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Second Opinions

Informing the Discussion on rhGH for Idiopathic Short Stature
 Informing the Discussion on rhGH for Idiopathic Short Stature 150 150 Juan F. Sotos, MD
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Growth hormone treatment for children with idiopathic short stature has remained controversial. Based on my experience and that of others, I recommend treatment. The use of growth hormone for idiopathic short stature has remained controversial in the field of endocrinology, mainly because of previous reports of its modest benefit and high cost. These reports led…

Adult Congenital Heart Disease: Let’s Finish What We Started
 Adult Congenital Heart Disease: Let’s Finish What We Started 150 150 Curt Daniels, MD
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Congenital heart disease is the most common birth defect, diagnosed in nearly 1 percent of all births in the United States. Traditionally, life expectancy in many infants with severe CHD was limited to months. However, advances in medical and surgical care have led to remarkable improvements in survival: the median age of those living with severe…

“Learning” Health Care Organizations
 “Learning” Health Care Organizations 150 150 Kelly Kelleher, MD, MPH
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In the push toward innovative health care, “learning” systems may offer solutions for evaluating new technologies without the challenges of randomized trials. “The only constant is change.” – Heraclitus The pace of innovation in health care is breathtaking and unlikely to slow in our lifetimes. The former secretary of the U.S. Department of Health and…

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