When sponsored CDS is a crime …

Today, The Department of Justice issued an announcement that was “the first ever criminal action against an EHR vendor.” Criminal action The core of the criminal action was something inevitable:  the tension between better health and better profit.  Here’s what I saw … all of which caused me to be not-so-surprised today when the news broke. In 2008 I was the CMIO at Allscripts.  Much of my work was focused on how our customers could use our products to improve the health of our patients.  We implemented clinical practice guidelines in the software as a way to help clinical teams and patients make well-informed decisions that would improve their health. The company was doing well, but there was always pressure to find more revenue. We had a small team that worked closely with pharmaceutical companies and generated revenue from these relationships.  I wasn’t very involved with this team, but due to my ownership of many of the clinical decision support initiatives, I started getting invited to meetings we had with pharmaceutical companies.  The first was an initiative that involved a company selling a statin drug.  They wanted to sponsor a program in which we would use a clinical decision support notification to alert clinicians to patients who might be candidates for statin therapy but had not yet been offered a statin drug.  On its face, this seemed appropriate: it invoked evidence based clinical guidance, ...
Source: Docnotes - Category: Primary Care Authors: Tags: Uncategorized Source Type: blogs

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Publication date: Available online 21 November 2019Source: Journal of Acupuncture and Meridian StudiesAuthor(s): Maria P. Volpato, Izabela C.A. Breda, Ravena C. de Carvalho, Caroline de Castro Moura, Laís L. Ferreira, Marcelo L. Silva, Josie R.T. Silva
Source: Journal of Acupuncture and Meridian Studies - Category: Complementary Medicine Source Type: research
Purpose of review With the exception of familial hypercholesterolaemia, the value of genetic testing for managing dyslipidaemias is not established. We review the genetics of major dyslipidaemias in context of clinical practice. Recent findings Genetic testing for familial hypercholesterolaemia is valuable to enhance diagnostic precision, cascade testing, risk prediction and the use of new medications. Hypertriglyceridaemia may be caused by rare recessive monogenic, or by polygenic, gene variants; genetic testing may be useful in the former, for which antisense therapy targeting apoC-III has been approved. Familial hi...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
Purpose of review Hyperlipidemia, hypertension, diabetes and related metabolic disorders increase the risk for cardiovascular disease (CVD). Despite significant progress in the identification of key mechanisms and genetic polymorphisms linked to various CVDs, the rates of CVDs continue to escalate, underscoring the need to evaluate additional mechanisms for more effective therapies. Environment and lifestyle changes can alter epigenetic mechanisms mediated by histone modifications and long noncoding RNAs (lncRNAs) which play important roles in gene regulation. The review summarizes recent findings on the role of epigenet...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
Purpose of review Genetic variance on blood pressure was shown about 100 years ago; a Mendelian inheritance was initially presumed. Platt and Pickering conducted a lively debate, whether blood pressure was inherited in a Mendelian fashion or whether the condition was polygenic. Genetic-hypertension research has appropriately followed both pathways. Recent findings Genome-wide association studies, Pickering model, have identified more than 500 blood-pressure loci, the targets of which are waiting to be evaluated. Then, come the ‘dark-horses’ of hypertension, namely ‘secondary’ causes. These cond...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: MOLECULAR GENETICS: Edited by Ali J. Marian Source Type: research
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Source: Journal of Pain Research - Category: Anesthesiology Tags: Journal of Pain Research Source Type: research
Publication date: Available online 6 April 2020Source: Antiviral ResearchAuthor(s): Saori Suzuki, Shintaro Shichinohe, Yasushi Itoh, Misako Nakayama, Hirohito Ishigaki, Yuya Mori, Ayako Ogata-Nakahara, Cong Thanh Nguyen, Masatoshi Okamatsu, Yoshihiro Sakoda, Hiroshi Kida, Kazumasa Ogasawara
Source: Antiviral Therapy - Category: Virology Source Type: research
The hypothalamus–pituitary–adrenal (HPA) axis acts to release cortisol into the blood stream, as cortisol calls the body into action to combat stress. When high amounts of cortisol interact with the hypothalamus, the HPA axis will slow down its activity. The amygdala detects stress, while the prefrontal cortex regulates our reactions to stress. Source: Bezdek K and Telzer E (2017) Have No Fear, the Brain is Here! How Your Brain Responds to Stress. Front. Young Minds. 5:71. doi: 10.3389/frym.2017.00071 _______ [Editor’s note: Continued from yesterday’s Exploring the human brain and how it responds to...
Source: SharpBrains - Category: Neuroscience Authors: Tags: Cognitive Neuroscience Education & Lifelong Learning Health & Wellness #WorldHealthDay brain burnout cognition Cortisol GAS General Adaptation Syndrome homeostasis memory neurobiology neurological exhaustion Stress Source Type: blogs
After 12 weeks of mat Pilates, obese young women with high blood pressure lost body fat and had significantly improved blood pressure compared with those who didn't participate.Medscape Medical News
Source: Medscape Cardiology Headlines - Category: Cardiology Tags: Diabetes & Endocrinology News Source Type: news
Firefighters are an understudied population that reports high rates of alcohol use and hazardous drinking. Pain, which is also commonly experienced by firefighters, may be associated with alcohol use and alcohol use motives, as research among the general p...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
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