert — a “surge” in cases:
“WBUR: We probably have succeeded in worrying people. How serious a threat are we facing in the coming weeks? Is there a storm coming?
OZONOFF: I think the threat that we’re facing is sort of a known, familiar and practical kind of thing. Which is that any virus that can make a lot of people even a little bit sick puts a real strain on our resources. That’s our fault, that’s not the virus’ fault.
It’s our fault that we have disinvested in the kind of community infrastructure that we need to take care of each other. So I think we need to be very concerned by the fact that we’ve left ourselves unprepared.”
Peer review for press releases?
Researchers often complain about reporters not being able to get it right. Now they’ve turned on their own. A study this week in the Annals of Internal Medicine found major faults in a significant sample of press releases issued by academic medical centers.
“Conclusion: Press releases from academic medical centers often promote research that has uncertain relevance to human health and do not provide key facts or acknowledge important limitations.”
Researchers chose a random 200 press releases to analyze and found, for example, that some made claims about human health based on animal studies. Few — 17 percent — “promoted studies with the strongest designs (randomized trials or meta-analyses).” Forty percent reported on “the most limited human studies” — including those with uncontrolled interventions, small samples or unpublished data.
The study’s limitation: “The effects of press release quality on media coverage were not directly assessed.”
The people who write these press releases have tough jobs. First, they have to extract the information out of wary, jargon-spewing researchers, along with a decent quote or two. Then they have to translate it into English. Then they have to make it sufficiently newsworthy to get someone from the shrinking pool of health reporters to do a story on it. Then, often, the researcher has to review it. By the time it goes through that grinder, you never know what’s going to emerge.
That’s why good journalists learn how to read and interpret the studies, not just the press releases.
Judge for yourself. We’re awash in academic medical centers here and they all have their own press offices, with lists of press releases: Beth Israel-Deaconness Medical Center, Brigham & Women’s Hospital, Tufts and Boston Medical Center.
Sales vs. science
Jerry Avorn is a — take a deep breath — pharmacoepidemiologist at Brigham and Women’s Hospital. He is credited with inventing the concept of “academic detailing,” in which well-informed doctors use science to counter sales pitches from drug company reps. See RxFacts.com for more.
This week, in The New England Journal of Medicine, he offers a good take on conservative opposition to comparative effectiveness research, describing the arguments of CER opponents as “Orwellian:”
“Betsy McCaughey, a former lieutenant governor of New York, linked funding for CER with the stimulus bill’s provisions supporting the use of electronic medical records. She warned that the inclusion of both initiatives was designed to enable electronic monitoring of individual patient-care decisions by the federal government and punishment of clinicians who fail to comply with imminent rationing guidelines. The radio talk-show host Rush Limbaugh then disseminated this message to millions of listeners, warning that once the stimulus bill ‘computerizes everybody’s health record,’ a new federal bureaucracy ‘will monitor treatments to make sure your doctor is doing what the federal government deems appropriate.’
“…Although these commentaries painted caricatures of new federal powers that were not in the bill, they were a shot across the bow of the entire CER enterprise.”
Avorn’s 2004 book, “Powerful Medicines,” talks about the way drug marketing influences prescribing practices — often to the detriment of patients and payers. The journal includes two other articles on CER.
SEIU vs. BIDMC
BI’s CEO Paul Levy responds to the ongoing campaign in his blog.
The Globe on delaying care and ignoring the VA
The Boston Globe this week has a story on people putting off care because they can’t afford co-pays.
The turnaround at Veteran’s Administration hospitals is a story no one wants to believe. The Globe also reported this week that few U.S. hospitals have taken advantage of a no-cost, VA-built electronic health records system.
There’s more by Tinker Ready over at Boston Health News.