Harvard's top 10 health stories of 2007
17 December 2007
Drug safety, genome science and sleep are among the top ten health issues of
2007 chosen by the editors of Harvard Medical School's Harvard Health
1. Drug safety failures. This year, rosiglitazone (Avandia),
a diabetes drug, became the latest medication found to have serious side
effects that weren't apparent when it was approved by the FDA. The FDA needs
more money and resources to conduct studies of drugs after they've been
approved for sale — and then the clout to take prompt action if safety
problems are identified.
2. Genome-wide association studies. These
studies take advantage of unique 'flags' flying in each 'neighbourhood' of
the vast genome. Researchers find the flags associated with disease and then
conduct an intensive search for genetic miscues just in that neighbourhood.
This process is a lot more efficient than a dragnet through the entire
genome. This year, genome-wide association studies have identified genes
associated with type 2 diabetes, multiple sclerosis, and resistance to HIV
infection, to name a few examples.
3. Rapid and cheap genome
sequencing. Sequencing a genome — identifying all the chemical base
pairs of someone's genes — is getting a lot faster and cheaper. Scientists
can now shatter the DNA of the genome into millions of pieces and
simultaneously sequence the letters. Then, computers knit the data into a
single sequence. Within a decade, the price of sequencing a genome may drop
to $1,000, say some experts. Cheap genome sequencing may soon usher in a new
era of personalized medicine, with health advice and medical treatments
tailored to each individual's genes.
4. Sleeping for health. The
evidence has reached critical mass: getting between seven and nine hours of
sleep a night is one of the pillars of good health, along with physical
activity and eating a healthful diet. Poor sleep has been linked to health
problems ranging from diabetes to heart disease to obesity.
Globalization of health. The trend toward globalization that has
affected so many aspects of the American economy is now changing American
medicine. Hospitals are creating global health residency programs.
Philanthropic organizations like the Bill and Melinda Gates Foundation are
pouring billions into efforts to combat disease on a global scale. This
worldwide outlook comes from more than just altruism —AIDS, avian flu, and
severe acute respiratory syndrome (SARS) have shown that many health
problems have little respect for borders.
6. Cooling off inflammation.
TNF-alpha blockers, drugs that interfere with a protein that contributes to
inflammation, have given doctors and patients an important new treatment
choice for conditions like rheumatoid arthritis. Daunting price tags and
serious side effects make the TNF-alpha blockers less than ideal, but by
tackling inflammation at its roots, they may light the way for a new
approach to treating many diseases with an inflammatory component--even
Parkinson's and Alzheimer's.
7. Covering the uninsured. With health
care costs continuing to increase and employers in the US cutting back on
coverage, lawmakers are filling in the gaps. Illinois has created the All
Kids program to cover children. Massachusetts law mandates that everyone in
the state must purchase health insurance, and other states may follow suit.
The Medicare Part D program, despite its flaws, has succeeded in extending
prescription drug coverage to seniors. Time will tell whether these
incremental steps will replace or merely delay more sweeping reform of a
system that leaves 47 million Americans without insurance.
reimbursement to quality health care. Momentum is building for an array
of incentives for doctors and hospitals to provide higher-quality medical
care. Medicare this year started paying doctors a bonus for reporting
certain quality measures, and its experiment to pay hospitals performance
bonuses is a success, according to most experts. Some health plans are using
quality-of-care disincentives by refusing to pay for care related to
complications from certain types of medical errors. And some providers are
instituting rigorous quality-of-care programs on their own — and agreeing
not to charge for care related to certain surgical complications. Many
details have yet to be worked out, but this approach could both improve
health outcomes and reduce costs.
9. A better mammogram? Two
studies this year found that magnetic resonance imaging (MRI) scans are
better than other techniques at identifying breast cancers in high-risk
women. The American Cancer Society revised its screening recommendations to
say that women at high risk for breast cancer should get a breast MRI every
year, in addition to a regular mammogram.
10. Peeking into the brain
for disease clues. New imaging technologies are letting researchers
"see" inside the brain and watch its inner workings. The hope is these tests
will mean more certain diagnoses for many conditions and, eventually, better
treatments. One example: University of Pittsburgh researchers have developed
a method of positron emission tomography (PET) scanning that identifies beta
amyloid, the protein fragment many researchers believe is the main cause of
Alzheimer's disease. This may provide a way to detect Alzheimer's before
symptoms appear, paving the way for preventive treatments.
Harvard Health Letter. See
www.health.harvard.edu/health for more information.
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