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LEADING THE NEWS
Asking the Important Questions: AGA Joins Choosing WiselyTM
As stewards in promoting and managing the delivery and use of our nation’s health-care resources, gastroenterologists need to ask important questions about the care patients receive.
• Is this test or procedure really necessary, and at this time?
• Has the patient already had it, and are efforts being duplicated?
• Will it bring them unintended harm?
• Is it a wise use of health-care dollars?
As part of our longstanding effort to play an active role in addressing these issues, the AGA is proud to announce our participation in Choosing WiselyTM. An initiative of the American Board of Internal Medicine (ABIM) Foundation, this campaign aims to build a more sustainable health-care system that delivers high-quality and effective care.
AGA is joining with cardiologists, radiologists, oncologists, nephrologists and others to develop lists of common tests or procedures that should be discussed with patients, based on appropriateness of care. These evidence-based lists, to be unveiled in spring 2012, will use current evidence about management and treatment options to identify areas in which quality and outcomes can be improved. We will engage members in discussions about the role of health-care professionals in making wise choices and in thinking about these issues.
“The AGA is honored to be joining the ABIM Foundation and many other respected medical societies in the Choosing WiselyTM campaign,” said C. Richard Boland, MD, AGAF, president of the AGA Institute. “The AGA believes that patients should have access to the screening tests that will most benefit them in the treatment and diagnosis of their condition. However, we realize that steps need to be taken to ensure that patients and health-care professionals understand how these tests should be used in order to minimize inappropriate use. Therefore, we are participating in this campaign to help educate patients and health-care providers about the proper guidelines and quality measures to consider when making important health-care decisions.”
Some experts estimate that our health-care system delivers unnecessary tests, procedures, doctor visits, hospital stays and other services that may not improve people’s health up to 30 percent of the time. Considered with the fact that CMS estimates U.S. health-care spending will reach $4.3 trillion by 2019, it is clear that our current health-care system is unsustainable and in need of an intervention.
Learn more about Choosing Wisely.
NEWS FROM THE LITERATURE
Biliary Atresia Patients Show 20-Year Transplant-Free Survival
Surgical treatment with Kasai portoenterostomy has improved the prognosis for patients with biliary atresia, although most patients ultimately require liver transplantation. Well-described patients with long-term, transplant-free survival are scarce. According to a study in Clinical Gastroenterology and Hepatology, more than 25 percent of patients with biliary atresia survive at least 20 years without liver transplantation in the Netherlands. Women with biliary atresia have a reduced perception of their health, compared with control patients. Twenty percent of long-term survivors are symptom-free, without clinical or ultrasonographic signs of cirrhosis or portal hypertension.
Clinical Gastroenterology and Hepatology 2011: 9(12): 1086-1091
Cardiovascular Disease Associated with NAFLD
NAFLD is the hepatic manifestation of metabolic syndrome, and is associated with cardiovascular risk. In patients with clinical indications for coronary angiogram, fatty liver is associated with coronary artery disease independently of other metabolic factors, stated researchers in a study published in Gut. However, fatty liver cannot predict cardiovascular mortality and morbidity in patients with established coronary artery disease.
Gut 2011: 60: 1721-27
Norovirus Vaccine Protects Against Illness, Infection
Noroviruses cause epidemic and sporadic acute gastroenteritis. No vaccine is available to prevent norovirus illness or infection. In a study appearing in the New England Journal of Medicine, doctors assessed the safety, immunogenicity and efficacy of an investigational, intranasally delivered norovirus virus-like particle vaccine to prevent acute viral gastroenteritis after challenge with a homologous viral strain, Norwalk virus. This norovirus virus-like particle vaccine provided protection against illness and infection after challenge with a homologous virus.
New England Journal of Medicine 2011: 365: 2178-2187
Doctors Review Guidelines for Gastroenteropancreatic Neuroendocrine Tumors
In an update of previous guidance published in 2005, doctors from the U.K. report that over the past few years, there have been advances in the management of neuroendocrine tumors, which have included clearer characterization, more specific and therapeutically relevant diagnosis, and improved treatments. According to their findings, which are published in Gut, there remain few randomized trials in the field and the disease is uncommon; all evidence must be considered weak in comparison with other more common cancers.
Gut 2012: 61: 6-32
PRACTICE
CGH Image of the Month
Aortobifemoral Prosthesis Penetrating into the Duodenal Lumen
Wolfgang Scheppach, Martina Polzien and Wolfgang Kuesters
A 73-year-old woman presented with melena four days before admission, weight loss and inappetence. She had peripheral arterial disease of the abdominal aorta and lower extremities, and had undergone aortobifemoral bypass surgery three years previously. On presentation, she was hemodynamically stable and had blood hemoglobin of 12.5 g/100 mL. Laboratory data were notable for serum C-reactive protein of 36.34 mg/100 mL and white blood cell count of 13,500/μL, which were unexplained at first.
At upper gastrointestinal endoscopy, no bleeding source was detected in the esophagus, stomach or duodenal bulb. In the third portion of the duodenum a longish foreign body was seen (figure), which was identified as the outer surface of the aortic Dacron graft.
Read more in Clinical Gastroenterology and Hepatology.
AHRQ Keeps You in the Know in Comparative Effectiveness
The Agency for Healthcare Research and Quality has posted the following to the Effective Health Care (EHC) program website.
Draft key questions for the following comparative effectiveness review are open for comment until Jan. 4, 2012:
Wireless Motility Capsule Versus Other Diagnostic Technologies for Evaluating Gastroparesis and Constipation: A Comparative Effectiveness Review. Comment on these key questions.
The EHC website also features Spanish-language consumer guides for the following comparative effectiveness reviews:
- Comparative Effectiveness of Therapies for Children with Autism Spectrum Disorders.
- Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults with Type 2 Diabetes: An Update of the 2007 Report.
- Comparative Effectiveness of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults.
CMS Call to Address Payment Rates under MPFS
CMS provides confidential feedback reports to physicians and physician group practices about the resource use and quality of care they provide to their Medicare patients. Section 3007 of the Affordable Care Act requires CMS to apply a value modifier, which compares the quality of care furnished to the cost of that care, to physician payment rates under the Medicare physician fee schedule starting with specific physicians and physician groups in 2015, and expanding to all physicians by 2017.
During a national provider call being held on Dec. 21, from 1 to 3 p.m. ET, CMS subject-matter experts will discuss how and why per capita cost measures are adjusted under these programs. This call provides an opportunity to have a public dialogue about the methodology, obtain stakeholder input and discuss ways to further improve these cost adjustment processes.
For more details, including instructions on registering for the call, please visit http://www.eventsvc.com/blhtechnologies. Registration will close at noon on the day of the call or when available space has been filled.
A slide presentation will be available prior to the call in the "Downloads" section of the program site. Learn more about the value-based payment modifier and physician feedback programs.
ANNOUNCEMENTS
AGA Partners with CDC to Expand Access to CRC Screening
The AGA is partnering with the CDC and state and tribal Colorectal Cancer Control Programs (CRCCP) to conduct a CRC screening and awareness event in March 2012 during Colorectal Cancer Awareness Month. The partnership with the CDC provides a unique opportunity for AGA to reach the underserved and to raise awareness of the need for CRC screening around the country.
The CRCCP programs in the following states are interested in participating in this exciting screening and awareness event:
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We are in the early stages of planning the event, which will allow AGA members to provide colonoscopies to uninsured and underinsured individuals, aged 50 and over, who could otherwise not afford this vital service. The participating state cancer control programs will match gastroenterologists in their areas with patients who are in need of free colonoscopy screenings.
If you are a member from one of these states and are interested in learning more about participating in this exciting program, please contact Aimee Frank, AGA director of public relations, either via e-mail or phone, 301-941-2620.
The CDC established the CRCCP in 2009 to increase CRC screening prevalence among Americans aged 50 years and older. Twenty-nine grantees (25 states and four tribal organizations) are currently funded. One component of the CRCCP is to offer no-cost screening to eligible low-income, uninsured and underinsured individuals. Programs have agreements with both primary and specialty care organizations in order to identify patients and provide services. Patient navigation is a critical component of the program to ensure patients successfully complete screening.
Show the Twitter Love
Check out what our followers retweeted most often last week. Then, spread the word by retweeting to your followers.
- The appendix may protect against C. difficile recurrence. Check out the article now! CGH: ow.ly/7Upof.
- We are looking for stories about how your digestive disease has impacted your life. DM us for more info or e-mail foundation@gastro.org.
- Dr. Christina Surawciz discusses fecal microbiota transplantation as treatment for C. difficile. CGH podcast: ow.ly/7RLi0.
- There are exciting new developments in treating HCV infection w/o interferon. Learn more in The AGA Journals Blog. ow.ly/7QhbJ.
Have any news that you would like us to share with our AGA members? Please send them to communications@gastro.org or share them on our social media channels:
- Become an AGA fan on Facebook.
- Join our LinkedIn group.
- Follow us on Twitter @AmerGastroAssn.
- Check out our videos on YouTube.
RESEARCH
Support the Future of GI Research
AGA members play a key role in sustaining our subspecialty. Through your gifts to the AGA Research Foundation, you support young investigators striving to develop independent research careers in GI; 100 percent of your gift will go directly to supporting research.
Make a secure online donation to the AGA Research Foundation Research Awards Program or call foundation staff at 301-222-4002.
Research Awards Deadlines Are Approaching
The AGA would like to remind you of the upcoming deadlines for the following research awards:
- The inaugural AGA-Emmet B. Keeffe Award in Translational or Clinical Research in Liver Disease will provide a young physician investigator $70,000 for one year to pursue research on viral hepatitis, liver transplantation or other liver disease-themed areas. This award, in memory of Emmet B. Keeffe, MD, will allow physician investigators to pursue independent, productive research careers in translational or clinical research related to liver disease. Applications are due on Feb. 3. Support of this program by Vertex Pharmaceuticals Incorporated and the many individuals who contributed to the Emmet B. Keeffe Liver Fellowship Fund is gratefully acknowledged.
- The 12th annual June & Donald O. Castell, MD, Esophageal Clinical Research Award provides $25,000 for research/salary support to young investigators interested in esophageal disease research. The application deadline is Jan. 20. Support of this program by the June and Donald O. Castell, MD, Gastroenterology Research and Education Trust is gratefully acknowledged.
- The Elsevier Pilot Research Award will give $25,000 for one year to investigators piloting GI or hepatology projects in different research directions than their prior focus. This provides time for investigators to obtain new data that can eventually lead to subsequent grant applications for a greater funding amount and longer period of time. The application deadline for this grant is Jan. 13.
- The deadline for the AGA-Takeda Research Scholar Award in GERD has been extended to Jan. 13. This award provides $60,000 per year for two years to young investigators working toward independent careers in gastroenterology, hepatology or related areas, and is limited to research relevant to GERD. Support of this program by Takeda Pharmaceuticals North America Incorporated is gratefully acknowledged.
All research awards candidates must be AGA members at the time of application submission. Apply online at www.gastro.org/foundation.
Your AGA Research Foundation Gifts Support ...
… Alana Sherker, MD, of Queens University, who received a 2011 AGA-Stuart Brotman Student Research Fellowship Award.
“The AGA has provided me with an opportunity to continue along the research about which I am passionate. Hepatitis C virus (HCV) is a leading cause of liver disease worldwide. Chronic HCV infection may lead to cirrhosis, liver failure and liver cancer, and is the dominant indication for liver transplantation. The best available treatment with peginterferon and ribavirin is costly, associated with significant adverse effects and frequently ineffective. Through my previous research with Jordan Feld, MD, we found that this small antimicrobial peptide, alpha-defensin, had an antiviral effect as well, and we hope to elucidate the mechanism of action through further investigation.”
“With the help of the AGA Research Foundation, Dr. Feld and his team of researchers, I hope we will be able to provide insight on a new potential therapeutic option for HCV.”
To make a donation, visit http://www.gastro.org/contribute.
EDUCATION & MEETINGS
AGA Institute Council Accepting Freston Conference Proposals
For the first time since the creation of the James W. Freston Single Topic Conference series, the AGA Institute Council will accept conference proposals from all AGA members. This is a unique opportunity for AGA members to help determine the topic of the 1.5-day conference, with a chance to serve as a conference director.
The council is looking for novel proposals covering primarily basic and translational science, with suggestions for new speakers and innovative conference formats. For the past four years, the James W. Freston Conference, funded by a generous educational endowment from Takeda Pharmaceuticals, has presented cutting-edge science from leaders in the areas of celiac disease, GI injury and stem cells. This conference typically attracts more than 100 attendees from around the world, and offers speakers and attendees an intimate environment to share findings and foster collaborations.
The fall 2013 conference is up to you. Submit a proposal by Jan. 18, 2012, for consideration.
Discount on Functional GI Disorders Resources
AGA members will receive a 20 percent discount on the purchase of educational products from the Rome Foundation.
The Rome Foundation computer-based learning program is a collection of state-of-the-art slides that brings to life information from the Rome III book and updates this information from the recent scientific literature.
Designed by the world’s leading experts on functional GI disorders, the program is the product of a two-year effort by international clinicians and investigators. Using animations and videos, the slides illustrate concepts that can be difficult to explain verbally. Every image includes a clearly written description with key references.
The slides are available for purchase as a complete set of 825 images, as modules or as individual slides.
The Rome III book, available in English and Spanish, is designed for one-stop learning about functional GI disorders. It serves as a valuable resource to general and specialist physicians, mental health professionals, and basic and clinical investigators.
Both products can be purchased from the Rome Foundation’s online store. Enter the discount code AGAMEMBER to save 20 percent on your order.
JOURNALS & PUBLICATIONS
El-Serag Named Incoming Editor-in-Chief of CGH
The AGA has selected Hashem B. El-Serag, MD, MPH, to lead its clinical specialty journal, Clinical Gastroenterology and Hepatology (CGH) starting in July 2012. Dr. El-Serag is currently the Dan L. Duncan professor of medicine and chief of the gastroenterology and hepatology section at Baylor College of Medicine (BCM). He also serves as GI section chief at the Michael E. DeBakey Veteran Affairs Medical Center.
Dr. El-Serag obtained his medical degree from Al-Arab Medical University in Libya and completed his fellowship in clinical gastroenterology at the University of New Mexico, where he also earned a masters degree in public health. In 1999, he joined the Houston VA Medical Center and BCM, where he ultimately became GI section chief in 2007.
Dr. El-Serag is renowned for his seminal research on the epidemiology of hepatocellular carcinoma, and is an internationally recognized authority on the epidemiology of several other digestive diseases, including hepatitis C, GERD and Barrett’s esophagus. He has been awarded more than 40 grants and published more than 230 journal papers.
Dr. El-Serag has been actively involved in several committees and courses for the AGA, notably as faculty member, and later co-director of the AGA Academic Skills Workshop; member and chair of the Abstract Selection Committee; and member of the Research Policy, Nominating and Future Trends committees. He also served as an associate editor for Gastroenterology, as well as on the editorial boards for the American Journal of Gastroenterology, Journal of Clinical Gastroenterology, Evidence-Based Gastroenterology and Digestive and Liver Disease.
Changes to CGH under Dr. El-Serag’s editorship will include such new sections as “Evidence-Based Reviews in Clinical Gastroenterology and Hepatology,” which will feature both solicited and unsolicited rigorous systematic reviews; and “Practice Management: The Road Ahead,” a section examining new and future developments in health-care policy and reform, and their effect on gastroenterology and hepatology practices. “We look forward to continuing the successful legacy of Dr. Wilcox’s group, and feel confident that with the outstanding group of incoming associate and special section editors and the AGA’s support, we will take CGH to a new high in terms of readership and impact,” Dr. El-Serag says.
Gastro and CGH Video Abstracts of the Month
Watch Stefan Zeuzem, MD, discuss his recently published Gastroenterology article, “Efficacy of the Protease Inhibitor BI 201335, Polymerase Inhibitor BI 207127, and Ribavirin in Patients with Chronic HCV Infection.” Provide your thoughts and comments on this important study via the YouTube comments tool.
Also watch Gene Y. Im, MD, discuss his recently published Clinical Gastroenterology and Hepatology article, “The Appendix May Protect Against Clostridium difficile Recurrence.” Provide your thoughts and comments on this important study via the YouTube comments tool.
View our comprehensive library of video abstracts and educational videos on the AGA YouTube channel.
Check Out New Content in Journals IBD Resource Center
New content has been added to the AGA journals' IBD Resource Center, the one-stop website dedicated to the latest IBD research published in Gastroenterology and Clinical Gastroenterology and Hepatology. The center, which debuted in May of this year, features original research, video abstracts, podcasts and clinical cases accompanied by striking images. Recently added content is easy to identify — simply look for the “New!” icon.
Newly added original research includes articles on the management of intra-abdominal abscesses in Crohn's disease and the loss of interaction between microbiota and mucosa of patients with ulcerative colitis. The center’s editor, John F. Kuemmerle, MD, AGAF, has also added new multimedia, including a podcast interview with Brooks D. Cash, MD, AGAF, about the prevalence of celiac disease among patients with nonconstipated IBD. Also, a new video abstract featuring Rayko Estatiev, MD, from the Medical University of Vienna, Austria, offers insight into the use of ferric carboxymaltose for iron deficiency anemia in IBD.
Gastroenterology’s popular 2011 special issue “Inflammatory Bowel Disease: An Update on Fundamental Biology and Clinical Management” is also available through the IBD Resource Center.
Also, be sure to check out the center’s other resources, including a link to active clinical trials in IBD, as well as a link to the AGA Directory of Gastroenterological Researchers. The directory can help connect investigators interested in IBD through identifying potential collaborators and mentors.
Dr. Kuemmerle and Editors-in-Chief M. Bishr Omary, MD, PhD, and C. Mel Wilcox, MD, are interested in receiving your feedback about the IBD Resource Center. Please e-mail comments to edubnansky@gastro.org.
POLICY
NPDB Exempt from Certain Sections of Privacy Act
HHS published a final rule exempting the national practitioner data bank system (NPDB) from certain sections of the Privacy Act of 1974. As a result of this rule, physicians will no longer be notified if someone is checking their record at the NPDB. According to HHS, the exemption is necessary because the NPDB expanded to include adverse licensure actions taken against health-care practitioners by any authority of the state responsible for the licensing of such practitioners or entities. The rule also requires states to report any negative action or finding that a state licensing authority, a peer review organization or a private accreditation entity has finalized against a health-care practitioner or entity.
The rule exempts the NBPD from requirements that physicians be provided an accounting of disclosures of their records, access to correct or amend their records, and the procedures whereby individuals can be notified at their request if the system contains records about them. HHS noted in the rule that notifying an individual who is the subject of an investigation could reveal the nature and scope of the investigation and could result in altering or destruction of evidence, improper influencing of witnesses and other actions that could compromise an investigation
Groups that can view information in the NPDB include: hospitals, other health-care entities that conduct peer review; state medical, dental and other health-care practitioner boards; state licensing authorities; agencies administering federal and state health-care programs and state Medicaid fraud-control units; law enforcement agencies; and quality control peer review organizations.
The final rule is effective Dec. 23, 2011.
CMS Issues Final Rule on Release of Medicare Data
CMS announced a final rule that will make more information available to the public about the performance of providers, while protecting patient privacy. The final rule explains how organizations can become qualified by CMS to receive standardized extracts of Medicare claims data under Parts A, B and D for the purpose of measuring provider and supplier performance. Qualified entities will be required to confidentially share measures, measurement methodologies and measure results with providers 60 days prior to publication of any performance reports.
The final rule is required by the Affordable Care Act as part of an initiative to promote transparency in the provision of health-care services, and will be effective Jan. 6, 2012.
CAREER
Increase your Resume's Exposure with GICareerSearch.com
GICareerSearch.com, the official online job bank of the AGA, is the premier job site for GI professionals. GICareerSearch.com offers hundreds of active job listings with new opportunities posted every day. Positions are available in academia and research, general gastroenterology, hepatology, pediatric gastroenterology and GI nursing.
Post your resume today.
Key resources:
- 24/7 Connectivity to Potential Employers. Job opportunities do not take a day off, neither should your resume. Be ready to answer the door when your opportunity comes knocking.
- Job Searches and Alerts. Use our search tools to find your ideal job fit. Receive e-mail notifications when new job matches are posted.
- Access to Invaluable Professional E-Newsletters. Our e-newsletters help you stay current in medical techniques and trends. Receive job-seeking advice, benefits and rewards available only to current HEALTHeCAREERS job seekers.
- Conference Connection™. Never miss out on a potential interview. With Conference Connection, you can set up face-to-face interviews with potential employers at industry events such as Digestive Disease Week®.
Find out more by visiting www.GICareerSearch.com, calling 888-884-8242 or e-mailing info@healthecareers.com.
GICareerSearch.com is a member of the HEALTHeCAREERS network of association career programs.
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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.
North Dakota
Regional Leaders in Gastroenterology
Immediate openings for BC/BE gastroenterologists interested in practicing in an organization experiencing dynamic growth and development. This procedure-oriented practice with Sanford Health Fargo offers you a great work-life balance with a call schedule of 1:8. Procedures performed include ERCP, EUS, SpyGlass® and capsule studies. Consults only in 583-bed level II trauma center with EMR and PACS. Opportunity to teach medical students and IM residents. Sanford Health Fargo consists of 585+ physicians located in Fargo and 34 regional primary care clinics.
Fargo, ND, with a metro population of 190,000, is a diverse, stimulating and family oriented city with all the amenities that make for a satisfying and fulfilling life. We offer exceptional K-12 and higher education systems, world-class health care, affordable housing, low cost of living, and myriad cultural and entertainment opportunities.
Jean Keller, physician recruiter
Sanford Health Physician Placement
Phone: 701-280-4853
E-mail: Jean.Keller@sanfordhealth.org
J1 candidates accepted.
