Advertisement
ATS 2015

ATS 2015

New research was presented at ATS 2015, the American Thoracic Society’s annual meeting, from May 15 to 20 in Denver. The features below highlight some of the studies that emerged from the conference. Predicting COPD Exacerbation Readmissions The Particulars: Previous studies have found that the 30-day readmission rate following an acute exacerbation of COPD (AECOPD) can be as high as 23%. However, predictors of readmission after AECOPD have not been well established in clinical investigations. Data Breakdown: For a study, researchers used uni­variate analysis to identify predictors of 30-day readmission among patients hospitalized with a primary diagnosis of AECOPD. The authors found that low forced ejection fraction in 1 second (FEV1) and a history of depression independently predicted 30-day readmission. Take Home Pearl: Depression and low FEV1 appear to predict 30-day readmission following hospitalizations for AECOPD. E-Cigarette Use in Older Adults The Particulars: Elec­tronic cigarettes (e-cigar­ettes) are increasingly being used by smokers. However, data are lacking on the use of e-cigarettes in older Americans, those with smoking-related lung disease, or ethnic minorities. Data Breakdown: Researchers assessed e-cigarette use among more than 10,000 Caucasian and African-American current and former smokers with at least 10-pack years. Those who had tried e-cigarettes were significantly more likely to be current smokers, compared with those who had not. About 91% of e-cigarette users reported using them to cut down on tobacco cigarette use, but only 47% did so. COPD exacerbation and chronic bronchitis rates were similar among e-cigarette users and non-users. Take Home Pearl: E-cigarette use does not appear to reduce tobacco cigarette use or alter the progression of COPD. Detecting Lung Changes During...
Decision Aids & Difficult Choices

Decision Aids & Difficult Choices

With advance care planning, clinicians can help honor patient preferences and goals in cases of incapacitating illness or when injuries prevent adequate communication. These tools are designed to help prioritize treatment goals, but each person’s personal care goals will vary with regard to life-sustaining interventions. Some will prioritize living longer, whereas others may not wish to be kept alive when it is unlikely that they will have a meaningful recovery or better quality of life. Studies show that religious and spiritual values and beliefs may also affect goals of care. Research suggests that less than half of severely or terminally ill patients have advance directives in their medical record. Compounding the problem is that physicians are accurate only about 65% of the time when predicting patient preferences for intensive care. Decision aids for advance care planning support three key components of the process: 1) learning about anticipated conditions and options for care; 2) considering these options; and 3) communicating preferences for future care. “The type of decision aid that will be most useful for decision makers depends on the patient’s current health status and the predictability of illness trajectories,” says Mary Butler, PhD, MBA (Figure). For example, healthy people may benefit most from general decision aids that focus on choice-of-healthcare proxies and goals of care for hypothetical situations. For patients with life-threatening illnesses, decision aids may focus on decisions to accept, withhold, or terminate specific treatments. Analyzing Current Decision Aids In a review published in Annals of Internal Medicine that was commissioned as a technical brief by the AHRQ Effective Health Care Program, Dr. Butler and colleagues provided an...

The Cult of Dr. Oz Crumbles

We all saw Dr. Oz respond to his “critics”, the 10 doctors who petitioned Columbia Medical School for his resignation. He vowed to not stay silent and found fault with them, for their conflict of interest with GMO companies and criminal activities. Yet, he failed to respond to the more than 1,300 doctors polled on SERMO, the largest social network exclusive of physicians, who similarly called for him to step down and posed questions to him. Over the years, Dr. Oz promoted many scientifically questionable practices. One of these, a weight loss product that he sold for profit, caused him to appear before a Congressional hearing to defend his actions. He no longer sells these products because they have not proven effective. Yet, for all those who purchased these products under the false assumption that they work, they were ripped off with no hope of recovering their lost dollars. They were fooled by someone who was supposed to be a trusted medical expert. After responding to his “critics”, he stated that his show is not a “medical show”. Yet, on his show he dresses as a doctor and fields medical questions. The audience is under the assumption that they are addressing questions to a doctor. So, what would one call his show if not a medical show? “Do we want celebrity doctors who invent their own science? Or do we want those who promote real medicine?”   On his show, Dr. Oz has promoted the belief in communicating with deceased loved ones. He had a psychic medium appear on his show. He believes there are medical benefits to it,...
[ HIDE/SHOW ]