Many Physicians Are Prescribing Non-Inert 'Placebo' Treatments

About half of a small random sample of U.S. physicians prescribe placebo treatments, according to a BMJ study released online. Using a mailed survey, researchers assessed the attitudes toward placebo treatments among some 700 internists and rheumatologists. (A placebo treatment was defined as one "whose benefits ... derive from positive patient expectations.") Roughly half the sample reported using placebo treatments at least two or three times a month. The placebos prescribed most often were over-the-counter analgesics and vitamins (each about 40%); antibiotics and sedatives were each used about 15% of the time. Physician characteristics such as age, sex, or practice region did not influence the likelihood of placebo use. BMJ 2008;337:a1938

Celebrate Open Access Day: Oct. 14th with Duke Libraries

Open Access is a growing international movement that uses the Internet to throw open the locked doors that once hid knowledge. It encourages the unrestricted sharing of research results with everyone, everywhere, for the advancement and enjoyment of science and society.

Duke Talks about Open Access
2:00 - 3:30 p.m., Perkins Library, Room 217

James Boyle, William Neal Reynolds Professor of Law, Chairman of the Board, Creative Commons.
Professor Boyle will focus on Creative Commons, an organization which is working to facilitate the free availability of art, scholarly and creative materials through online licenses that authors can attach to their work.

His talk will be followed by a panel of speakers from the Duke community who will share their perspectives and their activities within the Open Access arena.

• Melanie Dunshee, JD, AMLS, Assistant Dean for Library Services, Duke Law Library
• Ricardo Pietrobon, MD, PhD, MBA, Associate Vice Chair and Assistant Professor, Department of Surgery Duke University Health System
• Josh Sommer, fellow in Duke's Program on Global Health and Technology Access, co-founder Chordoma Foundation

Open Access Webcast
7:00 - 8:00 p.m., Perkins Link AND Medical Center Library (Room 104)

The Webcast features:

• Sir Richard Roberts, Nobel laureate, Chief Scientific Officer at New England Biolabs, US, and a member of the PLoS Biology Editorial Board.
• Philip E. Bourne, Ph.D. founding editor-in-chief of PLoS Computational Biology, Professor in the Skaggs School of Pharmacy and Pharmaceutical Sciences at the UC San Diego, Assoc. Dir. of the RCSB Protein Data Bank, Senior Advisor to the San Diego Supercomputer Center, Adjunct Professor at the Burnham Institute, and Co-Founder of SciVee.

Both speakers will discuss how Open Access impacts research and will answer questions on this topic from participating campuses.

Throughout the day, the libraries will feature short video clips on open access, make handouts about author rights, access to research, and copyright available, and distribute OA Day buttons. If you are a supporter of Open Access you are also invited to join our Facebook page.

For more information about the speakers and other events, please contact
Kevin Smith, kevin.l.smith@duke.edu, 668-4451 or Pat Thibodeau, at patricia.thibodeau@duke.edu, 660-1150. Additional information about Open Access Day is available at http://guides.mclibrary.duke.edu/openaccess or http://www.openaccessday.org/.

From the Literature

2007 focused update to the ACC/AHA guidelines for
the management of patients with ST-segment elevation
myocardial infarction: implications for emergency
department practice.

Pollack CV Jr, Antman EM, Hollander JE; American College of Cardiology; American Heart Association.Ann Emerg Med. 2008 Oct;52(4):344-355.e1. Epub 2008 Jun 2.

The American College of Cardiology and American Heart Association
have issued a "focused update" of their 2004 guidelines for the
management of ST-segment elevation myocardial infarction (STEMI).
Several of the issues addressed involve new data and new
recommendations on treatment decisions that may be made in the
emergency department. In this review, we present the new
recommendations that are pertinent to emergency medicine practice
and comment on their potential implementation into an evidence-based,
multidisciplinary approach to the timely care of the STEMI patient.

Check Out Our E-Books!

Increasingly our patrons are using e-books for quick lookups and clinical information, and this preference is increasing across all user groups. As a result, we have been building a diverse and substantial collection of core medical texts in electronic format. Statistics suggest that these resources are used frequently.

	We have several e-book packages that are worth checking out. Through MDConsult, we subscribe to such titles as Nelson Textbook of Pediatrics, Miller's Anesthesia, and Sabiston Textbook of Surgery.
	Rittenhouse's R2 offers Essentials of Clinical Geriatrics, Hurst's The Heart, and other titles.
	Books@Ovid provides some of the most heavily used nursing titles including Lippincott Manual of Nursing Practice and Nursing Care Plans & Documentation: Nursing Diagnoses and Collaborative Problems.
	Recently, we added a few titles from the STAT!Ref library. Users can choose from several core titles including Harrison's Principles of Internal Medicine and Schwartz's Principles of Surgery.

For more information about our electronic book offerings and access, visit the Library's E-book Web pages at http://www.mclibrary.duke.edu/find/ebooks. You can browse by subject or alphabetically by title or search by textword. We will continue to add to our collection of electronic texts, so check back often to keep up-to-date with new arrivals.

If you have any questions, comments or suggestions, please contact Karen Grigg at karen.grigg@duke.edu or (919) 660-1122.

From the Literature

The National Hospital Bill: The Most Expensive Conditions by Payer, 2006
By Roxanne M. Andrews, PhD
September 2008


The National Hospital Bill: The Most Expensive Conditions by Payer is a report prepared by the Agency for Healthcare Research and Quality (AHRQ). The report is useful as a benchmark to policymakers concerned with the rising costs of hospitalizations passed on to government, insurers, and consumers.

Issued as one of the Agency's Statistical Briefs, the reports track the growing burden of costs for inpatient hospitalizations in the United States by all payers. Highlighted in each report are the Top 20 Most Expensive Conditions taken from the HCUP Nationwide Inpatient Sample (NIS), a sample survey representative of all aggregate U.S. community hospitals. Included is the number of hospital admissions, the diagnosis based upon ICD-9-CM coding, the cost of procedures, how many billions were billed to Medicare, Medicaid, private insurance, and the uninsured. The statistics were generated from HCUPnet, a free, online query system that provides users with immediate access to largest set of publicly available, all-payer national, regional, and state-level hospital care databases from HCUP. Statistical reports include tables and charts.

This report does not include data for hospital outpatient visits, emergency care visits not resulting in admission, or fees for physician services. Separate data sets exist for emergency department visits and outpatient visits.


Source: Statistical Brief #59