1. ACP calls for policies that better support women and their families and improve health outcomes
Free Content-Paper: http://annals.org/aim/article/doi/10.7326/M17-3344
Free Content-Editorial: http://annals.org/aim/article/doi/10.7326/M18-1258
Note: B-roll and sound bites from ACP President, Ana Maria Lopez, MD, FACP, are available to view and download at http://www.dssimon.com/MM/ACP-womens-health/.
URLs go live when the embargo lifts
A new position paper from the American College of Physicians (ACP) examines the unique challenges women face within the U.S. health care system and calls for policies to better support them. The paper addresses a wide range of issues, such as support for paid family and medical leave, recommendations on policies to reduce domestic violence, sexual abuse and harassment, and participation in clinical trials. The paper also addresses access to coverage, including coverage for medically necessary reproductive services, and opposition to policies that would create barriers to their access to reproductive health services. The paper, "Women's Health Policy," is published in Annals of Internal Medicine.
ACP urges policymakers to strongly consider how to better integrate women's health needs over the course of their lifetime. Ensuring that women have access to non-discriminatory health care coverage is essential to improving the overall health and well-being of women living in the U.S., and a longstanding goal of ACP.
This paper was developed by ACP's Health and Public Policy Committee, which addresses issues that affect the health care of the American public and the practice of internal medicine and its subspecialties. ACP's evidence-based public policy positions are based on reviewed literature and input from the ACP's Board of Governors, Board of Regents, additional ACP councils, and nonmember experts in the field.
Media contact: For an embargoed PDF, please contact Lauren Evans at [email protected]. To interview ACP president Ana Maria Lopez, MD, FACP, please contact Jacquelyn Blaser at [email protected] or 202-261-4572.
2. Prediction tool helps tailor lung cancer screening to patient benefit and preferences
Abstract: http://annals.org/aim/article/doi/10.7326/M17-2561
Editorial: http://annals.org/aim/article/doi/10.7326/M18-1350
URLs go live when the embargo lifts
Utilizing a lung cancer risk prediction tool may help clinicians tailor lung cancer screening recommendations for eligible patients based on clinical benefit and personal preferences, as opposed to taking a one-size-fits-all approach to screening. The findings of a microsimulation study are published in Annals of Internal Medicine.
The National Lung Screening Trial found that annual screening with low-dose computed tomography (LDCT) substantially reduced mortality from lung cancer, the leading cause of cancer death in the United States. However, lung cancer screening can result in substantial harms and costs, making program implementation complicated. Patients make decisions about screening based on how they value the tradeoffs and risk. As such, many health systems are exploring how to implement LDCT screening programs that are effective and also take into consideration individual patient preferences.
Researchers from the University of Michigan Medical School created a simulation model, which used data from large randomized trials and could individualize estimates of risk/benefit, to examine factors that influence when LDCT screening is preference-sensitive. The model found that moderate differences in preferences about the downsides of LDCT screening influenced whether screening was appropriate for some eligible persons (annual lung cancer risk less than 0.3 percent or life expectancy less than 10.5 years). For higher-risk persons with longer life expectancy (roughly 50 percent of the eligible population), the benefits of screening overcame even highly negative views about screening. Those with higher-risk and longer life-expectancy also had robust net benefit even in scenarios where false-positive rates were very high (i.e., 60 percent rate of false-positive findings).
The web-based decision tool that incorporates the rules of thumb derived from the researchers' findings can be found at https://share.lungdecisionprecision.com/.
Media contact: For an embargoed PDF, please contact Lauren Evans at [email protected]. To interview the lead author, Tanner J. Caverly, MD, MPH, please contact Kara Gavin at [email protected].
3. Researchers warn that drinking horsetail juice may lead to severe hyponatremia
Abstract: http://annals.org/aim/article/doi/10.7326/L18-0028
URLs go live when the embargo lifts
Researchers warn that drinking horsetail juice may lead to severe, acute hyponatremia, a condition in which the body's sodium level becomes very low, causing the cells to swell. A brief case report is published in Annals of Internal Medicine.
Horsetail is a perennial plant that has been used as an herbal remedy since at least the Greek and Roman times. However, it may be associated with an unusual adverse event.
Researchers from Haga Hospital, The Hague, the Netherlands, reported the case of a 32-year-old woman who reported to the emergency department feeling restless and anxious after consuming a drink made by crushing horsetail plants in a blender. After an initial discharge with instructions to return if her condition worsened, the patient came back to the emergency department with a headache, feeling lethargic, and acting strangely. Before she could be examined, she had a tonic-clonic seizure lasting approximately 30 seconds and terminating on its own.
The researchers believe this is the first case of such severe, acute hyponatremia after consuming horsetail juice. However, they advise clinicians to be aware of this potential adverse event in patients consuming even a small amount of the plant.
Media contact: For an embargoed PDF, please contact Lauren Evans at [email protected]. To interview the lead author, Chloe C.A. Grim, MD, MSc, please contact contact her directly at [email protected].
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Also new in this issue:
Starving the Hungry Tapeworm: How Businessmen May Reform Health Care Cost
Laurence F. McMahon, Jr., MD, MPH; Vineet Chopra, MD, MSc
Ideas and Opinions
Abstract: http://annals.org/aim/article/doi/10.7326/M18-0432
Clonal Hematopoiesis Confers Predisposition to Both Cardiovascular Disease and Cancer: A Newly Recognized Link Between Two Major Killers
Benjamin L. Ebert, MD, PhD; Peter Libby, MD
Ideas and Opinions
Abstract: http://annals.org/aim/article/doi/10.7326/M18-0737
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