first opinion
The invisible wasteland of health care data
Physicians spend almost two hours each day doing patient documentation, on top of actually seeing and treating those patients. There are clinical notes, lab results, structured data sets for billing requirements, and more. You've heard about this before, but it's more than an issue of physician burnout or user errors. There are environmental implications to the enormous amounts of data that hospitals create.
In a new First Opinion essay, two physicians argue that the health care community must work to prevent the environmental damage caused by data storage and management. "Unbeknownst to many of us, our current practices are likely causing far-reaching harms that fly freely under our radars because they are supposedly better than the old practices," they write. Read more.
social determinants
Racial disparities in sudden cardiac arrest among athletes
Black athletes are five times more likely than white athletes to experience sudden cardiac arrest and sudden cardiac death, according to a study published last week in The Lancet. Researchers reviewed 30 years of research specifically focused on these conditions among athletes. While most research focuses on young competitive athletes, the study authors found that most exercise-related sudden cardiac deaths occur in masters athletes, meaning those who are 35 or older.
The authors note that there's no data suggesting that a race-based screening approach would mitigate the racial disparities. "Such an approach will likely cause more harm than benefit," the authors wrote. (I wonder if they read STAT's Embedded Bias series.) The racial disparities occur "without explanation," they wrote, adding that, among competitive athletes, the influence of social determinants of health are still poorly understood.
women's health
Effective therapies for menopause symptoms are largely unused
Why? It starts with one study. The Women's Health Initiative was a 2002 landmark study that suggested hormone therapy came with an increased risk of heart disease and breast cancer. The study specifically focused on older, postmenopausal women, most of whom were not experiencing symptoms like hot flashes anymore. But in its aftermath, both the media and policymakers construed the data as demonstrating a higher risk for menopausal women as well.
The use of hormone therapy subsequently plummeted. In 1999, almost 27% of menopausal women in the U.S. used estrogen. By 2020, less than 5% did. In my latest story, I talked to doctors about the latest research on the risks and benefits of hormone therapy, and about why patients might still be hesitant. Read more.
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