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Infant Deaths Higher Among Deprived Communities And Ethnic Minorities
Rates of infant death remain high in parts of England, largely among deprived communities and ethnic minorities, finds a study published on bmj.com today.
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Washington Post Examines Lobbying Efforts Of Health Information Technology Industry
The Washington Post on Saturday examined the role of the Healthcare Information and Management Systems Society in lobbying for the national adoption of health information technology as part of health reform efforts. According to the Post, HIMSS has collaborated with various allies, including technology vendors and research groups, "in a sophisticated, decade-long campaign to shape public opinion and win over Washington"s political machinery."HIMSS in the early part of this decade forged a "strategic alliance" with the Center for Information Technology Leadership, a not-for-profit health IT research group in Massachusetts, to develop and distribute data reports on the cost efficiency and benefits of health IT, the Post reports. CITL also had sponsorship ties with several health and technology companies, including Google, Microsoft, Kaiser Permanente and Siemens Medical Solutions. In 2004, CITL issued a report that concluded in part that a national health IT system could reduce spending by as much as $77.8 billion by limiting drug prescribing errors and notifying providers of more cost-effective drug alternatives.According to the Post, the findings of the report were used by the Obama administration in developing the $787 billion federal economic stimulus package, which included billions in new spending for the creation and adoption of health IT systems. Although a Congressional Budget Office report found that the assumptions of CITL report were "overly optimistic" -- a follow-up CBO analysis projected that electronic health records would reduce health care spending by $17 billion over 10 years -- the health IT measures in the stimulus package "represented a triumph" for HIMSS, "whose members now stand to gain billions in taxpayer dollars," the Post reports. The Post notes that HIMSS" "sudden success shows how the economic crisis created a remarkable opening for a political and financial windfall: the enactment of a sweeping new policy with no bureaucratic delays and virtually no public debate about an initiative aimed at transforming a sector that accounts for more than a sixth of the American economy" (O"Harrow, Washington Post, 5/16).Please note: The Kaiser Family Foundation is not associated with Kaiser Permanente or Kaiser Industries.
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Experts Call On Colleagues To Drive Optimal Care For All Post-Mi Patients In The UK
Today experts from the Primary Care Cardiovascular Society (PCCS) and HEART UK - the Cholesterol Charity, are calling upon primary care clinicians to embrace new guidance designed to support optimal care and treatment of post-myocardial infarction (MI) patients. Published in the latest issue of the British Journal of Cardiology, the guidance is unique as it is aligned to both patients and primary care, thereby recognising the vital role of empowering patients and their families in achieving the best possible clinical outcomes.2
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Researchers Compare Different Systems Of Measuring Treatment Intensity In Hypertension Care

It is known that more intensive management of hypertension can improve blood pressure control and thus improve cardiovascular outcomes. However, there are several different systems of measuring the intensity of management of hypertension, and they have not been previously compared. If one system performs best, it would be important to use it to measure intensity of management for research and quality improvement purposes. Researchers from Boston University have compared different measures of treatment intensity in hypertension care and have found that one of the measures should be preferred to the others. This study, which appears in the July issue of Circulation: Cardiovascular Quality and Outcomes, shows that the measure originally described by Okonofua, et al. (Hypertension, 2006) predicts blood pressure control more effectively than the other two measures studied. Eight hundred nineteen hypertensive outpatients were characterized with three different scores to measure treatment intensity over time. The first examined whether a patient had any-or-none medication increases. The second approach was a norm-based method, which models the chance of a medication increase at each visit and then scores each patient based on whether they received more or fewer medication increases then predicted. The third approach was a standard-based method, which is similar to the norm-based method, but expects a medication increase whenever the blood pressure is uncontrolled. The researchers compared whether these three scores could predict the final systolic blood pressure and discovered that the any-or-none medication increase and the norm-based measure did not predict blood pressure, and, therefore are not valid measures of treatment intensity. However, they did find that the standard-based measure was an excellent predictor of blood pressure control. "The norm-based method did not predict systolic blood pressure in a linear fashion. Further investigation revealed a U-shaped relationship between the norm-based score and systolic blood pressure," said lead author Adam Rose, MD, MSc, assistant professor of Medicine at BUSM and investigator at the Bedford VA Medical Center. "In contrast, the standard-based score was an excellent predictor of the final blood pressure, both in the overall population and in every subgroup that was examined. Many research and quality improvement efforts already measure or are proposing to measure treatment intensity in the care of chronic conditions, including diabetes, hypertension and hyperlipidemia." This study is important to researchers who measure treatment intensity in the care of chronic conditions and healthcare systems that wish to measure treatment intensity for quality improvement or pay for performance programs. This study suggests that, at least with regard to hypertension care, the standard-based score should be the preferred measure. This study was funded by the National Institute of Health. Allison Rubin Boston University Medical Center


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