@MichaelSheeley  #ciht11 Lots of cool & innovation going on in the health & fitness world. Very exciting things are happening!

Indeed there are. The latest evidence for this could be found at Friday’s HealthTech 2011 conference in Boston. Sponsored by Careinnovators, #ciht11 drew hundreds of entrepreneurs, who used the day to share ideas, hear what investors thought about their space, and for a few of the heartiest, to nail their elevator pitch in a bar during the height of happy hour.

The Entrepreneurs
The large, engaged crowd suggests that #ciht11 touched a nerve, at least among entrepreneurs. Many of them believe we are entering a renaissance era in health and wellness, even bigger than the 1980s bubble which produced Access Health and HealthWise, among others.

The renaissance is being driven, they say, by strong tailwinds from many sources. The aging of the baby boomers creates a vast new market, including millions who want to maintain good health and even more who will inevitably develop chronic diseases. Inexpensive smartphones and monitoring devices are becoming ubiquitous, giving consumers real-time access to support networks and non-obtrusive ways to record data. Today’s Web-based platforms make it easy to develop products and store data.

Plus, it won’t be long before people who never knew life without the Internet will outnumber those who grew up before it. If these people can spend hours tending to eStrawberries on an eFarm, then surely they will use cool games that help them stay healthy.

There have been early successes in the space, as yesterday’s conference showed. Companies that track your work-out, like MapMyRun and RunKeeper have up to 5.5 million registered users and 300,000 active users, according to speakers and Twitterers at the conference. Shape Up the Nation provides health and wellness services to more than 2 million people via contracts with employers and payers.

The Venture Capitalists

@PearlF #ciht11 Bessemer’s Stephen Kraus: there will be next generation gaming plays on wellness, 4 now not investing, hard 2 separate from noise

Venture Capitalists seem to be more circumspect about the supposed renaissance, however. They have invested only sporadically in the space, although the few investments they have made—including a remarkable $2.25 million bet that Aza Raskin, the former creative lead at Firefox and Sutha Kamal can grow Massive Health from scratch—are noteworthy.

To be sure, most VCs absolutely do believe that some startups in this space will become wildly successful. It’s just they haven’t yet seen many startups that merit an investment at this point. Too many unproven business models. Too many marketing plans based on the premise—famously recounted at the conference by Excel Venture Management’s Rick Blume—that ‘if I build it, they will come.’

How will these startups overcome the troubling reality that 26% of people who download a health-related app use it just once, or that nearly a third of those who use health apps don’t use them as their developers intended? How realistic is a business plan that relies on users to fundamentally change their health-related behaviors?

@MatthewBrowning #ciht11 ROI, ROI, ROI is most important to investors

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iPhone Can Diagnose Stroke Quickly, Accurately. Doctors that evaluate iPhone displays of CT scans and CT angiogram tests can diagnose a stroke with the same accuracy as if they had viewed the images on a medical computer workstation, a study showed.

Birth Control Pills Mask Signals That Draw the Sexes Together. New studies suggest that hormonal contraceptives disrupt women’s production of and responses to pheromones. This affects their attractiveness to men and their preferences for romantic partners.

Scientists Use Twitter to Document H1N1 Disease Activity. Retrospective review of Twitter feeds during the Swine Flu pandemic allowed US researchers to track disease burden in local communities and its spread throughout the nation.

Boston Scientific Chief Resigns. J. Raymond Elliott announced he will step down at the end of 2011 after less than two years in charge of the device maker. The move shocked investors and sent the company’s shares sliding.

Hospitalist Management Companies Finalize Merger. The tie-up between Hospitalists Management Group and Cogent Healthcare forms the largest private hospitalist company in the US.

Florida Bill Outlaws Asking Patients About Guns. The Florida legislature passed a bill that makes it illegal for pediatricians and other doctors to ask patients or their parents whether there are guns in the home.

Virtual Reality Shows Promise for Stroke Patients. A literature review suggests that systems like Nintendo Wii, PlayStation EyeToy and CyberGlove could help stroke patients intensify their rehab programs.

Pay-For-Delay Schemes Cost Taxpayers Billions.  An FTC report finds a 60% increase in deals where pharmaceutical companies pay generic drug makers to hold off entering the market.

School-Wide ECG Screening Feasible. A program that screened all students in a Chicago-area school for heart problems was clinically successful, but drew criticism for its broad scope and expected costs.

South Korean Study Finds 1 in 38 Children Has Autism Traits. The result is higher than US studies which show the prevalence to be 1%. US estimates rely on education and medical records, whereas the Korean study is based on a survey.

Aetna To Encourage Health With Online Gaming. The giant insurer announced a collaboration with Seattle-based Mindbloom to offer an online personal wellness game to its enrollees.

Android Will Surpass Apple’s App Store In Size By August 2011. Provided that current growth rates for new app uploads are maintained, research2guidance expects Android Market to reach 425,000 apps and overtake the App Store by this August.

Blacks Suffering Strokes Often Call Friends First, Not 911. A small study showed that most African Americans call a friend or relative instead of 911 when they develop stroke-like symptoms, potentially delaying the onset of lifesaving treatment.

Guilty Pleas Entered in $200M Medicare Fraud Case. Two South Florida companies entered guilty pleas in a Miami federal court for what prosecutors called a “staggering in scope” fraud scheme that falsely billed Medicare for more than $200 million and collected $80 million of the bogus claims.

VA Launches National Genomics Program. Officials described the ‘Million Veteran Program’ as an effort to consolidate genetic, military exposure, health, and lifestyle information into a single database.

$76 Billion in Pediatric Healthcare Costs Linked to Environmental Factors. These include care for children with reduced cognitive abilities due to lead exposure, ADHD caused by toxic chemicals, asthma triggered by air pollution, and so on.

Studies Suggest Sex Is Good for Your Health. Among other benefits, sex relieves stress, improves sleep, burns calories, eases depression, strengthens blood vessels, boosts the immune system and lowers the risk of prostate and breast cancer.

Smartphone Users Prefer Texts for Health Reminders. In a study, 41% of smartphone users said they want to receive text-based health reminders. About 20% said they would choose a message delivered through a smartphone app, and 19% preferred an alarm.

Study Questions Impact of Salt Intake on Hypertension. Researchers found that efforts to reduce dietary sodium intake may not help prevent deaths from cardiovascular disease.

75% of US Physicians Own a Portable Apple Device. These include iPhones, iPads or iPods. Fully 30% of US physicians own an iPad. An additional 28% plan to purchase one before the end of the year.

Nowadays, a lot of folks pursue happiness as if it were their primary mission in life. But what is happiness?

Philosophers tell us there are at least 2 kinds. There is so-called “hedonic well-being” which is short-term pleasure derived from things like a tasty meal, great sex or a day in the amusement park.  Then there’s “eudaimonic well-being” which comes from living with a sense of purpose, which is usually actualized by participating in meaningful activities like volunteering for a worthy cause, raising children or caring for others.

Scientists have recently joined their philosopher brethren in the analysis of happiness. Remarkably, they have produced evidence which suggests that people who are driven to achieve eudaimonic  happiness actually have better health outcomes than those motivated to achieve hedonic happiness. They are more likely to remain intact cognitively, for example. They even tend to live longer.

For example, in a cohort study of 7,000 people known as MIDUS (the Mid-Life in the US National Study of Americans), Carol Ryff and colleagues at the University of Wisconsin have tried to identify social and behavioral factors that predict one’s ability to maintain good health into old age. The team has focused on sociocultural sub-populations known to be associated with poor health outcomes…things like low education level.

Ryff’s group showed that people with low education levels and high levels of eudaimonic well-being had lower blood levels of interleukin-6, a bio-marker of inflammation that has been linked to cardiovascular disease, Alzheimer’s disease, even after accounting for hedonic well-being into account. Their write-up appears in Health Psychology.

As well, a study of 950 community-dwelling elderly folks linked eudaimonic well-being to a lower risk of developing Alzheimer’s disease. During their 7-year follow-up of this cohort, David Bennett and colleagues at Rush University Medical Center found that participants who reported having less of a sense of purpose in their lives were at least twice as likely to develop the debilitating condition as those who reported a greater sense of purpose. Their write-up appears the journal Archives of General Psychiatry. (more…)

As the mobile health apps market explodes, health consumers have been inundated with thousands of tools purporting to help them count calories, track work-outs, control diabetes, quit smoking and so forth.

There are nearly 8,000 health-related apps in the iTunes library alone. Of these, about 60% focus on diet, 20% on exercise, 9% on resistance training and 7% on improving sleep. Although the iTunes app store doesn’t publish download counts, the top free health-related app on the Android Market—an exercise monitoring device known as CardioTracker—has been downloaded between 1 million and 5 million times.

With this panoply of new resources a few clicks away, people have begun to wonder, “Do they actually improve health?”

Perhaps not, sadly. At least not yet. For example, a recent study by mobile health app analyst Pamela Culver revealed that a whopping 26% of people who downloaded a health-related app used it just once (in fairness, many of them probably moved-on to another app). Meanwhile, another study revealed that one-third of those who use health apps do not use them as their developers intended. 

Aside from the fact that many health-related apps are as visually appealing as a 1987 version of Super Mario Brothers, there are 2 major reasons why these tools have yet to live-up to their promise. Let’s take a look at them:

Failure to Leverage Clinical Guidelines
A galling problem with many health-related apps is that they do not incorporate tried-and-true methods to positively impact the behavior they supposedly target.

A study by George Washington University professor Lorien Abroms and colleagues recently made this point in spades. Abroms’ team reviewed 47 quit smoking apps that were available through the iTunes library. The apps ranged in price from free to $9.99. Nearly a third of them amounted to calendars which counted days since, or days until a quit date. An equal number of apps functioned to calculate dollars saved or health benefits accrued by kicking the habit. The remainder were an unsavory mash-up of cigarette rationing tools, hypnosis tools and, vey is mir, “virtual cigarettes” that people are supposed to use to pretend they are smoking. (more…)

Tension headaches are a nearly universal affliction. They are characterized by dull, non-pulsatile discomfort on both sides of the temples and forehead. They typically last for 30-60 minutes, but they can go on for days. Tension headaches affect at least 40% of adults in any given year. Nearly 80% of adults have experienced at least one during the course of their lifetimes.

It’s amazing therefore, that scientists don’t yet understand what causes them.

Triggers
To be sure, scientists and those who’ve experienced tension headaches know when they tend to occur and what things trigger them.

Tension headaches occur most commonly in the early morning and late afternoon. The morning variety is often triggered by lack of sleep, awkward sleeping positions, hangovers and caffeine withdrawal.

Afternoon tension headaches are triggered by poor posture or airborne irritants in the office, eyestrain from looking at a computer screen all day, teeth grinding, and plain-old everyday stress (see YouTube video, above). The hypoglycemia associated with missed lunches is another culprit, as is excessive caffeine intake.

But What Causes Them?
This is what scientists don’t yet understand. For years, the prevailing theory was that muscle tension, especially in the neck and shoulders, caused tension headaches. That theory has been disproven by studies in which tools that measure muscle contractions revealed no correlation between muscle tension and headaches.

Today, the prevailing belief is that the tension-type headache is caused by abnormalities in parts of the brain that perceive pain. These poorly understood abnormalities render the brain hypersensitive to the inputs it receives (similar mechanisms are also thought to be involved in fibromyalgia, a disorder characterized by diffuse bodily sensations of pain).

Treatment
Typically, tension headaches sufferers just “bear with them” until they subside, or use OTC pain killers like aspirin, acetaminophen and ibuprofen for quick relief. These drugs usually work, but taking them more than 10 days per month can precipitate so-called “rebound” or “medication-overuse” headaches, which feel like the tension headaches they’re supposed to treat. (more…)

Sleep deprivation has been linked to motor vehicle accidents, industrial accidents and medical errors. It has also been linked to obesity, diabetes, hypertension, depression, anxiety, reduced problem-solving capacity, memory lapses, an increased risk for the common cold and even premature death.

Recent data published in the CDC’s Morbidity and Mortality Weekly Report, while not cutting new ground in this area, has helped to quantify the extent of the problem among Americans, as well as its impact on car crashes. The news is not good.

According to the CDC report, between 50 and 70 million US adults suffer from chronic sleep deprivation and related disorders. Those estimates came from a study which found that 35% the nearly 75,000 adult participants in a 12-state sleep study reported getting less than 7 hours of sleep per night. Nearly 40% of these people claimed to doze off inadvertently at least once a day.

Furthermore, people who averaged less than 7 hours were more likely to nod-off while driving a car. Overall, nearly 5% of respondents said they had fallen asleep while driving during the last year. According to the CDC, this phenomenon causes 1,550 highway deaths and 40,000 injuries per year.

The numbers are probably higher than this, according to Allan Pack, who directs the Center for Sleep at University of Pennsylvania. “Most of us believe that there are a lot more fall asleep crashes than reported,” he said in an interview. “It’s probably not reported accurately because a number of states don’t even having a ‘falling asleep while driving’ tick in the box when reporting a car crash.” (more…)

In recent years, scientists have shown that financial incentives can drive short-term behavioral changes that are associated with improved health; things like losing weight and quitting cigarettes, for example. The rewards in these studies include direct cash incentives, gift cards and so on.

Recently, the Centers for Medicare and Medicaid Services announced plans to leverage this strategy with a $100 million initiative that permits states to offer incentives to Medicaid enrollees for adopting healthy behaviors.

Called a “demonstration program,” the CMS initiative is designed to figure out which strategies produce long-term behavioral changes. It should also help CMS determine the extent to which special populations (like adults with disabilities or children with special needs) can participate in the program, the level of satisfaction with the program, and the administrative costs incurred by State agencies that administer the program.

The program is funded by the new health care law (known as the Affordable Care Act). It invites each state to submit one proposal . Grant Applications are due to CMS by May 2, 2011. There are no state cost-sharing requirements.

According to CMS, the proposals must be “comprehensive, evidence-based, widely available, and easily accessible.” When states prepare their proposals, CMS recommends that they rely on evidence-based research which can be found in documents like the Guide to Community Preventive Services, the Guide to Clinical Preventive Services, and the National Registry of Evidence-based Programs.

“Keeping people healthy is an important goal of the Affordable Care Act,” HHS Secretary Kathleen Sebelius said in a press release. “One way to reach that goal is to encourage all Americans to make better choices about diet, exercise and smoking to avoid potentially disastrous outcomes down the road like heart disease, cancer or diabetes.” (more…)