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NEW YORK – Because quality measures intended to create patient-centered care are impractical, elitist, and ungrounded in the realities of most patients’ lives, physicians are forced to choose between being a failure, a bully, or both.

That’s according to Dr. Richard Young, director of research at the John S. Peters Health System in Fort Worth, Tex., and a speaker at the annual meeting of the North American Primary Care Research Group.

“The grand irony is that patient-centered care ... becomes a carrot-and-stick measurement system that incentivizes [doctors] to get what [they] want patients to do, not what the patients want,” Dr. Young said.

In a video interview, he also explains how borrowing “exception reporting” as practiced in the United Kingdom’s National Health Service would make the United States’ own quality measurement system more practical. Dr. Young also explains how physicians’ fear of missing quality measurement marks may lead them to avoid taking on the sickest and neediest of patients.

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On Twitter @whitneymcknight

NEW YORK – Because quality measures intended to create patient-centered care are impractical, elitist, and ungrounded in the realities of most patients’ lives, physicians are forced to choose between being a failure, a bully, or both.

That’s according to Dr. Richard Young, director of research at the John S. Peters Health System in Fort Worth, Tex., and a speaker at the annual meeting of the North American Primary Care Research Group.

“The grand irony is that patient-centered care ... becomes a carrot-and-stick measurement system that incentivizes [doctors] to get what [they] want patients to do, not what the patients want,” Dr. Young said.

In a video interview, he also explains how borrowing “exception reporting” as practiced in the United Kingdom’s National Health Service would make the United States’ own quality measurement system more practical. Dr. Young also explains how physicians’ fear of missing quality measurement marks may lead them to avoid taking on the sickest and neediest of patients.

[email protected]

On Twitter @whitneymcknight

NEW YORK – Because quality measures intended to create patient-centered care are impractical, elitist, and ungrounded in the realities of most patients’ lives, physicians are forced to choose between being a failure, a bully, or both.

That’s according to Dr. Richard Young, director of research at the John S. Peters Health System in Fort Worth, Tex., and a speaker at the annual meeting of the North American Primary Care Research Group.

“The grand irony is that patient-centered care ... becomes a carrot-and-stick measurement system that incentivizes [doctors] to get what [they] want patients to do, not what the patients want,” Dr. Young said.

In a video interview, he also explains how borrowing “exception reporting” as practiced in the United Kingdom’s National Health Service would make the United States’ own quality measurement system more practical. Dr. Young also explains how physicians’ fear of missing quality measurement marks may lead them to avoid taking on the sickest and neediest of patients.

[email protected]

On Twitter @whitneymcknight

SEATTLE – Desperate for help, many parents have tried treating infantile spasms and other childhood epilepsies with cannabidiol oils.

The Internet is full of parents’ testimonials that the marijuana extracts help. Although parents might be on to something, that won’t be known for certain until results are in from randomized, controlled trials about to get underway.

In the meantime, researchers at the University of California, Los Angeles, took a measure of the excitement in a recent anonymous survey of 117 parents.

In a video interview at the annual meeting of the American Epilepsy Society, Dr. Shaun Hussain, director of the infantile spasms program at UCLA and the study’s senior investigator, explained the survey findings and how to counsel parents pending randomized trial results.

[email protected]

SEATTLE – Desperate for help, many parents have tried treating infantile spasms and other childhood epilepsies with cannabidiol oils.

The Internet is full of parents’ testimonials that the marijuana extracts help. Although parents might be on to something, that won’t be known for certain until results are in from randomized, controlled trials about to get underway.

In the meantime, researchers at the University of California, Los Angeles, took a measure of the excitement in a recent anonymous survey of 117 parents.

In a video interview at the annual meeting of the American Epilepsy Society, Dr. Shaun Hussain, director of the infantile spasms program at UCLA and the study’s senior investigator, explained the survey findings and how to counsel parents pending randomized trial results.

[email protected]

SEATTLE – Desperate for help, many parents have tried treating infantile spasms and other childhood epilepsies with cannabidiol oils.

The Internet is full of parents’ testimonials that the marijuana extracts help. Although parents might be on to something, that won’t be known for certain until results are in from randomized, controlled trials about to get underway.

In the meantime, researchers at the University of California, Los Angeles, took a measure of the excitement in a recent anonymous survey of 117 parents.

In a video interview at the annual meeting of the American Epilepsy Society, Dr. Shaun Hussain, director of the infantile spasms program at UCLA and the study’s senior investigator, explained the survey findings and how to counsel parents pending randomized trial results.

[email protected]

SAN ANTONIO – In the FERGI trial, the combination of pictilisib and fulvestrant nearly doubled progression-free survival in a subset of patients with ER+/PR+ breast cancer, increasing the duration of response by almost 3 months, Dr. Eric Winer said at the San Antonio Breast Cancer Symposium.

But in the entire study cohort, the combination conferred no advantage over fulvestrant alone, with less than a 2-month survival advantage going to the combination therapy arm, said Dr. Winer of the Dana-Farber Cancer Institute, Boston.

The findings raise the question of whether pictilisib, a general inhibitor of the PI3 kinase pathway, confers any meaningful clinical results, especially in light of the excess of associated adverse events (31% with combined therapy vs. 20% with fulvestrant alone), according to Dr. Jennifer Litton of the University of Texas MD Anderson Cancer Center, Houston.

In this video interview, she shared her views on the study results, the drug’s mechanism, and its possible future – especially in light of the more effective and more selective PI3k inhibitors that are now in early clinical trials.

[email protected]

SAN ANTONIO – In the FERGI trial, the combination of pictilisib and fulvestrant nearly doubled progression-free survival in a subset of patients with ER+/PR+ breast cancer, increasing the duration of response by almost 3 months, Dr. Eric Winer said at the San Antonio Breast Cancer Symposium.

But in the entire study cohort, the combination conferred no advantage over fulvestrant alone, with less than a 2-month survival advantage going to the combination therapy arm, said Dr. Winer of the Dana-Farber Cancer Institute, Boston.

The findings raise the question of whether pictilisib, a general inhibitor of the PI3 kinase pathway, confers any meaningful clinical results, especially in light of the excess of associated adverse events (31% with combined therapy vs. 20% with fulvestrant alone), according to Dr. Jennifer Litton of the University of Texas MD Anderson Cancer Center, Houston.

In this video interview, she shared her views on the study results, the drug’s mechanism, and its possible future – especially in light of the more effective and more selective PI3k inhibitors that are now in early clinical trials.

[email protected]

SAN ANTONIO – In the FERGI trial, the combination of pictilisib and fulvestrant nearly doubled progression-free survival in a subset of patients with ER+/PR+ breast cancer, increasing the duration of response by almost 3 months, Dr. Eric Winer said at the San Antonio Breast Cancer Symposium.

But in the entire study cohort, the combination conferred no advantage over fulvestrant alone, with less than a 2-month survival advantage going to the combination therapy arm, said Dr. Winer of the Dana-Farber Cancer Institute, Boston.

The findings raise the question of whether pictilisib, a general inhibitor of the PI3 kinase pathway, confers any meaningful clinical results, especially in light of the excess of associated adverse events (31% with combined therapy vs. 20% with fulvestrant alone), according to Dr. Jennifer Litton of the University of Texas MD Anderson Cancer Center, Houston.

In this video interview, she shared her views on the study results, the drug’s mechanism, and its possible future – especially in light of the more effective and more selective PI3k inhibitors that are now in early clinical trials.

[email protected]

SEATTLE – To be safe, neurologists usually tell patients with psychogenic nonepileptic seizures to limit their driving as much as patients with confirmed epilepsy.

That might be an unnecessary restriction on their quality of life, however, according to a study from the Phoenix branch of the Mayo Clinic.

Epileptologist Dr. Kristine Ziemba, who conducted the study while a fellow at the Mayo Clinic, and is now a neurologist in St. Petersburg, Fla., explained why in a video interview at the annual meeting of the American Epilepsy Society.

[email protected]

SEATTLE – To be safe, neurologists usually tell patients with psychogenic nonepileptic seizures to limit their driving as much as patients with confirmed epilepsy.

That might be an unnecessary restriction on their quality of life, however, according to a study from the Phoenix branch of the Mayo Clinic.

Epileptologist Dr. Kristine Ziemba, who conducted the study while a fellow at the Mayo Clinic, and is now a neurologist in St. Petersburg, Fla., explained why in a video interview at the annual meeting of the American Epilepsy Society.

[email protected]

SEATTLE – To be safe, neurologists usually tell patients with psychogenic nonepileptic seizures to limit their driving as much as patients with confirmed epilepsy.

That might be an unnecessary restriction on their quality of life, however, according to a study from the Phoenix branch of the Mayo Clinic.

Epileptologist Dr. Kristine Ziemba, who conducted the study while a fellow at the Mayo Clinic, and is now a neurologist in St. Petersburg, Fla., explained why in a video interview at the annual meeting of the American Epilepsy Society.

[email protected]

SEATTLE– Surgery may cure, or at least greatly help, children with Lennox-Gastaut syndrome who have an abnormality on their brain MRI, according to researchers from the Cleveland Clinic Epilepsy Center.

LGS is a severe form of epilepsy that medications often do not help. Children have multiple seizures per day, with concomitant developmental problems. Until now, surgery has been considered only a palliative option. That may be about to change.

Investigator Dr. Ahsan Valappil, a pediatric epileptologist at the Cleveland Clinic, explained why in an interview at the annual meeting of the American Epilepsy Society.

[email protected]

SEATTLE– Surgery may cure, or at least greatly help, children with Lennox-Gastaut syndrome who have an abnormality on their brain MRI, according to researchers from the Cleveland Clinic Epilepsy Center.

LGS is a severe form of epilepsy that medications often do not help. Children have multiple seizures per day, with concomitant developmental problems. Until now, surgery has been considered only a palliative option. That may be about to change.

Investigator Dr. Ahsan Valappil, a pediatric epileptologist at the Cleveland Clinic, explained why in an interview at the annual meeting of the American Epilepsy Society.

[email protected]

SEATTLE– Surgery may cure, or at least greatly help, children with Lennox-Gastaut syndrome who have an abnormality on their brain MRI, according to researchers from the Cleveland Clinic Epilepsy Center.

LGS is a severe form of epilepsy that medications often do not help. Children have multiple seizures per day, with concomitant developmental problems. Until now, surgery has been considered only a palliative option. That may be about to change.

Investigator Dr. Ahsan Valappil, a pediatric epileptologist at the Cleveland Clinic, explained why in an interview at the annual meeting of the American Epilepsy Society.

[email protected]

SEATTLE – Epilepsy patients were significantly more likely to use opioid analgesics than were matched controls in a review of 2012 Accordant Health Services claims data.

Investigators matched 10,217 patients with epilepsy to 20,542 without epilepsy, based on gender, age, and insurance type. Cancer patients were among those excluded from the study. Based on prescriptions that were filled at least once, analgesic opioids were used by 26% of epilepsy patients versus 18% of controls (P < 0.001).

There was a significantly higher percentage of pain conditions in the epilepsy group, but diversion or other factors could also be at play, lead investigator Dr. Andrew Wilner, a neurologist with Angels Neurological Centers in Abington, Mass., explained at the annual meeting of the American Epilepsy Society.

The investigation is on-going. In the meantime, he said it’s a good idea to ask epilepsy patients about opioid use.

[email protected]

SEATTLE – Epilepsy patients were significantly more likely to use opioid analgesics than were matched controls in a review of 2012 Accordant Health Services claims data.

Investigators matched 10,217 patients with epilepsy to 20,542 without epilepsy, based on gender, age, and insurance type. Cancer patients were among those excluded from the study. Based on prescriptions that were filled at least once, analgesic opioids were used by 26% of epilepsy patients versus 18% of controls (P < 0.001).

There was a significantly higher percentage of pain conditions in the epilepsy group, but diversion or other factors could also be at play, lead investigator Dr. Andrew Wilner, a neurologist with Angels Neurological Centers in Abington, Mass., explained at the annual meeting of the American Epilepsy Society.

The investigation is on-going. In the meantime, he said it’s a good idea to ask epilepsy patients about opioid use.

[email protected]

SEATTLE – Epilepsy patients were significantly more likely to use opioid analgesics than were matched controls in a review of 2012 Accordant Health Services claims data.

Investigators matched 10,217 patients with epilepsy to 20,542 without epilepsy, based on gender, age, and insurance type. Cancer patients were among those excluded from the study. Based on prescriptions that were filled at least once, analgesic opioids were used by 26% of epilepsy patients versus 18% of controls (P < 0.001).

There was a significantly higher percentage of pain conditions in the epilepsy group, but diversion or other factors could also be at play, lead investigator Dr. Andrew Wilner, a neurologist with Angels Neurological Centers in Abington, Mass., explained at the annual meeting of the American Epilepsy Society.

The investigation is on-going. In the meantime, he said it’s a good idea to ask epilepsy patients about opioid use.

[email protected]

VANCOUVER, B.C. – Bleeding from uterine arteriovenous malformations was stopped with a combination of tranexamic acid, gonadotropin-releasing hormone agonist, and an aromatase inhibitor in a small case series in Canada.

The cocktail appears to be a safe alternative to uterine artery embolization and hysterectomy, which allows women to remain fertile, said Dr. Angelos Vilos, an ob.gyn. at Western University in London, Ontario, and the study’ lead investigator.

Dr. Vilos and his team used uterine tamponade to control bleeding, then gave the women oral tranexamic acid for 5 days. Patients also received a GnRH agonist – usually one injection of leuprolide – with oral letrozole for 5 days after the injection. In all cases, the arteriovenous malformations resolved within 3 months.

In a video interview at the AAGL meeting, Dr. Vilos said the approach could be a “game changer” if it holds up in future testing.

[email protected]

VANCOUVER, B.C. – Bleeding from uterine arteriovenous malformations was stopped with a combination of tranexamic acid, gonadotropin-releasing hormone agonist, and an aromatase inhibitor in a small case series in Canada.

The cocktail appears to be a safe alternative to uterine artery embolization and hysterectomy, which allows women to remain fertile, said Dr. Angelos Vilos, an ob.gyn. at Western University in London, Ontario, and the study’ lead investigator.

Dr. Vilos and his team used uterine tamponade to control bleeding, then gave the women oral tranexamic acid for 5 days. Patients also received a GnRH agonist – usually one injection of leuprolide – with oral letrozole for 5 days after the injection. In all cases, the arteriovenous malformations resolved within 3 months.

In a video interview at the AAGL meeting, Dr. Vilos said the approach could be a “game changer” if it holds up in future testing.

[email protected]

VANCOUVER, B.C. – Bleeding from uterine arteriovenous malformations was stopped with a combination of tranexamic acid, gonadotropin-releasing hormone agonist, and an aromatase inhibitor in a small case series in Canada.

The cocktail appears to be a safe alternative to uterine artery embolization and hysterectomy, which allows women to remain fertile, said Dr. Angelos Vilos, an ob.gyn. at Western University in London, Ontario, and the study’ lead investigator.

Dr. Vilos and his team used uterine tamponade to control bleeding, then gave the women oral tranexamic acid for 5 days. Patients also received a GnRH agonist – usually one injection of leuprolide – with oral letrozole for 5 days after the injection. In all cases, the arteriovenous malformations resolved within 3 months.

In a video interview at the AAGL meeting, Dr. Vilos said the approach could be a “game changer” if it holds up in future testing.

[email protected]

NEW YORK– Rather than relying on more obstetricians to practice in rural settings with limited access to maternity care, family physicians should be trusted to provide “excellent, quality care” to expectant mothers living in less populated areas – including delivering babies by cesarean section.

That’s the recommendation of Dr. Richard A. Young, director of research in family medicine at John Peters Smith Hospital, Fort Worth, Tex.

In a video interview at the annual meeting of the North American Primary Care Research Group, Dr. Young talked about the role family physicians can play in providing quality obstetrical care in underserved areas, and how they can collaborate with local obstetricians to ensure quality care even in complex cases.

[email protected]

On Twitter @whitneymcknight

NEW YORK– Rather than relying on more obstetricians to practice in rural settings with limited access to maternity care, family physicians should be trusted to provide “excellent, quality care” to expectant mothers living in less populated areas – including delivering babies by cesarean section.

That’s the recommendation of Dr. Richard A. Young, director of research in family medicine at John Peters Smith Hospital, Fort Worth, Tex.

In a video interview at the annual meeting of the North American Primary Care Research Group, Dr. Young talked about the role family physicians can play in providing quality obstetrical care in underserved areas, and how they can collaborate with local obstetricians to ensure quality care even in complex cases.

[email protected]

On Twitter @whitneymcknight

NEW YORK– Rather than relying on more obstetricians to practice in rural settings with limited access to maternity care, family physicians should be trusted to provide “excellent, quality care” to expectant mothers living in less populated areas – including delivering babies by cesarean section.

That’s the recommendation of Dr. Richard A. Young, director of research in family medicine at John Peters Smith Hospital, Fort Worth, Tex.

In a video interview at the annual meeting of the North American Primary Care Research Group, Dr. Young talked about the role family physicians can play in providing quality obstetrical care in underserved areas, and how they can collaborate with local obstetricians to ensure quality care even in complex cases.

[email protected]

On Twitter @whitneymcknight