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Rational Therapeutics for Infants and Children
The Institute of Medicine's (IOM's) Roundtable on Research and Development of Drugs, Biologics, and Medical Devices evolved from the Forum on Drug Development, which was established in 1986. Sponsor representatives and IOM determined the importance of maintaining a neutral setting for discussions regarding long-term and politically sensitive issues justified the need to revise and enhance past efforts. The new Roundtable is intended to be a mechanism by which a broad group of experts from the public* and private sectors can be convened to conduct a dialogue and exchange information related to the development of drugs, biologics, and medical devices. Members have expertise in clinical medicin...
Leadership Commitments to Improve Value in Health Care
This volume reports on discussions among multiple stakeholders about ways they might help transform health care in the United States. The U.S. healthcare system consists of a complex network of decentralized and loosely associated organizations, services, relationships, and participants. Each of the healthcare system's component sectors-patients, healthcare professionals, healthcare delivery organizations, healthcare product developers, clinical investigators and evaluators, regulators, insurers, employers and employees, and individuals involved in information technology-conducts activities that support a common goal: to improve patient health and wellbeing. Implicit in this goal is the commitment of each stakeholder group to contribute to the evidence base for health care, that is, to assist with the development and application of information about the efficacy, safety, effectiveness, value, and appropriateness of the health care delivered.
Public Health Systems and Emerging Infections
The Forum on Emerging Infections was created in 1996 in response to a request from the Centers for Disease Control and Prevention and the National Institutes of Health. The goal of the forum is to provide structured opportunities for representatives from academia, industry, professional and interest groups, and government to examine and discuss scientific and policy issues that relate to research, prevention, detection, and management of emerging infectious diseases. A critical part of this mission has been the convening of a series of workshops. Public Health Systems and Emerging Infections summarizes the fourth in a series of five workshops. With a focus on our knowledge and understanding of the role of private and public health sectors in emerging infectious disease surveillance and response, the participants explored the effects of privatization of public health laboratories and the modernization of public health care. The issues discussed included epidemiological investigation, surveillance, communication, coordination, resource allocations, and economic support.
Managed Care Systems and Emerging Infections
This workshop summary report examines how the managed care revolution has created both problems and opportunities in the fight against infectious diseases. It highlights ways in which managed care systems can aid research, develop clinical guidelines, manage the use of antibiotics, support public education efforts, and monitor the spread of emerging infections and microbial resistance.
Fluid Resuscitation
Historically, 20% of all injured combatants die on the battlefield before they can be evacuated to a field hospital. Blood lossâ€"hemorrhageâ€"is the single major cause of death among those killed in action whose lives might otherwise be saved. Fluid resuscitation and the treatment of hypovolemia (the abnormally decreased volume of circulating fluid in the body) offer the greatest opportunity for reducing mortality and morbidity associated with battlefield casualties. In Fluid Resuscitation, a committee of experts assess current resuscitation fluids and protocols for the treatment of combat casualties and make recommendations for future research. Chapters focus on the pathophysiology o...
Rebuilding the Unity of Health and the Environment
This is a summary of the workshop Rebuilding the Unity of Health and the Environment: A New Vision of Environmental Health for the 21st Century. The goal of this workshop was to emphasize the connection between human health and the natural, built, and social environments. This workshop integrated talks from many fields and created a dialogue among various environmental health stakeholders. The language presented in this respect should not be viewed as an endorsement by the Environmental Health Sciences Roundtable or the Institute of Medicine of what action is needed for the future, but rather as an effort to synthesize the various perspectives presented.
Organ Procurement and Transplantation
Each day, nearly 60 Americans receive a transplanted kidney, liver, or other organâ€"a literal "second chance at life"â€"but 11 others die waiting for an organ transplant. The number of donors, although rising, is not growing fast enough to meet the increasing demand. Intended to improve the current system of organ procurement and allocation, the "Final Rule," a 1998 regulation issued by the U.S. Department of Health and Human Services, sparked further controversy with its attempts to eliminate the apparent geographic disparities in the time an individual must wait for an organ. This book assesses the potential impact of the Final Rule on organ transplantation. It also presents new, original analyses of data, and assesses medical practices, social and economic observations, and other information on: access to transplantation services for low-income populations and racial and ethnic minority groups; organ donation rates; waiting times for transplantation; patient survival rates and organ failure rates leading to retransplantation; and cost of organ transplantation services.
Redesigning the Clinical Effectiveness Research Paradigm
Recent scientific and technological advances have accelerated our understanding of the causes of disease development and progression, and resulted in innovative treatments and therapies. Ongoing work to elucidate the effects of individual genetic variation on patient outcomes suggests the rapid pace of discovery in the biomedical sciences will only accelerate. However, these advances belie an important and increasing shortfall between the expansion in therapy and treatment options and knowledge about how these interventions might be applied appropriately to individual patients. The impressive gains made in Americans' health over the past decades provide only a preview of what might be possib...
The Learning Healthcare System
As our nation enters a new era of medical science that offers the real prospect of personalized health care, we will be confronted by an increasingly complex array of health care options and decisions. The Learning Healthcare System considers how health care is structured to develop and to apply evidence-from health profession training and infrastructure development to advances in research methodology, patient engagement, payment schemes, and measurement-and highlights opportunities for the creation of a sustainable learning health care system that gets the right care to people when they need it and then captures the results for improvement. This book will be of primary interest to hospital ...
Emerging Infectious Diseases from the Global to the Local Perspective
In October 1999, the Forum on Emerging Infections of the Institute of Medicine convened a two-day workshop titled "International Aspects of Emerging Infections." Key representatives from the international community explored the forces that drive emerging infectious diseases to prominence. Representatives from the Americas, Africa, Asia and the Pacific, and Europe made formal presentations and engaged in panel discussions. Emerging Infectious Diseases from the Global to the Local Perspective includes summaries of the formal presentations and suggests an agenda for future action. The topics addressed cover a wide range of issues, including trends in the incidence of infectious diseases around the world, descriptions of the wide variety of factors that contribute to the emergence and reemergence of these diseases, efforts to coordinate surveillance activities and responses within and across borders, and the resource, research, and international needs that remain to be addressed.
