News in brief - Aug. 18, 2003

Physician handbook on older driver safety available - NIH reorganization suggested - Guidelines needed for body scan businesses - SARS could still pose challenges

Physician handbook on older driver safety available

The American Medical Association and the National Highway Traffic Safety Administration have released a guide to help doctors keep their older patients driving safely.

The "Physician's Guide to Assessing and Counseling Older Drivers" includes an office-based assessment of patients' driving abilities, a list of medical conditions and medications that could impair driving, advice for counseling patients on retiring from driving, information on state licensing requirements and physician reporting laws, and educational materials for patients and their family members. The guide is available at the AMA Web site (www.ama-assn.org/go/olderdrivers).

Older driver safety is a growing public health concern. Motor vehicle crashes are the leading cause of injury-related deaths in people ages 65-74, according to the NHTSA.

NIH reorganization suggested

The National Academies of Science recommended making some organizational changes at the National Institutes of Health in a congressionally mandated report released July 29.

The report suggests studying the mergers of the National Institute on Drug Abuse with the National Institute on Alcohol Abuse and Alcoholism, and the National Institute of General Medicine with the National Human Genome Research Institute.

The document also recommends reconsidering the special status granted to the National Cancer Institute. Because the NCI director is appointed by the president and the budget is set without input from the NIH director, it is possible that an unnecessary rift could be created between the goals and leadership of NIH and those of NCI, the report suggests.

NIH-sponsored clinical research, whether it takes place at NIH or at outside hospitals, should be consolidated under a new entity called the National Center for Clinical Research and Research Resources, which would build upon the current National Center for Research Resources. This would improve collaboration and data sharing among clinical research programs, the report says.

The National Academies of Science also takes issue with the appointment process for the 140 NIH advisory committees. To avoid any perceived politicization of the committee appointment process, participation should be based solely on a person's scientific or clinical expertise, or his or her involvement in relevant issues, says the report.

Guidelines needed for body scan businesses

Body scanning technologies have led to a proliferation of businesses that allow anyone with cash to acquire detailed images depicting their innermost anatomical workings. But the lack of guidelines governing these scans makes it difficult to determine their usefulness, said Stanford University researchers in a recent study.

Guidelines are needed today, said authors of a paper in the August issue of Radiology. "Even though the scanning services are readily available and heavily marketed, we still don't fully understand the potential risks, so fully informing patients is impossible," said Judy Illes, PhD, senior research scholar at Stanford University Medical Center's Center for Biomedical Ethics and the Dept. of Radiology.

Proponents of self-referred whole-body CT scanning believe the risks of the procedure are minor when compared with possible benefits, which could include early detection of disease and a sense of empowerment in individuals concerned about their overall well-being.

The paper's authors, however, raised questions regarding the risk of radiation exposure associated with CT scanning, which can deliver as much as 2 rads of radiation, depending on the procedure and the patient's body -- about the same as 250 chest x-rays.

Other risks include undergoing a medical procedure that has not been evaluated for effectiveness, hidden medical and psychological consequences of false-positive results, and the risk of positive results that are clinically insignificant but lead to unnecessary medical procedures, such as biopsies.

SARS could still pose challenges

While the global spread of SARS was contained through an unprecedented level of international scientific collaboration and the use of well-established infection control measures, it is still possible that there will be a resurgence, and now is the time to prepare, warned the General Accounting Office in a July 30 report.

Lessons to carry forward include the importance of early identification of infected individuals and their contacts, the effectiveness of safety precautions to control transmission and ensure the protection of health care workers, and the need to use isolation and quarantine in some cases, the GAO said. "Swift and unfettered communication among health care workers, public health officials, government agencies, as well as the public provided the essential backbone to support ongoing efforts to contain the disease," the report states.