What do you do if you have a CME activity planned, say, for tomorrow on breast cancer prevention and treatment, and a controversial new mammography guideline comes out that contradicts long-standing previous standards of care?

I’m sure most faculty worth their salt could and would be up on something like this soon after it hits the news, but it’s got to be a scramble. Do you add more time to the Q&A? Provide more followup? Get down on your knees and wail, “why me?” Just curious. It’s probably nothing to you all, but I’m just thinking about stories that change five minutes before the magazine goes to press and the angst that can cause, and thinking this is pretty analogous.

Pharma Gossip has put together a good list of clinical evidence sources that can be trusted. Are there any you would add?

OK, this is just too weird not to mention, though I doubt you’ll be developing CME activities around it any time soon: Blue Rats Walk Again. Yep, sounds like something called the Brilliant Blue G dye, when injected into rats very soon after a devastating spinal cord injury, gets them back on their feet. And turns them blue.

Kind of cute, isn’t he? Here’s a link to the actual research abstract: Systemic administration of an antagonist of the ATP-sensitive receptor P2X7 improves recovery after spinal cord injury.

Just caught a link to this NYT article on CME Linkages and thought, boy do these docs need CME: Disparities: Study Finds Risk in Off-Label Prescribing. Basically, the study said that the docs surveyed only knew the correct status of about half the drugs they were asked about. Here’s the scariest snippet:

Confusion was greatest with psychiatric drugs, the survey of some 600 doctors found. Nearly one in five who prescribed Seroquel (quetiapine) in the previous year thought it was approved for patients with dementia and agitation, even though it was never approved for this use and even carried a “black box” warning that it was dangerous for elderly patients with dementia. And one in three doctors who used lorazepam (often marketed as Ativan) to treat chronic anxiety thought it had been approved for this use; in fact, the F.D.A. warning advises against using it for this purpose.

So I have to ask, where are they getting their information? It sure isn’t from accredited CME.

Google just launched PLoS Currents: Influenza. The site is designed to allow researchers to share the latest research on influenza. From the Google blog:

PLoS Currents: Influenza, which we are launching today, is built on three key components: a small expert research community that PLoS is working with to run the website; Google Knol with new features that allow content to be gathered together in collections after being vetted by expert moderators; and a new, independent database at the National Center for Biotechnology Information (NCBI) called Rapid Research Notes, where research targeted for rapid communication, such as the content in PLoS Currents: Influenza will be freely and permanently accessible. To ensure that researchers are properly credited for their work, PLoS Currents content will also be given a unique identifier by the NCBI so that it is citable.

To enable contributions to PLoS Currents: Influenza to be shared as rapidly as possible, they will not be subject to in-depth peer review; however, unsuitable submissions will be screened out by a board of expert moderators led by Eddie Holmes (Center for Infectious Disease Dynamics, Pennsylvania State University) and Peter Palese (Department of Microbiology, Mount Sinai School of Medicine).

While the contributions won’t be peer-reviewed, the hope is that the researchers will submit their work to peer-reviewed journals as well, and also publish their findings on the site.

That’s how one doctor describes a kiosk that dispenses generics in his office, according to this article. Well, it’s an interesting way to get generics samples into docs hands, anyway.

This is the best healthcare news I’ve heard in a while: Reversing Trend, Big Drop Is Seen in Breast Cancer (link is to the New York Times, but this news is everywhere). From the article:

Rates of the most common form of breast cancer dropped a startling 15 percent from August 2002 to December 2003, researchers reported yesterday.



The reason, they believe, may be because during that time, millions of women abandoned hormone treatment for the symptoms of menopause after a large national study concluded that the hormones slightly increased breast cancer risk.

For a great discussion of this issue, and some quibbling with the numbers used by the New York Times, visit Dr. Charles.

From Anne Taylor-Vaisey: Last week I wrote about the series of 16 articles published in Health Research Policy and Systems on improving the use of evidence in guideline development.��The last articles in�the series have been published and you can read about them here.

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Around this time of year I always look forward to the publication of the BMJ Christmas issue. The 2006 issue isn‘t out yet, but, for your viewing pleasure, here are some links to issues of Christmases past.

Nearly 8 million people are tuning into a surgical webcast site out of Hartford, Conn., according to this article. While doctors are using the site to get CME, more and more patients also are tuning in:

“Doctors have less and less time to get trained, less and less time to get their continuing medical education credits so the original idea was that we would create an online community where they could come and get trained,” said Peter Gailey, who co-founded the webcast company.



“The great surprise has been the value to consumers,” he said. “The growth on our web site has been very strong on the consumer side as more people go online to get information about their health care.”

This article from the Washington Post details the recent guilty plea from Pearson “Trey” Sunderland III, who was chief of the Geriatric Psychiatry Branch of the National Institute of Mental Health. From the article:

Sunderland, 55, admitted to entering consulting agreements with the drugmaker beginning in 1998 without receiving the required approval in advance or disclosing his income after the fact. Sunderland was paid as a consultant on two projects in which his department was collaborating with Pfizer on research to identify chemical warning signs of Alzheimer’s disease.