Clinical Information Support

[Harrison]

One of the challenges being an editor for this site is selecting and aggregating the hundreds of articles that may be helpful to patients. Generally, I seek the “scientific” articles or studies, but even these may conflict with each other…as you’ve seen. It’s very frustrating.

We’ve also discussed the value of “peer-reviewed” articles, as we all strive for the most authoritative information we can find. This was a nice discussion from a while back:
Suggestions for critical paper/presentation review .

Lest we forget, the turf wars continue in all aspects of medical publishing. Yesterday, I noted a particularly incendiary article in the WSJ which raises some interesting points. Though Avandia was the focal point of contention, you will see the relevant problems the author describes in yesterday’s op-ed section, Journalistic Malpractice.

Despite these shortcomings, you patients have fulfilled a critical role in helping us all by asking questions, offering ideas and constructive opinions. Keep up the good work – it helps people near and far!

[Harrison]

If you read the WSJ article, the NEJM was mentioned. In this month's issue of the NEJM, there are a few interesting articles; here are the abstracts:

Surgery versus Prolonged Conservative Treatment for Sciatica

This randomized trial of 283 patients with 6 to 12 weeks of severe sciatica compared early microdiskectomy surgery with a strategy of prolonged conservative treatment with eventual surgery if needed. Patients who had early surgery reported faster recovery and more rapid improvement in leg pain. After 1 year, the outcomes in the two groups were similar, and 95% of the patients in both groups reported recovery.

Treatment of Lumbar Degenerative Spondylolisthesis

This clinical trial compared surgical treatment with nonsurgical treatment of spondylolisthesis. Because of extensive patient crossover, the data were essentially nonrandomized, and as-treated analyses were performed. During 2 years of follow-up, patients treated surgically had greater improvement in pain and function than those treated nonsurgically. Patients treated nonsurgically showed moderate improvement over time.

http://content.nejm.org/this_week/356/22/index.shtml

BTW: Subscriptions to the NEJM are not terribly expensive. But if you want the articles, I'd be happy to email them to you.

[jeffdanto]

If you'd like, I can email anyone the full content of the NEJM articles. I get them for free through school right now. Guess that's one of the perks of grad school!

Also, given that I'm going to school for Health Information Systems, and since Tricia and I are now in Chicago and are surrounded by numerous Health Agencies (AMA, HIMSS, AMIA, etc), there are plenty of people to talk to, and I may be able to get another perspective on the ADR/lack of insurance coverage topic from someone in the industry, if you'd like.

Feel free to let me know by sending me a message about the additional perspective, or the NEJM articles.