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Minority Diabetes Reports
Tuesday, February 28th, 2012
By Beth Fitzgerald, February 21, 2012 in Healthcare. Feb. 21, 2012.
For Dr. Joycelyn Elders — and other speakers — where you live is just as important as who you are
The wide disparities in health between black and white Americans are more a matter of place — where people live — than of race.
That was one of the recurring themes at “Taking Good Care: A History of Health and Wellness in the Black Community,” a day-long conference held at Rutgers-Newark last week.
It was sounded implicitly by former Surgeon General Dr. Joycelyn Elders, who delivered the 32nd annual Marion Thompson Wright lecture.
“Today we could all do more for our own health than all the medical discoveries in the past 100 years. We need to take care of our own health,” Elders urged.
And it was made explicitly by Dr. William F. Owen Jr., former president of the University of Medicine and Dentistry of New Jersey, in his talk, “My Genetic Code or My Zip Code: Which is More Important?” Read More
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Minority Diabetes Reports
Tuesday, February 28th, 2012
Springer Link: L. Qi, R. Nassir, R. Kosoy, L. Garcia, J. D. Curb, L. Tinker, B. V. Howard, J. Robbins and M. F. Seldin. DOI: 10.1007/s00125-012-2486-4. Feb. 10, 2012.
Abstract
Aims/hypothesis
Type 2 diabetes is more prevalent in African-Americans (AFAs) and Hispanic-Americans (HAs) than in European-Americans. We assessed whether continental admixture was correlated with diabetes risk in these high-risk groups.
Methods
We estimated the proportion of sub-Saharan African (AFR), Amerindian (AMI) and European admixture using 92 ancestry-informative marker genotypes in 16,476 AFA and HA women from the Women’s Health Initiative. Cox regression models were used to examine the association between admixture and diabetes risk, with and without accounting for socioeconomic status (SES) and adiposity measurements.
Results
AFR admixture was significantly associated with diabetes risk in AFA women when adjusting for entry age, neighbourhood SES and BMI or waist/hip ratio (WHR) (all
p < 0.0001). In HA women, AMI admixture had significant associations with diabetes risk that remained significant after adjustment for SES and BMI (all
p < 0.0005). In both AFAs and HAs, SES showed significant negative associations while BMI or WHR had significant positive associations with diabetes risk, with and without adjustment for genetic admixture.
Read More
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Clinical Trials
Tuesday, February 28th, 2012
Mortality Rates in Trials of Subjects With Type 2 Diabetes
Journal of the American Heart Association: Ebrahim Barkoudah, MD; Hicham Skali, MD, MSc; Hajime Uno, PhD; Scott D. Solomon, MD; Marc A. Pfeffer, MD, PhD.
Abstract
Background—In randomized controlled trials (RCTs) of subjects with type 2 diabetes mellitus, mortality rates vary substantially. We sought to examine the inclusion and exclusion criteria of these RCTs to explore relationships with mortality.
Methods and Results—MEDLINE database was searched from August 1980 through March 2011. Selection criterion included published RCTs of adults with type 2 diabetes mellitus of at least 1000 patients, reporting all-cause mortality and having follow-up duration of at least 1 year. Twenty-two trials were eligible. Annualized mortality rates were derived. Inclusion and exclusion criteria were tabulated for each trial. Trials were categorized in 4 groups according to annual mortality rates: <1, ≥1 to <2, ≥2 to <4, and ≥4 per 100 patient-years. The analysis cohort included 91842 patients and 6837 deaths. Mortality rates ranged from 0.28 to 8.24 per 100 patient-years. Patients enrolled in the highest mortality category were more likely to be older and had longer diabetes duration and higher blood pressure. The selection for hypertension was common in the low- as well as high-mortality trials. Although the mortality rates were higher in RCTs with prior cardiovascular morbidity, the selection for chronic kidney disease—defined by either higher serum creatinine or lower estimated glomerular filtration rate and/or the presence of proteinuria—was associated with the highest mortality rates. Read More
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Clinical Trials
Tuesday, February 28th, 2012
Cardiovascular Business: Written by Justine Cadet – February 22, 2012.
LAS VEGAS—Using a protocol-based remote monitoring program did not help to control the blood pressure or blood sugar of hypertensive and diabetic patients in the primary care setting, based on an e-session study at the annual Healthcare Information and Management Systems Society (HIMSS) conference. In addition to patient outcomes, the researchers found that the lack of integration and reimbursement caused a greater workload and cost burden.
“Simultaneous control of blood glucose and blood pressure is complex and difficult to achieve, but could help to improve outcomes with costly illnesses like diabetes and hypertension,” wrote lead authors Bonnie J. Wakefield, PhD, RN, research associate professor at Sinclair School of Nursing at the University of Missouri, and Richelle J. Koopman, MD, assistant professor of family and community medicine at the University of Missouri School of Medicine, both in Columbia. “Thus, the use of remote monitoring programs can shift some responsibility for patient management from the patient’s primary physician to other clinicians, such as nurses or pharmacists.” Read More
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Clinical Trials
Tuesday, February 28th, 2012
Govhealthit: Mary Mosquera – February 22, 2012.
The Agency for Healthcare Research and Quality wants to develop a searchable Registry of Patient Registries, which are databases that track the experience of individuals with diseases and conditions, to encourage collaboration and information sharing.
The registry will catalog patient registries in a model similar tohttp://clinicaltrials.gov/ ”>ClinicalTrials.gov, which lists trials of new therapies for research but does not require listing of patient long-term observational studies. By aligning with ClinicalTrials.gov, the new registry will reduce duplication and foster transparency.
Patient registries may be designed for various purposes, such as to observe the natural history of disease, examine comparative effectiveness or fulfill post-approval drug approval commitments, according to AHRQ in a Feb. 22 announcement in the preview section of the Federal Register. The public can comment on the proposal for 60 days. Read More
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Clinical Trials
Tuesday, February 28th, 2012
Bio-IT World By Ann Neuer February 21, 2012 | Imagine buying a new car or a new house but not knowing the price until the papers have already been drawn up and it’s time to sign on the dotted line. According to Christine Pierre, President of RxTrials, that’s exactly the situation investigative sites face as they attempt to negotiate budgets and contracts for clinical trials.
“The budget still comes so late in the study start up process for the site. We’ve been trying to address this for more than two decades, and here it is 25 years later, and we still are being asked to consider studies and go through site selection, the pre-site visit and regulatory process before we have the budget in front of us. It makes no business sense,” Pierre says. Read More
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Clinical Trials
Tuesday, February 28th, 2012
Future-Science: Paul Wicks – February 2012, Vol. 2, No. 2, Pages 125-127 , DOI 10.4155/cli.11.182 (doi:10.4155/cli.11.182)
‘Information (or data) wants to be free’ – so goes the mantra of hackers and data activists. In the past this meant computer geeks hacking into secure private networks to fulfill their own curiosity or liberate secret knowledge. Today, voluntary ‘data liberation’, as practiced by governments and corporations, is relatively commonplace and semiorganized groups with data freedom agendas, such as Wikileaks and Anonymous, have entered the mainstream consciousness.
For me, it feels increasingly challenging to delineate the margins where free data is good or bad. A highly networked, mobile-enabled popular uprising is considered a ‘revolution’ when it’s against an oppressive regime, but considered a ‘menace’ when it is a disenfranchised mob rioting in a western democracy. Bravely recorded videos of civilians attacked by autocratic regime military forces are essential in prosecuting crimes against humanity, but videos leaked from within a democratic military are a ‘threat to national security’. So while data itself may want to be free, we don’t always want it to be. And so, to clinical trials.
From a societal perspective, the requirement for any trials conducted in the USA to register on ClinicalTrials.gov can only be a good thing in preventing past sins, such as suppressing negative trials or changing end points. As the US government makes this data open, it also allows repurposing. For instance, PatientsLikeMe imports the complete dataset from ClinicalTrials.gov every night to let our membership know (free of charge) about the 30,000+ active trials for which they may be eligible. So far, so good. But what if even more clinical trial data were free? Read More
