Wednesday, July 30, 2008

Pall-pourri

1)
Archives of Internal Medicine
has a literature review and discussion on relationship building and good communication skills, with a focus on what can be done in brief patient encounters. (It has a specific primary care focus.) To be sure, the literature is sparse, and this paper mostly discusses it in a narrative fashion, making some common-sense recommendations. I'm noting it because, as an educator, I'm constantly telling my residents/fellows/etc. that good communication does not necessarily mean a huge time commitment (and certainly, anecdotally, it can be a huge time saver - I believe this even though I have nothing to back it up), and so it's good to see a paper specifically addressing the time-issues involved in patient-centered communication.

2)
Journal of Pharmacy Practice has a review article on symptom management of non-motor symptoms in Parkinson's disease (GI symptoms, psychosis, pain, dysautonomias, etc.).

3)
JNCI has a commentary warning about the over-selling of epidemiological findings in cancer research. That is - findings that suggest X 'is associated with' Y, even though there is no experimental evidence to suggest there is a causal link (e.g. coffee consumption is associated with lower risk for liver cancer - findings like that). The article is mostly a critical overview of how, why, and when such associations turn out to be 'wrong' (not causal) and is a good one for the EBM teaching file. The topic is important for a variety of reasons, not least because our patients read sensationalistic (or at least over-sold, uncritical) accounts of these findings and they can create false hope or 'false-guilt' (I caused my cancer because I didn't do enough aerobic exercise, etc.).

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