Appropriate and safe use of diagnostic imaging.

Risks of diagnostic imaging include cancer from radiation exposure and nephrogenic systemic fibrosis. The increase in volume of imaging between 1980 and 2006 has led to a sixfold increase in annual per capita radiation exposure. It is predicted that 2 percent of future cancers will be caused by radiation from computed tomography (CT) exposure.

Hereditary hemochromatosis.

Hereditary hemochromatosis is an autosomal recessive disorder that disrupts the body's regulation of iron. It is the most common genetic disease in whites. Men have a 24-fold increased rate of iron-overload disease compared with women.

Clinical inquiries. What's the best way to motivate patients to exercise?

There is no single best strategy for motivating patients to exercise, given the lack of data from rigorous comparison studies. There are, however, several interventions for adults that are effective. They include: writing a patient-specific behavioral health "green" prescription, encouraging patients to join forces with accountability partners or support groups, and recommending the use of pedometers.

PPIs are therapeutically interchangeable and ideal for a managed care intervention such as therapeutic MAC.

PPIs Are Therapeutically Interchangeable and Ideal for a Managed Care Intervention Such as Therapeutic MAC Mabasa and Ma recently published a pharmacy claims database review on the effect of a therapeutic MAC intervention for proton pump inhibitors (PPIs). A therapeutic MAC program establishes a therapeutic maximum allowable cost for a drug category and, unless medical necessity exists, requires patients to pay the drug cost difference when a nonpreferred agent is dispensed. In their Canadian employer group, rabeprazole 10 mg daily was the preferred agent,2 costing Can 71� daily.

Forecasting cholesterol management--end of the statin gold rush?

For the last 15 years or more, lowering the low-density lipoprotein (LDL) component of total serum cholesterol has been the principal focus in cholesterol management. Ever more powerful HMG CoA reductase inhibitors (statins) captured attention in their ability to lower LDL cholesterol (LDL-C). Simvastatin was approved by the U.

Referral bias and other perspectives on the HEDIS measuring stick for quality of care in depression treatment.

The National Committee for Quality Assurance (NCQA) is an independent not-for-profit organization based in Washington, DC, whose vision is to transform health care quality through measurement, transparency and accountability. 1 Using the Health Plan Employer Data and Information Set (HEDIS), NCQA has determined how more than 90 percent of the nation's managed care organizations will collect, audit, and report their performance on a range of standardized quality measures. Many of the HEDIS measures are undisputedly useful in promoting population health, such as rate of beta-blocker use after myocardial infarctions or rate of cervical cancer screening.

Implementation of the Beers criteria: sticks and stones--or throw me a bone.

Sticks and Stones Or Throw Me a Bone BOGSAT. While not very flattering, BOGSAT (Bunch of Old Guys Sitting Around Talking) accurately describes traditional decision making across many disciplines, including medicine. In an attempt to validate expert opinion panels using the BOGSAT method, the Evidence-Based Medicine (EBM) movement sprang up from the original writings of Dr.