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To find patients at highest risk, hospitals combine consumer data with clinical information
Big data is all the rage in healthcare these days. However, one interesting development in this field is how hospitals are integrating consumer data with clinical data to identify patients at high risk. For example, if the post-surgical heart patient buys a package of cigarettes, some hospitals say they want to know. This is a trend with interesting implications for clinical laboratories.
Risk to patients balanced against risk to labs as FDA moves on lab developed tests
Clinical Informatics News
In the nearly 40 years that laboratory developed tests have enjoyed a policy of "enforcement discretion," they have grown from a small but vital niche used mainly by hospital labs to diagnose rare diseases, to an industry where big players like Myriad Genetics and Genomic Health can post profits in the hundreds of millions of dollars.
Open Payments website launches
The federal government today launched a highly anticipated website detailing at least $3.5 billion in financial ties in a five-month period between medical device and drug companies and physicians and teaching hospitals. The Open Payments website is the first public repository of national data describing financial relationships between industry and healthcare providers. Critics of these payments say these payments can inappropriately influence clinical decisions.
Mandatory extended RAS testing for mCRC
Multiple subgroup analyses of randomized trials have suggested that patients who have "extended RAS" mutations (in exons 3 and 4 of KRAS and exons 2, 3, and 4 of NRAS) not only may not benefit from anti-epidermal growth factor receptor (EGFR) therapy but may potentially be harmed. Sorich MJ, Wiese, M.D., and colleagues conducted a systematic review and meta-analysis of such reported trials. Overall, nine trials of 5948 participants evaluated for both KRAS exon 2 and new RAS mutations met the inclusion criteria.
Graphene sensor tracks down cancer biomarkers
An ultrasensitive biosensor made from the wonder material graphene has been used to detect molecules that indicate an increased risk of developing cancer. The biosensor has been shown to be more than five times more sensitive than bioassay tests currently in use, and was able to provide results in a matter of minutes, opening up the possibility of a rapid, point-of-care diagnostic tool for patients.
Prescription for the angry patient: Communication
The Huffington Post
Anger is the human response to unmet needs or expectations. When patients enter a hospital, they expect good care and good communication, and they usually expect to leave the hospital in better shape than they were in when admitted. Unfortunately, any deviance in meeting needs or expectations can result in anger. To complicate things, healthcare providers typically add to this anger by failing to communicate with the patient regarding why expectations were not met. Providers literally throw fuel on the fire by failing to communicate.
Cancer genome sequencing will mean more targeted therapies
As the cost of DNA sequencing plummets, the possibility of testing all cancer patients' tumor genomes is becoming a reality. For just $1000 or so, a doctor might submit most any malignant specimen for a complete genetic work-up. The sample might be a core needle biopsy taken from a breast, a blood sample from a person with leukemia, or a snippet of a sarcoma removed in an operating room. In principle, checking a tumor for genetic changes should be straightforward, do-able. But most cancer patients undergo surgery and other treatment long before their doctors consider sending a biopsy for full molecular evaluation.
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