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Wednesday, May 11, 2016

Morning Rounds by Megan Thielking

Happy Wednesday, folks, and welcome to the Morning Rounds, where I bring you the news in science and medicine. 

STAT-Harvard poll finds Americans wary of fast-tracked drug approvals

Nearly 60 percent of Americans say they oppose changing government policy to allow fast-tracked FDA approval for some new drugs, according to a new STAT-Harvard poll. About half of the public echoes that same concern for new medical devices. Congress is pushing for new legislation that would allow accelerated FDA approvals in certain cases. The House passed that legislation, in the form of the 21st Century Cures Act, last July; the Senate is currently working on its own version. More findings from the poll — including Americans’ views on direct-to-consumer drug advertising — and analysis here from STAT’s David Nather and Sheila Kaplan.

Telemedicine is gaining steam in rural areas

More and more Medicare beneficiaries are using telemedicine to seek medical care and advice, though the practice is still only covered for patients living in rural areas where health care can be hard to reach. In 2013, there were 107,000 telemedicine visits made by Medicare beneficiaries, a 28 percent increase since 2003.

It’s still a small number of people: Only 1 percent of Medicare beneficiaries living in rural areas used a telemedicine visit in 2013. And though there's debate over who should pay for the visits, the practice may be garnering more interest from private insurers in the future. Half of US states have passed laws mandating telemedicine visits be reimbursed at the same rate as conventional doctor’s office visits. New data on the subject was just published in JAMA

House tosses around Obamacare alternative ideas

House Speaker Paul Ryan has promised a viable alternative to Obamacare, and today, if we’re lucky, a House hearing might bring more details about such a plan. The Energy and Commerce Committee meets this morning at 10 to talk about potential proposals to replace the 2010 law. The committee has said they’ll discuss how to keep patients happy with low costs and good plans that aren’t government-mandated.  

Lab Chat: A heart modeled after a patient's own

 

An irregular heart rhythm affects the heart. (Trayanova et al. Nature Communications)

This 3-D model of a patient’s own heart could help doctors provide tailored cardiac care. Researchers at Johns Hopkins created such models based on MRI scans of 41 heart attack patients who were about to have defibrillators implanted. Then, they used the models to predict which of those patients would actually go on to experience an arrhythmia, or irregular heartbeat. Here’s what lead author Natalia Trayanova of Johns Hopkins told me about the model, described in this morning’s Nature Communications.

What types of patients did you test the model on?

We are focusing on people who have structural heart disease, because with that, you get a lot of arrhythmia. These 41 patients ... were followed up for five to seven years. We were blind to this, we just received the scans. We created the models from the MRI scans, and we predicted which of the patients will go on to have an arrhythmia and which will not. If a patient had a positive virtual heart test, that patient had a four-fold higher arrhythmia risk than patients with a negative test.

What are the next steps?

We have to test this in a larger study, with many more patients in a clinical trial. Because we can predict which patients are at risk, we hopefully can predict which patients don’t actually need defibrillators. We also want to use it for different treatment scenarios, or for pre-procedure planning. Doctors could navigate the heart on the computer, making procedures shorter because they wouldn’t have to probe the heart during surgery.

Inside STAT: What literally eating your words does to the digestive tract

Tomorrow, the Washington Post's Dana Milbank is set to chow down on all 18 inches of his column predicting Donald Trump wouldn't get the Republican presidential nomination. That prediction, of course, turned out to be wrong, so Milbank's eating his words. But what will all that newspaper and ink do to his digestive system? STAT's Damian Garde investigates

Researchers mine EHRs to predict flu outbreaks 

Plucking data from the cloud could help health officials keep a closer eye on influenza outbreaks. A new method described in this morning’s Scientific Reports pulled treatment data from the electronic health records of more than 23 million patients. Then, researchers combined this data with historical patterns of flu outbreaks to create an algorithm to predict potential outbreaks. The authors of the new paper say the method was able to accurately predict the timing of flu season peaks, and also how many cases would crop up. It’s a tool similar to Google Flu Trends, a service which ended in August 2015.

Chronic use of some acid reflux drugs causes concerns

Long-term exposure to acid reflux drugs known as proton pump inhibitors — such as Nexium — could cause accelerated aging of blood vessels, finds a new study published in Circulation Research. When researchers dosed human endothelial cells, which line the inside of blood vessels, with PPIs they found that the drugs seemed to lower acid levels in those cells. The drugs didn’t affect the health of endothelial cells when used just for a few weeks, though. Rather, the researchers echo concerns laid out in previous research that using PPIs for years could increase a patient’s risk of serious cardiovascular problems.

What to read around the web today

  • CDC labs faced secret sanctions for mishandling bioterror germs. USA Today
  • Does zapping your brain increase performance? Scientific American
  • Eric Vilain and the intersex controversy. Nature

More reads from STAT

Thanks for reading! More tomorrow,

Megan

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