Saturday, December 6, 2008

My Report on the American College of Allergy, Asthma & Immunology's 2008 meeting

I would like to report on the recent Annual Meeting of the American College of Allergy, Asthma & Immunology. I attended the meeting, which was held in Seattle from November 6-11 of 2008.

1. New products - only 2: Astepro (a "better tolerated" version of Astelin) reviewed here and DX-88. This is an IV product to treat hereditary angioedema. This may end up being a significant treatment for the very few people affected by this disorder.

2. The number of pharmaceutical companies and their staff present was noticeably less. I did not mind, but one result of less educational support from pharmaceutical companies for our meetings would be higher tuition costs. In practice, I can't think of a company that hasn't laid off some of their sales people.

3. Abstracts: very few on new product development or reporting of completed trials. This does not bode well for the pipeline for allergic diseases.

4. SLIT reported here

5. New guidelines for skin testing were reviewed. I'd like to thank the member of the Practice Parameters Committee for their hard work. I think it will make a difference.

6. I attended a session on mold accumulation in buildings. The speaker was an industrial hygienist (IH), who cautioned that mold found inside a building does not mean the mold caused human disease. Unfortunately, every basket can have a bad apple. Here, the unscrupulous IH can alarm some patients and drum up business for remediation measures. I have dealt with some IH like this as well as some very professional IH. I don't know how to easily distinguish them apart. Be careful and don't be afraid to ask for a second opinion if the recommendation comes with a high price tag for a lot of work.

7. Asthma is the most mixed up disease I can think of. Seriously! Many specialties in medicine and in health care professionals deal with asthma but no one can agree on the ideal way to treat asthma. Groups try and try. Name just one other disease where so many people are affected and so few are well controlled.

8. I evaluated EMR programs with electronic prescription writers. My concerns are that there are no standards, so with health care reform approaching, inevidentably there will be shakedown and changes is software. What if your manufacturer does not survive? There's a huge cost. None were clearly superior.

9. I evaluated extract programs. There are only a few choices. The leader is ALK's program. Seemed pretty stream-lined for a busy practice. I am still evaluating it. Currently it lacks a way to track inventory of extract bottles.

10. I evaluated spirometers. Most of the devices now need only a small handheld transducer, which can be connected to laptop by an electric cord. Costs run the same, about $3,500. My beef is with the OSHA-required disposable (and unreuseable) mouthpieces, because they cost about $2 each. Note, we've had problems with our software and Window's VISTA operating system. Very aggravating, because data is lost, local technicians can't really rewrite the code, time is lost and all of this screws up patient care.

Me in front of the original Starbucks store, just a few blocks away from the hotel. I wanted to see where it all started, even I have never bought a single cup of coffee from them. I hate the taste of coffee. I'm Chinese, so tea is where I get my caffeine jolts when I need them.

A close encounter with a dust mite on steroids.
The "Sleepless on Seattle water house."
Here I am giving my poster presentation for research into the incidence of asthma in South Carolina.

Miscellaneous Comments:

1. I think downtown Seattle is a very scenic place during November. With all the water around, I wonder how bad their mold allergy problems are.

2. I hate how the airlines now charge people for checked in baggage, but I realize that this is actually more reflective of the true cost of moving mass from A to B. What I'd like for the airplanes to do is charge people carrying TOO much carry-on baggage. Why? I sat next to a business woman who brought on essentially 3 large carry-on items - her "purse" the size of a backpack and basically 2 rolling suitcases. This was annoying because she had to put them into the overhead compartments, which barely fit them. She had to try several compartments because she did not board early, so the compartments nearest to her were too full. She ended up moving other people's items so that she could get her baggage into 1 compartment. All the while, the rest of the boarding passengers could not pass by. When asked to step aside to let the rest board, she turned and said "I'm almost finished" and keep right on stuffing her suitcases into a bin.

1 comment:

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