Chantix's Suicide Risk Makes It Unsuitable As First Line Smoking Cessation Drug

By Catharine Paddock, PhD
Medical News Today

A new study finds that the smoking-cessation drug varenicline (Pfizer's Chantix) has too poor a safety profile to make it suitable for first-line use. Researchers from Wake Forest Baptist Medical Center, and other research centers in the US, found the drug, known as Champix outside the US, was 8 times more likely to result in reports of suicidal behavior or depression than nicotine replacement products. They report their findings in the 2 November issue of PLoS One, an online journal of the Public Library of Science.

The findings contradict those of a recent review by the US Food and Drug Administration (FDA) that found varenicline, which already carries an FDA "black box warning", did not increase the risk of being hospitalized for psychiatric problems such as depression.

The entire story can be found here.

12 Are Charged in Medicare Fraud Schemes Said to Cost $95 Million

By Kirk Semple
The New York Times
City Room
Originally published November 2, 2011

Federal agents swarmed several medical clinics and homes in New York City on Wednesday, arresting 10 people on charges of running Medicare fraud schemes that bilked the government out of $95 million, federal officials said.

Another defendant charged in one of the schemes surrendered later to the authorities and a 12th defendant was still at large on Wednesday afternoon, the officials said.

The defendants included three medical doctors, a doctor of osteopathy and a chiropractor, the United States Department of Justice said in a news release.

The cases are part of an aggressive campaign by the Justice Department and the Department of Health and Human Services to combat the escalating problem of health care fraud. In 2007, a special team was formed to combat fraud in Medicare, the federal program that helps provide health care for older people.

The entire story can be read here.

Privacy and Security for EHR: US and EU Compared

PRIVACY AND SECURITY IN THE IMPLEMENTATION OF

HEALTH INFORMATION TECHNOLOGY (ELECTRONIC

HEALTH RECORDS): U.S. AND EU COMPARED

By Janine Hiller, Matthew McMullen, Wade Chumey, and David Baumer

Abstract

The importance of the adoption of Electronic Health Records (EHRs) and the associated cost savings cannot be ignored as an element in the changing delivery of health care. However, the potential cost savings predicted in the use of EHR are accompanied by potential risks, either technical or legal, to privacy and security. The U.S. legal framework for healthcare privacy is a combination of constitutional, statutory, and regulatory law at the federal and state levels. In contrast, it is generally believed that EU protection of privacy, including personally identifiable medical information, is more comprehensive than that of U.S. privacy laws. Direct comparisons of U.S. and EU medical privacy laws can be made with reference to the five Fair Information Practices Principles (FIPs) adopted by the Federal Trade Commission and other international bodies. The analysis reveals that while the federal response to the privacy of health records in the U.S. seems to be a gain over conflicting state law, in contrast to EU law, U.S. patients currently have little choice in the electronic recording of sensitive medical information if they want to be treated, and minimal control over the sharing of that information. A combination of technical and legal improvements in EHRs could make the loss of privacy associated with EHRs de minimis. The EU has come closer to this position, encouraging the adoption of EHRs and confirming the application of privacy protections at the same time. It can be argued that the EU is proactive in its approach; whereas because of a different viewpoint toward an individual’s right to privacy, the U.S. system lacks a strong framework for healthcare privacy, which will affect the  implementation of EHRs. If the U.S. is going to implement EHRs effectively, technical and policy aspects of privacy must be central to the discussion.

The entire .pdf can be found here.

Thanks to Ken Pope for this lead.

Children’s hospital loses personal info of 500,000 patients

wftv.com

In a potential security breach at Nemours Children’s Health System, officials say they have lost the personal information of thousands of Florida patients.

Company officials say the patient information was being stored in a filing cabinet at a facility in Delaware. Officials said inside the cabinet were nonpassword protected computer backup tapes containing the personal and financial information of 500,000 Florida patients.

The whole story and video can be found here.

DSM 5 Against Everyone Else

By Allen Frances, M.D.

Psychology Today Blog

Allen Frances, MD

So far, opposition to DSM 5 has been expressed by the following organizations: British Psychological Society; American Counseling Association; Society for Humanistic Psychology (APA Division 32); Society for Community Research and Action: Division of Community Psychology (APA Division 27); Society for Group Psychology & Psychotherapy (APA Division 49); Developmental Psychology (APA Division 7); UK Council for Psychotherapy; Association for Women in Psychology; Constructivist Psychology Network; Society for Descriptive Psychology; and the Society of Indian Psychologists.

An editorial by the Society Of Biological Psychiatry wondered whether DSM 5 was necessary at all. The community of personality disorders researchers is virtually unanimous in its opposition to the DSM 5 personality disorders section. There has also been widespread opposition to the sections on somatic, autistic, gender, paraphilic, and psychotic disorders.

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Strikingly, there seems to be virtually no support for DSM 5 outside the very narrow circle of the several hundred experts who have created it and the leadership of the American Psychiatric Association (APA) which stands to reap large profits from its publication. There is no group and precious few individuals outside of APA who have anything good to say about DSM 5. And even within the DSM 5 work groups and the APA governance structures, there is widespread discontent with the process and considerable disagreement about the product.

The entire blog can be accessed here.

Ghost Writing Persists in Major Medical Journals

By Robert Preidt
MedicineNet.com

Honorary and ghost authors were involved in 21% of articles published in six leading medical journals in 2008, which shows that this type of inappropriate authorship remains a problem, a new study says.

Honorary authors are people named as authors despite not making a substantial enough contribution to take responsibility for the research. Ghost authors are people who play a major role in the research or who participate in writing the article, but are not named as authors.

The lack of transparency and accountability associated with both types of inappropriate authorship has been a concern for decades, according to the study authors.

The entire report can be read here.

The original article concludes:

"Ensuring appropriate authorship remains an important issue for authors, academic and research institutions, and scientific journals. Full transparency in authorship is essential for maintaining integrity and accountability in scientific publication and ensuring public confidence in medical research. The results of this study should raise awareness among the scientific community about the importance of ensuring appropriate authorship credit and responsibility. Future research should continue to monitor inappropriate authorship and investigate ways that the scientific community could increase its effectiveness in addressing the problem."

Further information about the original article can be found here.

BMJ 2011; 343:d6128 doi: 10.1136/bmj.d6128 (Published 25 October 2011)

Cite this as: BMJ 2011; 343:d6128

Dutch 'Lord of the Data' Forged Dozens of Studies

By Gretchen Vogel
Science Magazine

Diederik Stapel

One of the Netherlands' leading social psychologists made up or manipulated data in dozens of papers over nearly a decade, an investigating committee has concluded.

Diederik Stapel was suspended from his position at Tilburg University in the Netherlands in September after three junior researchers reported that they suspected scientific misconduct in his work. Soon after being confronted with the accusations, Stapel reportedly told university officials that some of his papers contained falsified data. The university launched an investigation, as did the University of Groningen and the University of Amsterdam, where Stapel had worked previously. The Tilburg commission today released an interim report (in Dutch), which includes preliminary results from all three investigations. The investigators found "several dozens of publications" in which fictitious data has been used. Fourteen of the 21 Ph.D. theses Stapel supervised are also tainted, the committee concluded. 

The entire story can be read here.

Diederik Stapel returned his doctoral degree as reported today (11/11/11) in Science Insider.

An additional and more comprehensive report (added 11/17/11) can be found here.

Photo by Jack Tummers.

Dilemma 7: An Invitation to Assess

You are checking your email after a busy day. The following email catches your attention.


==================================
From: PsychBuilder – High Tech Psychology at Low Cost
Sent: Monday, November 10, 2011 6:37 PM
Subject: Online Assessment Tool to Promote your Practice

Dear Psychologist,

My name is Dr. Rob West, President and CEO of PsychBuilder Inc. located in San Jose, California. My company has developed a unique opportunity for you and your associates. PsychBuilder Inc. developed the first internet-based administration and scoring of the Personality Assessment Symptom Scale-2, the PASS-2. Psychologists have used the PASS-2 for psychological diagnoses and evaluations for a number of years. The PASS-2 is administered online, from any computer, iPad, or iPhone connected to the internet. The test usually takes approximately 40 to 60 minutes to administer. Results will be available to you and the patient online.

Important to an entrepreneurial psychologist like you, this assessment bridges the gap between psychology and primary care. Numerous patients from family practice offices can be given the internet link (http://www.psychbuilder.org/) and a security code to complete the PASS-2. The test is designed to determine if the patient can benefit from psychotherapy, psychotropic agents, or other psychological services. While it is not a complete assessment, it can guide patients to you for further psychological consultation.

After a patient completes the assessment, an email will be sent to you (based on the security code) and the patient within 24 hours, providing a secure link to review the results of the PASS-2. Patient contact information will be part of the administration process.

The cost of the online administration is $25, to be paid by the patient. For this to be a successful venture, we ask you to promote this program to your referring physicians, nurse practitioners, and physician assistants in order to enhance their ability to identify, evaluate and provide needed treatment for their patients.

We have great data on the PASS-2 for reliability and validity in identifying primary care patients who can benefit from psychological services. Unfortunately, many patients struggling with mental health issues in primary care settings are not properly identified or treated.

Because of busy primary care practices, the PASS-2 can be completed at home, if the office does not have internet access for patient use.

The physician, nurse practitioner, or physician’s assistant will offer patients this important opportunity via a specially designed 4 x 6 card. On that card, there will be information that explains the importance of completing this assessment, the cost, and that a licensed psychologist will review the results and contact the patient by phone within 3 to 5 business days.

An important factor is that there is no cost to you, as the psychologist. You will receive a high quality report that offers diagnostic possibilities, suicide potential, and treatment planning options for new patients.

I encourage you to review our web site at http://www.psychbuilder.com/. If you have further questions, feel free to contact me.

Sincerely,


Robert West, PhD, ABPP
Psychologist

========================================

What are potential ethical issues with this invitation?


What clinical concerns arise for you in this scenario?


What should you do with this email solicitation?


What would you likely do with this email solicitation?

Losing the Battle: The Challenge of Military Suicide

Policy Brief
Center for a New American Security

Dr. Margaret C. Harrell and Nancy Berglass

This policy brief has four objectives. First, it examines the phenomenon of suicide within the U.S. military community, including both the frequency of suicide and the extent to which suicide is related to military service.  It outlines steps taken by the Department of Defense (DOD), the armed services and the Department of Veterans Affairs (VA) to reduce suicide in the armed forces and among veterans. It then identifies obstacles to reducing suicides further and makes recommendations to address each of those obstacles.

The entire publication can be found here.

Help for Service Members, Veterans and Military Families

Veterans Crisis Line: 1.800.273.TALK (8255), Press 1