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Monday, November 28, 2016

On Call by Casey Ross
Good morning!  Turkey hangover? Here's an infusion of news on hospitals and health care to get you back into the swing of things.  For another wake up call, try our basic bio quiz, drawn from 8th grade science tests. Tweet us your score @statnews.

Landmark law: Mental health reform may soon be coming

For the first time in a decade, mental health care in the United States is on the verge of a major overhaul.

On the table is the $6.3 billion 21st Century Cures bill, which establishes a federal assistant secretary for mental health and substance abuse, creates a federal lab to investigate the most effective treatments and supports jail diversion, among many other reforms.

The House is expected to vote on the bill Wednesday, and Senate leaders are pledging to act before year’s end.

The 1,000-page bill, which also delivers $1 billion to help states respond to the opioid crisis, is far from a panacea. Approving it will not immediately end reliance on emergency rooms to respond to the overwhelming needs of the mentally ill.

But the law — crafted in response to the Sandy Hook Elementary School shooting — represents rare progress on an issue that hasn’t received any meaningful attention from Congress in a very long time.

Just in: You’re never too old for a mammogram

It's a hotly debated question: What’s the right age to stop doing mammograms?

Today, the largest-ever study on that question concludes there should be no cut off: Women should keep getting tested into old age, based on their individual health status.

“The continuing increase of cancer detection rate and positive predictive values in women between the ages of 75 and 90 does not provide evidence for age-based mammography cessation," said the study’s author, Dr. Cindy Lee of the University of California, San Francisco.

Lee and her research team analyzed nearly 7 million screening mammograms performed over seven years. They found that the cancer detection rate gradually increased as patients aged from 40 to 90.

The findings will be presented today at the annual meeting of the Radiological Society of North America

New in education: Baylor teaches doctors to put genetics to good use

The use of genetic information to treat disease is generating a lot of hope in medicine. But first, doctors must know how to apply it to patients.

That’s why Baylor College of Medicine is starting a new residency program next summer that combines internal medicine with genetics. It is one of a handful of schools to start training doctors in the emerging field, which is still full of mysteries.

Residents and the program’s faculty are “almost going to have to create the field as they go on,” Dr. Ashok Balasubramanyam, Baylor’s interim chair of medicine, told STAT’s Andrew Joseph.  “The standards for diagnosing, the standards for matching the genetic data with the phenotype of the patient, are absolutely critical. And there are very few textbooks about that.”

So little is known about some mutations, for example, that doctors can falsely think they put patients at risk for diseases. Plus, environmental factors can outweigh what your genes suggest about your disease risk.

Pediatric medical genetics programs have existed for years to treat children with birth defects, intellectual disabilities, and metabolic diseases. But with more genetic data has come a better understanding of what that means for adult diseases, including certain cancers and heart problems.

As Dr. Brendan Lee, chair of molecular and human genetics at Baylor College of Medicine, puts it: “It turns out genetics doesn’t stop when you’re 18.”

Zag of the Day: It takes a village to reduce NICU admissions

Maybe a series of 15-minute visits over nine months is not the best way to get ready for childbirth.

You might have been saying that for years. But a prenatal care strategy by Boston-based Centering Healthcare Institute is generating fresh evidence to back it up.

Here’s how it works: Groups of 8 to 12 expectant mothers attend up to 10 sessions with caregivers on a variety of topics from labor and delivery to proper infant care and nutrition. Participants often form friendships in the process. Using the strategy among Medicaid patients in South Carolina reduced NICU admissions to 3.5 percent, compared to 12 percent in patients who received individual care, a new study shows.

“It creates a support structure for the women and gives clinicians a chance to really dive into these topics with their patients,” said Angie Truesdale, Centering’s chief executive. “And you get better prenatal care attendance.”

The study showed the program also saved a heap of money: Investment of $14,875 to enroll 85 women in the program cut NICU costs by more than $67,000. 

Referrals

  • Will hospitals soon be weighing in on nursing home quality? (NPR)
  • These hospitals failed to report patient deaths and injuries from medical devices (Boston Globe
  • Why you should listen to what your genes are trying to tell you. (Washington Post)
  • Donald Trump’s plans for Obamacare might end coal country's love affair with him. (STAT)

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

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Stay well, and come back tomorrow.
Casey

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