New Topics and Topic Updates

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What's New in the Healthwise® Knowledgebase

Version 10.4

January 2015

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
  • Decision Point Updates
  • Health and Disease Topic Updates
  • Online Form Updates
  • Symptom Topic Updates
  • NCI Topic Updates
  • Medication Topic Updates
  • Aisle 7 (CAM) Content Updates
  • Topic Title Changes and Topic Replacements
  • Medical Guideline Review
  • What's Next

New Health and Disease Topics

  • Fetal Monitoring During Labor : This new topic describes the types of fetal heart monitoring that a woman may have during labor. It explains that monitoring can be done all the time (continuous) or at set times during labor (intermittent). It also explains when each type might be done.
  • High Blood Pressure in Children : This new topic explains high blood pressures and its causes, what is normal for children, and how it is diagnosed and treated.
  • Hoarding Disorder : This new topic describes hoarding disorder. It includes information about symptoms and treatments.
  • KOH Preparation : This new topic describes a test that may be used to diagnose fungal infections like ringworm, athlete's foot, thrush, and fungal nail infections. Information includes how the test is done and how it feels. This new topic combines and replaces several separate KOH preparation topics.
  • Nicotine Tests : This new topic describes nicotine testing, including why the tests are used and what they can find.
  • Psoriatic Arthritis : This new topic describes psoriatic arthritis and provides information about symptoms, treatment, and home care.
  • Vegan Diet : This new topic describes the vegan diet. It includes information on how to eat a balanced diet and get the nutrients your body needs when you don't eat foods that come from animals.

Enhanced Content

  • Dry Eye Syndrome : This topic now includes more details about why tears are important, how dry eye syndrome may last a long time for some people, and that treatment can be expensive.
  • Doulas and Support During Childbirth : This topic has been updated to include more information about doulas and how they can have a positive effect on labor and delivery.

New NCI Topics

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

New Medication Topics

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.

New Aisle 7 (CAM) Content

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

Decision Point Updates

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.

  • Click here to view a Decision Point. Abdominal Aortic Aneurysm: Should I Get a Screening Test? : We made changes about screening for abdominal aortic aneurysm based on the updated recommendation from the U.S. Preventive Services Task Force.
  • Click here to view a Decision Point. Breast Cancer Screening and Dense Breasts: What Are My Options? : In "What might a doctor recommend?" we replaced a list of screening options with revised language to say that for a woman with dense breasts and no other risk factors, mammogram is the recommended test, and that there isn't enough evidence from studies to show that having other tests will help. We now also say that women with dense breasts and other risk factors for breast cancer should talk with their doctors to decide about screening tests, and that, in some cases, further screening with breast ultrasound or MRI may be done.
  • Click here to view a Decision Point. Breast Cancer: Should I Have Breast-Conserving Surgery or a Mastectomy for Early-Stage Cancer? : We revised the order of key points to list those on breast-conserving surgery first. In the key points we also now say that recovery with mastectomy will take longer than recovery with breast-conserving surgery. In "What will help you decide which type of surgery to choose?" we say that some women, such as those who are age 70 or older, may not need radiation after breast-conserving surgery. And in "Why might your doctor recommend a mastectomy instead of breast-conserving surgery?" we include testing positive for the BRCA gene change.
  • Click here to view a Decision Point. Health Screenings: Should I Buy Commercial Tests? : We made changes about screening for abdominal aortic aneurysm based on the updated recommendation from the U.S. Preventive Services Task Force.
  • Click here to view a Decision Point. Heart Valve Problems: Should I Choose a Mechanical Valve or Tissue Valve to Replace My Heart Valve? : We revised information to focus on the risks of another valve replacement surgery and the risks of warfarin therapy.
  • Click here to view a Decision Point. Hepatitis B and C: Should I Be Tested? : We revised the duration of hepatitis C treatment from 6 to 12 months to the more typical 3 to 12 months. And we added that newer treatments for hepatitis C work better and have fewer side effects.
  • Click here to view a Decision Point. Hepatitis C: Should I Take Antiviral Medicine? : We added that newer treatments for hepatitis C work better and have fewer side effects. We removed the section "Who should take antiviral medicines for hepatitis C?" to align with the 2014 AASLD/IDSA/IAS guidelines. We also added information about newer treatments for genotype 1: sofosbuvir plus simeprevir and ledipasvir-sofosbuvir (Harvoni).
  • Click here to view a Decision Point. Sleep Apnea: Should I Have Surgery? : We added information about nerve stimulation treatment for sleep apnea.
  • Click here to view a Decision Point. Statins: Should I Take Them? : We added information about statins and the risk of diabetes as a side effect for some people.
  • Click here to view a Decision Point. Stroke Prevention: Should I Have a Carotid Artery Procedure? : We revised this document so that the decision is about a carotid procedure to prevent a stroke rather than only a decision about carotid endarterectomy.

Health and Disease Topic Updates

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.

  • Combination Antiviral Therapy for Hepatitis C : We added newly approved regimens for hepatitis C genotype 1: sofosbuvir plus simeprevir and ledipasvir-sofosbuvir (Harvoni).
  • Dense Breasts : In "What are my options for screening dense breasts for breast cancer?" we replaced a list of screening options with revised language to say that for a woman with dense breasts and no other risk factors, mammogram is the recommended test, and that there isn't enough evidence from studies to show that having other tests will help. We also added that women with dense breasts and other risk factors for breast cancer should talk with their doctors about screening, and that, in some cases, if further screening is needed, a breast ultrasound or MRI may be done.
  • Diabetes: Lower Your Heart Disease Risk : To align with the 2014 AHA/ADA Scientific Statement, we added kidney damage as a risk factor for heart disease.
  • Hepatitis C Genotypes : We added newly approved regimens for hepatitis C genotype 1: sofosbuvir plus simeprevir and ledipasvir-sofosbuvir (Harvoni).
  • High Blood Pressure During Pregnancy : In "How is it treated?" we added the recommendation from the USPSTF that women at risk for preeclampsia may be given low-dose aspirin during the second and third trimester.
  • Insomnia :
  • Obesity : We added a new weight-loss medicine, Contrave.
  • Oral Diabetes Medicines That Can Cause Low Blood Sugar : We added the new SGLT2 inhibitor, empagliflozin (Jardiance).
  • Preeclampsia :
    • Prevention: We added the recommendation from the USPSTF that women at risk for preeclampsia may be given low-dose aspirin during the second and third trimester.
  • Sleep Apnea
    • Surgery: We added information about nerve stimulation treatment for sleep apnea.
  • Sleep Apnea: Less Common Surgeries : We added information about nerve stimulation treatment for sleep apnea.
  • Type 1 Diabetes :
    • Exams and Tests: We added the new autoantibody zinc transporter 8 (ZnT8Ab) assay as an example of an autoantibody test used to diagnose the type of diabetes.
  • Type 2 Diabetes :
    • Medications: We added the new SGLT2 inhibitor, empagliflozin (Jardiance).
    • Exams and Tests: We added the new autoantibody zinc transporter 8 (ZnT8Ab) assay as an example of an autoantibody test used to diagnose the type of diabetes.
  • Type 2 Diabetes in Children :
    • Exams and Tests: We added the new autoantibody zinc transporter 8 (ZnT8Ab) assay as an example of an autoantibody test used to diagnose the type of diabetes.

We made changes based on the CDC recommendation of two different types of pneumococcal vaccines for people ages 65 and older.

We made changes to include apixaban (Eliquis) as an anticoagulant that is used for deep vein thrombosis and pulmonary embolism.

We made changes about screening for abdominal aortic aneurysm based on the updated recommendation from the USPSTF.

Online Form Updates

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.

Symptom Topic Updates

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.

NCI Topic Updates

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

Medication Topic Updates

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.

Aisle 7 (CAM) Content Updates

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

Topic Title Changes and Topic Replacements

Topic title changes

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.

  • KOH (Potassium Hydroxide) Preparation (aa140452; hw61612) has been removed and replaced with KOH Preparation.
  • KOH (Potassium Hydroxide) Preparation for Fungal Nail Infections has been removed and replaced with KOH Preparation.
  • KOH (Potassium Hydroxide) Test for Thrush has been removed and replaced with KOH Preparation.

Drug details

Healthwise is changing its drug content policy. As part of this policy, we are archiving all Healthwise drug details. 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.

Medical Guideline Review

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 Academy of Pediatric Dentistry Council (2014). Policy on use of fluoride.
  • American College of Cardiology/American Heart Association/American Association for Thoracic Surgery/Preventive Cardiovascular Nurses Association/Society for Cardiovascular Angiography and Interventions/Society of Thoracic Surgeons (2014). 2014 Focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease.
  • American Association for the Study of Liver Diseases/Infectious Diseases Society of American (2014). Recommendations for testing, managing, and treating hepatitis C.
  • National Osteoporosis Foundation (2014). Clinician's guide to prevention and treatment of osteoporosis.
  • Qaseem A, et al. (2014). Diagnosis of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 161(3): 210–220. DOI: 10.7326/M12-3187. Accessed October 05, 2014.
  • U.S. Preventive Services Task Force (2014). Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia.
  • U.S. Preventive Services Task Force (2014). Screening for abdominal aortic aneurysm.

What's Next

New topics

These topics are in development and are expected to release within the next six months:

  • Nicotine tests
  • Rhabdomyolysis
  • Tumor markers
  • What you need to know about Medicare