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Version 10.2

July 2014

What's New in the Healthwise Knowledgebase lists new documents, noteworthy enhancements to existing documents, and medically significant changes to existing documents. We do not list every change, such as editorial changes, made for this release. Refer to Tech Docs for a complete list of new and updated documents.

  • New Health and Disease Topics
  • Enhanced Content
  • New NCI Topics
  • New Medication Topics
  • New Aisle 7 (CAM) Content
  • Actionset Updates
  • Decision Point Updates
  • Health and Disease Topic Updates
  • Illustration Updates
  • Medical Test Topic Updates
  • Symptom Topic Updates
  • NCI Topic Updates
  • Medication Topic Updates
  • Aisle 7 (CAM) Content Updates
  • Topic Title Changes and Topic Replacements
  • Medical Guideline Reviews
  • What's Next
  • Birth Control Hormones: The Implant: This new topic describes what the progestin implant is, how it works, and its advantages and disadvantages.
  • Birth Control Hormones: The Mini-Pill: This new topic describes what the progestin mini-pill is, how it works, and its advantages and disadvantages.
  • Birth Control Hormones: The Patch: This new topic describes what the estrogen-progestin patch is, how it works, and its advantages and disadvantages.
  • Birth Control Hormones: The Pill: This new topic describes what the estrogen-progestin pill is, how it works, and its advantages and disadvantages.
  • Birth Control Hormones: The Ring: This new topic describes what the estrogen-progestin ring is, how it works, and its advantages and disadvantages.
  • Birth Control Hormones: The Shot: This new topic describes what the progestin shot is, how it works, and its advantages and disadvantages.
  • The Difference Between Hospice and Palliative Care: This new topic helps readers understand how these two types of care are different. It compares things like time and place of care and the types of care involved.
  • Giant Cell Arteritis: This new topic describes giant cell arteritis and medicines used to treat it.
  • High Blood Pressure: Over-the-Counter Medicines to Avoid: This new topic helps readers understand what kinds of nonprescription medicines might interact with their high blood pressure medicine.
  • Keloid Scars: This new topic describes what keloid scars are, what causes them, and how to prevent and treat them.
  • Nightmares and Other Sleep Problems in Children: This new topic describes sleep problems in children. It includes information on nightmares, night terrors, sleepwalking, and night talking. It describes when and how the problems occur and ways parents can help their children.
  • Abnormal Uterine Bleeding: Should I Have a Hysterectomy?: This topic, which originally discussed the pros and cons of hormone medicines for abnormal uterine bleeding, now compares the pros and cons of hysterectomy with those of more conservative treatments, including hormone medicine.
  • Lung Cancer Screening: This topic explains screening guidelines for lung cancer, including for whom low-dose CT-scan screening is recommended. We have updated the recommended ages for screening and have added other information from the latest guidelines for lung cancer screening.
  • Rehabilitation Programs for Multiple Sclerosis: This topic is no longer in an Actionset format. It has been rewritten in plain language that is easy to understand. Our plain-language content has a reading level of 6th- to 8th-grade or lower.
  • Understanding Health Insurance: We added brief information about the Affordable Care Act and provided Web resources for the ACA.

We have updated the language about palliative care in the following documents:

  • Alzheimer's Disease
  • Amyotrophic Lateral Sclerosis (ALS)
  • Bladder Cancer
  • Breast Cancer, Metastatic or Recurrent
  • Cancer Pain
  • Cervical Cancer
  • Chronic Kidney Disease
  • Cirrhosis
  • Colorectal Cancer, Metastatic or Recurrent
  • COPD (Chronic Obstructive Pulmonary Disease)
  • Coronary Artery Disease
  • Dementia
  • Endometrial (Uterine) Cancer
  • Heart Attack and Unstable Angina
  • Heart Failure
  • Hepatitis C
  • Kidney (Renal Cell) Cancer
  • Leukemia
  • Lung Cancer
  • Non-Hodgkin's Lymphoma
  • Ovarian Cancer
  • Pancreatic Cancer
  • Parkinson's Disease
  • Prostate Cancer, Advanced or Metastatic
  • Skin Cancer, Melanoma
  • Testicular Cancer
  • Thyroid Cancer

We revised the following documents to help readers focus on the key points for the specific health issue. Also, we verified that the content is written in plain language and is at or below a 6th- to 8th-grade reading level.

  • Polymyalgia Rheumatica
  • Temper Tantrums

Refer to Tech Docs for a complete list of new National Cancer Institute content.

Medication topics from Cerner Multum, Inc., are not included in all systems. Added topics may include new information and/or the addition of new drug names. Refer to Tech Docs for a complete list of new titles.

Refer to Tech Docs for a complete list of new Aisle 7 (CAM) content.

We continually monitor changes in medicine to ensure our topics are accurate and up-to-date. In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • Diabetes in Children: Giving Insulin Shots to a Child: We added information about a subcutaneous cannula for insulin delivery.
  • Diabetes: Living With an Insulin Pump: We added information about new types of insulin pumps, including the insulin pump patch.

We continually monitor changes in medicine to ensure our topics are accurate and up-to-date. In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • Atrial Fibrillation: Which Anticoagulant Should I Take to Prevent Stroke?: In Get the Facts under "How are these medicines different?" we added that the newer oral anticoagulants have a lower risk of intracranial bleeding compared with warfarin.
  • Breast Cancer Risk: Should I Have a BRCA Gene Test?: In Get the Facts under "How do you know if you have a strong family history of breast or ovarian cancer?" we revised our risk information to reflect the updated 2013 U.S. Preventive Services Task Force guideline on risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women.
  • Breast Cancer: What Should I Do if I'm at High Risk?: In Get the Facts under "How do you know if you are at high risk for breast cancer?" we revised our risk information to reflect the updated 2013 U.S. Preventive Services Task Force guideline on risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women.
  • Diabetes: Should I Get an Insulin Pump?: In Get the Facts, we added information about new types of insulin pumps and new features, including the insulin pump patch and pumps that monitor blood sugar.
  • Hepatitis C: Should I Take Antiviral Medicine?:
    • Get the Facts: We updated the key points to reflect the new successful treatments for hepatitis C. Under "What medicines are used to treat hepatitis C?" we added the new medicines simeprevir and sofosbuvir to the discussion of medicines used to treat hepatitis C. Under "Who should take antiviral medicines for hepatitis C?" we removed information that was becoming outdated and added "The medicines used in the past to treat hepatitis C were not always very effective, especially for infection with genotype 1. However, new medicines are available that are much more effective and have fewer side effects. So people who may not have been treated before are being treated successfully now." We will update this section again when treatment recommendations are released. Under "How well do antiviral medicines work?" we added information about the effectiveness of treatment using sofosbuvir.
    • Compare Your Options: Under "What is usually involved?" for taking antiviral medicine, we changed "You take shots and pills for 6 months to a year" to "You take medicine for 12 weeks to a year" to reflect the new treatments for hepatitis C. And under "What else do you need to make your decision?" we updated the questions and answers of the quiz to reflect the new, more successful treatments for hepatitis C.
  • Multiple Sclerosis: Should I Start Taking Medicines for MS?: In Get the Facts, under What if you don't take MS medicines? we added information about alternative therapy, with a note to talk to your doctor before trying it.

We continually monitor changes in medicine to ensure our topics are accurate and up-to-date. In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • Allergic Rhinitis:
    • Other Treatment: We now talk about sublingual immunotherapy for certain pollen allergies.
  • Anticoagulants for Pulmonary Embolism: We added dabigatran (Pradaxa) to the list of medicines that are used to treat pulmonary embolism.
  • Anticoagulants Other Than Warfarin for Atrial Fibrillation: We removed the link to the interactive tool (CHADS2) to calculate stroke risk, because the tool is not consistent with the recommended calculation (CHA2DS2-VASC) in the AHA/ACC/HRS 2014 guideline for the management of patients with atrial fibrillation.
  • Anticoagulants Other Than Warfarin for Deep Vein Thrombosis: We added apixaban (Eliquis) and dabigatran (Pradaxa) to the list of medicines used to prevent or treat deep vein thrombosis.
  • Asthma in Children:
    • Other Treatment: We now mention immunotherapy pills for certain allergies.
  • Asthma in Teens and Adults:
    • Other Treatment: We now mention immunotherapy pills for certain allergies.
  • Atrial Fibrillation: We removed the links to the interactive tool (CHADS2) to calculate stroke risk, because the tool is not consistent with the recommended calculation (CHA2DS2-VASC) in the AHA/ACC/HRS 2014 guideline for the management of patients with atrial fibrillation.
  • Birth Control for Teens: We added more information about the importance of using condoms to help protect against STIs.
  • Catheter Ablation for Atrial Fibrillation: We removed the link to the interactive tool (CHADS2) to calculate stroke risk, because the tool is not consistent with the recommended calculation (CHA2DS2-VASC) in the AHA/ACC/HRS 2014 guideline for the management of patients with atrial fibrillation.
  • Childbirth: Laboring in Water and Water Delivery: We now say that the American College of Obstetricians and Gynecologists does not recommend giving birth in water.
  • Congenital Heart Defects: Caring for Your Child: Under "Giving medicine," we added a recommendation for the parent to get instructions on how to give blood thinners safely.
  • Deep Vein Thrombosis:
    • Medications: We added apixaban (Eliquis) and dabigatran (Pradaxa) to the list of anticoagulants.
  • Emergency Contraception: We added a warning that if you are overweight or obese, emergency contraception pills may not work as well to prevent a pregnancy.
  • Family History and the Risk for Breast or Ovarian Cancer: Under "What is a BRCA gene change?" we revised our risk information to reflect the updated 2013 U.S. Preventive Services Task Force guideline on risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women.
  • Hay Fever and Other Seasonal Allergies: We now talk about immunotherapy as a treatment option for some people.
  • Health Screening: Finding Health Problems Early:
    • Lung Cancer Screening: We added the USPSTF recommendations about annual lung cancer screening.
  • Heart Disease and Stroke in Women: Reducing Your Risk: We added stroke prevention information based on the American Heart Association/American Stroke Association guidelines for the prevention of stroke in women.
  • Heart Tests: When Do You Need Them?: We added invasive heart tests and noninvasive imaging tests to the list of tests. We added information on cardiac catheterization, coronary angiogram, cardiac CT, cardiac MRI, cardiac perfusion scan, and cardiac blood pool scan. We added a new section that encourages shared decision making.
  • Hepatitis C:
    • Topic Overview: Under "How is it treated?" we added the new medicine sofosbuvir to the examples of antiviral medicines used to treat hepatitis C.
    • Medications: Under "Medicine choices," we removed the separate genotype sections and created a link to a new document containing updated information about new drug combinations for hepatitis C treatment. And under "What to think about," we updated the time frames typically used for treatment of the different hepatitis virus genotypes.
  • Heroin: We added information on how a naloxone rescue kit may be used to help prevent an opioid-induced overdose.
  • Medical Marijuana: We say medical marijuana may help relieve symptoms such as pain and spasticity in people who have multiple sclerosis.
  • Multiple Sclerosis: Alternative Treatments: Based on a summary of evidence of complementary and alternative treatments for multiple sclerosis, we now note that some forms of natural or man-made substances related to marijuana may help with pain or spasticity; ginkgo biloba or magnet therapy may help with fatigue; and reflexology may help with skin feelings such as tingling and numbness. We also note several treatments that are not likely to help.
  • Multiple Sclerosis: Medicines for Muscle Stiffness and Tremors: We say some forms of natural or man-made cannabinoids may help relieve spasticity.
  • Multiple Sclerosis (MS):
    • Medications: We added information on cannabinoids for MS symptoms such as pain and spasticity.
  • Multiple Sclerosis: Pain Medicines: We say some forms of natural or man-made cannabinoids may help relieve pain.
  • Pancreatic Cancer:
    • Exams and Tests: We added a blood chemistry screen and tumor marker tests to the list of tests that may be done to look for or diagnose pancreatic cancer.
    • Treatment Overview: We now include targeted therapy with treatments for pancreatic cancer.
  • Preeclampsia: We added information about the increased long-term risk of heart disease, stroke, and kidney disease in women who have had preeclampsia.
  • Preventing Poisoning in Young Children: We added a warning for parents to keep e-cigarettes away from children. They can cause illness or death.
  • Pulmonary Embolism:
    • Medications: We added dabigatran (Pradaxa) to the list of medicines that are used to treat pulmonary embolism.
  • Safe Use of Long-Acting Opiates: We added information on how a naloxone rescue kit may be used to help prevent an opioid-induced overdose.
  • Schizophrenia: We added information to reflect diagnostic changes set forth by the DSM-5.
  • Type 1 Diabetes in Children: Caring for Your Child: We added information about a subcutaneous cannula for insulin delivery.
  • Warfarin for Atrial Fibrillation: We removed the link to the interactive tool (CHADS2) to calculate stroke risk because the tool is not consistent with the recommended calculation (CHA2DS2-VASC) in the AHA/ACC/HRS 2014 guideline for the management of patients with atrial fibrillation.

In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • The illustration of effects of statins if you don't have heart disease has been revised. It appears in the topic Statins: Should I Take Them?
  • The illustration of effects of statins if you have heart disease has been revised. It appears in the topic Statins: Should I Take Them?

We continually monitor changes in medicine to ensure our topics are accurate and up-to-date. In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • Breast Cancer (BRCA) Gene Test:
    • Test Overview: We revised our risk information to reflect the updated 2013 U.S. Preventive Services Task Force guideline on risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women.
  • Chlamydia Tests: We revised the list of tests used for chlamydia screening to reflect the updated CDC recommendation to use Nucleic acid amplification tests (NAATs) as the primary screening test.
  • Gonorrhea Tests: We revised the list of tests used for gonorrhea screening to reflect the updated CDC recommendation to use Nucleic acid amplification tests (NAATs) as the primary screening test.

We continually monitor changes in medicine to ensure our topics are accurate and up-to-date. In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • Pregnancy-Related Problems:
    • Check Your Symptoms: We updated the triage questions based on the weeks of pregnancy at less than 20 weeks, 20 to 24 weeks, 24 to 37 weeks, and over 37 weeks.
  • Problems After Delivery of Your Baby:
    • Check Your Symptoms: We added a question on pus that develops at the site of a C-section incision.

Refer to Tech Docs for a complete list of updated National Cancer Institute content.

Medication topics from Cerner Multum, Inc. are not included in all systems. Updates may include new information and/or the addition of new drug names. Refer to Tech Docs for a complete list of updated titles.

Refer to Tech Docs for a complete list of updated Aisle 7 (CAM) content.

Topic title changes

  • Allergy Shots (Immunotherapy) for Allergic Rhinitis is now titled Allergy Shots for Allergic Rhinitis.
  • Allergy Shots (Immunotherapy) for Asthma is now titled Allergy Shots for Asthma.
  • Dysfunctional Uterine Bleeding: Should I Use Hormone Therapy? is now titled Abnormal Uterine Bleeding: Should I Have a Hysterectomy?.
  • Rivaroxaban for Deep Vein Thrombosis is now titled Anticoagulants Other Than Warfarin for Deep Vein Thrombosis.
  • Women and Coronary Artery Disease is now titled Heart Disease and Stroke in Women: Reducing Your Risk.

Topic replacements

We archived the following searchable topics, and we name the replacement topics below. Refer to Tech Docs for a complete list of archived documents.

  • Birth Control Pills, Hormone Therapy, and Coronary Artery Disease has been removed and replaced with Heart Disease and Stroke in Women: Reducing Your Risk.
  • Interactive Tool: What Is Your Risk for a Stroke if You Have Atrial Fibrillation? has been removed and replaced with Atrial Fibrillation.
  • Protease Inhibitors (PIs) for Hepatitis C has been removed and replaced with Combination Antiviral Therapy for Hepatitis C.

Drug details

Healthwise is changing its drug content policy. As part of this policy, we will be archiving all Healthwise drug details over the next several quarters. Healthwise will continue to provide hundreds of other pieces of drug content as well as nearly 2000 pieces on specific medications for those clients who license Multum.

We will now focus on the drugs tied to quality measures issued by organizations such as NCQA, the Joint Commission, and the Centers for Medicare and Medicaid Services. For these drugs, we will be adding new consumer-facing content as well as content that provides a behavioral approach to medication adherence.

Refer to Tech Docs for a complete list of drug details that were archived this quarter.

To ensure the medical accuracy and consistency of Healthwise consumer health content, our medical content specialists, physicians, and librarians regularly review medical guidelines and association statements, gold-standard journals, news, and evidence-based publications and databases.

The medical guidelines listed below are examples of updated guidelines we reviewed for this release.

  • American Heart Association/American Stroke Association (2014). Guidelines for the prevention of stroke in women.
  • American Heart Association/American College of Cardiology/Heart Rhythm Society (2014). Guideline for the management of patients with atrial fibrillation.
  • U.S. Preventive Services Task Force (2013). Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women.
  • U.S. Preventive Services Task Force (2013). Screening for peripheral arterial disease and cardiovascular disease risk assessment with the ankle-brachial index in adults.
  • U.S. Preventive Services Task Force (2014). Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer.
  • Wilderness Medical Society (2014). Practice guidelines for the prevention and treatment of heat-related illness.

New topics

Topics on the following subjects are in development and are expected to release within the next six months:

  • Diabetes: How Your Treatment Can Change As You Get Older
  • Neutropenia: Preventing Infections
  • Spirituality and Your Health

By: Healthwise Staff Current as of: April 29, 2014
Medical Review:


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