Thursday, June 29, 2006

Citation analysis strategies

A new article in Biomedical Digital Libraries provides an initial analysis of Web of Science, Scopus, and Google Scholar for citation tracking in oncology and condensed matter physics. In the study, each tool contributed unique results and authors concluded that none of the resources provided a complete picture of citation patterns on its own.

--Bakkalbasi N, Bauer K, Glover J, Wang L. Three options for citation tracking: Google Scholar, Scopus and Web of Science. Biomed Dig Libr 2006, 3:7.

United Kingdom and open access

The UK Research Councils posted a position statement yesterday calling for researchers funded by the councils to deposit their works resulting from such funding into a repository.

The individual groups that comprise the UK Research Councils are charged with determining the appropriate means for pursuing this policy in collaboration with their stakeholders.

The Medical Research Council will require that research papers funded by their group be placed in PubMed Central within 6 months.

The Biotechnology and Biological Sciences Research Council announced that new projects will be required to deposit resulting works into an appropriate e-print repository "at the earliest opportunity." Researchers receiving current or past funding from the council are also encouraged to deposit their works in a repository as well.

Other member councils, such as the Engineering and Physical Sciences Research Council, have not yet come to a decision regarding the means by which broader access to funded research results will be attained.

Monday, June 26, 2006

Controversy? New England Journal of Medicine and a bird flu letter

Wired's Bodyhack blog posts the interesting saga of a letter from Chinese authors, published in last week's NEJM, which reports a fatal human case of avian flu occurring in 2003 -- 2 years before China officially reported any human cases of avian flu to the World Health Organization.

NEJM received several emails and faxes that seemed to be from the authors of the letter, asking that it be taken out of the journal, but the issue had already gone to press and it was too late to remove it. Later, NEJM confirmed that the emails had not come from the letter's first author Wu-Chun Cao, who confirmed that the letter should be published; some of the emails and faxes, however, had the author's email address or other information and NEJM is currently in the process of contacting the other authors to see if any of the other requests were authentic.

The full-text of the letter is available on the NEJM site, and the editor notes, "We earlier reported that the Journal had received e-mail requests to withdraw the letter "Fatal Infection with Influenza A (H5N1) Virus in China." The corresponding author, Wu-Chun Cao, M.D., Ph.D., has informed us by telephone and facsimile that those e-mails were not sent by him. He has not requested withdrawal of the letter, and so it stands as published in the issue of June 22, 2006."

Disturbing for a number of reasons: from a public health perspective, what are the ramifications of China withholding information on an infectious disease of possible global significance? When a journal receives correspondence purporting to be from an author of a manuscript or letter, to what extent do they need to verify it is truly from the author?

Tuesday, June 20, 2006

FDA and the Institute for Safe Medication Practices launch campaign to reduce medical errors

The campaign, a joint effort between the FDA and the ISMP (a nonprofit organization), will target the reduction of errors due to unclear medical abbreviations (including symbols, dosage shorthand).

There's no mention of plans for evaluating its success or the degree of dissemination of the educational materials; it will be interesting to see what types of outcomes are noted in updates to the project description.

Thursday, June 08, 2006

Variety post: cost studies, drug effectiveness, Cochrane, media coverage, causality

A few interesting things I've read lately...

New FDA drug labeling changes

A New England Journal of Medicine perspective piece (Avorn J, Shrank W; NEJM 2006 Jun 8; 354:2409-11),Highlights and a Hidden Hazard — The FDA's New Labeling Regulations, discusses the new FDA drug labeling rules that are going into effect later this month. The article notes that a new "highlights" section on the label and a web-based compendium of the better-organized labeling information may prove useful for some users but comments that the potential for significant consumer behavior change seems unlikely given the fairly conservative nature of the changes. The authors also point out that the new rules give little assistance to prescribers.

The new labeling regulations also contain a section limiting drug companies' legal liability for harm caused by their pharmaceuticals. Avorn and Shrank note, "Beginning at the end of this month, the new regulations would preempt nearly all action by patients in state courts against drug manufacturers for unanticipated injuries resulting from the use of their products. This immunity would apply even if a company failed to warn prescribers or patients adequately about a known risk, unless a patient could prove that the company intentionally committed fraud — a very hard test to meet...[T]he changes the FDA will begin implementing next month include a regulatory time bomb that could severely limit the accountability of companies that fail to adequately evaluate or report the risks associated with their products."

The full text of the final rule and the pending changes are available on the Food and Drug Administration site: New requirements for prescribing information.

Quality improvement project: Saving 100,000 lives in US hospitals

The British Medical Journal last week included an article, Saving 100,000 lives in US hospitals, describing a US project to reduce the number of unnecessary deaths of patients in our healthcare system. (McCannon JC et al (Institute for Healthcare Improvement). BMJ 2006 Jun 3;332:1328-1330.)

The project includes over 3,000 participating institutions in the US, comprising > 80% of the total number of national hospital discharges. Over 18 months, this program is attempting to more rapidly disseminate proven strategies for improving the quality of healthcare delivery; it includes a strong focus on the role that internal politics and buy-in within an institution plays with regard to the success (or failure) of any QI initiative.

The six interventions for the project are listed in Box 1 of the article -

  • Deploy rapid response teams to patients at risk of cardiac or respiratory arrest

  • Deliver reliable, evidence based care for acute myocardial infarction

  • Prevent adverse drug events through drug reconciliation (reliable documentation of changes in drug orders)

  • Prevent central line infections

  • Prevent surgical site infections

  • Prevent ventilator associated pneumonia

The BMJ issue also includes editorial commentary on the piece, "Improving health care through redesign: It's time to shift from small projects to whole systems" (BMJ 2006 Jun 3;332:1286-1287).

The editorial notes, "We cannot accept waiting as inevitable, increased risks to patients at different times of the day or week, or the current levels of hospital acquired infection and errors... Systems and processes of care cannot continue to evolve in an uncontrolled fashion. We must design in quality and reliability and design out waits and delays. As the 100 000 lives campaign and the other quality improvement programmes outlined show, we know how to engage staff and promote improvement through the development of strong clinical champions with a vision that incorporates the pursuit of perfection in patient care. If we can harness this potential with engagement of patients, carers, and staff high quality health services will result."

Thursday, June 01, 2006

Harold Varmus and open access publishing

Wired magazine has a great piece by Jamie Shreeve posted today, "Free Radical" -- discussing Harold Varmus's role in advocating open access publishing and in the Public Library of Science organization.

“Our mission is to transform how science publishing is done,” Varmus says. “We aren’t trying to torpedo the industry. But we are definitely going to change it.”