Consumers deserve full transparency about the performance of the hospitals they choose

Consumer Reports / By Catherine Roberts / April 06, 2017
www.consumerreports.org

More than 1,000 U.S. hospitals perform heart surgery, and about half voluntarily share their complication and mortality rates with Consumer Reports.  

That’s a good start, and up 16 percent from 2014, when we first published heart hospital ratings. But it also means that many hospitals still don’t make heart surgery success rates readily available to patients.

That’s a problem, says David Shahian, M.D., who oversees data and quality measures at the Society of Thoracic Surgeons (STS), the organization that gathers the numbers from hospitals and shares them with Consumer Reports.

Public reporting not only provides vital information to patients about where to get heart surgery but also encourages hospitals to improve, “by comparing them to their peers and showing them where they are falling short,” he says. “We believe transparency and sharing your outcomes is a professional ethical responsibility.”

We contacted these 23 hospitals that perform a large number of heart surgeries but don’t publically report through STS or Consumer Reports to ask why not—and if they would share results with us, and with patients.

• Arkansas Heart Hospital, Little Rock, AR
• Baptist Memorial Hospital, Memphis, TN
• Christiana Care Health System, Newark, DE
• Dartmouth-Hitchcock Medical Center, Lebanon, NH *
• Florida Hospital, Orlando, FL*
• Forrest General Hospital, Hattiesburg, MS
• Hackensack University Medical Center, Hackensack, NJ*
• Hospital of the University of Pennsylvania, Philadelphia, PA*
• Houston Methodist Hospital, Houston, TX
• Kansas Heart Hospital, Wichita, KS
• Leesburg Regional Medical Center, Leesburg, FL
• Mayo Clinic Hospital, Rochester, MN*
• Methodist Hospital, San Antonio, TX
• Mount Sinai Medical Center, Miami Beach, FL
• New Hanover Regional Medical Center, Wilmington, NC
• Northeast Georgia Medical Center, Gainesville, GA*
• NorthShore University Health System, Evanston, IL
• OhioHealth Riverside Methodist Hospital, Columbus, OH
• Penn Presbyterian Medical Center, Philadelphia, PA*
• Saint Francis Hospital and Medical Center, Hartford, CT
• St. Vincent's Medical Center Riverside, Jacksonville, FL
• The University of Vermont Health Network University of Vermont Medical Center, Burlington, VT
• University of Maryland Medical Center, Baltimore, MD*

* This hospital does not currently make its data publicly available but has committed to doing so in the next update.

More on Heart Health

• Take Charge of Your Heart Health
• Understanding the Stages of Heart Disease
• The Healing Power of a Heart-Healthy Diet
• How Heart Attacks in Women and Men Are Different
• Slowing Down the Rush to Open Heart Surgery
• Top Hospitals for Congenital Heart Disease
• Who Really Needs Cholesterol and Blood Pressure Drugs
• Blood Pressure Monitor Buying Guide  

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What Hospitals Say About Heart Surgery Success Rates

Some hospitals, such as the Mayo Clinic in Rochester, Minn., said they missed the deadline. One, Kansas Heart Hospital in Wichita, told us that it doesn’t report due to the costs of belonging to the STS database, which usually come to several thousand dollars per year.

Note that some hospitals, including prominent hospitals such as  Cedars-Sinai Medical Center in Los Angeles and New York-Presbyterian Hospital in New York City, do provide heart surgery success rates to STS, and make it available on the STS website, but don't consent to publish that information through Consumer Reports.

Providing patients with that information should be a priority for any facility, especially those with national standing, says Doris Peter, Ph.D., director of Consumer Reports’ Health Ratings Center. “Hospitals that do these procedures likely profit nicely from them, and I would expect them to invest some of that into improving quality and sharing data with the public.”

How to Get the Data You Need

Shahian says that if the hospital you’re considering doesn’t share its data with Consumer Reports or STS, try to get that information on your own.

But calling the hospital directly isn’t the best bet: When we tried that at several hospitals, the staff wasn’t able to connect us with the right person to answer our questions.

Instead, Shahian recommends asking your surgeon these questions:

• Does the hospital where you perform surgery participate in the Society of Thoracic Surgeons database?
• If so, how does it perform in the STS ratings, and would you be willing to go over their most recent report with me?

If the surgeon won’t have that discussion or says the hospital doesn’t collect the data, Shahian says to consider another doctor and medical center.

4 Supplements to Question After Age 50

Calcium, iron, and more may not be so good for you. What you should know.

Consumer Reports / December 16, 2016 / Lauren Cooper

Vitamins and minerals are marketed to keep you healthy. But some may carry more risks than benefits, especially as we age.

“Supplements are most useful when they’re used to replace dietary deficiencies,” says Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser. “Therefore, most of us don’t need them. Such needless use can be harmful, especially if you also take prescription medications.”

In addition, the evidence supporting supplements is often flimsy or mixed, and because of lax regulation, you can’t always be sure what they contain. The following four supplements may be especially harmful to your health if you’re over 50.

Folic Acid Supplements

Research has suggested, but not proved, that folic acid (vitamin B9) may help ward off Alzheimer’s disease, depression, and heart disease.

Still, a recent study published by the American Journal of Clinical Nutrition links excess folate (including folic acid) to burning, tingling, or numbness in the extremities of people with a common gene variant.

“The odds were sevenfold higher for those who consumed more than 800 mcg daily,” says co-author Ligi Paul, Ph.D., of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University.

In addition, taking as little as 300 mcg daily may mask a B12 deficiency, which is relatively common in older adults, says Orly Avitzur, M.D., Consumer Reports’ medical director. “Undiagnosed, that can lead to nerve damage, cognitive trouble, and even psychiatric problems,” she says.

Folic acid can also reduce the effectiveness of the seizure drug fosphenytoin (Cerebyx and generic) and the cancer drug methotrexate (Rheumatrex and generic).

Who might need it? Women who are pregnant or planning to get pregnant, to prevent birth defects.

Calcium Supplements
You might take calcium supplements to strengthen your bones, which can weaken with age. But regular use may increase the risk of kidney stones and possibly heart disease.

A study in the Journal of the American Heart Association in October found that people who took calcium supplements over a 10-year period were more likely to accumulate the artery plaque that can lead to heart attacks.

Supplemental calcium can also negatively interact with some heart and thyroid medications.

Who might need it? People who eat little or no calcium-rich food, such as dairy products and leafy vegetables.

Iron Supplements
Anemia­, or low blood levels of iron­­, is more common with age. But taking too much iron can mask symptoms of anemia, which can be caused by internal bleeding, and lead to a missed diagnosis.

Iron supplements can also inhibit the absorption of certain antibiotics and blood pressure-lowering drugs such as captopril (Capoten and generic).

And if you have hemochromatosis, a common genetic condition, iron pills can lead to an overload of the nutrient in vital organs, potentially causing diabetes symptoms, heart problems, and liver damage.

Who might need it? People with diagnosed iron-deficiency anemia.

Vitamin E Supplements
These supplements are said by some to help prevent cancer, dementia, and heart disease, but there’s little proof—and plenty of reason to avoid them.

Research has linked regular use to a 13 percent higher risk of heart failure in certain populations. A study published in JAMA in 2011 also found that taking 400 IU daily may boost the likelihood of prostate cancer by 17 percent. Vitamin E supplements may also make some chemotherapy drugs
less effective.

Who might need it? Our experts don’t recommend it for anyone.

3 Supplements to Consider
Vitamin D—It might make sense if you’ve been diagnosed with osteoporosis, get little sunlight, or rarely consume D-rich foods such as fatty fish, eggs, and fortified milk.

AREDS2 (a blend of vitamins C and E, copper, lutein, zeaxanthin, and zinc)—It might make sense if you have age-related macular degeneration, a leading cause of vision loss.

Vitamin B12—It might make sense if you’re a strict vegan, or if you regularly take certain kinds of heartburn drugs or metformin, a diabetes medication.

Does Milk Chocolate Have Health Benefits?

Consumer Reports

By Sari Harrar
January 20, 2016

Dark chocolate is rich in flavonoids, antioxidant compounds also found in tea and wine, that may help protect against heart disease. Flavonoids are generally higher in dark chocolate, but milk chocolate may pack a health punch, too. In an analysis of studies involving 20,951 people, researchers at the University of Aberdeen in Scotland suggested that those who ate the most chocolate over an average of 11.3 years (most of it milk chocolate) had a lower risk of coronary heart disease and stroke than those who ate the least amount or none at all. However, the researchers were quick to point out that healthier people may simply eat more chocolate.

Whether you're a milk or dark chocolate fan, go easy. A 1.55-ounce bar of milk chocolate has 235 calories, 13 grams of fat, and 22 grams of sugar. The same amount of 70 percent dark chocolate has 263 calories, 12 grams of fat, and 11 grams of sugars.

One benefit dark chocolate has over milk: fiber. You get nearly 5 grams in a 1.55-ounce bar—compared to 1.5 grams in the same serving of milk chocolate.