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Andrew E. Rosenberg, M.D.
University of Miami Health Service
William Westra, M.D.
Johns Hopkins Medical Institute
Cesar Moran, M.D.
The University of Texas MD Anderson Cancer Center
Has the time come for integration of radiology and pathology?
For years, certain pathologists and radiologists have floated the idea that an integrated diagnostic service involving both medical specialties could improve patient safety and contribute to improved patient outcomes. Now that the U.S. healthcare system is encouraging tighter integration of clinical services, advocates of an integrated diagnostic service involving radiology and pathology believe that the era of integrated diagnostics may be soon upon us.
Medical lab inspections questioned
Kristin Turner had warned her boss several times that the blood analyzer at Maryland General Hospital wasn't working properly. It would break down in the middle of testing; samples were cross-contaminated; lab technicians couldn't validate the machine to be confident it generated correct results. The machine was never fixed. On March 12, 2003, Turner used the analyzer to run tests for HIV and hepatitis C. There were about 88 patient samples on the analyzer that day, she remembers. Many of the samples were being analyzed to confirm a previous positive HIV test.
How doctors deliver bad news
The Wall Street Journal
Doctors are trying new ways of solving an old problem — how to break bad news, which is as much a staple of doctors' lives as ordering blood work and reviewing scans. One issue: Patients and their families, of course, aren't all going to respond in the same way. Research into the effectiveness of training doctors in how to deliver bad news has turned up mixed results, with patients often not noticing any benefit.
US science leaders to tackle ethics of gene-editing technology
The leading U.S. scientific organization, responding to concerns expressed by scientists and ethicists, has launched an ambitious initiative to recommend guidelines for new genetic technology that has the potential to create "designer babies." The technology, called CRISPR-Cas9, allows scientists to edit virtually any gene they target. The technique is akin to a biological word-processing program that finds and replaces genetic defects.
The new paradigm of healthcare delivery
ADVANCE for Laboratory Administrators
As a nation, our healthcare system is transitioning to a service mode, where there is more emphasis on value. The economic task for medical laboratories of the future is to think about how they can diagnose patients efficiently, providing the maximum benefit for the lowest cost.
Weak oversight allows lab failures to put patients at risk
Lab tests influence about 70 percent of medical decisions, guiding treatments big and small: How much blood thinner should a heart-attack patient receive? Does the baby need antibiotics? Should you start taking cholesterol-lowering medication? Even nonmedical tests can be life changing: employment drug screening, blood work for life insurance, paternity testing. The results need to be right.
We're about to enter a new era in medicine
We know more about how the human body works — how we live and die — than we ever have before. We've mapped the human genome, the blueprint that's largely responsible for who we are, and scientists are now able to sequence a person's individual genome for less than $1,000 — we can look at a person's genes and find their unique genetic makeup. In theory, this could provide doctors with an unprecedented amount of medical information about a patient.
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The new kind of clinical trial: It's personal
In recent years, various new types of diagnostics, trial designs and therapies have been developed that take patient individuality into account and have begun to yield some astonishing results. The drug ivacaftor, for example, was designed to treat a particular genetic variation of cystic fibrosis, oncologists now routinely use tumor genetics as a basis for cancer treatment regimes, and regenerative medicine is producing patient-specific implants for body parts ranging from windpipes to bladders.
Clinical genomic sequencing could impact treatment decisions in advanced prostate cancer patients
An international collaboration of researchers are advancing precision medicine to men with advanced prostate cancer. The researchers, led by Arul Chinnaiyan, M.D., Ph.D., and Charles L. Sawyers, M.D., co-leaders of the Stand Up to Cancer-Prostate Cancer Foundation Dream Team, sequenced the DNA and RNA of tumor biopsy samples from 150 men with metastatic castration resistant prostate cancer, an advanced cancer that has stopped responding to standard hormone-based therapies. This is the first major analysis of this common and aggressive type of cancer in a clinical context. The study is published in Cell.
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