From the Literature: State of the USA Health Indicators

State of the USA Health Indicators: Letter Report

Researchers, policymakers, sociologists and doctors have long asked how to best measure the health of a nation, yet the challenge persists. The nonprofit State of the USA, Inc. (SUSA) is taking on this challenge, demonstrating how to measure the health of the United States. The organization is developing a new website intended to provide reliable and objective facts about the U.S. in a number of key areas, including health, and to provide an interactive tool with which individuals can track the progress made in each of these areas.
In 2008, SUSA asked the Institute of Medicine's Committee on the State of the USA Health Indicators to provide guidance on 20 key indicators to be used on the organization's website that would be valuable in assessing health. Each indicator was required to demonstrate:

• a clear importance to health or health care,
• the availability of reliable, high quality data to measure change in the indicators over time,
• the potential to be measured with federally collected data, and
• the capability to be broken down by geography, populations subgroups including race and ethnicity, and socioeconomic status.

Taken together, the selected indicators reflect the overall health of the nation and the efficiency and efficacy of U.S. health systems. The complete list of 20 can be found in the report brief and book.

From the Literature: PCI vs. CABG

Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease

Serruys, et al for the SYNTAX Investigators
Published at www.nejm.org February 18, 2009 (10.1056/NEJMoa0804626)

In the international SYNTAX trial, 1800 patients with three-vessel or left main coronary artery disease were randomly assigned to either revascularization with coronary-artery bypass grafting (CABG) or percutaneous coronary intervention involving drug-eluting stents. The need for repeat revascularization was significantly lower with CABG, but the risk of stroke was significantly higher — a tradeoff that must be considered in making clinical decisions regarding patients with advanced coronary disease. (summary courtesy of NEJM)

The newly published trial has received a fair amount of press because of it's timing: a provision in the new stimulus bill requires more comparisons of treatments' effectiveness.

Tech Time with Dr. Adams

Can it be that we've reached the convergence of handheld devices - my pager, phone, email, and web access? And, what's happened to "voice over IP?"

Are interns really getting smartphones?

Recent hearsay from med students who are interviewing for internships is that several institutions are handing out smartphones to interns - Harvard, Columbia, and Penn, the Treo, iPhone, and Blackberry. Is this really true?

Testimonial
Personally I own a Blackberry Pearl and I'm very satisfied because of the physical keyboard. But, I also carry an iPod Touch in my opposite pocket because the Apple apps are just too tempting. Not to mention, ePocrates Essentials, the drug look-up, is now available for Touch and iPhone and Duke gives me free access to the ePocrates upgrade. The smartphone supports my personal space/workflow - I can forward my pager to the phone, check my email and look up something on the fly via the web browser.

Quick Reads
Both major financial newspapers have reputable resources for quick reviews of personal technology, including videos:

• WSJ, Walt Mossberg
  http://online.wsj.com/


• NYT, David Pogue and Matt Richtell
  http://www.nytimes.com/

Here I am, first time in the blogosphere myself. Will I regret?
~Martha Adams, MD

Dietary Supplements Labels Database Improved

NLM's Dietary Supplements Labels Database includes information from the labels of over 3,000 brands of dietary supplements in the marketplace, including vitamins, minerals, herbs or other botanicals, amino acids, and other specialty supplements. It now includes several interface improvements, more products, and an auto-complete (search) feature. Other recent additions/changes include:

• Search box on every page
  
• Age/gender categories under "Products"
  
• Glossary page with A-Z anchor links
  
• Updated FDA Recalls, FDA MedWatch and FTC Actions
  
• More products (3000)
  

The database is designed to help both the general public and health care providers find information about ingredients in brand-name products, including name, form, active and inactive ingredients, amount of active ingredient/unit, manufacturer/distributor information, suggested dose, label claims, warnings, percentage of daily value, and further label information.

Tea with Trailblazers

Join us for a presentation by two of Duke's African-American trailblazers in medicine: Dr. Haywood Brown and Dr. Danny Jacobs; Feb. 9th; 2:30-4 pm; First Stack Level.

From the Literature: Peanut Product Recall Blog

The FDA, CDC and HHS have partnered to create a new way to share information about the peanut recall - the Peanut Product Recall Blog. This blog was designed to foster communication and conversations, as well as provide ongoing information about the peanut butter and peanut-containing product recalls and outbreak investigations. The blog also contains links to podcasts and other social media methods. Moreover, the blog represents a transparent and low-cost way to share medical and public health information with clinicians and consumers quickly and easily. The blog also cuts across traditional bureaucratic lines: it will include posts from CDC, FDA and HHS representatives.

Of potential help to consumers and clinicians alike: the frequently updated map: "Investigation of Outbreak of Infections Caused by Salmonella Typhimurium 2008-2009" and the link to the product recall list.

What other kinds of medical information do you think could be published or shared in this way?

Wear Red Day - Feb. 6th!

Help support the fight against heart disease in women by wearing red on Friday, Feb. 6th. It's a great way to raise awareness!

Meet the women of Untold Stories of the Heart, a television special which aired nationwide recently, focusing on real women's stories of struggle, success and support on their journey to heart health.