Committee to Evaluate the Artificial Heart Program of the National Heart, Lung, and Blood Institute's Books

The Artificial Heart

Prototypes, Policies, and Patients

By: Institute of Medicine,Division of Health Care Services,Committee to Evaluate the Artificial Heart Program of the National Heart, Lung, and Blood Institute

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The Artificial Heart

Prototypes, Policies, and Patients

By: Institute of Medicine,Division of Health Care Services,Committee to Evaluate the Artificial Heart Program of the National Heart, Lung, and Blood Institute

A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program-and in particular, the National Institutes of Health's major investment-raising important questions. The volume includes: Consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments. A look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions. Examination of how this technology's use can be targeted most appropriately. Attention to achieving access to this technology for all those who can benefit from it. The committee also offers three mechanisms to aid in allocating research and development funds.

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313

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National Academies Press

Published Date

ISBN 10

0309045320

ISBN 13

9780309045322

The Artificial Heart

Prototypes, Policies, and Patients

By: Institute of Medicine,Division of Health Care Services,Committee to Evaluate the Artificial Heart Program of the National Heart, Lung, and Blood Institute

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The Artificial Heart

Prototypes, Policies, and Patients

By: Institute of Medicine,Division of Health Care Services,Committee to Evaluate the Artificial Heart Program of the National Heart, Lung, and Blood Institute

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313

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National Academies Press

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ISBN 10

0309045320

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9780309045322

Assessment of the Scientific Information for the Radiation Exposure Screening and Education Program

By: National Research Council,Division on Earth and Life Studies,Board on Radiation Effects Research,Committee to Assess the Scientific Information for the Radiation Exposure Screening and Education Program

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Assessment of the Scientific Information for the Radiation Exposure Screening and Education Program

The Radiation Exposure Compensation Act (RECA) was set up by Congress in 1990 to compensate people who have been diagnosed with specified cancers and chronic diseases that could have resulted from exposure to nuclear-weapons tests at various U.S. test sites. Eligible claimants include civilian onsite participants, downwinders who lived in areas currently designated by RECA, and uranium workers and ore transporters who meet specified residence or exposure criteria. The Health Resources and Services Administration (HRSA), which oversees the screening, education, and referral services program for RECA populations, asked the National Academies to review its program and assess whether new scientific information could be used to improve its program and determine if additional populations or geographic areas should be covered under RECA. The report recommends Congress should establish a new science-based process using a method called "probability of causation/assigned share" (PC/AS) to determine eligibility for compensation. Because fallout may have been higher for people outside RECA-designated areas, the new PC/AS process should apply to all residents of the continental US, Alaska, Hawaii, and overseas US territories who have been diagnosed with specific RECA-compensable diseases and who may have been exposed, even in utero, to radiation from U.S. nuclear-weapons testing fallout. However, because the risks of radiation-induced disease are generally low at the exposure levels of concern in RECA populations, in most cases it is unlikely that exposure to radioactive fallout was a substantial contributing cause of cancer.

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430

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National Academies Press

Published Date

ISBN 10

0309165148

ISBN 13

9780309165143

Improving the Social Security Disability Decision Process

By: Institute of Medicine,Board on Military and Veterans Health,Committee on Improving the Disability Decision Process: SSA's Listing of Impairments and Agency Access to Medical Expertise

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Improving the Social Security Disability Decision Process

By: Institute of Medicine,Board on Military and Veterans Health,Committee on Improving the Disability Decision Process: SSA's Listing of Impairments and Agency Access to Medical Expertise

The Social Security Administration (SSA) provides Social Security Disability Insurance (SSDI) benefits to disabled persons of less than full retirement age and to their dependents. SSA also provides Supplemental Security Income (SSI) payments to disabled persons who are under age 65. For both programs, disability is defined as a "medically determinable physical or mental impairment" that prevents an individual from engaging in any substantial gainful activity and is expected to last at least 12 months or result in death. Assuming that an applicant meets the nonmedical requirements for eligibility (e.g., quarters of covered employment for SSDI; income and asset limits for SSI), the file is sent to the Disability Determination Services (DDS) agency operated by the state in which he or she lives for a determination of medical eligibility. SSA reimburses the states for the full costs of the DDSs. The DDSs apply a sequential decision process specified by SSA to make an initial decision whether a claim should be allowed or denied. If the claim is denied, the decision can be appealed through several levels of administrative and judicial review. On average, the DDSs allow 37 percent of the claims they adjudicate through the five-step process. A third of those denied decide to appeal, and three-quarters of the appeals result in allowances. Nearly 30 percent of the allowances made each year are made during the appeals process after an initial denial. In 2003, the Commissioner of Social Security announced her intent to develop a "new approach" to disability determination. In late 2004, SSA asked the Institute of Medicine (IOM) to help in two areas related to its initiatives to improve the disability decision process: 1) Improvements in the criteria for determining the severity of impairments, and 2) Improvements in the use of medical expertise in the disability decision process. This interim report provides preliminary recommendations addressing the three tasks that relate to medical expertise issues, with a special focus on the appropriate qualifications of medical and psychological experts involved in disability decision making. After further information gathering and analyses of the effectiveness of the disability decision process in identifying those who qualify for benefits and those who do not, the committee may refine its recommendations concerning medical and psychological expertise in the final report. The final report will address a number of issues with potential implications for the qualifications of the medical experts involved in the disability decision process.

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290

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National Academies Press

Published Date

ISBN 10

0309103819

ISBN 13

9780309103817

Adverse Effects of Pertussis and Rubella Vaccines

By: Institute of Medicine,Committee to Review the Adverse Consequences of Pertussis and RubellaVaccines

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Adverse Effects of Pertussis and Rubella Vaccines

By: Institute of Medicine,Committee to Review the Adverse Consequences of Pertussis and RubellaVaccines

Parents have come to depend on vaccines to protect their children from a variety of diseases. Some evidence suggests, however, that vaccination against pertussis (whooping cough) and rubella (German measles) is, in a small number of cases, associated with increased risk of serious illness. This book examines the controversy over the evidence and offers a comprehensively documented assessment of the risk of illness following immunization with vaccines against pertussis and rubella. Based on extensive review of the evidence from epidemiologic studies, case histories, studies in animals, and other sources of information, the book examines: The relation of pertussis vaccines to a number of serious adverse events, including encephalopathy and other central nervous system disorders, sudden infant death syndrome, autism, Guillain-Barre syndrome, learning disabilities, and Reye syndrome. The relation of rubella vaccines to arthritis, various neuropathies, and thrombocytopenic purpura. The volume, which includes a description of the committee's methods for evaluating evidence and directions for future research, will be important reading for public health officials, pediatricians, researchers, and concerned parents.

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382

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National Academies Press

Published Date

ISBN 10

0309103681

ISBN 13

9780309103688

Sources of Medical Technology

Universities and Industry

By: Institute of Medicine,Committee on Technological Innovation in Medicine

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Sources of Medical Technology

Universities and Industry

By: Institute of Medicine,Committee on Technological Innovation in Medicine

Evidence suggests that medical innovation is becoming increasingly dependent on interdisciplinary research and on the crossing of institutional boundaries. This volume focuses on the conditions governing the supply of new medical technologies and suggest that the boundaries between disciplines, institutions, and the private and public sectors have been redrawn and reshaped. Individual essays explore the nature, organization, and management of interdisciplinary R&D in medicine; the introduction into clinical practice of the laser, endoscopic innovations, cochlear implantation, cardiovascular imaging technologies, and synthetic insulin; the division of innovating labor in biotechnology; the government- industry-university interface; perspectives on industrial R&D management; and the growing intertwining of the public and proprietary in medical technology.

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255

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National Academies Press

Published Date

ISBN 10

0309051894

ISBN 13

9780309051897

HIV and the Blood Supply

An Analysis of Crisis Decisionmaking

By: Institute of Medicine,Committee to Study HIV Transmission Through Blood and Blood Products

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HIV and the Blood Supply

An Analysis of Crisis Decisionmaking

By: Institute of Medicine,Committee to Study HIV Transmission Through Blood and Blood Products

During the early years of the AIDS epidemic, thousands of Americans became infected with HIV through the nation's blood supply. Because little reliable information existed at the time AIDS first began showing up in hemophiliacs and in others who had received transfusions, experts disagreed about whether blood and blood products could transmit the disease. During this period of great uncertainty, decision-making regarding the blood supply became increasingly difficult and fraught with risk. This volume provides a balanced inquiry into the blood safety controversy, which involves private sexual practices, personal tragedy for the victims of HIV/AIDS, and public confidence in America's blood services system. The book focuses on critical decisions as information about the danger to the blood supply emerged. The committee draws conclusions about what was doneâ€"and recommends what should be done to produce better outcomes in the face of future threats to blood safety. The committee frames its analysis around four critical area: Product treatmentâ€"Could effective methods for inactivating HIV in blood have been introduced sooner? Donor screening and referralâ€"including a review of screening to exlude high-risk individuals. Regulations and recall of contaminated bloodâ€"analyzing decisions by federal agencies and the private sector. Risk communicationâ€"examining whether infections could have been averted by better communication of the risks.

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349

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National Academies Press

Published Date

ISBN 10

0309053293

ISBN 13

9780309053297

The Unequal Burden of Cancer

An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved

By: Institute of Medicine,Committee on Cancer Research Among Minorities and the Medically Underserved

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The Unequal Burden of Cancer

An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved

By: Institute of Medicine,Committee on Cancer Research Among Minorities and the Medically Underserved

We know more about cancer prevention, detection, and treatment than ever beforeâ€"yet not all segments of the U.S. population have benefited to the fullest extent possible from these advances. Some ethnic minorities experience more cancer than the majority population, and poor peopleâ€"no matter what their ethnicityâ€"often lack access to adequate cancer care. This book provides an authoritative view of cancer as it is experienced by ethnic minorities and the medically underserved. It offers conclusions and recommendations in these areas: Defining and understanding special populations, and improving the collection of cancer-related data. Setting appropriate priorities for and increasing the effectiveness of specific National Institutes of Health (NIH) research programs, to ensure that special populations are represented in clinical trials. Disseminating research results to health professionals serving these populations, with sensitivity to the issues of cancer survivorship. The book provides background data on the nation's struggle against cancer, activities and expenditures of the NIH, and other relevant topics.

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353

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National Academies Press

Published Date

ISBN 10

0309071542

ISBN 13

9780309071543

Halcion

An Independent Assessment of Safety and Efficacy Data

By: Institute of Medicine,Division of Health Sciences Policy,Committee on Halcion: An Assessment of Data Adequacy and Confidence

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Halcion

An Independent Assessment of Safety and Efficacy Data

By: Institute of Medicine,Division of Health Sciences Policy,Committee on Halcion: An Assessment of Data Adequacy and Confidence

Regulatory agencies within the United States and the United Kingdom, among several other countries, have reviewed extensively the safety and efficacy of Halcion (triazolam)â€"a once commonly used hypnotic drug. Concerns began to emerge about the safety of Halcion when a Dutch physician reported a possible link between it and a syndrome that included such effects as depression, amnesia, hallucinations, and increased anxiety. In addition, in 1991 its manufacturer, Upjohn, noted that "errors had been identified in a report of one of the clinical studies included in the original" application for approval. Since then, the drug has been removed from the market in several countries, whereas in the United States and Canada, the drug's labeling has been modified to reduce the recommended dose and duration of treatment and to heighten awareness of possible side effects. Yet different data and analyses have resulted in conflicting messages that are difficult to reconcile and interpret. In response to a request from the Food and Drug Administration to resolve these controversial issues related to the safety and efficacy of Halcion, this IOM book assesses the adequacy of the drug's clinical trials; the quality and quantity of data on adverse reactions; overall confidence in the data on effectiveness, adverse events, and side effects at different doses; and whether additional studies are needed.

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177

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National Academies Press

Published Date

ISBN 10

0309059763

ISBN 13

9780309059763

Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests

Review of the National Cancer Institute Report and Public Health Implications

By: Committee on Thyroid Screening Related to I-131 Exposure,Committee on Exposure of the American People to I-131 from the Nevada Atomic Bomb Tests,Commission on Life Sciences,Institute of Medicine,Division on Earth and Life Studies,National Research Council

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Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests

Review of the National Cancer Institute Report and Public Health Implications

In 1997, after more than a decade of research, the National Cancer Institute (NCI) released a report which provided their assessment of radiation exposures that Americans may have received from radioactive iodine released from the atomic bomb tests conducted in Nevada during the 1950s and early 1960s. This book provides an evaluation of the soundness of the methodology used by the NCI study to estimate: Past radiation doses. Possible health consequences of exposure to iodine-131. Implications for clinical practice. Possible public health strategies--such as systematic screening for thyroid cancer--to respond to the exposures. In addition, the book provides an evaluation of the NCI estimates of the number of thyroid cancers that might result from the nuclear testing program and provides guidance on approaches the U.S. government might use to communicate with the public about Iodine-131 exposures and health risks.

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289

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National Academies Press

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ISBN 10

030952248X

ISBN 13

9780309522489

AIDS and Behavior

An Integrated Approach

By: Institute of Medicine,Committee on Substance Abuse and Mental Health Issues in AIDS Research

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AIDS and Behavior

An Integrated Approach

By: Institute of Medicine,Committee on Substance Abuse and Mental Health Issues in AIDS Research

HIV is spreading rapidly, and effective treatments continue to elude science. Preventive interventions are now our best defense against the epidemicâ€"but they require a clear understanding of the behavioral and mental health aspects of HIV infection and AIDS. AIDS and Behavior provides an update of what investigators in the biobehavioral, psychological, and social sciences have discovered recently about those aspects of the disease and offers specific recommendations for research directions and priorities. This volume candidly discusses the sexual and drug-use behaviors that promote transmission of HIV and reports on the latest efforts to monitor the epidemic in its social contexts. The committee reviews new findings on how and why risky behaviors occur and efforts to develop strategies for changing such behaviors. The volume presents findings on the disease's progression and on the psychosocial impacts of HIV and AIDS, with a view toward intervention and improved caregiving. AIDS and Behavior also evaluates the status of behavioral and prevention aspects of AIDS research at the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. The volume presents background on the three institutes; their recent reorganization; their research budgets, programs, and priorities; and other important details. The committee offers specific recommendations for the institutes concerning the balance between biomedical and behavioral investigations, adequacy of administrative structures, and other research management issues. Anyone interested in the continuing quest for new knowledge on preventing HIV and AIDS will want to own this book: policymakers, researchers, research administrators, public health professionals, psychologists, AIDS advocates and service providers, faculty, and students.

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357

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National Academies Press

Published Date

ISBN 10

0309050936

ISBN 13

9780309050937

Assessing Medical Technologies

By: Institute of Medicine,Division of Health Promotion and Disease Prevention,Division of Health Sciences Policy,Committee for Evaluating Medical Technologies in Clinical Use

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Assessing Medical Technologies

By: Institute of Medicine,Division of Health Promotion and Disease Prevention,Division of Health Sciences Policy,Committee for Evaluating Medical Technologies in Clinical Use

New drugs, new devices, improved surgical techniques, and innovative diagnostic procedures and equipment emerge rapidly. But development of these technologies has outpaced evaluation of their safety, efficacy, cost-effectiveness, and ethical and social consequences. This volume, which is "strongly recommended" by The New England Journal of Medicine "to all those interested in the future of the practice of medicine," examines how new discoveries can be translated into better care, and how the current system's inefficiencies prevent effective health care delivery. In addition, the book offers detailed profiles of 20 organizations currently involved in medical technology assessment, and proposes ways to organize U.S. efforts and create a coordinated national system for evaluating new medical treatments and technology.

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592

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National Academies Press

Published Date

ISBN 10

030903583X

ISBN 13

9780309035835

The Impact of Academic Research on Industrial Performance

By: National Academy of Engineering,Committee on the Impact of Academic Research on Industrial Performance

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The Impact of Academic Research on Industrial Performance

By: National Academy of Engineering,Committee on the Impact of Academic Research on Industrial Performance

Drawing on the findings of sector-specific workshops, e-mail surveys, research literature, expert testimony, and committee and panel members' expertise, this National Academy of Engineering study assesses the qualitative impact of academic research on five industriesâ€"network systems and communications; medical devices and equipment; aerospace; transportation, distribution, and logistics services; and financial services. The book documents the range and significance of academic research contributions to the five industriesâ€"comparing the importance of different types of contributions, the multi- and interdisciplinary nature of these contributions, and the multiple vectors by which academic research is linked to each industry. The book calls for action to address six cross-cutting challenges to university-industry interactions: the growing disciplinary and time-horizon-related imbalances in federal R&D funding, barriers to university-industry interaction in service industries, the critical role of academic research in the advancement of information technology, the role of academic research in the regulation of industry, the impact of technology transfer activities on core university research and education missions, and the search for new pathways and mechanisms to enhance the contributions of academic research to industry. The book also includes findings and recommendations specific to each industry.

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265

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National Academies Press

Published Date

ISBN 10

0309089735

ISBN 13

9780309089739

Book's by Committee to Evaluate the Artificial Heart Program of the National Heart, Lung, and Blood Institute

The Artificial Heart

The Artificial Heart

The Artificial Heart

The Artificial Heart

Assessment of the Scientific Information for the Radiation Exposure Screening and Education Program

Assessment of the Scientific Information for the Radiation Exposure Screening and Education Program

Improving the Social Security Disability Decision Process

Improving the Social Security Disability Decision Process

Adverse Effects of Pertussis and Rubella Vaccines

Adverse Effects of Pertussis and Rubella Vaccines

Sources of Medical Technology

Sources of Medical Technology

HIV and the Blood Supply

HIV and the Blood Supply

The Unequal Burden of Cancer

The Unequal Burden of Cancer

Halcion

Halcion

Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests

Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests

AIDS and Behavior

AIDS and Behavior

Assessing Medical Technologies

Assessing Medical Technologies

The Impact of Academic Research on Industrial Performance

The Impact of Academic Research on Industrial Performance

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