Thursday, March 12, 2009

Health Headlines - March 12

Former NYC Health Chief Likely to Be Named as FDA Leader

Dr. Margaret A. Hamburg, a former New York City health commissioner, is likely to be nominated this week as President Barack Obama's choice to lead the U.S. Food and Drug Administration, The New York Times reports.

Hamburg, 53, would succeed Dr. Andrew C. von Eschenbach, who led the agency from 2005 until last January. The Obama administration was also expected to name Baltimore's health commissioner, Dr. Joshua Sharfstein, as Hamburg's chief deputy. Sharfstein led Obama's transition team for the FDA, the Times said.

Hamburg was appointed by former Mayor David N. Dinkins as acting city health commissioner in 1991 and became commissioner the following year. When former Mayor Rudolph Giuliani took office in 1994, she was asked to stay on the job. Under Hamburg's lead, a tuberculosis control program produced sharp declines in the incidence of the disease in New York, and child immunizations also rose, the paper reported.

Hamburg's selection was first reported Wednesday on the The Wall Street Journal's Web site, the Times said. "Peggy has a deep commitment to the public health and, while she appreciates the vital role of industry, will surely focus on what is best for the public," Dr. Harvey V. Fineberg, president of the Institute of Medicine, the medical arm of the National Academy of Sciences, told the Times.

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Doctor May Have Faked Data in Many Studies

A highly influential Massachusetts anesthesiologist may have fabricated results in at least 21 published studies, according to officials at Baystate Medical Center in Springfield.

Dr. Scott S. Reuben has published dozens of studies on the use of more than one type of drug to relieve post-surgical pain and speed recovery. This method, multimodal analgesia, is an important and emerging field of anesthesiology, the Boston Globe reported.

Last year, hospital officials launched an investigation of Reuben's work and identified 21 published papers over 13 years in which all or some of the data were fabricated. In many cases, "there was no clinical trial, because there were no patients," said Dr. Hal Jenson, Baystate's chief academic officer.

Several medical journals were notified about the investigation results, and they are in the process of retracting Reuben's papers, Jenson told the Globe.

If proven true, this may be among the largest and longest-running medical fraud cases, according to experts.

"This would be the largest research fraud in anesthesia," said Dr. Steven Shafer, editor of the journal Anesthesia & Analgesia.

"Doctors have been using [his] findings very widely. His findings had a huge impact on the field. The act of fabricating data is so difficult for me to comprehend. It's beyond my ability to imagine," Shafer told the Globe.

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Health Surveys May Be Skewed by Excluding Cell Phones

More than one in six American homes -- 17.5 percent of them -- had only wireless phones as of a year ago and that could be skewing telephone survey results for everything from political polls to product marketing and health surveys, the Associated Press reported Wednesday.

Major survey organizations, including the U.S. Centers for Disease Control and Prevention's National Health Interview Survey (NHIS), do not include wireless numbers when they conduct random-digit telephone surveys. In a 2007 survey using Census updates, the CDC found that cell-only households varied widely by state, sometimes within regions and between neighboring states, according to Stephen Blumberg, a senior scientist at the CDC's National Center for Health Statistics.

"We would expect that today, in 2009, the prevalence rates in every state have increased, perhaps by 5 percentage points or more. What we don't know is whether the rate of growth is the same in every state," Blumberg told the AP in an interview. The issue is important, because the NHIS updates and releases estimates for 15 key adult health indicators every three months, according to a CDC news release issued Wednesday about cell phone usage in the United States.

Blumberg told the AP that health surveys omitting cell-only respondents could, among other things, underestimate not only the number of smokers and binge drinkers, but also those who exercise regularly.

Oklahoma and Utah -- at 26 percent -- lead the country in going wireless, according to federal estimates released Wednesday, and that rate was at least 20 percent in nine other states Nebraska, Arkansas, Idaho, Iowa, Kentucky, New Mexico, Texas, South Carolina and Tennessee and the District of Columbia., the AP reported.

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Prostate Cancer Overdiagnosed in U.S.: Study

Overdiagnosis of prostate cancer is a problem in the United States, according to a study that found as many as 42 percent of prostate cancer tumors detected through prostate specific antigen (PSA) screening tests are too slow-growing to ever be a threat.

Researchers used three different models to analyze prostate cancer diagnosed in U.S. men ages 54 to 80 between 1985 and 2000. They found that between 23 percent and 42 percent of PSA-detected prostate cancers would otherwise not have been detected in the patient's lifetime, the Associated Press reported.

The study was published online Tuesday in the Journal of the National Cancer Institute.

Overdiagnosis of prostate cancer is a concern, because detecting an early tumor forces men to decide between watchful waiting, radiation, surgery, or hormone therapy. Some treatments cause side effects such as impotence and incontinence, which means that men with tumors that pose no threat may needlessly suffer treatment-related complications, the AP reported.

The study "reinforces the message that we are overdiagnosing prostate cancer," said Dr. Len Lichtenfeld of the American Cancer Society.

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U.S. Mental Health Care Gets Low Score

Mental health care services for adults in the United States received a D in a report card issued Wednesday by the National Alliance on Mental Illness (NAMI).

The advocacy group issued the same grade three years ago and said there hasn't been enough improvement to warrant a better score, CNN reported. In addition, state budget cuts threaten to further reduce mental health care.

"Ironically, state budget cuts occur during a time of economic crisis, when mental health services are needed even more urgently than before," Michael Fitzpatrick, NAMI's executive director, said in a statement. "It's a vicious cycle that can lead to ruin."

Since the last report card, 14 states improved their grade, and 12 states lost ground. Oklahoma improved from a D to a B, while South Carolina had the largest drop, from a B to a D, CNN reported.

About 25 percent of Americans suffer mental illness at some point in their lives, and mental illness is the greatest cause of disability in the United States, according to NAMI.

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