JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. the Archives of Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF SURGERY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, February 18, 2008)
E-MAIL ACCESS MAY IMPROVE PATIENT-SURGEON COMMUNICATION
SURVIVAL RATES APPEAR TO DIFFER AMONG LEVEL I TRAUMA CENTERS
ARCHIVES OF OTOLARYNGOLOGY—HEAD & NECK SURGERY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, February 18, 2008)
ANTIBIOTICS NOT ASSOCIATED WITH SIGNIFICANT BENEFIT IN PREVENTING FLUID BUILDUP IN CHILDREN WITH EAR INFECTIONS
ARCHIVES OF DERMATOLOGY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, February 18, 2008)
EDUCATION PROGRAMS MAY BOOST TEENS’ KNOWLEDGE ABOUT ACNE
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 18, 2008
Media Advisory: To contact corresponding author Leigh Delbridge, M.D., F.R.A.C.S., e-mail: leighd{at}med.usyd.edu.au.
E-MAIL ACCESS MAY IMPROVE PATIENT-SURGEON COMMUNICATION
CHICAGO—Providing patients with e-mail access to their surgeon appears to improve communication without affecting patient satisfaction, according to a report in the February issue of Archives of Surgery, one of the JAMA/Archives journals.
"The fundamental basis of the physician-patient relationship has always been face-to-face communication. However, advances in communications technology have, from time to time, challenged that assumption," according to background information in the article. Although e-mail has been used worldwide to transform communication in various industries such as banking and retail, little has been published regarding its use in health care "other than dire warnings about the potential minefield of legal disasters and litigation that might accompany its use."
Peter Stalberg, M.D., Ph.D., of the Royal North Shore Hospital, Sydney, Australia, and colleagues studied 100 patients prior to undergoing thyroid or parathyroid surgery. Of those, 50 (average age 45.1) were assigned to receive an information sheet including the surgeon’s e-mail address and a statement informing them that the surgeon’s preferred method of communication was e-mail. Another 50 patients (average age 48.2) received an information sheet that did not include an e-mail address or statement about the surgeon’s preferred mode of communication. The surgeon’s e-mail address was available to both groups on the appointment card and a website. Researchers assessed patient communication with the surgeon outside of consultation as well as information provided on patient satisfaction questionnaires.
In total, 26 of 100 patients (26 percent) initiated additional communication with the surgeon around the time of operation, 19 of 50 (38 percent) in the group provided with e-mail information and 7 of 50 (14 percent) in the group not given e-mail information on the contact sheet. "Of those who initiated communication, 22 of 26 (84 percent) did so by e-mail; three (12 percent), by fax and one (4 percent), by telephone," the authors write. For patients using email, 18 of 22 (81 percent) were in the group provided with e-mail information, while four of the 22 (18 percent) were in the group that did not receive e-mail information on their contact sheet.
Most e-mails sent addressed one issue, while only a few addressed multiple issues, with the most issues being four in one e-mail. Some of the most popular issues raised by email were general information (21 e-mails), postoperative recovery (eight e-mails), results (five e-mails) and reassurance (four e-mails). There were no differences in patient satisfaction with communication between the two groups.
"People who use e-mail certainly would like to have e-mail access to their physicians," the authors conclude. "Despite the many concerns, we believe that this study shows that the provision to patients of readily available e-mail access to their surgeon provides a very effective means of improving communication prior to patients undergoing elective surgery."
(Arch Surg. 2008;143[2]:164-169. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 18, 2008
Media Advisory: To contact Shahid Shafi, M.D., M.P.H., call Connie Piloto at 214-648-3404.
SURVIVAL RATES APPEAR TO DIFFER AMONG LEVEL I TRAUMA CENTERS
CHICAGO—Trauma centers designated as level I may have significantly different results when treating patients with similar injuries, according to a report in the February issue of Archives of Surgery, one of the JAMA/Archives journals.
"Decades of concerted efforts by trauma professionals and patient advocacy groups have led to the development of trauma centers in most states," the authors write as background information in the article. "A critical component of these systems is the use of explicit criteria for the availability of personnel, equipment and services through the process of trauma center verification by the American College of Surgeons (ACS)." These criteria are based on structures and processes deemed essential for providing the best care.
Shahid Shafi, M.D., M.P.H., and colleagues at the University of Texas Southwestern Medical School, Dallas, analyzed data from 211,479 patients admitted to 47 level I trauma centers between 1999 and 2003. The patients were divided into three groups based on the severity of their injuries, assessed by a number of measures such as blood pressure and the presence or absence of shock. The average percentage of patients who survived was calculated for all trauma centers; survival rates from individual centers were then compared to this average.
The average survival rate was 99 percent for patients with mild injuries, 75 percent for those with moderate injuries and 35 percent for those with severe injuries. "For mild injuries, survival at five centers (11 percent) was significantly worse than that at their counterpart centers," the authors write. "With increasing injury severity, the percentages of outcome disparities increased (15 percent of centers for moderate injuries and 21 percent of centers for severe injuries) and persisted in subgroups of patients with head injuries, patients sustaining penetrating injuries and older (more than 55 years) individuals."
"These variations in outcomes may represent a substantial quality chasm in the delivery of trauma care," they continue. It is possible that the verification process may not specify all resources needed to provide optimal care, the authors note. For example, one previous study showed that the presence of a trauma and surgical critical care fellowship program improved outcomes at level I trauma centers, though it is not a criterion required for verification.
In addition, having all the necessary resources does not ensure they will be deployed adequately. "If confirmed, our preliminary data suggest that the logical next step for the trauma community is to move beyond focusing on personnel and processes and to start focusing on the outcomes achieved by the use of those resources," the authors conclude.
(Arch Surg. 2008;143[2]:115-119. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 18, 2008
Media Advisory: To contact senior author Maroeska M. Rovers, Ph.D., e-mail: m.rovers{at}umcutrecht.nl.
ANTIBIOTICS NOT ASSOCIATED WITH SIGNIFICANT BENEFIT IN PREVENTING FLUID BUILDUP IN CHILDREN WITH EAR INFECTIONS
CHICAGO—When prescribed to children with middle ear infections, antibiotics are not associated with a significant reduction in fluid buildup in the ear, according to a meta-analysis of previously published studies in the February issue of Archives of Otolaryngology—Head & Neck Surgery, one of the JAMA/Archives journals.
Ear infections are among the most common diseases in infants and children, according to background information in the article. Middle ear infections (acute otitis media) may lead to fluid buildup in the middle ear, a condition known as otitis media with effusion. "The effusion may lead to a conductive hearing loss of 15 decibels to 40 decibels, and this hearing loss could have an adverse effect on language development, cognitive development, behavior and quality of life," the authors write.
Laura Koopman, M.Sc., of University Medical Center Utrecht, the Netherlands, and colleagues analyzed data from 1,328 children age 6 months to 12 years with acute middle ear infections who participated in five randomized controlled trials comparing antibiotics to placebo or to no treatment. A total of 660 children were assigned to not receive antibiotics.
Overall, 44 percent of the children were younger than age 2 and 51.8 percent had recurrent ear infections. The risk of developing middle ear effusion was highest for children in these groups. Children taking antibiotics were 90 percent as likely to develop effusion as those who did not take antibiotics, but this difference was not statistically significant.
"Because of a marginal effect of antibiotic therapy on the development of asymptomatic middle ear effusion and the known negative effects of prescribing antibiotics, including the development of antibiotic resistance and adverse effects, we do not recommend prescribing antibiotics to prevent middle ear effusion," the authors write. The results align with current treatment guidelines, which do not recommend prescribing antibiotics to prevent effusion.
"However, more research is needed to identify relevant subgroups of children who have middle ear effusion that might benefit from other treatments," they conclude.
(Arch Otolaryngol Head Neck Surg. 2008;134[2]:128-132. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by the Dutch College of General Practitioners and by a grant from the Netherlands Organization for Health Research and Development. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 18, 2008
Media Advisory: To contact corresponding author Richard J. Antaya, M.D., call Jackie Weaver at 203-432-8555.
EDUCATION PROGRAMS MAY BOOST TEENS’ KNOWLEDGE ABOUT ACNE
CHICAGO—Both written handouts and computerized presentations with audiovisual components may be effective in teaching adolescents about acne, according to a report in the February issue of Archives of Dermatology, one of the JAMA/Archives journals.
Despite the number of teens with acne, substantial misunderstanding remains about its causes and treatment, the authors write as background information in the article. "Surveys of patients with acne in academic and community settings have revealed widespread misconceptions regarding acne’s pathogenesis, natural course and response to therapy," they continue. Surveys also indicate that many patients receive information about acne from television, parents, friends and magazines.
Phoebe E. Koch, M.D., of the Yale University School of Medicine, New Haven, Conn. and colleagues studied 100 teens age 13 to 17 who visited a private dermatology practice or one of three general pediatric clinics. Participants completed a brief questionnaire to assess their existing knowledge of acne, then were randomly assigned by coin toss to receive either the written (45 teens) or audiovisual presentation (35 teens). The teens took another quiz immediately following and one month after reading the handout or viewing the presentation. Both of the education tools focused on common misperceptions about acne and provided information about causes, factors that may exacerbate the condition and treatment options.
Teens in both the handout and computer groups scored higher on the acne knowledge test immediately after and one month following the intervention than they did during the initial assessment. There was no significant difference in scores between the groups either before or after the education session, suggesting that the two methods were equally effective.
"The results of our study support the notion that computerized audiovisual presentations serve as effective teaching tools in the clinic and may relieve the burden on busy health care providers," the authors write.
"The improvement in knowledge scores achieved by most participants, including those who had previously seen a physician for their acne, is consistent with previous research in suggesting there is room for improvement in acne education," they conclude. "Future studies could provide additional clarification regarding the specific combination of educational interventions that may be most effective and feasible in the setting of an outpatient clinic. In addition, future research could evaluate the effect that increased knowledge about acne might have on an adolescent population in terms of self-confidence, compliance with skin care regimen and, most notably, improved clinical outcomes."
(Arch Dermatol. 2008;144[2]:208-214. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported in part by a grant from the Children’s Clinical Research Center; the General Clinical Research Centers Program, Yale University Office of Student Research; the National Center for Research Resources, National Institutes of Health; and a clinical research fellowship from the Doris Duke Charitable Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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