The top 10 health stories of 2007, from the editors of the Harvard Health Letter
The editors of Harvard Medical School's Harvard Health Letter have chosen the top 10 health stories of 2007. Here are this year's newsmakers:
- 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.
- Genome-wide association studies. These studies take advantage of unique "flags" flying in each "neighborhood" of the vast genome. Researchers find the flags associated with disease and then conduct an intensive search for genetic miscues just in that neighborhood. 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.
- Genome sequencing in a jiffy — and cheap. 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.
- Waking up to a new health habit: Sleep. 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.
- Health is going global. 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.
- 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.
- Covering the uninsured. With health care costs continuing to increase and employers 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.
- Tying 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.
- 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.
- 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.