Medicine
Despite the existence of well-established guidelines for clinicians on applying effective smoking cessation interventions in practice, one in five adults in the U.S. continues to smoke. This fact has led researchers to explore other ways to motivate smokers to quit, such as using imaging technology to show them the personal consequences of tobacco use. In a randomized trial recently published in the Archives of Internal Medicine, researchers tested the "pictures are worth a thousand words" theory by comparing cessation rates between smokers who received standard therapy plus carotid plaque ultrasonographic screening to smokers receiving standard therapy alone. The results were uniformly disappointing. Even though 58 percent of smokers in the intervention group were found to have carotid plaques, there was no statistical difference in cessation rates between the groups after one year, and patients with plaques were not more likely to quit smoking than those with normal ultrasound results.
In an accompanying editorial, Dr. Patrick O'Malley called for a renewed emphasis on developing communication skills throughout medical training:
We rely too much on technology and testing that are misapplied to problems that really should be addressed with cognitive, emotion handling, and relationship-centered skills. We need a paradigm shift in priorities and incentives to shift from excessive reliance on technologies, a terribly wasteful practice, to training and cultivation of communication- and relationship-based skills that are likely much more effective in the psychosocial domains of care.
Here are my two take-home points for physicians and patients:
1) To help smokers quit, talking trumps technology.
2) Don't confuse cardiovascular imaging with preventive medicine.
**
Part of the above post was originally published on the AFP Community Blog.
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Enthusiasm for lung cancer screening has never been higher, following publication of the National Lung Screening Trial (NLST) report that heavy smokers who underwent 3 rounds of low-dose computed tomography (CT) screening were 20 percent less...
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- 4 Reasons To Not Be Screened For Lung Cancer
NOTE: A revised and updated version of this post, including my take on the July 29, 2013 U.S. Preventive Services Task Force draft recommendations for lung cancer screening, is available here. ** Lung cancer is the leading cause of cancer death in the...
- The Doctor Will "tweet" You Now
There’s a lot of evidence that to prevent many serious health conditions, including diabetes, obesity, heart disease, and stroke, making healthy lifestyle changes are just as good, if not better than, taking medications. Lifestyle changes may consist...
Medicine
Don't confuse cardiovascular imaging with preventive medicine
Despite the existence of well-established guidelines for clinicians on applying effective smoking cessation interventions in practice, one in five adults in the U.S. continues to smoke. This fact has led researchers to explore other ways to motivate smokers to quit, such as using imaging technology to show them the personal consequences of tobacco use. In a randomized trial recently published in the Archives of Internal Medicine, researchers tested the "pictures are worth a thousand words" theory by comparing cessation rates between smokers who received standard therapy plus carotid plaque ultrasonographic screening to smokers receiving standard therapy alone. The results were uniformly disappointing. Even though 58 percent of smokers in the intervention group were found to have carotid plaques, there was no statistical difference in cessation rates between the groups after one year, and patients with plaques were not more likely to quit smoking than those with normal ultrasound results.
In an accompanying editorial, Dr. Patrick O'Malley called for a renewed emphasis on developing communication skills throughout medical training:
We rely too much on technology and testing that are misapplied to problems that really should be addressed with cognitive, emotion handling, and relationship-centered skills. We need a paradigm shift in priorities and incentives to shift from excessive reliance on technologies, a terribly wasteful practice, to training and cultivation of communication- and relationship-based skills that are likely much more effective in the psychosocial domains of care.
Here are my two take-home points for physicians and patients:
1) To help smokers quit, talking trumps technology.
2) Don't confuse cardiovascular imaging with preventive medicine.
**
Part of the above post was originally published on the AFP Community Blog.
- Shared Decision-making For Lung Cancer Screening: Will It Work?
Earlier this month, the Centers for Medicare & Medicaid Services (CMS) officially proposed coverage for annual low-dose computed tomography (LDCT) screening for lung cancer in current or former smokers age 55 to 74 years with at least a 30 pack-year...
- Lung Cancer Screening: Understanding "relative Risk"
Enthusiasm for lung cancer screening has never been higher, following publication of the National Lung Screening Trial (NLST) report that heavy smokers who underwent 3 rounds of low-dose computed tomography (CT) screening were 20 percent less...
- Low-value Health Care: Coronary Ct Screening In Texas
Like many states, Texas is facing a fiscal crisis caused by decreased revenue from the economic recession and skyrocketing health care costs. Even without the expansion of publicly financed health insurance mandated by last year's health reform law,...
- 4 Reasons To Not Be Screened For Lung Cancer
NOTE: A revised and updated version of this post, including my take on the July 29, 2013 U.S. Preventive Services Task Force draft recommendations for lung cancer screening, is available here. ** Lung cancer is the leading cause of cancer death in the...
- The Doctor Will "tweet" You Now
There’s a lot of evidence that to prevent many serious health conditions, including diabetes, obesity, heart disease, and stroke, making healthy lifestyle changes are just as good, if not better than, taking medications. Lifestyle changes may consist...