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Delivering the best care to the right patient at the right timePublic release date: 25-Jun-2013 [ | E-mail | Share ]
Contact: Sheila Galloro sgalloro@nmh.org 312-926-0735 Northwestern Memorial Hospital
Northwestern Medicine cardiac electrophysiologist publishes research on how to integrate personalized, evidence-based care so patients benefit
There are two popular models when it comes to delivering the best healthcare using evidence-based guidelines or applying personalized medicine. Each method has its own merits and drawbacks, but according to one Northwestern Medicine cardiologist, when the two theories are integrated the result is an optimal healthcare delivery model that is both less expensive and better for the patient.
"It should not be one or the other but instead a combination of both," said Jeffrey Goldberger, MD, an attending cardiologist and cardiac electrophysiologist at Northwestern Memorial Hospital and director of Cardiac Electrophysiology Research at Northwestern's Bluhm Cardiovascular Institute.
"My interest in evidence-based medicine and personalized medicine stems from my involvement in the problem the medical community has in identifying patients who are at risk for sudden cardiac deaths. Using the guidelines I outlined in my article, I think we can better treat patients with implantable defibrillators. Based on the research, we are clearly over treating some patients and not treating other patients who would benefit."
Goldberger's research was published in a June 25, 2013 article in The Journal of the American Medical Association (JAMA).
Evidence-based medicine dates back to ancient Greece but gained popularity in the 1990s. It consists of basing treatment on the body of clinical data and clinical trials available. Personalized medicine is tailoring medical treatment to the individual characteristics of each patient, focusing on a patient's family history, genetic testing, or other characteristics.
According to Goldberger, who is also a professor at Northwestern University Feinberg School of Medicine, physicians should not follow one theory over the other. Instead, they should bring in personalized medicine to treat those subgroups not helped using evidence-based guidelines, he said.
"For example, many physicians administer a thrombolytic, or clot-dissolving drug, when someone is having a heart attack because the clinical data show those drugs help most patients," Goldberger said. "However, for some older patients these drugs can cause a stroke, so it's best to use personalized medicine to determine the best treatment for these older patients."
"Cultivating a healthcare culture poised to explore these opportunities is critical, but it will entail active participation from a whole range of stakeholders, including physicians, insurers, regulators and healthcare organizations," Goldberger added. "By combining both theories, we have a real opportunity to deliver more precise treatments to the exact patient population who needs it."
In addition to his clinical practice and teaching, Goldberger is an editorial consultant and reviewer for more than 20 medical journals. His clinical interests include pacemakers, cardiac rhythm disorders, catheter ablation, implantable defibrillators and supraventricular tachycardia.
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Read Goldberger's full JAMA article: http://jama.jamanetwork.com/article.aspx?articleid=1691756
Northwestern Medicine is the shared vision that joins Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine in a collaborative effort to transform medicine through quality healthcare, academic excellence and scientific discovery.
To learn more about cardiac care at Northwestern Memorial, or to find a physician, visit the Bluhm Cardiovascular Institute website or call 312-926-0779.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Delivering the best care to the right patient at the right timePublic release date: 25-Jun-2013 [ | E-mail | Share ]
Contact: Sheila Galloro sgalloro@nmh.org 312-926-0735 Northwestern Memorial Hospital
Northwestern Medicine cardiac electrophysiologist publishes research on how to integrate personalized, evidence-based care so patients benefit
There are two popular models when it comes to delivering the best healthcare using evidence-based guidelines or applying personalized medicine. Each method has its own merits and drawbacks, but according to one Northwestern Medicine cardiologist, when the two theories are integrated the result is an optimal healthcare delivery model that is both less expensive and better for the patient.
"It should not be one or the other but instead a combination of both," said Jeffrey Goldberger, MD, an attending cardiologist and cardiac electrophysiologist at Northwestern Memorial Hospital and director of Cardiac Electrophysiology Research at Northwestern's Bluhm Cardiovascular Institute.
"My interest in evidence-based medicine and personalized medicine stems from my involvement in the problem the medical community has in identifying patients who are at risk for sudden cardiac deaths. Using the guidelines I outlined in my article, I think we can better treat patients with implantable defibrillators. Based on the research, we are clearly over treating some patients and not treating other patients who would benefit."
Goldberger's research was published in a June 25, 2013 article in The Journal of the American Medical Association (JAMA).
Evidence-based medicine dates back to ancient Greece but gained popularity in the 1990s. It consists of basing treatment on the body of clinical data and clinical trials available. Personalized medicine is tailoring medical treatment to the individual characteristics of each patient, focusing on a patient's family history, genetic testing, or other characteristics.
According to Goldberger, who is also a professor at Northwestern University Feinberg School of Medicine, physicians should not follow one theory over the other. Instead, they should bring in personalized medicine to treat those subgroups not helped using evidence-based guidelines, he said.
"For example, many physicians administer a thrombolytic, or clot-dissolving drug, when someone is having a heart attack because the clinical data show those drugs help most patients," Goldberger said. "However, for some older patients these drugs can cause a stroke, so it's best to use personalized medicine to determine the best treatment for these older patients."
"Cultivating a healthcare culture poised to explore these opportunities is critical, but it will entail active participation from a whole range of stakeholders, including physicians, insurers, regulators and healthcare organizations," Goldberger added. "By combining both theories, we have a real opportunity to deliver more precise treatments to the exact patient population who needs it."
In addition to his clinical practice and teaching, Goldberger is an editorial consultant and reviewer for more than 20 medical journals. His clinical interests include pacemakers, cardiac rhythm disorders, catheter ablation, implantable defibrillators and supraventricular tachycardia.
###
Read Goldberger's full JAMA article: http://jama.jamanetwork.com/article.aspx?articleid=1691756
Northwestern Medicine is the shared vision that joins Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine in a collaborative effort to transform medicine through quality healthcare, academic excellence and scientific discovery.
To learn more about cardiac care at Northwestern Memorial, or to find a physician, visit the Bluhm Cardiovascular Institute website or call 312-926-0779.
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
LOS ANGELES (Reuters) - A pneumonia outbreak is threatening hundreds of bighorn sheep in California's Mojave National Preserve, and wildlife officials said Monday they see no promising options for saving the state's biggest herd or protecting a nearby population in Nevada.
The disease is believed to have killed 20 bighorn sheep during the past month in the 1.6-million-acre (650,000-hectare) desert preserve, which lies 50 miles southwest of Las Vegas, National Park Service spokeswoman Linda Slater said.
"I suspect that many more are infected," Slater said, adding that the entire herd, numbering as many as 300 animals, is in danger. "The biologists seem to be very pessimistic."
Potential options under consideration include shooting some or all of the remaining members of the herd in a bid to prevent further spread of the disease, or continuing to monitor the situation and essentially let nature run its course, wildlife officials said.
"There really are no good options," Slater said.
Episodic waves of disease have thinned bighorn herds for years. Fewer than 100,000 sheep are believed to roam the rugged mountain slopes of the West today, compared with an estimated 1.2 million head that inhabited the region at one time.
A series of nine separate outbreaks across five western states, including Nevada, in the winter of 2009-2010 claimed roughly 1,000 bighorn sheep, prized as game animals for the prominent curled horns of the adult males, or rams.
The current outbreak is the most severe ever to hit the desert species of bighorn sheep in California, home to 5,200 head in roughly 60 herds across the state, said Steve Torres, a supervisor for the California Fish and Wildlife Department's investigations lab.
It was also the first to hit the Mojave National Preserve since it was established in 1994.
The infected bighorn herd, one of five groups in the Mojave preserve, is a "foundation" herd and one of California's healthiest, used to re-establish the species in other parts of the state, officials said. It also is the state's largest.
Tests have confirmed that at least five of the animals on Old Dad Mountain died from a strain of pneumonia carried by domestic sheep and goats that is usually fatal when transmitted to bighorn sheep, which have no natural defenses to the disease.
Nevada wildlife officials worry the disease could spread to their state's nearest herd, just 45 miles to the northeast, especially now that rutting season is beginning and males are known to wander as far as 100 miles from home.
But Nevada officials are hoping that an extreme hot spell in the forecast will tend to keep young rams close to their familiar water sources.
California's wildlife investigator Torres said another big jump in infections within the herd could come with the start of mating season next month.
(Additional reporting by Laila Kearney; Editing by Lisa Shumaker)
Astronaut wives were the "American royalty" of the 1960s, catapulted into the spotlight by their husbands, the Mercury Seven -- NASA's first astronauts.
But though they were seen smiling on the cover of "Life" magazine and drinking tea with Jackie Kennedy, things weren't always so peachy at home, says author Lily Koppel, who stopped by HuffPost Live on Monday to dish on her new book, The Astronaut Wives Club.
"There was very much a credo that the woman [I interviewed] have shared with me that was if you don't have a happy marriage, your husband is not going to have a space flight," she said. "So even when things weren't picture perfect at home, they had to look picture perfect on the cover of 'Life.'"
Also joining Koppel were several of the astronaut wives that she interviewed for her book. Sue Bean, the former wife of Alan Bean, said that her ex's missions took a toll on their marriage.
"After the lunar flight, I think sometimes the guys saw things a little bit differently. That type of experience can't help but change your outlook on the world, and we drifted apart," she said. "I became more independent and basically wanted him to not fly again. He flew two flights and backed up a third and I think that it probably wasn't a good idea to express my wishes because he loved doing what he did. There were other ladies that cared about him and I guess in the end it was more than our marriage could sustain."
Watch the clip above to hear more on what it's like being married to an astronaut.
Keep in touch! Check out HuffPost Divorce on Facebook and Twitter.
PRAGUE (AP) ? Czech Prime Minister Petr Necas announced Sunday that he will resign over a spy and bribery scandal involving his government.
Necas said he also will quit on Monday as chairman of his conservative Civic Democratic Party.
He has been under pressure to quit since police conducted raids all across the country this week and arrested eight people, including Necas' closest aide and the head of his office, Jana Nagyova. She was charged with ordering a military intelligence agency to spy on three people, including Necas' estranged wife.
Seven other people, including the current and former heads of the Military Intelligence agency and three former lawmakers of his party, were charged with bribery or misuse of power.
"I am aware of my political responsibility," Necas said.
His decision will end his three-party coalition government, which was created after the 2010 parliamentary election. But Necas said he hopes it can stay in power until a parliamentary election planned next year.
This is an optimal solution of the current situation," Necas said. Two coalition partners, the conservative TOP 09 party and the Liberal Democrats, agreed with that plan Sunday.
"We're obliged to do all we can for the government to continue," said Finance Minister Miroslav Kalousek, the deputy head of TOP 09.
That might not happen, however. It is up to the President Milos Zeman to select a new prime minister who would try to form a new government, and it is not immediately clear if he is ready to accept such a solution. The current coalition also doesn't have a clear parliamentary majority and governs with the help from independent lawmakers.
Early elections also are not easy to call because it would have to be approved by three-fifths of the 200 lawmakers, and the opposition does not have enough seats to force it.
The negotiations between the parties are expected to start immediately, and it is not clear how much time they will need to find a solution to the crisis.
Earlier this week, prosecutors said Nagyova was suspected of directing the alleged illegal surveillance without any authorization. In their explanation for the sweeping raids at government offices and other locations, they said Nagyova's motives were "purely private."
Necas announced earlier this week that he and his wife, Radka, have filed for divorce. Newspapers have speculated about an affair between him and Nagyova.
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Public release date: 25-Jun-2013
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