Hospitals make unsupported claims for robotic surgery

Don't believe everything you read about the superiority of robotic surgery, even if the claims are on a hospital website.

A new study of 400 randomly selected hospital websites found that 89 percent claimed robotic surgery is better than conventional surgery (for example, less pain, shorter recovery, less blood loss, improved cancer outcomes), even though there are no rigorous studies showing such benefits. Promotional materials provided by device manufacturers were used on 73 percent of the websites.

The study was led by Marty Makary of Johns Hopkins University School of Medicine, who specializes in minimally invasive laparoscopic surgery. He said the websites don't say whether robotic surgery is being compared to laparoscopic or cut-open-the-body surgery. If it's the latter, then it's "an irrelevant comparison because robots are only used in cases where minimally invasive techniques are called for," he said.

The study appeared online last week in the Journal for Healthcare Quality. - Marie McCullough

Non-dermatologists are likely to miss skin cancers

A new study might make you wonder whether you want a primary care doctor to evaluate you for skin cancer.

The study published in the May issue of the Archives of Dermatology looked at how well dermatologists and other doctors, most of them in primary care, agreed about suspicious skin growths on patients. Only 22 percent of the 400 lesions that non-dermatologists referred to dermatologists to evaluate turned out to be cancerous.

But, while the dermatologists were examining the patients, they found another 111 growths that worried them. Fifty-five percent of those turned out to be cancerous. Of all the skin cancers that were diagnosed, nearly half were not the referral lesion.

The study group, led by doctors at Yale University and the Veterans Affairs Connecticut Healthcare System, say that non-dermatologists could use more training about skin cancer, particularly the value of a total body exam. They also raised concerns about the growing use of teledermatology because it allows dermatologists to see only the lesions that concerned the referring doctors. "There's an opportunity to miss a lot of other potentially dangerous lesions," said Daniel Federman, a Yale physician and senior author of the study. - Stacey Burling

Depressed patients apt to stray from their drug regimens

People with chronic diseases are more likely to be depressed, and depressed people are less likely to stick to drug regimens for those illnesses, a new study finds.

The researchers, from institutions in California and Pittsburgh, conducted a meta-analysis - a statistical technique for combining separate studies - of 31 previous studies involving 18,245 participants with chronic conditions such as diabetes, hypertension, asthma, and heart disease. The result: Depressed patients were 76 percent more likely than non-depressed patients to be "non-adherent" to medication requirements.

An association can't prove cause-and-effect, nor does it necessarily mean that treating depression would improve adherence. Still, the authors conclude online in the Journal of General Internal Medicine, "it is clear that clinicians should be asking about medication adherence in those with depression and should be asking about depression in those who are not adhering" to their medications." - Don Sapatkin

Share a wind instrument and you may share a cold or flu

Sharing musical wind instruments may be a good way to share a cold or flu, suggests a new study by Tufts University School of Medicine.

Researchers tested 20 clarinets, flutes, and saxophones and found bacteria, mold, and yeast living in or on the instruments.

Then they used an aerosol generator to simulate playing and applied disease-causing bacteria such as E. coli, plus a deactivated strain of tuberculosis. They found that most bacteria survived for hours to a few days, while the TB strain hung on for 13 days.

Anecdotal evidence suggests that people who play wind instruments have recurring respiratory illnesses and sore throats, yet there are no standards for cleaning of shared instruments in schools, according to the study.

The researchers suggest that players have their own instruments, mouthpieces, and reeds. Or the instruments should be disassembled and cleaned using alcohol wipes or a commercial disinfectant.

The study appeared May 12 in the International Journal of Environmental Health Research.

- M.M.