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Wednesday, December 7, 2016

On Call by Casey Ross
Good morning! Here's the latest news on hospitals and health care. For more, follow @statnews on Twitter or like us on Facebook.

Just in: Med school is pushing students to the brink

Long hours. Crushing debt. Fierce competition.

New research published in JAMA shows the stresses of medical school are taking a hefty toll: 27 percent of students worldwide suffer from symptoms of depression, and 11 percent report thoughts of suicide.

“We were surprised by the high prevalence,” said study author Dr. Douglas Mata of Brigham and Women’s Hospital and Harvard Medical School. He said that those who screen positive for suicidal ideation are 100 times more likely to take their own life.

Depression rates in North America were far higher than in Europe. Mata noted that US students face a particularly high debt burden, often upward of $250,000, and urged medical schools to offer counseling and to relieve both the workload and the competition. 

“I’m a big proponent of going to pass-fail grading,” he said, noting that both Harvard and Baylor College of Medicine are making that switch. “It places more emphasis on learning for your patients and the sake of learning, and removes the superficial graded aspect.”

Read more.

Zag of the Day: Keeping a closer eye on cancer patients

Cancer research is a booming business. But because Phase 1 clinical trials typically involve drugs previously not tested on humans, they require intensive patient monitoring — and medical facilities aren’t always prepared for that level of oversight.

So the Smilow Cancer Hospital at Yale-New Haven recently unveiled the Phase I Clinical Trial Infusion Center, which now serves roughly 200 patients a week in more than three dozen trials. The roughly 6,000-square-foot facility features 11 semi-private infusion bays, one private room with a bed, and a dining lounge (key for patients and family members whose treatment days can span 12 hours). The nursing station faces the infusion rooms, to keep everyone in sight.

“We don’t know sometimes what these drugs can do to their bodies,” said Kathleen Moseman, who helps manage the infusion center. “Patients can change in a moment.”

Sponsor content by The Leukemia & Lymphoma Society

American Society of Hematology’s annual meeting highlights LLS’s Beat AML Master Trial

At the 58th ASH Annual Meeting and Exposition, Louis DeGennaro, Ph.D., The Leukemia & Lymphoma Society’s President and CEO, joined Kenneth Anderson, M.D., Dana-Farber Cancer Institute, and the three lead investigators of the Beat AML Master Trial to discuss this groundbreaking new clinical trial for acute myeloid leukemia, which aims to match the “right patient with the right drug.” Read more.

Are today’s doctors prepared to handle house calls?

By 2060, the number of patients over age 65 will double, to 98 million.

Caring for more people in their homes will help preserve access to care, but is the medical profession prepared to do such house calls?

In a First Opinion for STAT, Drs. Katherine T. O’Brien and June M. McKoy point out a number of critical gaps in training, such as management of urinary and feeding tubes, and treatment of infected wounds. It’s not glamorous work, but teaching it is crucial if house calls are to make a comeback.

Read more.

In praise of data keepers: A difficult search finds answers in Kansas City

Dr. Ashish Gupta of Cleveland was trying to study the best treatments for acquired aplastic anemia in pediatric patients. But the disease, which can lead to life-threatening complications, is exceedingly rare.

In Kansas City, he found his treasure trove: A database of cases from more than 45 children’s hospitals.

“Honestly, it’s a gold mine,” Gupta said of the database, known as Pediatric Health Information System, which is operated by the Children’s Hospital Association. It delivered to him 5,000 cases to examine from across the country.

From the data, Gupta eventually came to an important conclusion — that children struggling with the disease fared better when they got a bone marrow transplant as soon as possible. Currently, if a matched, related donor is not available, the standard of care is immunosuppressive therapy. But Gupta determined that transplants from even unrelated donors are giving patients a better chance.  "Children particularly tolerate transplants better than adults," Gupta said.

It remains to be seen whether that finding will lead better outcomes. But Gupta noted that having the data to help pry open the black box was a huge benefit. “You can see what happened with every single hospital admission, which is amazing,” Gupta said. “It really expands the options for your research.”   

Referrals

  • Pulled from a pond, a virus makes medical history (STAT)
  • Why doctors and hospitals are telling patients, ‘Show me the money!’ (Kaiser)
  • Dana Farber re-thinks strategy after ad appears on controversial Breitbart site (Boston Globe)
  • A lesson in life’s end for aspiring medical students (STAT)
  • Hospital groups say ACA repeal could cost billions (FierceHealthcare)

Have a news tip or comment you want to send me?

Send me an email
Stay well, and come back tomorrow.
Casey

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