Genetic Risk Scores (GRSs): Ready for Inclusion in the Medical Record?
Conclusions: Polygenic hazard scores can be used for personalised genetic risk estimates that can predict for age at onset of aggressive PCa.We are on the cusp of the emergence of proposals to pursue broad predictive genetic screening for cancer (see: Broader Genetic Testing for Cancers May Benefit Population Health). Such screening will inevitably lead to the reporting of"actionable" results to patients' physicians and inclusion in the EHR. In the paper cited above, it was shown that the analysis of a patient's DNA SNIPs can be used to calculate a GRS that predicts the age of onset for aggressive c...
Source: Lab Soft News - April 4, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs
A mix of treatments may extend life for men with aggressive prostate cancer
For men diagnosed with aggressive cancer that’s confined to the prostate and nearby tissues, the overarching goal of treatment is to keep the disease from spreading (or metastasizing) in the body. Doctors can treat these men with localized therapies, such as surgery and different types of radiation that target the prostate directly. And they can also give systemic treatments that kill off rogue cancer cells in the bloodstream. Hormonal therapy, for instance, is a systemic treatment that kills prostate cancer cells by depriving them of testosterone, which fuels their growth.
Now a new study shows that a mix of different t...
Source: Harvard Health Blog - March 31, 2018 Category: Consumer Health News Authors: Charlie Schmidt Tags: Cancer Men's Health Prostate Health Source Type: blogs
The problem of misunderstanding 23andMe genetic test results
Home delivery for everything from fresh produce to custom-selected clothing has become a way of life for many Americans. While most home-delivery conveniences are generally changing our lives for the better — giving us more time and choices — at-home genetics kits that reveal information about the risk of developing certain cancers represent a risky step in our on-demand culture.
The FDA recently gave 23andMe the green light to sell the first direct-to-consumer tests for mutations in the BRCA1 and BRCA2 genes, which are linked to serious risks of developing cancer. All a buyer has to do is ship a saliva sample to t...
Source: Kevin, M.D. - Medical Weblog - March 28, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/susan-domchek" rel="tag" > Susan Domchek, MD < /a > Tags: Conditions Genetics Oncology/Hematology Source Type: blogs
The Future of Value-Based Care Relies Upon Providers: Taking the Reins on Alternative Payment Models
By CHUCK SAUNDERS and NEAL SHORE, MD
2017 was a pivotal year for the growth of value-based care. For many practices, this meant completing their first performance year as part of the Merit-Based Incentive Payment System (MIPS). A much smaller percentage of practices was able to participate in approved advanced Alternative Payment Models (APMs).
While practices await feedback on their 2017 performance, early lessons have already become evident. Clearly, as practices are assigned greater responsibility and accountability for patient populations, it becomes increasingly important that they effectively navigate the reimburseme...
Source: The Health Care Blog - March 23, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
The Barbershop Study: How an Unorthodox Study on Black Men ’ s Health Brought Down the House
This study essentially shows that a health care system that moves itself into barbershops is effective in one third of men found to have poorly controlled blood pressure. I’m also fairly sure a pharmacist in my living room will improve my lipid profile. And it bears repeating, that despite this herculean effort, two-thirds of black men chose not to connect with a healthcare system that was in their barbershop. You can go ahead and put money on the odds that Harry White remains out of reach – its one you’ll win 66% of the time. I’ll also point out the study duration was six months – Harry had sho...
Source: The Health Care Blog - March 21, 2018 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs
The Barbershop Study: How an Unorthodox Study on Black Men ’ s Health Brought Down the House and Where It Went Wrong
This study essentially shows that a health care system that moves itself into barbershops is effective in one third of men found to have poorly controlled blood pressure. I’m also fairly sure a pharmacist in my living room will improve my lipid profile. And it bears repeating, that despite this herculean effort, two-thirds of black men chose not to connect with a healthcare system that was in their barbershop. You can go ahead and put money on the odds that Harry White remains out of reach – its one you’ll win 66% of the time. I’ll also point out the study duration was six months – Harry had sho...
Source: The Health Care Blog - March 21, 2018 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs
Which Direct-To-Consumer Genetic Test to Choose?
Due to the collapse of the price of genetic testing and the FDA’s gradual ease of the regulatory environment, direct-to-consumer (DTC) genetic testing companies are booming. You can inquire your deoxyribonucleic acid about your ancestry, health risks, metabolism, and some start-ups even promise you to find true love or your kids’ talents. As the jungle of DTC companies is getting denser, more and more people ask me which genetic tests are worth the try. They love the possibility of getting access to their DNA but don’t know where to start. Here’s the DTC genetic testing kick-starter package!
Navigating through...
Source: The Medical Futurist - March 20, 2018 Category: Information Technology Authors: nora Tags: Genomics 23andme ancestry DNA DTC future genetic test Genetic testing genetics Genome genome sequencing Health 2.0 Source Type: blogs
The FDA approval of 23andMe ’s BRCA test: What it means for you
The approval by the Food and Drug Administration of 23andMe’s BRCA test is bound to create a discussion about the merits and pitfalls of direct to consumer genetic testing for cancer risk.
It is also going to add fuel to a growing fire about how we as a nation assess genetic risks for cancer, and whether society is prepared for what is inevitably going to become a genomic-influenced and informed culture of health.
From my perspective, as someone who has given considerable thought to these questions over the past several years, there are no easy answers.
The announcement was straightforward: the FDA approved a test t...
Source: Kevin, M.D. - Medical Weblog - March 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/j-leonard-lichtenfeld" rel="tag" > J. Leonard Lichtenfeld, MD < /a > Tags: Conditions Genetics Oncology/Hematology Source Type: blogs
FDA approves new drug for men at high risk of prostate cancer spread
A newly approved drug called apalutamide is giving hope to thousands of men confronting a tenacious problem after being treated for prostate cancer. Prostate-specific antigen (PSA) levels should plummet to zero after surgery, and to near zero after radiation therapy, but in some men, they continue rising even when there’s no other evidence of cancer in the body. Doctors typically respond to spiking PSA with drugs that block the production of testosterone, which is the male sex hormone that fuels prostate cancer. However, this type of medically induced castration, called hormonal therapy, doesn’t always reduce PSA. More...
Source: Harvard Health Blog - March 15, 2018 Category: Consumer Health News Authors: Charlie Schmidt Tags: Cancer Health Men's Health Prostate Health Source Type: blogs
Knowing when to screen … and when to quit
Follow me on Twitter @RobShmerling
Let us sing the praises of good medical screening tests.
These are the tests that can detect medical problems before they become untreatable and before they cause complications or even death. Even better are those screening tests that detect “predisease” — abnormalities that aren’t dangerous on their own but can lead to problems later.
According to the US Preventive Services Task Force, relatively few screening tests are considered good enough to routinely recommend for adults, including
mammography for breast cancer (women)
Pap smear for cervical cancer (women)
bone density test...
Source: Harvard Health Blog - March 1, 2018 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Cancer Health Prevention Screening Source Type: blogs
The Skeptical Oncologist
By BISHAL GYAWALI, MD
Why conduct post approval studies at all?
Atezolizumab previously received accelerated approval in second-line metastatic or advanced urothelial cancer based on response rates from a single arm trial. The results of post approval confirmatory phase 3 are now published and demonstrate that atezolizumab did not improve survival versus chemotherapy (11.1 v 10.6 months, HR 0.87, p = 0.41). The concept of accelerated approval is to grant early and conditional approval and access to drugs in diseases of unmet need, and that the decision to fully approve or revoke be made based on results of confirmato...
Source: The Health Care Blog - February 7, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Newer drugs are improving survival for men with metastatic prostate cancer
This study provides important information that men with advanced forms of prostate cancer are now living longer than they once did, sometimes years longer. Those of us who have been treating prostate cancer for decades appreciate this study’s fundamental finding that the improved longevity from newer cancer drugs is considerable.”
The post Newer drugs are improving survival for men with metastatic prostate cancer appeared first on Harvard Health Blog. (Source: Harvard Health Blog)
Source: Harvard Health Blog - January 31, 2018 Category: Consumer Health News Authors: Charlie Schmidt Tags: Cancer Health Men's Health Prostate Health Source Type: blogs
What ’s the point of a perfect patient chart?
Last week I made a patient’s chart perfect.
Not bragging, but ultimately it ended up being pretty easy, and I’ll explain how and why in a little bit.
This was a patient I had not seen in several years, with a number of chronic medical problems, for which he had been taking less than optimal care of himself since I had seen him last.
Here for a “checkup,” we talked about his health conditions and how he had been over the past few years. I got a little update on his family and all the things he had been up to, and then he and I — along with his wife, who was here with him for the appointment ...
Source: Kevin, M.D. - Medical Weblog - January 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/fred-n-pelzman" rel="tag" > Fred N. Pelzman, MD < /a > Tags: Physician Health IT Primary Care Source Type: blogs
Hospice Care is covered by Medicare and Most Other Insurance
Dear Carol: My dad has aggressive prostate cancer that has spread to his liver and bones. His oncologist isn’t very communicative and when I asked about hospice care he said that’s up to us. He told us that Dad won’t get better but that he can keep treating him if we want. The treatments make Dad miserable. If they won’t help, what’s the point? I feel strongly that Dad needs hospice care and have been trying to talk my mom into it but she’s dragging her feet. How do we go about getting the service? Which one do we choose? Will Mom have to go on Medicaid to get it paid for? This is her biggest fear. – ST...
Source: Minding Our Elders - January 14, 2018 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs
What Is An Abnormal Test Result?
By ROBERT MCNUTT, MD
Most teachers of evidence-based-medicine talk about tests as “positive, or negative”. A positive test is one in which the result of the test is abnormal; a negative test is one in which the test’s result is normal. A problem with this way of teaching about the value of test results is that often physicians and patients think there are only two possible test results, normal or not. However, test results are never just, “normal or abnormal”; test results may take on many values, not just two. ,
Researchers distinguish normal test results by performing the test in people who are ...
Source: The Health Care Blog - January 9, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized McNutt Negative Positive Testing Source Type: blogs
