American Gastroenterological Association - Advancing the Science and Practice of Gastroenterology

News from the Literature | Policy | Practice | Research | Trainees | Education & Meetings | Journals & Publications | Announcements

LEADING THE NEWS

NEWS FROM THE LITERATURE

Most NASH Patients Who Develop HCC Are Men

NASH can progress to hepatocellular carcinoma (HCC). In a study appearing in Clinical Gastroenterology and Hepatology, doctors found that most patients with NASH who develop HCC are men; the patients have high rates of obesity, diabetes and hypertension. Male patients appear to develop HCC at a less advanced stage of liver fibrosis than female patients.

Clinical Gastroenterology and Hepatology 2011: 9(5): 428-433

Aspirin or NSAID Use Increases Diverticulitis Risk

NSAIDs, including aspirin, have been implicated in diverticular complications. Regular use of aspirin or NSAIDs is associated with an increased risk of diverticulitis and diverticular bleeding, suggest doctors in a study published in Gastroenterology. Patients at risk of diverticular complications should carefully consider the potential risks and benefits of using these medications.

Gastroenterology 2011: 140(5): 1427-1433

How Accurately Do Commercial Kits Measure Gastrin?

Zollinger-Ellison syndrome (ZES) is characterized by hypersecretion of gastric acid, severe peptic ulcerations in the upper small intestine and diarrhea. It is usually diagnosed by measuring increased levels of gastrin in plasma. Study results appearing in Gastroenterology indicated that seven of 12 tested commercial kits inaccurately measure plasma concentrations of gastrin; these assays used antibodies with inappropriate specificity that were insufficiently validated. Misdiagnosis of gastrinoma based on lack of specificity of assays for gastrin results in ineffective or inappropriate therapy for patients with ZES.

Gastroenterology 2011: 140(5): 1444-1453

Doctors Assess Impact of IL28B Genotype on SVR

Single nucleotide polymorphisms (SNPs) in the gene that encodes interleukin (IL)-28B predict response of patients with chronic hepatitis C to antiviral therapy. According to data published in Clinical Gastroenterology and Hepatology, an early virologic response to pegylated interferon and ribavirin is more likely among carriers of rs12979860 C/C and rs8099917 T/T, which might underlie their high rates of sustained virologic response. Determination of the IL28B genotype and whether patients have a rapid virologic response might be used in future studies of patients with hepatitis C virus genotype 1 or 4.

Clinical Gastroenterology and Hepatology 2011: 9(4): 344-350.e2

POLICY

Physician Ally in Congress to Speak at DDW^®

Sen. Mark Kirk, R-IL, a staunch supporter of physician interests in Congress, will discuss the state of health-care reform at the AGA PAC fundraising lunch during DDW^® 2011 in Chicago, IL. The event will take place on Monday, May 9, from noon–2 p.m. in room CC10CD at the Hyatt McCormick Place. The cost is $50 for AGA members and $25 for AGA trainee members. Please note that due to Sen. Kirk’s need to return to Washington, DC, he will begin speaking at noon.

More than a year after the health-care reform bill passed, it remains a highly divisive issue. While the outcome is uncertain, it is likely that dramatic changes are coming to medical practice — from the way we treat our patients to how we run our practices.

Sen. Kirk, a member of the committees that oversee health-care reform and the federal budget, will discuss the present and future of implementation of the health-care reform law, biomedical research funding, the impact of the upcoming 2012 elections, and what is in store for medical liability reform, Medicare reimbursement and more.

AGA members are encouraged to attend this event for a unique, insider’s perspective into the issues that are affecting the science and practice of gastroenterology.

Members can RSVP online or by e-mailing Lauren DePutter at ldeputter@gastro.org, by Monday, May 2, or, at DDW, members are encouraged to visit the AGA PAC booth #2017.

Other Public Policy Events at DDW®
Health-Care Reform: Key Practice Implications AGA Trainee/Young GI Public Policy Roundtable at DDW®

PRACTICE

Try the Meaningful Use Attestation Calculator

Eligible professionals participating in the Medicare electronic health record (EHR) incentive program must attest to having met meaningful use requirements in order to receive their EHR incentive payments. Keeping track of the objectives and specifications for each can be tedious.

CMS has developed the meaningful use attestation calculator to help Medicare eligible professionals, as well as eligible hospitals and critical access hospitals (CAHs), determine if they have met all of the objectives and their associated measures for meaningful use prior to completing attestation for the Medicare EHR incentive program. The tool does not calculate clinical quality measures. These measures are reported directly from a certified EHR and will need to be entered in the Web-based attestation system in order to receive an incentive payment. This calculator is not the same as the actual attestation; rather, it is a tool that allows Medicare eligible professionals to assess their readiness to successfully complete the attestation process.

To use the calculator, enter your core and menu measure meaningful use data. The calculator will display whether a provider has met the necessary criteria for these objectives. The user can then print a copy of the measures they have entered and see whether they have passed or failed each specific measure. The calculator will indicate in red those measures for which the input values did not meet the required thresholds and will mark them as "failed."

In order to better understand the meaningful use criteria, eligible professionals, eligible hospitals and CAHs can also review the stage-one meaningful use specification sheets for eligible professionals, and eligible hospitals and CAHs.

Want More Information about the EHR Incentive Programs?

To learn how to successfully navigate the attestation process and ask questions of CMS experts, CMS will hold two national calls about attestation:

• Tuesday, May 3, 2 to 3:30 p.m. ET (for eligible hospitals)
• Thursday, May 5, 1:30 to 3 p.m. ET (for eligible professionals)

Register for the call and visit the CMS EHR incentive programs website for the latest news and updates on the incentive programs.

FDA Offers Extension for Transition to SS1 Alternatives

The FDA has extended the transition period for health-care facilities to transition to legally marketed alternatives to Steris Corporation’s modified System 1 processor (SS1). All health-care facilities must be transitioned by Feb. 2, 2012. The agency does not anticipate any future extensions to the transition period.

The FDA has not approved or cleared the SS1 for its labeled claims. Steris Corporation has chosen not to seek FDA clearance of this device and, therefore, its use should be discontinued as soon as practicable. At this time, the FDA expects that Steris Corporation will continue to support existing SS1 units throughout the extended transition period. During this period, the FDA will monitor the availability and supply of legally marketed replacement products.

The FDA does not expect to take regulatory action against health-care facilities for failing to replace SS1 units within the transition period. But these facilities should be aware that the current SS1 is a misbranded and adulterated medical device because it has not been cleared by the FDA as safe and effective for its labeled claims.

Learn more.

CMS Issues PQRS and eRx Experience Report

CMS’ 2009 Physician Quality Reporting System and electronic prescribing (eRx) experience report states that 119,804 physicians and other eligible professionals in 12,647 practices who satisfactorily reported data on quality measures to Medicare received incentive payments under the Physician Quality Reporting System totaling more than $234 million — well above the $36 million paid in 2007, the first year of the program. Under the eRx incentive program, CMS paid $148 million to 48,354 physicians and other eligible professionals in 2009, the first payment year for the program. Results show that participation in the Physician Quality Reporting System has grown at about 50 percent every year, on average, since the program began. Additional 2009 program results can be found in a CMS fact sheet.

AGA will provide a detailed analysis of the report for its members in early June.

RESEARCH

Your AGA Research Foundation Gifts Support ...

 … Michele Battle, PhD, from Medical College of Wisconsin, who received a Research Scholar Award in 2009.

“I am honored to have been chosen as a recipient of the 2009 AGA Research Foundation’s Research Scholar Award. My long-term goal is to develop a research program focused on understanding the regulators and pathways required to create the functional specificity of discrete regions of the small intestine. The research monies provided by the AGA Research Foundation’s Research Scholar Award will enable me to pursue this goal.”

“I am sincerely grateful that the AGA Research Foundation has made a strong commitment to supporting the research programs of junior investigators like me at a time in our careers when it is essential to compile compelling preliminary data in order to be competitive in the large pool of researchers seeking NIH R01 funding. I am confident that this award will provide me with the necessary resources to obtain R01 funding and to continue to build a strong research program focused on intestinal development and function.”

To make a donation, visit www.gastro.org/contribute.

TRAINEES

AGA to Hold Trainee/Young GI Public Policy Roundtable at DDW^®

Between the health-care reform debate and the research funding crisis, it is a challenging time to be starting a career as a physician or scientist. AGA members are invited to attend the AGA Trainee/Young GI Public Policy Roundtable Briefing during DDW^® 2011 in Chicago, IL to discuss their concerns with colleagues and members of the AGA Public Affairs & Advocacy Committee. The event will be held on Monday, May 9, from 5 to 6:30 p.m., at the InterContinental Hotel.

“Health-care reform and the federal budget is impacting the science and practice of medicine. It is essential that gastroenterologists — particularly trainees and young GIs — take an active role in shaping their future by participating in the legislative process,” said Robert Burakoff, MD, MPH, AGAF, chair of the AGA Public Affairs & Advocacy Committee.

In addition to providing a forum for members to share their views and concerns about key issues facing the field, attendees will learn how they can affect change through political and legislative efforts.

AGA has built itself into a leader of political and legislative advocacy on behalf of gastroenterologists and their patients. The organization is working to further enhance its reputation in these areas by developing a more extensive grassroots program to bring its message to policymakers in Congress.

The event is free and refreshments will be served. Members should RSVP to attend by Monday, May 2 by contacting Lauren DePutter at 240-482-3221 or ldeputter@gastro.org. Onsite at DDW, members can visit the AGA PAC booth #2017 in the exhibit hall.

For more information about AGA’s public policy activities, visit www.gastro.org/advocacy. Learn more about other public policy events at DDW.

Win an Apple iPad
E-mail us your concerns about your future by May 2 and be entered in a raffle to win an Apple iPad. The winner will be announced at the event and must be present to win.

EDUCATION & MEETINGS

Explore the Ins and Outs of Mentoring at DDW^® Session

The AGA Research Policy Committee and the AGA Women’s Committee are proud to co-sponsor a session at DDW^® focusing on multiple aspects of mentoring with a special focus on women and minorities.

The session speakers will articulate the opportunities and complexities of navigating an academic career, particularly concepts of needing to balance competing demands of clinical excellence and research priorities. John Carethers, MD, AGAF, and Dawn Provenzale, MD, will talk about career mentorship and research mentoring. Rohit Loomba, MD, and Edda Fiebiger, PhD, will speak on “How to Be a Good Mentee and the Importance of Mentoring for Junior Investigators” from both the clinical and basic science perspective.

The mentor-mentee relationship is a key component to a successful career. All DDW registrants are encouraged to attend this session to learn more about mentoring and how to make it work for them.

Mentoring: Who, When and Why will be held on Sunday, May 8 from 4 to 5:30 p.m. at the McCormick Place Convention Center, room S401A.

Immediately following this symposium, 2011 AGA Research Foundation award recipients will be recognized at the AGA’s research recognition celebration on Sunday, May 8 at 5:45 p.m. at the McCormick Hyatt, room CC10CD.

Learn and Talk About HAE at DDW^® 2011

Hereditary angioedema (HAE) is a rare, potentially life-threatening condition characterized by attacks of angioedema anywhere in the body. HAE symptoms can mimic other gastrointestinal emergencies, including acute abdomen and IBD, and an estimated one-third of undiagnosed HAE patients have undergone exploratory surgery during an abdominal attack.

Early recognition is critical to avoid unnecessary procedures and put patients on the path to appropriate management faster. To help improve care for patients, the AGA has partnered with other specialist organizations in the program, HAE: Learn About It, Talk About It. Visit booth #2453 at DDW^® to become part of the movement to improve patient care in HAE, or www.LetsTalkHAE.com for educational resources, including a podcast series and iPhone application, and to find an HAE-treating physician to refer a potential patient.

This program is supported by ViroPharma Incorporated.

AGA Session at DDW to Explore New HCV Treatments

The AGA will use the DDW^® product theater as its venue for presenting cutting-edge information related to new treatments for hepatitis C virus. The session titled, Protease Inhibitors for Hepatitis C — Uses for Boceprevir and Telaprevir in Clinical Practice, will take place in the exhibit hall on Tuesday, May 10, from 10:30 a.m. until noon. Based on late-breaking abstract presentations, this session will delve deeper into some of the leading studies involving clinical trials for telaprevir and boceprevir.

Expert presenters include:

• Paul Y. Kwo, MD, associate professor of medicine at Indiana University, who will elaborate on his research on telapravir for hepatitis C virus.
• Ira M. Jacobson, MD, principal investigator on many important trials involving antiviral therapy for both hepatitis B and C and a world-renowned hepatology expert, will examine how telaprevir-based regimens substantially improved sustained virologic response (SVR) rates across all IL28B genotypes in an advanced trial.
• Steven L. Flamm, MD, professor of medicine and surgery at Northwestern University and widely published in the field of hepatic diseases, will discuss his assessment of how SVR with boceprevir combined with peginterferon alfa-2a and ribavirin in patients who met identical entry criteria.

This session provides an opportunity to explore these studies in greater detail and more time for Q-and-A with the expert speakers. Learn more about this session and other AGA sessions at DDW.

JOURNALS & PUBLICATIONS

Call for Papers on Clinical Trials: Gastroenterology

Gastroenterology is committed to advancing clinical practice in the field of digestive disease. Recognizing that clinical trials generally have the greatest impact of all studies on clinical practice, Editor Anil K. Rustgi, MD, and his associate editors strongly encourage authors to submit their manuscripts on clinical trials (diagnostic validation, therapeutic efficacy) of drugs, biological materials and devices in digestive, liver and pancreatic diseases, including studies at Phases I, II and especially III, to Gastroenterology for consideration. The journal is also interested in publishing trials in endoscopic and imaging modalities.

There are several important reasons to submit clinical trial research for publication in Gastroenterology:

• With an impact factor of 12.9, Gastroenterology is the premier journal in the field.
• Gastroenterology is the journal that will directly reach the largest portion of physicians who care for and make treatment decisions for patients with GI or liver disease.
• Authors who submit their manuscripts to Gastroenterology typically will receive decisions within three weeks or fewer.
• Accepted manuscripts will be published online and indexed on PubMed within 10 days of acceptance.

To submit your manuscript to Gastroenterology, go to www.editorialmanager.com/gastro.

For important information on how to report clinical trials, go to www.gastrojournal.org/authorinfo. To review the current and past issues of the journal, go to www.gastrojournal.org.

ANNOUNCEMENTS

FDA Updates Tysabri Prescribing Information

The FDA has updated the Tysabri (natalizumab) prescribing information to give new information about the size of the risk of progressive multifocal leukoencephalopathy (PML), a rare but serious brain infection, associated with use of Tysabri for the treatment of multiple sclerosis and Crohn's disease. The update includes new safety information about patients who have taken other drugs that suppress the immune system, who may be at a higher risk for PML.

Tysabri, in a class of medications called immunomodulators, has been approved by the FDA for the treatment of relapsing forms of multiple sclerosis since November 2004 and for the treatment of moderately to severely active Crohn's disease since January 2008. The revised label includes a table summarizing rates of PML with Tysabri use according to the number of infusions and information on a newly identified PML risk factor.

Learn more.

Stay Connected with AGA during DDW^®

AGA continues to lead the way in gastroenterology by using popular social networking and microblogging sites that provide new opportunities for members to connect and engage with their colleagues and stay current with the latest AGA news and information. Websites such as Facebook, Twitter, YouTube and LinkedIn offer different ways to interact and keep members up to date on the latest news in the field, AGA public policy activities and the latest research from the AGA journals.

As we approach DDW^®, the largest meeting in the field of gastroenterology, we are aware that attendees are sometimes unable to attend sessions or programs in which they are interested due to the breadth of cutting-edge data being presented. Once again this year, AGA will help members stay abreast of the latest news in the field being discussed throughout the meeting via Facebook and Twitter.

Facebook
Facebook is a social networking site that allows people to connect with each other and perform a variety of social functions such as sharing photos, posting notes or blogs, joining groups, showing support for causes, as well as thousands of other applications. Becoming a fan of our Facebook page will allow you to start discussions on our wall regarding DDW and maintain an open dialogue among colleagues.

Twitter
Twitter is a social networking and "microblogging" service that allows its users to stay connected through short messages known as "tweets." Typically, users sign up to follow other users. By following AGA's tweets, as well as those with the hashtag #AGA and #DDW11, followers will be able to receive real-time updates from AGA and through their colleagues' observations from multiple sessions occurring throughout the meeting.

To help ensure that we are updating followers on as many topics of interest as possible, AGA is identifying gastroenterologists who are interested in "tweeting" from the meeting and/or starting discussions via our Facebook wall to update colleagues on interesting sessions and discussions.

If you are interested in working with us, please contact the AGA Communications Department at communications@gastro.org.

Classifieds

Place GI Position Listings and Activity Announcements

For as little as $82.50, you can place a classified ad of 100 words or less in AGA's weekly e-mail newsletter, AGA eDigest, or AGA's bi-monthly magazine, AGA Perspectives. If you place ads in both AGA Perspectives and AGA eDigest, you will receive a 10 percent discount. Advertising in either includes a free online classified listing. Learn more.

District of Columbia
Gastroenterologist BC/BE to join suburban Washington, DC busy 100 percent outpatient consultative GI practice with adjacent accredited endoscopy center. Practice includes onsite PillCam small bowel studies. We have operational state-of-the art EMR. Applicant must be experienced in all endoscopic procedures. Early pathway to partnership. E-mail resume to drdbd@aol.com or fax to 301-897-5290.

Maryland
Large multi-specialty practice serving Montgomery County, MD seeks a BE/BC gastroenterologist.  Excellent opportunity to join a large private practice with an integrated referral system. Please forward your CV to elliotrgoldstein@yahoo.com.

North Dakota
Procedure-Oriented Practice: Sanford Health Fargo is currently seeking BC/BE gastroenterologists. Excellent productivity-based opportunity — 60 percent endoscopy and 40 percent outpatient. Seven endoscopy suites just steps from the clinic. Hospital consults only; 100 percent hospitalist coverage. ERCP and EUS skills are desirable but not required. Call 1:8. Opportunity exists to teach medical students and internal medicine residents. Offering a competitive compensation plan with two years guaranteed salary, plus incentives and a comprehensive benefits package. Willing to sponsor physicians with H1B or J1 visas.

Fargo, North Dakota, a diverse metropolitan community of 190,000, offers exceptional K-12 and higher education systems, world-class health care, affordable housing, low cost of living and a myriad of cultural and entertainment opportunities. The only things lacking are traffic jams and high crime rates. Visit www.fmchamber.com and www.fargo.k12.nd.us to learn more or contact:

Jean Keller, physician recruiter
Sanford Physician Placement
Phone: 701-280-4853
E-mail: Jean.Keller@sanfordhealth.org
www.sanfordhealth.org

AA/EOE