[RESEARCH] Doctors' versus patients' global assessments of treatment effectiveness: empirical survey of diverse treatments in clinical trials
Objective To examine whether doctors’ global assessments of treatment effects agree with patients’ global assessments.
Design Survey of trials included in systematic reviews of treatments for diverse conditions.
Data sources Cochrane database of systematic reviews.
Data extracted Data on patients’ global assessments and on doctors’ global assessment for the same treatment against the same comparator.
Main outcome measures Relative odds ratio (ratio of odds ratios of global improvement with the experimental intervention versus control according to doctors compared with patients), and improvement rates according to doctors and patients.
Results Doctors’ global assessments were compared with patients’ global assessments for 63 different treatment comparisons (240 trials) in 18 conditions. The summary relative odds ratio across the comparisons was not significant (0.98, 95% confidence interval 0.88 to 1.08; I2=0%, 95% confidence interval 0% to 30%). In 62 of the 63 comparisons the effects of treatment rated by patients and by doctors did not differ beyond chance, but for single comparisons the confidence intervals were large. Rates of improvement on average did not differ between doctors’ assessments and patients’ assessments (summary relative odds ratio 0.98, 0.88 to 1.06; I2=0%, 0% to 24%).
Conclusion Doctors’ global assessments of the effects of treatments are on average similar to those of patients.
Many doctors aren't bothered when their patients can't lower cholesterol
Filed under: Prevention
Although you may be frustrated when your efforts to lower your cholesterol don't work, your doctor may not be. In a recent study of general and family practitioners there seemed to be a scary number of doctors who weren't surprised or frustrated when their patients were unable to get cholesterol levels down. 61% of doctors stated they don't feel frustrated when they are unable to lower cholesterol levels in their patients, despite understanding the severe health risks that go along with it. Are they not taking it seriously? Is it that they just don't expect their patients to take it seriously? Whatever the issue, make sure you have a doctor that takes a personal interest in you and your health.
Does your doctor take side-effects seriously?
Filed under: Drugs
A recent study has come up with some results that don't bode so well for doctors: it seems more often than not they "write off" concerns expressed by their patients regarding medication side-effects. The study included 650 adults who believed they were experiencing adverse drug reactions related to their cholesterol meds, and the majority of their doctors blew off the concerns and denied the possibility that the symptoms and the medications could be connected. This trend rings true even for the most commonly seen side-effects for the most commonly prescribed drugs -- what's up with that?The study wasn't designed to find out why this happened, just that it does. Some experts guess that it's simply because there are no laws (and no way to regulate) that doctors learn the side-effects of every medication they prescribe.
So I guess it's up to you, as the patient, to educate yourself and make sure you have a doctor who listens.
Stress!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Filed under: Prevention, Research, Stress
Did you know that between 60 to 90 percent of all doctors' visits are related to anxiety, insomnia, depression, obsessive anger and hostility, high blood pressure and heart attacks? It's true. And what is the common link among each of these issues listed? Stress!!!!!!!!!
Because stress signals your body to respond with surges of the hormones adrenaline and cortisol, blood pressure rises and your heart beats faster. We stress about our jobs, we stress about money, we stress about being stuck in traffic, we stress about stress! It becomes a vicious circle of stress begetting more stress, and it is a very damaging to our cardiovascular health.
How do we fix it? Some doctors suggest relaxing with meditation. Simply find a nice, quiet area to spend about 10 to 20 minutes breathing slow, deep and focused breaths. You can also repeat a word or sound, a mantra to help you drift off a bit in your mind.
I know what some of you must already be thinking: "Who has 10 to 20 minutes to waste sitting alone in a room?" Everyone's schedule is hectic (hence the stress in the first place) and time is a valuable commodity. But, 10 to 20 minutes? It's very do-able. First thing in the morning, middle of the day, before bed -- I'm sure the time is there somewhere. And, based on the research, these 10 to 20 minutes will not be wasted at all.
Reporting drug side effects - One click away!
Filed under: Type 1, Type 2, Childhood, Adult Onset, Drugs, Allie Beatty, Support, Personalities
A recent study found that 87% of patients who experienced an adverse symptom from a prescribed drug spoke to their doctor. However less than half of the doctors went through with filing the adverse event paperwork to notify the drug manufacturer. Why is this?
The research was published in the latest issue of Drug Safety. Doctors dismissed patients' complaints, and told them their symptoms were not connected to use of the drug. One doctor commented that the time it takes to complete the adverse event drug paperwork is time-consuming, and often not worth it unless it is life threatening. Would Hippocrates have accepted that answer? Please review your Hippocratic Oath, doc.
Your doctor is too busy to file the necessary paperwork to notify the FDA a drug is potentially harmful. What is a patient to do? Good question and here's an answer! If you experienced any adverse side effects from the use of a prescription drug, please let the FDA know. Click BEGIN and bring this monkey business to an end!
Read | Permalink | Email this | Linking Blogs | CommentsTest for congenital heart disease used immediately
Filed under: Research
The application of research into actual everyday practice is typically something that takes years to happen. Scientific findings are tested, re-tested, scrutinized, re-scrutinized, etc. But, a new diagnostic test to predict heart failure has gone into immediate clinical practice. This new test, which can help doctors evaluate cardiac function, looks for B-type natriuretic peptide (BNP) in patients, thereby giving doctors diagnose and treat congestive heart failure.
Published as an article in the February 2007 issue of Harvard Men's Health Watch, the information contained therein highlights the family of hormones to which BNP belongs, usually called natriuretic peptides. These particular type of peptides are the heart's natural line of defense that blocks stress, and also plays a crucial role in promoting proper circulation. They also lower blood pressure, promote urine excretion, relax blood vessels, and reduce the heart's workload. All in all, these peptides are a very good thing to have working.
What the doctors discovered during their most recent study of BNP is that an overload of this peptide in the blood stream could signal the early stages of congestive heart failure. This is because when people have congestive heart failure, they are often unable to pump blood efficiently, causing the heart chambers to swell with blood. As the heart cells are pushed past their normal size by the swelling, they produce extra BNP.
Scientists are now looking into the possible role of BNP in coronary artery disease. If a link is found, it will be interesting to find out if a related diagnostic test will be utilized as immediately as the test for congestive heart failure has been.
Permalink | Email this | Linking Blogs | CommentsSmall change may help in a big way
Filed under: Type 1, Type 2, Research
Sometimes change can come in the form of something mammoth in size, while other times it can appear as 
something simple. Regardless of the scale, it is the totality of the effect that change that matters most. And, insofar as smaller, simpler changes go, a recent classification of infections may have a profound effect on the future of diabetes complications.
This change comes as the result of a joint effort by several research groups, hailing from as far and as wide as Texas to the Netherlands. Publishing their landmark study on the classification of diabetic foot infections has validated and tweaked the Infectious Disease Society of America's already standing system of labeling infections as mild, moderate or severe. The doctors involved in the study see this study as having a dramatic impact on predicting hospitalization and amputation. Furthermore, it will assist doctors in communicating with their patients and guiding them most effectively through therapy.
For more information on this classification system, visit: www.diabetic-foot.net
[RESEARCH] Understanding help seeking behaviour among male offenders: qualitative interview study
Objective To explore the factors that influence help seeking for mental distress by offenders.
Design Qualitative study based on in-depth interviews with prisoners before and after release.
Setting One category B local prison in southern England.
Participants 35 male offenders aged 18-52, a quarter of whom had been flagged as being at risk of self harm.
Results Most respondents reported that they would not seek help from a general practitioner or other healthcare professional if experiencing mental distress. When followed up after release, none had sought medical help despite the fact that many had considerable emotional problems. Many participants were hesitant to seek help because they feared being given a formal diagnosis of mental illness. Some of these men feared the stigma that such a diagnosis would bring, whereas others feared that a diagnosis would mean having to confront the problem. Lack of trust emerged as the most prominent theme in prisoners' discourse about not seeking help from health professionals. Distrust towards the "system" and authority figures in general was linked to adverse childhood experiences. Distrust directed specifically at healthcare professionals was often expressed as specific negative beliefs: many perceived that health professionals (most often doctors) "just don't care," "just want to medicate," and treat patients "superficially." Those men who would consider going to a general practitioner reported positive previous experiences of being respected and listened to.
Conclusions Distrust is a major barrier to accessing health care among offenders. Like most people, the respondents in this study wanted to feel listened to, acknowledged, and treated as individuals by health professionals. By ensuring that a positive precedent is set, particularly for sceptical groups such as ex-prisoners, general practitioners and prison doctors may be able to encourage future help seeking. Information specifically designed for prisoners is needed to help to de-stigmatise mental illness, and preparation for release should include provision of information about access to health and social services. Awareness training for health professionals is recommended: trust might be fostered in this population by seemingly trivial gestures that indicate respect.
Medicare covers aortic ultrasound for those at risk of aneurysm
Filed under: Prevention, Research, Aging Heart Health
Approximately 15,000 Americans die each year from ruptured aortic aneurysms, making it the 10th most common 
cause of death in the U.S. Doctors assert that routine screenings are vital in early detection and treatment of aortic aneurysms, especially since the treatment itself is such an easy process. Involving an abdominal ultrasound, not at all unlike the painless ultrasound a pregnant mother may have performed, doctors are able to monitor the size of aneurysms. And now, making this early detection even more of a possibility, qualified Medicare patients will be able to receive screenings for aneurysms as part of their "Welcome to Medicare" physical exam.
Men 65 and older who are, or at one time were, smokers are eligible for the free screening, as are both men and women who have a family history of aortic aneurysms. These factors are of great importance, for it is possible to inherit genes making one more prone to aneurysms, and people who smoke or used to smoke are at an elevated risk. What's more, people who have high blood pressure and/or raised cholesterol levels are also at risk.
On average, men are four times more likely than women, especially men age 65 and older. For women, aneurysms are more likely to occur after the age of 75. But, as stated, smoking or a history of smoking and high blood pressure/cholesterol can factor into these averages.
For more information on the Medicare screening and eligibility, visit: http://www.vascularweb.org/patients/medicarescreening/index.html
Dr. Funny
Filed under: Type 1, Type 2, Childhood, Adult Onset, Opinion, Support, Personalities
Perhaps you feel the same way - but it's hard to catalogue the funny moments of life with diabetes. However the barometer sometimes registers off the chart when you mentally note the dialogue on doctor's visits.
I'd like to cite my newest friend (in my head) George, of the B.A.D Blog. He did an awesome blog on his doctor dropping a consoling F-bomb one day, after trying to explain erratic blood sugars to George. For those of you who are not familiar with the F-bomb...it is a four letter expletive. George's response was classic. He couldn't decide if that made his doctor cool or scary - but it did make him a little more human. George, like many of us, put doctors on an automatic pedestal akin to godlike.
Doctors, much like children, say the funniest things sometimes. It doesn't even have to be medically related - but when you ask a doctor something that is not related to their profession - you'll get a creative answer. Doctor's don't like to be wrong - but they'll give it their all before they admit defeat. I'd also like to thank George for the unrelenting entertainment.