Health Leaders: #Lacks family members now have a say in #Henrietta’s immortal scientific legacy

My report from Health Leaders on a recent talk by members of Henrietta Lacks’ famfile_000-4ily.

The ongoing story of the late Henrietta Lacks, the African-American
woman who unwittingly provided cells for years of medical research, has much to offer those battling disparities
in healthcare, according to family members who spoke in Boston last week.

That message, delivered at a panel discussion, came from Lacks’ grandson David Lacks, Jr. and her great granddaughter Victoria Baptiste, RN, as well as Joseph Betancourt, MD, director of the Disparities Solutions Center at Massachusetts General Hospital.

From ob/gyn to surgery, MGH study found salaries for male doctors higher than #female #doctors at public US #medical #schools

From JAMA Internal Medicine:

  • Question Do differences in salary exist between male and female academic physicians in US public medical schools?

  • nci-vol-1926-150

    Just like the old days? 

    Relying on Freedom of Information laws that mandate release of salary information of public university employees in several states, this study analyzed sex differences in academic physician salary among 10 241 physicians in 24 public medical schools. Accounting for physician age, experience, faculty rank, specialty, scientific authorship, National Institutes of Health funding, clinical trial participation, and Medicare reimbursements, female physicians earned less than males.

  • Meaning Significant sex differences in salary exist in public medical schools after accounting for clinical and research productivity.

Well, not  everywhere. More from The New York Times

The researchers also found stark variations in the salary gap at different medical schools, suggesting some address pay inequities more aggressively than others.

“The biggest surprise is there are some schools where this doesn’t seem to be an issue,” said Dr. Anupam B. Jena, the study’s lead author and an associate professor of health care policy at Harvard Medical School.

Genetics and autism: One study, one story

Two Boston-linked stories today on the genetics of Autism.

ss sciFrom the Scientist Last year a team of Australian scientists claimed to have developed a genetic test that predicts risk for autism spectrum disorder (ASD) with “72 percent accuracy.”y night at a Boston fundraiser in support of his research into the functioning of brain synapses in autism

The Scientists reports that they said the test  “may provide a tool for screening at birth or during infancy to provide an index of at-risk status.”

But a new study, led by Benjamin Neale from Massachusetts General Hospital, suggests that those claims were overblown. Neale’s team replicated the Australian group’s research in a larger sample, and found that the proposed panel of markers did not accurately predict ASDs.

“The claims in the original manuscript were quite bold. If they were true, it really would have been quite a major advance for the field, with serious ramifications for patients and other risk populations,” said Neale. “I think it’s important to ensure that this kind of work is of the highest quality.”

More here from SciBlogger Emily Willingham. 

And, this from WBUR

BOSTON — For Timmy and Stuart Supple, a pool is one of the best places to be. That’s where their mother thought the boys, who are 8 and 10 years old and severely autistic, would be the most calm and least stressed for a very important introduction.

“We, we, we go see the doctor?” 10-year-old Stuart asked his mother.

His mother, Kate Supple, tells him the man standing in front of him by the pool is the doctor. Dr. Thomas Sudhof has never met the boys, but he wants to see their autism unchecked.

Sudhof isn’t a pediatrician or one of the myriad of therapists trying to get into their world and bring them out. The Stanford University neuroscientist — who this year shared the Nobel Prize in medicine for his decades of study into how brain cells communicate — has been studying Tommy and Stuart’s genes, specifically an alteration in one gene, for five years. The Supples hosted Sudhof Wednesda

From the Scientist Last year a team of Australian scientists claimed to have developed a genetic test that predicts risk for autism spectrum disorder (ASD) with “72 percent accuracy.”y night at a Boston fundraiser in support of his research into the functioning of brain synapses in autism

The Scientists reports that they said the test  “may provide a tool for screening at birth or during infancy to provide an index of at-risk status.”

But a new study, led by Benjamin Neale from Massachusetts General Hospital, suggests that those claims were overblown. Neale’s team replicated the Australian group’s research in a larger sample, and found that the proposed panel of markers did not accurately predict ASDs.

“The claims in the original manuscript were quite bold. If they were true, it really would have been quite a major advance for the field, with serious ramifications for patients and other risk populations,” said Neale. “I think it’s important to ensure that this kind of work is of the highest quality.”

For Halloween, tour the dark side of Massachusetts medical history

             We’re sorry we missed the last Longwood Avenue walking tour for the season. Advertised as a tour of Boston’s “world-renowned” medical centers, the trip is clearly upbeat, with an emphasis on firsts and breakthroughs.  For a bit of the seamier side of Boston health history, you can still catch the Boston by Foot “Darkside” tour, which covers sites associated with the city’s smallpox and influenza epidemics.

Maybe they could combine the two by offering a healthcare/darkside tour.  First stop: Betsy Lehman Center for Patient Safety and Medical Error Reduction – named for the Boston Globe health news reporter who died in 1994 as the result of a medication error — an overdose of chemotherapy. They would have to add a Cambridge leg to the tour to get to Mt. Auburn Hospital, where a doctor took mid-surgery break to go cash his paycheck. Or, consider the Harvard monkeys. They keep dying at Harvard’s primate research center. And, they got caught up in a case of fraud when former psychology professor embellished the results of his research.

Murderous and murdered docs? The alleged “Craig’s List killer” – a BU med student – committed suicide in jail before he could be tried for murdering an “escort” in a Copley Square hotel.  Head to the suburbs for a walk in the woods where a Wellesley allergist was convicted of beating his wife and slashing her throat. Prosecutors said he was motivated by his appetite for prostitutes and phone sex. Richard Sharpe, a so-called “cross-dressing” dermatologist”  convicted of fatally shooting his wife point blank with a hunting rifle, also committed suicide in jail.

But, in Boston’s most notorious medical murder, the victim was doctor. In 1849, Boston Brahman Dr. George Parkman tried to collect a debt from a chemist co-worker and ended up dead. The killer chemist dismembered the body and hid it behind a wall at what was then Harvard Medical School, which was then at the site that is now Mass General Hospital. Download the app for a self guided walking tour.

Halloween ghoulishness aside, domestic violence is not to be taken lightly. Sharpe’s daughter has spoken out via a group called The R.O.S.E. Fund (Regaining One’s Self Esteem), which among other efforts seeks to transform “the lives of survivors that have physical reminders of their abusive past. In partnership with our medical affiliates we provide female survivors of domestic abuse with access to medical and dental reconstructive procedures to help them to regain their self-esteem.”  So, add one more stop to the tour — Mass Eye and Ear – where docs help heal victims of violence..

Health reform and cancer: Mass can’t get either one right?

Fortune/CNN jumps all over Mass health reform

 …(T)he plans offer lavish subsidies that swell the demand for health care, they do nothing to increase the supply of medical services in a market suffering from shortages of everything from family doctors to nurses to hospital beds. Two years after enacting health-care reform to rein in costs, Massachusetts strengthened “certificate of need laws” that prevent hospitals and other providers from competing with high-cost, entrenched suppliers. The state now requires that ambulatory surgical centers and outpatient treatment facilities get permission from regulators before they can enter the market. Their rivals invariably lobby the regulators to block competition, and usually win.

 And, the NY Times holds up MGH research as an example of the limits of targeted cancer therapies.

 Enthusiasts for the targeted drug have been saying for years that tumors will eventually be characterized by their molecular profiles — which mutated genes they have — rather than where in the body they occur. Names like breast cancer and lung cancer will be supplanted by terms like B-RAF-positive or EGFR-positive tumors. And drugs will be chosen based on that profile, the way antibiotics are generally selected based on the pathogen that is causing the infection, not on where in the body the infection occurs.

 Massachusetts General Hospital, for instance, is running a clinical trial testing a drug from AstraZeneca on any type of cancer — providing it has a mutation in the gene B-RAF, the same gene that is the target of PLX4032.

 But the test of PLX4032 in colon cancer suggests that the location of the tumor still does matter, that it will not be just a case of looking at the target. There are other examples as well. Erbitux and Vectibix do not work in colon cancer patients with a mutation in a gene called K-RAS. But the relationship between the mutation and the effectiveness of Erbitux does not seem to hold in lung cancer.

 

Can a computer save you from an extra x-ray?

Two news round ups today.

First, check out the latest edition of the Health Wonk Review, hosted by Boston’s own David Williams at  The Health Business Blog.  As he reports: It’s a wonderful day in the wonkerhood, with so much health care policy fodder to chomp on. Let’s jump right in.

Also, here’s some local news of note:

Kaiser Health News and NPR report on an MGH study about HIT doing its job.

A funny thing happens when a computer challenges orders for medical scans that aren’t likely to help diagnose patients: Doctors often drop the test requests.

This morning’s Globe gives us this disturbing news:

At least 200 emergency medical technicians and paramedics in Massachusetts and New Hampshire have been practicing without legitimate certification, paying for fake credentials, rather than receiving medical training, state public health officials said.

 The Boston Review rounds up some of the usual and unusual suspects for a debate on industry influence on medicine.

 They start with pharma critic and former NEJM editor Marcia Angell, the run several responses:

Some of Angell’s respondents share her concerns and extend them to other areas of medical practice—including nursing and the identification of novel diseases. But not everyone agrees. Emma D’Arcy thinks that patients, newly empowered by modern information and communications technology, can make sensible judgments about treatments and drugs. And Thomas Stossel, writing separately, rejects the entire framework of analysis. For Stossel, results (what he calls “value”) are the only significant measure in assessing the nexus of academia and industry. The results that matter are longer lives of higher quality with less pain. And measured by these standards, the nexus looks pretty good.

Finally, here’s a little advance news — Tinker Ready is now the “Hub Leader” for Nature Network Boston

 The site comes via the Nature family of peer-reviewed research journals. She’ll be blogging and tweeting for this networking site for scientists, entrepreneurs, policymakers and others interested in the life sciences. Once they work the bugs out of the home page, we’ll have a more formal announcement.  In the meantime, feel free to browse and/or join up.

%d bloggers like this: