Oransky: Find sources with outside perspective
AHCJ Treasurer Ivan Oransky, M.D., who’s also the executive editor of Reuters Health and a teacher at NYU, stopped by Ed Yong’s “Not Exactly Rocket Science” blog to offer his tips for finding sources when reporting on studies.
Oransky writes that the key is to focus on a source that provides outside perspective, not just on a source that provides an opposing viewpoint. Sometimes, Oransky says, that outside perspective will simply reinforce what the study’s authors have said. And there’s nothing wrong with that.
He also gives practical directions for finding knowledgeable sources, with specific suggestions both for reporters on deadline and for those who have the luxury of reporting things out a little.
Survey looks at use of leftover pain meds
One in five people in Utah have been prescribed pain medication in the past year, according to new figures from the Morbidty and Mortality Weekly report from the Centers for Disease Control and Prevention.
While the survey only takes into account the use of pain medications in Utah, the CDC notes that “This percentage is comparable to the 18.4% of insured persons aged ≥18 years who reported receiving a prescription for opioids in a national study in 2002.”
The report says that deaths in Utah as a result of “poisoning by prescription pain medications” increased nearly 600 percent from 1999 to 2007. It also looks at the problem of leftover medication and people using medications not prescribed to them:
An estimated 72% of respondents who were prescribed an opioid had leftover medication, and 71% of those with leftover medication kept it; during the same period, 97% of those who used opioids that were not prescribed to them said they received them from friends or relatives.
The state has set out some recommendations for health care providers aimed at reducing the availability of unused medications.
The data comes from the Behavioral Risk Factor Surveillance System, an on-going telephone survey system that collects information about health risk behaviors, preventive health practices and health care access. Utah is apparently the first state to include pain medication questions in the BRFSS, “although Kansas added a module of questions regarding chronic pain in 2005 and 2007 with one follow-up question asking how the pain was treated.”
New federal caregiver database full of holes
Filed under: Hot Health Headline, Public records, Tools
Tracy Weber and Charles Ornstein are still working with databases of disciplined caregivers, this time exposing gaping holes in the federal database released to hospitals on March 1 (LA Times version | ProPublica version). Weber and Ornstein trace the holes to a lack of reporting by state agencies, and mention California, South Dakota, New Hampshire, Alabama, Delaware, Ohio, Tennessee, Indiana as states whose database entries were demonstrably incomplete. Some states don’t even have a single disciplined caregiver showing up in the federal database even though scores of offenders are listed on those states’ own sites.
The omissions took federal health officials by surprise. Only last month, a spokesman for the agency that oversees the database told reporters that “no data is missing.” Another official said the agency had been “constantly” checking its data against state licensing board websites.
But Friday, the head of the Health Resources and Services Administration (HRSA) acknowledged that records were missing. She said her agency had launched a “full and complete” review to determine what is wrong and how to fix it.
The Department of Health and Human Services has reacted swiftly, Ornstein and Weber report. HHS boss Kathleen Sebelius sent U.S. governors a letter requesting that they identify and correct any holes in the federal database by June 1, at which point any states whose entries were not updated will be named and shamed in an HSS report. HHS will train state staff in compliance and audit the database to make sure everybody’s following the rules. States have, as of yet, not faced any penalties for failing to update the list over the preceding two decades.
Antidepressants don’t shorten disability leave
Kathleen Koster of Employee Benefit News reports on a newly released study which, Koster writes, found that “Even with antidepressant treatment, employee depression severity levels positively correlate with the length and cost of short term disability leave.”
The 34,000 patients whose data were studied were all “diagnosed with depression and treated with antidepressants.” Keep in mind that, in this context, STD refers to “short term disability” leave.
When compared to other chronic diseases’ effect on annual STD cost of patients, those associated with depressed individuals ($1,038 for patients with depression and $1,685 for the severely depressed) exceeded the STD costs for hypertension ($66), diabetes ($118), chronic obstructive pulmonary disease ($197), and rheumatoid arthritis ($851), based on estimates by a study by Carls et al. using the same data source standardized to the same year.
In terms of days lost, 18% of patients with depression used short-term disability leave, while only 7.2% of the matched control group took advantage of the leave. Depressed patients also took more than 30 absentee days, approximately four days more on average than among matched controls. Associated costs to these days off were also disparate, with $3,925 associated with depressed employees and $3,360 with the control group.
And, from the study’s abstract:
Among antidepressant users, medical costs were not statistically different for compliant versus noncompliant patients; drug costs were higher for compliant patients, primarily because of antidepressants’ costs.
CDC health overview: Diagnostic scans tripled
Filed under: Health data, Hot Health Headline, Studies
The CDC has released the 2009 version of Health, United States, their annual summary of health numbers and trends. It’s an epic heap of data; get the full PDF here.
For a 574-page, 10.22 MB government document, it’s surprisingly easy to navigate. There’s a table of contents, links and a nifty little feature which allows you to pull up a spreadsheet of the data from any chart or graph. In addition to the lead story on medical technology and scanning, the report includes 150 data tables. That’s a bit too much to summarize here, so we’ll settle for the CDC’s version of the highlights:
- … the rate of magnetic resonance imaging, known as MRI, and computed and positron emission tomography or CT/PET scans, ordered or provided, tripled between 1996 and 2007.
- The rate of adults aged 45 and over discharged from the hospital after receiving at least one knee replacement procedure increased 70 percent from 1996 to 2006 (26.5 per 10,000 population in 1996 to 45.2 per 10,000 in 2006).
- From 1988-1994 to 2003-2006, use of antidiabetic drugs among adults aged 45 years and over increased about 50 percent, and the use of statin drugs to lower cholesterol among this age group increased almost tenfold.
- The number of new organ transplantations per 1 million people increased 31 percent for kidney transplants (43.7 per 1 million in 1997 vs. 57.2 in 2006) and 42 percent for liver transplants between 1997 and 2006 (15.6 per 1 million in 1997 vs. 22.2 in 2006).
- Life expectancy at birth increased more for the black than for the white population between 1990 and 2007, thereby narrowing the gap in life expectancy between these two racial groups. Overall U.S. life expectancy in 2007 was 77.9 years.
- In 2007, 20 percent of U.S. adults were current cigarette smokers, a slight decrease from 21 percent in the previous three years. Men were more likely to be current cigarette smokers than women (22 percent vs. 17 percent).
- In 2005-2006, 30 percent of adults often or almost always had trouble sleeping in the past month.
- In 2007, 20 percent of adults 18 years and over had at least one emergency department visit in the past year, and 7 percent had two or more visits.
- The percentage of the population taking at least one prescription drug during the previous month increased from 38 percent in 1988-1994 to 47 percent in 2003-2006, and the percentage taking three or more prescription drugs increased from 11 percent to 21 percent.
Food Environment Atlas full of story ideas, data
Filed under: Health data, Hot Health Headline, Tools
The Food Environment Atlas, produced by the U.S. Department of Agriculture’s Economic Research Service, may be one of the best things to happen to folks who love maps and health statistics.
The folks at Daily Yonder have put together a little showcase of what the atlas can do, but it’s a testament to the Atlas’ astonishing depth that they’ve only scratched the surface. Want a county-by-county map of the relative price of low-fat milk versus sugary drinks? How about the percentage of households with no car that live more than a mile from the nearest grocery store or even the level of tax charged for salty vending machine snacks? No sweat!
With county-by-county information about food taxes, physical activity, socioeconomic characteristics, rates of diabetes and obesity and lots more, reporters should find a treasure trove of story ideas and data. And the data behind the application is available to download as an Excel file.
Jeff Porter, AHCJ’s resident data guru, says the site features “great underlying documentation and enough info to join up with any county-level data with the same geographic codes.”
The data for the map is collected from the CDC, the National Cancer Institute; the USDA, the National Farm-to-School Network and the Bridging the Gap Program at the University of Illinois at Chicago.
(Hat tip to John Hale at The Rural Blog)
Member news: New book; new Web site
“Open Government: Collaboration, Transparency, and Participation in Practice,” a new book published by O’Reilly media, was edited by AHCJ member Daniel Lathrop and Laurel Ruma. Lathrop is chief digital strategist for InvestigateWest.
Journalist Daniel Weintraub has launched HealthyCal.org, a nonprofit Web site focused on news about the health of Californians and their communities. The site is initially funded by the California Endowment and is staffed by contributing journalists and community members. Weintraub previously was a columnist and blogger at the Sacramento Bee.
Report measures health factors at county level
Filed under: Health data, Health policy, Public health, Studies, Tools
A county-by-county collection of reports set to be released tomorrow could be a good source for local data on a number of health factors. The County Health Rankings, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, is the first of what is expected to be an annual look at health within each state.
The rankings will “show how counties measure up within each state in terms of how healthy people are, how long they live, and how important factors affect their health, such as tobacco use, obesity, access to healthcare, education, community safety, and air quality,” according to a press release.
A Feb. 17 briefing will include experts representing public health, health policy, education, and business who are expected to discuss the rankings and ways that communities can become healthier. The briefing, which starts at 9:30 a.m. EST, will be webcast. You can RSVP for this event online and a link will be sent to those who RSVP as soon as it’s available. For those in Washington, D.C, the briefing will be at the Columbus Club at Union Station, 50 Massachusetts Ave. NE - you also will need to RSVP.
Speakers are expected to include:
- Risa Lavizzo-Mourey, M.D., M.B.A., President and CEO, Robert Wood Johnson Foundation
- David R. Williams, M.P.H., Ph.D., Norman Professor of Public Health, Harvard School of Public Health
- Patrick Remington, M.D, M.P.H., Associate Dean for Public Health, University of Wisconsin School of Medicine and Public Health
- Andrew Webber, President and CEO, National Business Coalition on Health
- Judith A. Monroe, M.D., FAAFP, State Health Commissioner, Indiana State Department of Health
- Donald Shell, M.D., M.A., Health Officer, Prince George’s County Health Department
(Full disclosure: The Robert Wood Johnson Foundation is one of a number of organizations supporting AHCJ’s educational efforts.)
Update
See how many news organizations have covered the rankings.
Doctors turn to ‘speed dating’ to find patients
American Medical News‘ Victoria Stagg Elliott outlines a Texas program called “Doc Swap,” which is a sort of speed dating for medical professionals and patients. A doctor and potential patient have five minutes to find out if they’re a good fit for each other before the rotation bell rings and they start the five-minute discussion over again with another partner. 
For Texas Health, it’s a “low-cost way to drive patients to affiliated physicians.” For physicians, even representatives say it’s “good marketing,” as they can net three or four new patients for just an hour’s worth of unpaid effort.
Elliot writes that it appears to be the first such event in the country, though less formal doctor-patient meet-and-greets are common. Physicians say it’s a good way to filter out patients who wouldn’t be a good fit for their practice and expertise, and to help direct patients to the right specialist from the start.
Firing patients
“Doc Swap” and its take on the doctor-patient relationship fit with a recent column on doctors “firing” their patients. Beck says it’s a common topic of discussion among doctors, and lays out the basic criteria for showing a patient the door.
The list of reasons is relatively short, according to medical associations: Patients who are chronically abusive, disruptive or drug-seeking may be asked to leave a practice. So might those who habitually miss appointments or refuse to pay reasonable bills. Failing to heed medical advice isn’t necessarily grounds for a split, but some doctors suggest that patients who won’t quit smoking, use illicit drugs or have potentially harmful habits (daily enemas, say) might be more comfortable in another practice.
The comments on a related blog post provide a few more physician perspectives.
Welcome to the newest members of AHCJ
AHCJ welcomes these new members:
- Wilson Lowrey, associate professor, University of Alabama; Tuscaloosa, Ala.
- Marilyn Nelson, independent journalist; Flagstaff, Ariz.
- Andrew Kimball, independent journalist; San Rafael, Calif.
- Shari Roan, staff writer, Los Angeles Times; Los Angeles
- Angilee Shah, independent journalist; Walnut, Calif.; @angshah
- Lee Bowman, correspondent, Scripps Howard News Service; Washington, D.C.
- Charlotte Schubert, senior editor and Washington correspondent, Nature Medicine; Washington, D.C.; @schubertcm
- Caroline Stetler, post graduate fellow, Investigative Reporting Workshop; Washington, D.C.; @carolinestetler
- Ada Alvarez, independent journalist; North Miami, Fla.
- Kris Hundley, staff writer, St. Petersburg Times; St. Petersburg, Fla.
- Christine Sexton, independent journalist; Tallahassee, Fla.
- Angie Best-Boss, independent journalist; New Palestine, Ind.
- Rachel Gotbaum, independent journalist; Jamaica Plain, Mass.
- Ted Agres, independent journalist; Laurel, Md.
- Cynthia Saver, independent journalist; Columbia, Md.
- Julie Andrews, health research editor, Bottom Line Health; New York
- Katherine Harmon, reporter, Scientific American; Brooklyn, N.Y.; @katherineharmon
- Deborah Wuest, independent journalist; Ithaca, N.Y.
- Lisa Benton, student, Ohio Center for Broadcasting; Columbus, Ohio
- Theresa Brown, independent journalist; Pittsburgh
- Ellen Meyer, managing editor, Skin & Aging; Chester Springs, Pa.
- Lorry Schoenly, independent journalist; Fairless Hills, Pa.; @lorryschoenly
- Kate Johnson, independent journalist; Montreal; @kjohnsonmed
- Anne Halloran, independent journalist; Seattle
- Shamane Mills, senior broadcast specialist, Wisconsin Public Radio; Madison, Wis.
If you haven’t joined yet, see what member benefits you’re missing out on: Access to more than 50 journals and databases, tip sheets and articles from your colleagues on how they’ve reported stories, conferences, workshops, online training, reporting guides and more. Join AHCJ today to get a wealth of support and tools to help you.
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Awards for Excellence in Health Care JournalismDeadline: Feb. 3
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- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
