Thursday, September 15, 2011

The Morning Drill: September 15, 2011

A collection of dentistry and health related links/comments for your day.

ADA asks senator not to fund midlevel provider projects

The ADA is urging Sen. Tom Harkin (D-Iowa), who chairs the U.S. Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education, not to consider a healthcare appropriations measure that includes funding for the "alternative dental healthcare provider demonstration projects" that were created as part of the healthcare reform law.

According to a members-only bulletin released September 9, the ADA is asking ADA members in Sen. Harkin's home state to contact him and express their opposition to funding the demonstration projects, with particular emphasis on the following points:
  •     The existing dental workforce model is a proven delivery system.
  •     The dentist workforce is growing; five dental schools have opened since 2000 and more than a dozen schools are at varying stages of development.
  •     Dental practices have become more efficient. Today, it takes only 88 practices to serve the same number of dental patients as 100 practices during the 1980s.
  •     There is no evidence to support the economic feasibility of midlevel providers.
  •     A few states are already testing new dental delivery models, and scarce federal dollars should not be used to duplicate these efforts.
  •     Federal funding for oral health programs should focus on fully implementing the prevention and public health infrastructure programs, as education and prevention are the most cost-effective ways of minimizing untreated dental disease.
  •     A recent article published in the Journal of the American Medical Association concluded that increasing Medicaid reimbursements levels to dentists boosted the number of Medicaid-eligible children treated.
Sacha Rumaner, 30, suffered anaphylactic shock and was dead within minutes, moments after complaining she felt hot and had an itchy leg and back before sliding to the surgery floor.

Tests later revealed she had suffered a deadly reaction to chlorhexidinel a chemical in the Corsodyl mouthwash being used to treat a possible infection, a week after she had a tooth out at the Morley Street dental clinic in Brighton, East Sussex. She turned blue, had no pulse and stopped breathing.

Dentist Labina Rahman told the Brighton inquest she used Corsodyl on a weekly basis but had never heard of anyone having a fatal reaction.

Brighton and Hove assistant deputy coroner Dr Karen Henderson said anaphylactic shock was the main cause of cardiac arrest in dental patients so the staff should have treated her with adrenaline.
New Drug Allows Shorter Hepatitis Therapy for Some
Response-guided therapy with the protease inhibitor telaprevir (Incivek) can cut the treatment period for hepatitis C (HCV) in half, researchers reported.

In an open-label randomized trial, 24 and 48 weeks of standard therapy – each combined with telaprevir for the first 12 weeks – had equivalent efficacy among patients who responded early and strongly, according to Kenneth Sherman, MD, PhD, of the University of Cincinnati College of Medicine, and colleagues.

But those getting the shorter therapy had significantly fewer adverse events, they reported in the Sept. 15 issue of the New England Journal of Medicine.

Telaprevir was approved earlier this year to be used in combination with standard HCV therapy with pegylated interferon and ribavirin. It is one of two new medications -- the other is boceprevir (Victrelis) -- that target the virus directly, in contrast to the standard therapy, which boosts the immune system.

Both the standard therapy and telaprevir are associated with a range of adverse events that can lead patients to stop therapy, the researchers noted, so that a shorter course would have important advantages.
In a Race to Out-Rave, 5-Star Web Reviews Go for $5
In tens of millions of reviews on Web sites like, Citysearch, TripAdvisor and Yelp, new books are better than Tolstoy, restaurants are undiscovered gems and hotels surpass the Ritz.

Or so the reviewers say. As online retailers increasingly depend on reviews as a sales tool, an industry of fibbers and promoters has sprung up to buy and sell raves for a pittance.

“For $5, I will submit two great reviews for your business,” offered one entrepreneur on the help-for-hire site Fiverr, one of a multitude of similar pitches. On another forum, Digital Point, a poster wrote, “I will pay for positive feedback on TripAdvisor.” A Craigslist post proposed this: “If you have an active Yelp account and would like to make very easy money please respond.”

The boundless demand for positive reviews has made the review system an arms race of sorts. As more five-star reviews are handed out, even more five-star reviews are needed. Few want to risk being left behind.

Sandra Parker, a freelance writer who was hired by a review factory this spring to pump out Amazon reviews for $10 each, said her instructions were simple. “We were not asked to provide a five-star review, but would be asked to turn down an assignment if we could not give one,” said Ms. Parker, whose brief notices for a dozen memoirs are stuffed with superlatives like “a must-read” and “a lifetime’s worth of wisdom.”

Determining the number of fake reviews on the Web is difficult. But it is enough of a problem to attract a team of Cornell researchers, who recently published a paper about creating a computer algorithm for detecting fake reviewers. They were instantly approached by a dozen companies, including Amazon, Hilton, TripAdvisor and several specialist travel sites, all of which have a strong interest in limiting the spread of bogus reviews.

“The whole system falls apart if made-up reviews are given the same weight as honest ones,” said one of the researchers, Myle Ott. Among those seeking out Mr. Ott, a 22-year-old Ph.D. candidate in computer science, after the study was published was Google, which asked for his résumé, he said.

Linchi Kwok, an assistant professor at Syracuse University who is researching social media and the hospitality industry, explained that as Internet shopping has become more “social,” with customer reviews an essential part of the sales pitch, marketers are realizing they must watch over those opinions as much as they manage any other marketing campaign.
Enjoy your morning!

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