Prevention Matters

Republican message-meister Frank Luntz was invited to Capitol Hill this week to advise House Republicans on how to best frame their views on health reform. However, CQ reports, his urging of members to focus on healthy lifestyles and wellness wasn't exactly a home run.

“I don’t want to live that kind of life,” responded Louie Gohmert, R-Texas.

“You don’t want to live that kind of life?” Luntz asked.

“Yeah, you’re eating your BBQ. Clearly you don’t want to live that kind of life,” he went on, to some laughter.

“Hey, ribs are a food group,” an unidentified member called out, to which Luntz responded: “His ribs could actually get up and walk out of the office.”

Google Health is trying to apply lessons learned from one of its users to improve the accuracy of medical records. An item on the Google blog tells how the user, whom they call "e-patient Dave," found that data was imported into his Google Health Account from his hospital in Boston that included "diagnoses that were both alarming and wrong."

The data came from the billing codes and associated descriptions used by the hopsital to fillout Dave's insurance forms.

"These descriptions, from the International Classification of Diseases (ICD-9), often do not accurately describe a patient because the right ICD-9 code may not exist," says Roni Zeiger, M.D., Product Manager of Google Health. "So the doctor or hospital administrator chooses something that is 'close enough' for billing purposes. In other cases, the assigned code is precisely what the doctor is trying to rule out, and if the patient turns out not to have that often scary diagnosis, it is still associated with their record."

Google Health and Dave met with hospital officials, and they worked out a plan to address the situation. The hospital agreed to stop sending ICD-9 billing codes and will instead only send to Google Health the free text descriptions entered by doctors. The hospital is also working with the National Library of Medicine (NLM) to associate those free text descriptions with a more clinically useful coding system called SNOMED-CT.

"The result will be more accurate and useful information in patients' Google Health profiles," Zeiger says.

Ad Age gives the CDC kudos on its communication work on the H1N1 epidemic and how it is "managing the conversational airwaves."

"It is neither sexy nor flashy, but it's highly effective -- and critically timely," Pete Blackshaw writes. "Moreover, the approach is building credibility. The agency has added nearly 15,000 Twitter followers in the past two days, bringing the total to 40,000. Data from my employer, Nielsen Online, also suggest the CDC website is generating unprecedented links and references, including from Wikipedia, across all dimensions of this issue.

The article lists 10 specific communications lessons to be learned from the CDC experience. It's worth a read.

A penny-per-ounce excise tax could reduce consumption of sugared beverages by more than 10%, Dr. Kelly Brownell, Director of the Rudd Center for Food Policy and Obesity at Yale University and Dr. Thomas Frieden, Health Commissioner for the City of New York, suggest in an April 30 "Perspective" piece in the New England Journal of Medicine. Brownell and Frieden say a review of places that have enacted soda taxes shows that every 10% increase in the price results in a drop in consumption by 7.8%.

They say sugar-sweetened beverages may be the "single largest driver of the obesity epidemic," and that proposals to tax sugared beverages gain support from the general public if the revenue is used for programs to prevent childhood obesity, such as media campaigns, physical activity facilities, and healthier food in schools. A poll of New York residents found that 52% supported a "soda tax," but the number increased to 72% when respondents were told that the revenue would be used for obesity prevention.

The Associated Press reported last week on a study showing that the drug Avodart lowered the chances of a prostate cancer diagnosis by 23 percent after four years of use. Health News Review's Gary Schwitzer dug a little further and found some figures that may take the bloom off that rose.

"The story said that 'to prevent a single case of cancer, 71 men would have to take finasteride [a similar drug] for 7 years." But it didn't then do the math. The story says Avodart is $3 per pill, so---

"71 men x 365 days/yr. x 7 yrs. x $3/pill = $544,215 to prevent a single case of prostate cancer."

"How can these kinds of numbers be left out of stories?" Schwitzer asks.

The Harvard School of Public Health has released a new survey of Americans and their family members are doing to try to avoid the flu epidemic. Here’s what they say:

59% have washed their hands or used hand sanitizer more frequently
25% have avoided crowded places such as sporting events, malls or public transportation
20% have avoided people they thought may have recently visited Mexico
17% have avoided Mexican restaurants or grocery stores
8% have worn a face mask
5% have purchased a face mask
5% have talked with their doctor about health issues related to swine flu
1% have gotten a prescription for or purchased antivirals

Some of these approaches - like hand-washing - are evidence-based, while others - like avoiding crowdedplaces and Mexcan restaurants - are not. But it's an interesting list.

"An overwhelming majority of Americans believe that they can get the current swine flu from being in close contact with someone who has it (83%), and few believe that they can get the disease from eating pork (13%)," the study says. "Some Americans also believe that they can get the swine flu from being near, but not in close contact with, someone with swine flu (29%), or from being in contact with pigs (34%). "

A Colorado congresswoman's efforts to determine a "Prevention Dividend" for taxpayers was named Partnership for Prevention's Best Prevention Idea of the Week, while a North Dakota legislator's efforts to undo a voter-mandated tobacco initiative was named the Worst Prevention Idea of the week.

The Best/Worst Idea awards are a regular feature of Prevention Matters, the blog of Partnership for Prevention. Each week, Partnership for Prevention's staff will choose the designees based on nominations of items in the previous week's news submitted by members, staff and the public at large. To submit a nomination or for more information, contact Damon Thompson at dthompson@prevent.org .


BEST

Congresswoman Developing Metric for “Prevention Dividend”

U.S. Rep. Diana DeGette, D-CO, says she’s exploring a new way to calculate not simply the costs of preventative care, but the long-term benefits — what she calls the "prevention dividend." “We need to put a new emphasis on preventative care — anti-smoking efforts, cancer screening and pre-natal care, where every dollar spent saves four dollars in long-term care,” she says.


WORST

North Dakota State Sen. John Andrist, R-Crosby, introduced legislation asking the state's voters to undo their approval last November of an initiative that mandated millions of dollars for anti-tobacco efforts. The measure by Andrist, who says he doesn’t think voters fully understood what they were voting on, would divert and dilute funding that the voters directed to prevention and cessation program. UPDATE: The Senate approved the measure April 29 by a 24-23 vote, but a House committee gutted the measure a day later.