Wednesday, August 27, 2008

Medication errors

A nice brief piece from NPR's Day to Day today, discussing outpatient medication errors--touches particularly on patient education and doctor/patient communication as key to addressing the issue.
Painkillers, sleeping pills and anti-anxiety drugs are being prescribed to out-patients in high doses, without the oversight of a doctor. A new study found that in the last 20 years there has been a 500 percent increase in the death rate from medication errors made at home. Medical contributor Dr. Sydney Spiesel discusses the data with Alex Chadwick.


Monday, August 11, 2008

July JMLA case

The latest JMLA case, Addressing Hemolysis in an Infant Due to Mother–Infant ABO Blood Incompatibility, is available in the July issue of the journal.

The question that this case focuses on: Is [intravenous immunoglobulin G] a safe and effective alternative to exchange transfusion in a premature infant with hemolysis and hyperbilirubinemia secondary to ABO incompatibility, who has failed phototherapy?

See the full-text of the case for definition of the medical terms, discussion of the search, and an analysis of the literature on this topic!

Adoption of electronic medical records

This week's MedlinePlus podcast from the National Library of Medicine covers data about provider and patient perceptions and adoption of EMRs; Rob Logan PhD is filling in for Dr Lindberg this week. The transcript of the podcast is here and the MedlinePlus topic page on EMRs is here.


Friday, August 08, 2008

Learning about qualitative research in today's BMJ

This week's British Medical Journal includes several great overview/tutorial pieces about aspects of qualitative research:

- Ayelet Kuper, Scott Reeves, and Wendy Levinson. An introduction to reading and appraising qualitative research. BMJ 2008;337:a288

- Ayelet Kuper, Lorelei Lingard, and Wendy Levinson. Critically appraising qualitative research. BMJ 2008;337:a1035

- Scott Reeves, Ayelet Kuper, and Brian David Hodges. Qualitative research methodologies: ethnography. BMJ 2008;337:a1020

- Scott Reeves, Mathieu Albert, Ayelet Kuper, and Brian David Hodges. Why use theories in qualitative research? BMJ 2008;337:a949

- Brian David Hodges, Ayelet Kuper, and Scott Reeves. Discourse analysis. BMJ 2008;337:a879

- Lorelei Lingard, Mathieu Albert, and Wendy Levinson. Grounded theory, mixed methods, and action research. BMJ 2008;337:a567


Monday, August 04, 2008

Search challenge 11

This month's topic: What information (online or print) and support resources are available for children with wheat allergy and their parents?

Post your suggestions in the comments and come back on Tuesday Sept. 2 for more discussion!


Search challenge 10: strategies

Search challenge 10 examines the issue of how to decide on appropriate screening practices for breast cancer in a young woman whose grandmother developed breast cancer at a relatively young age.

A search that incorporates the main "components" of the question might look something like:
("Breast Neoplasms/diagnosis"[Majr] OR breast neoplasms/genetics[majr]) AND (inherited[tiab] OR familial[tiab] OR high risk[tiab] OR family history[tiab] OR grandmother[tiab] OR pedigree[tiab] OR second degree[tiab] OR heredity[tiab] OR hereditary[tiab]) AND (age factors[mh] OR risk[mh] OR predictive value of tests[mh] OR sensitivity and specificity[mh]) AND (diagnostic imaging[majr] OR mass screening[majr]) AND english[la] AND humans[mh] NOT (case reports[pt] OR letter[pt] OR comment[pt] OR editorial[pt])

A few good articles on the topics, drawn from PubMed and a Google search:

Claus EB, Risch N, Thompson WD. Autosomal dominant inheritance of early-onset breast cancer. Implications for risk prediction. Cancer. 1994 Feb 1;73(3):643-51. PMID: 8299086

Kriege M, Brekelmans CT, Obdeijn IM, Boetes C, Zonderland HM, Muller SH, Kok T, Manoliu RA, Besnard AP, Tilanus-Linthorst MM, Seynaeve C, Bartels CC, Kaas R, Meijer S, Oosterwijk JC, Hoogerbrugge N, Tollenaar RA, Rutgers EJ, de Koning HJ, Klijn JG. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer. Breast Cancer Res Treat. 2006 Nov;100(1):109-19. Epub 2006 Jun 22. PMID: 16791481

Kriege M, Brekelmans CT, Boetes C, Besnard PE, Zonderland HM, Obdeijn IM, Manoliu RA, Kok T, Peterse H, Tilanus-Linthorst MM, Muller SH, Meijer S, Oosterwijk JC, Beex LV, Tollenaar RA, de Koning HJ, Rutgers EJ, Klijn JG; Magnetic Resonance Imaging Screening Study Group. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med. 2004 Jul 29;351(5):427-37. PMID: 15282350

NCCN practice guidelines in oncology: Breast cancer risk reduction, 2008. Vol. 1,

NCCN practice guidelines in oncology: Breast cancer screening and diagnosis, 2008. Vol. 1,

NCCN practice guidelines in oncology: Genetic/familial high risk assessment: Breast and ovarian, 2008. Vol. 1,

Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, Morris E, Pisano E, Schnall M, Sener S, Smith RA, Warner E, Yaffe M, Andrews KS, Russell CA; American Cancer Society Breast Cancer Advisory Group. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007 Mar-Apr;57(2):75-89. Erratum in: CA Cancer J Clin. 2007 May-Jun;57(3):185. PMID: 17392385

Smith RA, Saslow D, Sawyer KA, Burke W, Costanza ME, Evans WP 3rd, Foster RS Jr, Hendrick E, Eyre HJ, Sener S; American Cancer Society High-Risk Work Group;American Cancer Society Screening Older Women Work Group; American Cancer Society Mammography Work Group; American Cancer Society Physical Examination Work Group; American Cancer Society New Technologies Work Group; American Cancer Society Breast Cancer Advisory Group. American Cancer Society guidelines for breast cancer screening: update 2003.CA Cancer J Clin. 2003 May-Jun;53(3):141-69.PMID: 12809408

Yu J, Park A, Morris E, Liberman L, Borgen PI, King TA. MRI screening in a clinic population with a family history of breast cancer. Ann Surg Oncol. 2008 Feb;15(2):452-61. Epub 2007 Nov 17. PMID: 18026801