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Vital Signs
Media Mentions - DMS and DHMC in the news
Among the people and programs coming in for
prominent media coverage in recent months
was the director of DMS's Center for the Evaluative
Clinical Sciences. In a three part-series on
Medicare, the Washington Post wrote that "the
typical Medicare patient in Los Angeles costs the
government $3,152 more than
a comparable patient in the District"
of Columbia and "a patient
in Miami costs $3,615
more than one in Baltimore.
Those disparities cannot be explained
by differences in local
prices or rates of illness, said Dr.
John Wennberg, a Dartmouth physician and an expert
on geographical variations in medical care."
Rather, "higher spending is related to the number
of specialists, hospital beds, and technology
available." The Post also moderated a live, online
discussion between its readers and Wennberg—whose research was also cited in a letter to the editor
and an article in the Wall Street Journal.
The New York Daily News cited a DMS neuroscientist,
noting that "people with mild cognitive
impairment (MCI) have trouble remembering
new information. More perplexing are people who
don't have MCI but are suffering from more than
just 'senior moments.' Dr. Andrew Saykin calls them
'cognitive complainers.' . . . 'Early on we thought
the people in this cognitive
complaint group might just represent
the 'worried well' who are
somewhat hyper-aware and
afraid of developing Alzheimer's
disease or another dementia,'
said Saykin, director of the
brain-imaging lab at Dartmouth-
Hitchcock Medical Center. [But] people
actually appear to be very sensitive to changes
that are occurring in the brain . . . early on."
"Dartmouth-Hitchcock Medical Center in New Hampshire decided to pioneer a radically new approach. Full disclosure, detailed results, good and bad," reported ABC's World News Tonight in a story about hospitals that voluntarily disclose performance data. "The trust that you develop with your patient is the most important thing over the long term," Paul Gardent, DHMC executive vice president told ABC's John McKenzie. "This full disclosure even includes the cost estimates of various procedures and results of patient satisfaction surveys," McKenzie said. "It does highlight where we need to improve," added Gardent."
Fifteen years have passed since the Americans
with Disabilities Act was enacted to protect workers
who have a mental or physical impairment,"
began an article in a suburban New York paper.
However, "'workers with epilepsy
face big hurdles when it
comes to unemployment,' says
Dr. Gregory Holmes, chief of neurology
at Dartmouth. Only about
25% of adults with epilepsy have
full-time employment . . . a statistic
that is out of line even after
accounting for their lower college-graduation
rates," Holmes told the Journal News, which
serves New York's Westchester, Rockland, and
Putnam counties. "Patients will tell you that's often
due to the epilepsy itself," Holmes added.
Shape magazine recently consulted a
DHMC
physician for advice on how to avoid motion sickness.
"Although it's often tough
to predict who will be affected,
if you know you're prone to motion
sickness, take medication
ahead of time, advises Jay Buckey,
M.D., associate professor of
medicine at Dartmouth Medical
School." What the article failed
to mention was that Buckey, in addition to being
a physician, is a former astronaut. On the 1998
NASA Neurolab mission, he endured extreme motion—speeds upwards of 17,500 miles per hour.
"Tom Wolfe was so taken with Michael Gazzaniga's The Social Brain that not only did he send Gazzaniga a note calling it the best book on the brain ever written, he had [a professor in one of his novels] recommend it in class." So began a New York Times review of a new book by Dartmouth's bestknown neuroscientist. The book also inspired an editorial in the Times of London, which called Gazzaniga "a fascinating character—a rare, secular voice among a choir of Christians who sit on the President's Council on Bioethics."
To explain two recent studies on micro-
RNA—a molecule that helps regulate gene
expression and protein production—the
New York Times turned to
microRNA's "discoverer,
Victor Ambros of Dartmouth.
With his colleagues Rosalind
Lee and Rhonda
Feinbaum, he found a
gene called lin-4. When
the gene was activated, its
messenger RNA folded itself up into a little
hairpin twist, and that was its product"—a
microRNA molecule.
"Peter Jennings's death from lung cancer,"
said the Dallas Morning News, "has left many
of the nation's 48 million former smokers
asking apparently simple questions: Should
they be screened? Why
don't doctors perform routine
checks for lung cancer?"
The answer: "'We
don't know if it works,'
said Dr. William Black of Dartmouth.
And if it doesn't
work, it could generate a
lot of unnecessary anxiety, medical treatment
and cost." Black, who is cochair of the
multicenter National Lung Screening Trial,
was featured in the cover story in Dartmouth
Medicine's Summer 2005 issue.
Another subject of that cover story turned
up in the New York Times, explaining a medical
analogy regarding the Discovery launch.
"The more NASA looks
for damage, engineers and
other experts say, the more
it will find," wrote the
Times, likening NASA officials to doctors who have
increasingly powerful diagnostic
tools at their fingertips.
"Dr. H. Gilbert Welch, a professor of medicine
at Dartmouth and an expert on medical
diagnosis, agreed. 'A lot of what we're
calling disease now never becomes clinically
apparent during the life of the patient,'
he said. 'Everything you find is less threatening,
but you can never say anything is a
zero threat.' NASA faces a similar challenge,
he said: 'I'm sure they want to do the
best they can. But the harder they look,
they'll find more things.'"
"Most Women Overestimate Breast Cancer Risk" was the headline on Fox
News Online
coverage of a University of Michigan study.
The article quoted the author
of a DMS study that
came to the same conclusion
10 years ago. "Researcher
Lisa Schwartz, M.D.,
says cancer awareness campaigns
often scare people
with numbers that highlight
the magnitude of cancer risk but provide
little context." Drawing on Schwartz's
research, Fox explained that "a 40-year-old
woman who has never smoked, for example,
has a 0.2% chance of dying from breast cancer
before she is 50."
"Aspirin does it all," said the New York Daily
News of the tried-and-true painkiller. "Aspirin's
role as an anti-inflammatory agent
also appears to interfere with the growth of
intestinal cancer cells. In 2002, a study [by
Dr. John Baron] at Dartmouth Medical School
was the first to show a link
between taking aspirin and
reducing the number of
polyps that lead to cancer.
The study looked at 1,121
people who had colon
polyps removed. . . . Three
years later, the researchers
found that only 38% of those getting baby
aspirin had new polyps, compared with 47%
of people getting placebos."
"In an unprecedented move," the New York
Times reported, Medicare plans to "give doctors—free of charge—software to computerize
their medical
practices.
. . . Medicare says
the lack of electronic
records is one of the biggest
impediments to improving health care. . . .
Given Medicare's heft, the
software giveaway could
transform American medicine,
said Dr. John Wasson, a
Dartmouth health-care
researcher. But, Dr. Wasson
added, it may take a
while. 'If you look at it
from a five-year point of view, it will make a
huge difference,' he said."
"Even after adjusting for age, health, and income differences among states, New Hampshire receives one of the lowest Medicare reimbursement rates in the country," wrote the Boston Globe. "New Hampshire gets an average of $5,400 per patient, while Massachusetts gets nearly $7,500. . . . Despite the smaller payments, New Hampshire patients are among the most likely to recover from serious illnesses and surgeries." To explain the apparent contradiction, the Globe quoted "Megan McAndrew, editor of the Dartmouth Atlas, a compilation of medical statistics. 'You don't have the duplication of services like you do in Boston. . . . More health care doesn't mean better health,' she said."
Vermont Public Radio reported on a study of
post-traumatic stress disorder (PTSD) that
was "designed to compare the effectiveness
of two very different therapies" in women
veterans, the reporter explained.
"Dartmouth researcher
Dr. Paula Schnurr is
one of the study's principal
investigators. . . . Schnurr
says because the core
symptoms of PTSD are the
same for women and men,
male combat veterans and civilians will benefit
from the research." (See the Summer
2005 issue for more on this study.)
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