Rating conflicts of interest at medical centers

The American Medical Student Association scorecard rates the conflict of interest policies at academic medical centers. The scorecard rates 151 medical colleges on such things as policies for accepting gifts and meals, consulting relationships and disclosure policies. Of the three Kentucky schools listed, the University of Kentucky College of Medicine rated a B, the University of Louisville School of Medicine a D and the Pikeville College of Osteopathic Medicine an F. They explain their methodology here.

NutritionData

I wanted to know the nutrition facts for McDonald's $1 sausage breakfast burrito, which I've been eating too often in recent days, and found what I needed at NutritionData:

Since its launch in 2003, Nutrition Data has grown into one of the most credible and useful sources of nutritional analysis on the Web. In July 2006, Nutrition Data was acquired by CondéNet, a digital publisher under the Condé Nast Publications umbrella dedicated to editorial excellence. Nutrition Data's continuing goal is to provide the most accurate and comprehensive nutrition analysis available, and to make it accessible and understandable to all.

The information in Nutrition Data's database comes from the USDA's National Nutrient Database for Standard Reference and is supplemented by listings provided by restaurants and food manufacturers. The source for each individual food item is listed in the footnotes of that food's analysis page. In addition to food composition data, Nutrition Data also provides a variety of proprietary tools to analyze and interpret that data. These interpretations represent Nutrition Data's opinion and are based on calculations derived from Daily Reference Values (DRVs), Reference Daily Intakes (RDIs), published research, and recommendations of the FDA.

While Nutrition Data cannot guarantee the absolute accuracy of every listing, we make every attempt possible to ensure the quality of our data.

Not coincidentally, I will be cutting back my breakfast burrito consumption.

Can you believe reporters when they write, "studies have shown"?

Stats.org deconstructs the phrase "studies have shown" in reporting on infants fed breast milk versus formula:

... in the increasingly overly-simplified, context-free world of reporting on health, the phrase “studies have shown” is often a formula for telling the reader what the reporter assumes has actually been shown.

Fixing publication bias

Ben Goldacre of Bad Science notes recent studies exposing publication bias:

The key issue is simple. In any situation, to make any kind of sensible decision about which treatment is best, a doctor must be able to take into account all of the available information. But drug companies have repeatedly been shown to bury unflattering data.

Sometimes they bury data which shows drugs to be actively harmful. This happened in the case of Vioxx and heart attacks, and SSRIs and suicidal thoughts. Such stories feel, intuitively, like cover ups. But there are also more subtle issues at stake, in the burying of results showing minimal efficacy, and these have only been revealed through the excellent investigative work of medical academics.

And says there are two quick fixes:

The first is obvious. Nobody should get ethical approval to perform a clinical trial unless there is a clear undertaking that the results will be published, in full, in a publicly available forum, and that the researchers will have full academic freedom to do so. Any company trying to silence academics should be named and shamed, and even attempting to do so should be a regulatory offence.

That’s the butch solution. But there is also a more elegant one, which is arguably even more important: a compulsory international trials register. Give every trial an ID number, so we can all see that a trial exists, they can’t go quietly missing in action, and we know when and where to look if they do.

U.S. National Library of Medicine Drug Information Portal

Their database helps you quickly find detailed and presumably trustworthy information on more than 12,000 drugs.

A visual medical dictionary and a cure for all diseases

ResearchBuzz writes about a new visual medical dictionary:

... enter a drug, disease, or therapy name. I tried shingles. I got two potential results — one for a disease and one for a drug (a vaccine). When I held my mouse over each word, I got a definition and some additional information. But even cooler is what I got on the right side of the screen.

The right side of the screen gives you a visual tree of medical terms related to the word you specified. Some of these words are WAY too general to be useful (like “pain”) but some of them are very specific. Each of the new items will also give you a definition and will branch out into its own tree of definitions.

The dictionary is from CureHunter, a company that offers "precision medical data mining." I know nothing about the company itself, but what it sells -- at $490 a year for an individual -- is intriguing:

CureHunter is the only fully integrated scientific search, data retrieval and analysis engine on the web that can read the entire US National Library of Medicine Medline Archive and automatically extract and quantify the evidence for successful clinical outcomes of all known drugs for all known human diseases.

I'm put off, though, by its search box on the home page. It says, "To find Cure enter Disease name." Yeah, right. If only a cure to all diseases was as simple as a Google search. The company does explain limitations to its methods on its frequently asked questions page.

MedWorm

 MedWorm says it collects medical information from more than 4,000 "authoritative data sources" via RSS, combines them, categorizes them and redistributes them in new feeds you can subscribe to for free. It was built by an IT engineer in the UK:

"I had been using RSS in the technology sector for my own personal use for some time when I began to realise that it could be of great benefit to some members of my family who are doctors. Since medical professionals are constantly in need of the latest information on medical research and the best methods of treatment, and are also usually overworked with little time to spare, RSS seemed ideal since it could provide the very latest information that is both concise and highly relevant to a specific area of expertise.

I set up MedWorm as a way of using my IT skills to give something back to society, having grown somewhat disheartened of making rich people richer working for big corporate companies. I believe that as more physicians, health care workers and those in medical research start to make use of RSS, medicine will see huge leaps forward as the flow of the right information getting to the right people vastly improves. It can also be instrumental in providing patients with the additional information they are rightly hungry for when faced with illness. I am very excited about how MedWorm can contribute to this process."

Military injury reports

Michael Ravnitzky pointed out on posting on FOI-L earlier this week that that you can get reports on military injuries on the Army Medical Surveillance Activity Web site. Although its an Army site, it includes Navy, Air Force and Marine reports too. "These statistics are not readily available anywhere else, so this is an important data resource," he wrote. There is in-depth information about how soldiers are injured, including the body parts most affected and eye-opening summaries such as the one for March 2007, which says that 47,671 of the 504,416 soldiers assigned to the Army - 9.5 percent - had an injury that required medical attention that month.

Kentucky Health Care Information Center

Kentucky's Health Care Information Center" provides both performance and outcome information on hospitals in Kentucky, as well as information about quality of care. "

A guide to statistical information at WHO

The World Health Organization an online guide to the 50 health indicators it collects on 192 member states.

Emerging Infectious Diseases

As if you didn't already have enough to worry about: You can read the Centers for Disease Control and Prevention's magazine, Emerging Infectious Diseases, online. One of the "expedited" articles on the site today is a letter on "Pandemic Influenza School Closure Policies." The letter, by a member of the research staff at the Program on Science and Global Security at Princeton University, says:

Although the United States is a nation dedicated to federalism, an uncoordinated approach for community response measures such as school closure decisions could jeopardize our efforts in containing a deadly pandemic. If schools were to remain open until a certain percentage of students and faculty became ill, as they do during typical influenza seasons, then control measures to contain the outbreaks would likely be far more difficult to achieve because a chain of transmission would be established.

DailyMed

The National Library of Medicine's DailyMed "provides high quality information about marketed drugs." "This Web site provides health information providers and the public with a standard, comprehensive, up-to-date, look-up and download resource of medication content and labeling as found in medication package inserts," the site says.

State Health Facts

State Health Facts from the Kaiser Family Foundation is "Your source for state health data," including data on Medicare prescription drug plans, a big issue in the news right now.

Pain.com

The mission of Pain.com, from the Dannemiller Memorial Educational Foundation, is "To be the premier educational and informational resource on the Internet for health care professionals and consumers who have an interest in pain and its management." Free, but registration required.

Kids Health

Depth Reporting was sick as a dog last week so he Googled "cure for the common cold" just to see what came up. The top result was this page from the site, Kids Health, which he hadn't heard of before: "KidsHealth is the largest and most-visited site on the Web providing doctor-approved health information about children from before birth through adolescence," the site says. "Created by The Nemours Foundation's Center for Children's Health Media, the award-winning KidsHealth provides families with accurate, up-to-date, and jargon-free health information they can use."

Medical podcasts from Johns Hopkins

Johns Hopkins broadcasts a free, weekly health and medicine podcast, 5 to seven minutes long, advertised as "a lively discussion of the week’s medical news and how it may affect you."

Report card on state doctor discipline Web sites

Public Citizen has released its 2006 ranking of state medical and osteopathic board web sites. It gives a score and details on what information is made public. The Kentucky Board of Medical Licensure ranked 24 out of 65 sites, while the Medical Licensing Board of Indiana ranked 58. Public Citizen also issues recommendations for each site.