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    Healthwise Helps You Make Better Health Decisions

    About Healthwise

    Healthwise is a nonprofit organization founded in 1975 with the mission to help people make better health decisions. More than 100 million times a year people like you use Healthwise® information to take an active role in their health.

    The best formula for making health decisions is to combine the most reliable medical facts with your personal feelings. Put more simply: Medical Information + Your Information = Better Health Decisions.

    Your decisions influence your overall well-being as well as the quality and cost of your care. By taking an active role in your health, you are likely to be happier with the care you receive and the results you achieve.

    Read these Healthwise stories to see how Healthwise helps people make better health decisions.

    Patricia survives heart attack

    Patricia used the Healthwise Knowledgebase to save her own life.

    Patricia had just finished her Saturday-morning chores when her lungs began burning. She was sweating and had some numbness in her arms. She drew a bath thinking, "I must be having a panic attack—I'll be all right if I can just relax."

    A few hours later, the 42-year-old still felt like she had "an elephant sitting on my chest." Patricia canceled her usual horse-riding lesson and took a nap instead. When she awoke, she felt even worse.

    "Then I thought: Check [the Healthwise® Knowledgebase on] the Internet," says Patricia. "I had almost every heart attack symptom described in the Healthwise® Knowledgebase. I knew I had to get to the hospital right away!"

    Hospital tests confirmed that Patricia had indeed had a heart attack, and the following Tuesday she had triple-bypass heart surgery. Today, Patricia is back in the saddle, riding horses and enjoying life.

    Carolyn Brzezicki

    Count on Carolyn Brzezicki—Healthwise clinical specialist and writer, mom, sister, friend, and registered nurse.

    "Stories like Patricia's inspire our work every day," says Carolyn Brzezicki. "Each of us at Healthwise thinks about our own stories of how we've turned to our information to help our families, friends, and ourselves make better decisions."

    Carolyn, a Healthwise clinical specialist, writer, and content developer, focuses on helping people live better with diabetes. She also reviews the studies, medical literature, and guidelines to assess how new findings in diabetes may affect the content.

    Living within just a few miles of her extended family, Carolyn is able to be there for them when they need her—when they're feeling great or not so great. Just like you, she looks for information that's easy to use and understand for her and her family.

    Her volunteer work in a diabetes-nutrition center, with hospice, and as a facilitator for a bereavement support group reminds her how confusing medical issues can be. So when she's at work, she always thinks about what's most important for people to know and how it should be explained.

    "Because I'm a registered nurse, family and friends call me with questions about a medical test, a new medicine, or what to do about an issue. I always go straight to the Healthwise Knowledgebase," says Carolyn. "Over the years, Healthwise has helped me in so many ways. I'm so proud of our work and how it makes a real difference in people's lives."

    Robert Kloner, MD

    World-class heart doctor Robert Kloner, MD, PhD, is in your corner.

    Robert Kloner is one of 295 experts who review Healthwise information for accuracy and currency. He helps us help you make better health decisions on heart-related issues.

    Dr. Kloner is known as one of America's leading heart experts. For the past 30 years Dr. Kloner has taught at medical schools, participated in major research projects, and contributed to medical journal articles. He is professor of medicine at the Keck School of Medicine of University of Southern California. He is also director of research at the Heart Institute of Good Samaritan Hospital in Los Angeles and an attending cardiologist at Los Angeles County/University of Southern California Medical School.

    Dr. Kloner previously directed the Cardiac Research Laboratory at Harvard Medical School. He has also edited 18 authoritative medical texts.

    "Good information is critical to good health and good health care," says Dr. Kloner. "With easy-to-understand, reliable information, people can make good decisions. When I hear stories like Patricia's, I'm especially gratified to be part of the Healthwise review team."


    Healthwise benefits from readers' input to keep our content helpful. Send us your comments by contacting your sponsoring organization or by emailing Healthwise at If you contact Healthwise, you can expect a reply within about two weeks. For answers to your specific health issues, contact your health professional. Or if you think you need care right away, call 911 or other emergency services.

    P.O. Box 1989
    2601 N. Bogus Basin Road
    Boise, Idaho 83701

    Last updated: March 2011

    Healthwise Medical Review Board

    The ( is directed by our chief medical officer, Dr. Adam C. Husney, and our medical directors, Dr. Kathleen Romito and Dr. Heather Quinn. Both are board-certified physicians. Dr. Christine Maldonado provides leadership on behavioral health issues for all Healthwise products. There is also a panel of board-certified Associate Medical Directors and Medical Editors who are involved in the planning, product and content development, and the regular and routine review of content written by Healthwise.

    Chief Medical Officer:Adam C. Husney, MD, Family Medicine, Boise, Idaho

    Medical Director:Heather Quinn, MD, Family Medicine, Boise, Idaho

    Medical Director:Kathleen Romito, MD, Family Medicine, Boise, Idaho

    Behavioral Health Specialist:Christine Maldonado, PhD, Behavioral Health, Boise, Idaho

    Associate Medical Directors:

    • John Pope, MD, Pediatrics, Phoenix, Arizona
    • E. Gregory Thompson, MD, Internal Medicine, Boise, Idaho

    Medical Editors:

    • Steven J. Atlas, MD, MPH, Internal Medicine, Boston, Massachusetts
    • Michael F. Bierer, MD, Internal Medicine/Addiction Medicine, Boston, Massachusetts
    • Wendy Y. Chen, MD, Hematology/Oncology, Boston, Massachusetts
    • O. Kenrik Duru, MD, Internal Medicine, Los Angeles, California
    • Joann G. Elmore, MD, MPH, FACP, Internal Medicine/Infectious Disease, Seattle, Washington
    • Rafael (Ralph) Gonzales, MD, MSPH, Internal Medicine, San Francisco, California
    • Ethan A. Halm, MD, MPH, Internal Medicine, Dallas, Texas
    • Richard M. Hoffman, MD, MPH, Internal Medicine, Albuquerque, New Mexico
    • Jean S. Kutner, MD, MSPH, Geriatrics, Aurora, Colorado
    • Michael P. Pignone, MD, MPH, FACP, Internal Medicine, Durham, North Carolina
    • Neil R. Powe, MD, MPH, Internal Medicine, Oakland, California
    • John W. Williams Jr., MD, MHSc, Internal Medicine, Durham, North Carolina
    • John B. Wong, MD, Internal Medicine/Clinical Decision Making, Boston, Massachusetts

    The Healthwise Medical Review Board also includes health professionals and medical specialists who review Healthwise content from a specialist's point of view. Their credentials include board certification, licensure, and/or registration; academic appointments at leading medical schools; involvement in research; and publication in peer-reviewed journals and medical textbooks. Most important, they share the Healthwise commitment to empowering patients with reliable health information and building strong patient-provider relationships. This encourages partnerships in the decision-making process. With input from these specialists, and with oversight by one of the Medical Directors or Medical Editors, Healthwise medical writers develop health information based on scientific evidence and current clinical practice.

    Before approving reviewers, Healthwise verifies that they have current licenses, registrations, and certifications with state or national agencies. We also verify with bodies that certify in specialty areas, if appropriate. The reviewers must be in good standing with these organizations during the time they review Healthwise content. We check this standing at least every 3 years. In addition, reviewers agree to notify Healthwise immediately if the status of their licenses, registrations, or certifications changes. The following physicians and health professionals are members of the Healthwise Medical Review Board:

    Addiction Medicine

    Michael F. Bierer, MD, Internal Medicine, Boston, Massachusetts

    Allergy and Immunology

    Rohit K Katial, MD, Denver, Colorado

    Lora J. Stewart, MD, Pediatric Allergy and Immunology, Denver, Colorado


    John M. Freedman, MD, Anesthesiology, Santa Rosa, California


    Stephen Fort, MD, MRCP, FRCPC, Interventional Cardiology, Kelowna, British Columbia, Canada

    Robert A. Kloner, MD, PhD, Los Angeles, California

    Jared Magnani, MD, Cardiovascular Disease, Pittsburgh, Pennsylvania

    John A. McPherson, MD, FACC, FSCAI, Interventional Cardiology, Nashville, Tennessee

    John M. Miller, MD, Electrophysiology, Indianapolis, Indiana

    George J. Philippides, MD, FACC, Boston, Massachusetts

    Rita F. Redberg, MD, San Francisco, California


    Christine Goertz, DC, PhD, Davenport, Iowa


    Arden G. Christen, DDS, MSD, MA, FACD, Indianapolis, Indiana

    Steven K. Patterson, BSc, DDS, MPH, Edmonton, Alberta, Canada

    Bryan D. Tompson, DDS, FRCDC, Orthodontics, Toronto, Ontario, Canada


    Randall D. Burr, MD, Boise, Idaho

    Ellen K. Roh, MD, Boston, Massachusetts

    Diet and Nutrition

    Barbara L. Grant, RDN, CSO, FAND, LD, Oncology Nutritionist, Boise, Idaho

    Rhonda O'Brien, MS, RD, CDE, Dietitian and Certified Diabetes Educator, Boise, Idaho

    Colleen O'Connor, PhD, RD, Registered Dietitian, London, Ontario, Canada

    Emergency Medicine

    William H. Blahd Jr, MD, FACEP, New York, New York

    David Messenger, BSc, MD, FRCPC, FCCP, Critical Care Medicine, Kingston, Ontario, Canada

    Endocrinology, Diabetes, and Metabolism

    Alan C. Dalkin, MD, Charlottesville, Virginia

    Jennifer Hone, MD, Santa Barbara, California

    Matthew I. Kim, MD, Boston, Massachusetts

    David C.W. Lau, MD, PhD, FRCPC, Calgary, Alberta, Canada


    Martin Englund, MD, Lund, Sweden

    Leslie A. Tengelsen, PhD, DVM, Zoonotic Diseases, Boise, Idaho


    William S. Marras, PhD, CPE, Bioengineering and Ergonomics, Columbus, Ohio

    Exercise Physiology

    Heather O. Chambliss, PhD, FACSM, Exercise Science, Memphis, Tennessee

    Richard B. Kreider, PhD, FACSM, FASEP, Exercise Physiology, Waco, Texas

    Family Medicine

    David Agler, MD, Boise, Idaho

    Thomas M. Bailey, MD, CCFP, Victoria, British Columbia, Canada

    Patrice Burgess, MD, FAAFP, Boise, Idaho

    Christine H. Fordyce, MD, Geriatrics, Seattle, Washington

    Adam C. Husney, MD, Boise, Idaho

    Marco Mannarino, MD, Edmonton, Alberta, Canada

    Kathleen Romito, MD, Boise, Idaho

    Donald Sproule, MD, CM, CCFP, FCFP, Montreal, Quebec, Canada


    Peter J. Kahrilas, MD, Chicago, Illinois

    Jerry S. Trier, MD, Boston, Massachusetts

    Arvydas D. Vanagunas, MD, FACP, FACG, Chicago, Illinois


    Siobhan M. Dolan, MD, MPH, Medical Genetics, Bronx, New York

    Geriatric Medicine

    Carla J. Herman, MD, MPH, Albuquerque, New Mexico

    Jean S. Kutner, MD, MSPH, Geriatrics, Aurora, Colorado

    Elizabeth A. Phelan, MD, MS, Seattle, Washington


    Wendy Y. Chen, MD, Hematology/Oncology, Boston, Massachusetts

    Andrea Jean Evenski, MD, Oncology, Columbia, Missouri

    Jeffrey S. Ginsberg, MD, FRCPC, Hematology, Hamilton, Ontario, Canada

    Brian Leber, MDCM, FRCPC, Hematology, Hamilton, Ontario, Canada

    Joseph F. O'Donnell, MD, Hanover, New Hampshire

    Michael S. Rabin, MD, Medical Oncology, Boston, Massachusetts

    Jimmy Ruiz, MD, Winston-Salem, North Carolina

    Douglas A. Stewart, MD, FRCPC, Medical Oncology, Calgary, Alberta, Canada


    W. Thomas London, MD, Philadelphia, Pennsylvania

    Hospice and Palliative Medicine

    Robin L. Fainsinger, MB, ChB, LMCC, CCFP, Palliative Medicine, Edmonton, Alberta, Canada

    Shelly R. Garone, MD, Roseville, California

    Infectious Diseases

    W. David Colby, IV, MSc, MD, FRCPC, Travel Medicine and Tropical Diseases, London, Ontario, Canada

    Christine Hahn, MD, Medical Epidemiology, Boise, Idaho

    Peter Shalit, MD, PhD, Internal Medicine, Seattle, Washington

    Dennis L. Stevens, MD, PhD, Boise, Idaho

    Raymond A. Strikas, MD, MPH, FACS, Atlanta, Georgia

    Internal Medicine

    Steven J. Atlas, MD, MPH, Boston, Massachusetts

    Roger Chou, MD, Portland, Oregon

    O. Kenrik Duru, MD, Los Angeles, California

    Joann G. Elmore, MD, MPH, FACP, Internal Medicine/Infectious Disease, Seattle, Washington

    Rafael (Ralph) Gonzales, MD, MSPH, San Francisco, California

    Ethan A. Halm, MD, MPH, Dallas, Texas

    Richard M. Hoffman, MD, MPH, Albuquerque, New Mexico

    Brigid McCaw, MD, MPH, MS, FACP, Family Violence, Oakland, California

    Brian O'Brien, MD, FRCPC, Halifax, Nova Scotia, Canada

    Michael P. Pignone, MD, MPH, FACP, Durham, North Carolina

    Anne C. Poinier, MD, Boise, Idaho

    Neil R. Powe, MD, MPH, Oakland, California

    Caroline Rhoads, MD, Seattle, Washington

    Elizabeth T. Russo, MD, Internal Medicine, Boston, Massachusetts

    E. Gregory Thompson, MD, Boise, Idaho

    John W. Williams Jr. MD, MHSc, Durham, North Carolina

    John B. Wong, MD, Internal Medicine/Clinical Decision Making, Boston, Massachusetts

    Maternal-Fetal Medicine

    William M. Gilbert, MD, Sacramento, California


    Frances E. Likis, DrPH, NP, CNM, FACNM, FAAN, Nashville, Tennessee

    Neonatal-Perinatal Medicine

    Kim E. Dow, MD, FRCPC, Kingston, Ontario, Canada

    Jennifer Merchant, MD, Boise, Idaho


    Mitchell H. Rosner, MD, Charlottesville, Virginia

    Tushar J. Vachharajani, MD, FASN, FACP, Clemmons, North Carolina


    Colin H. Chalk, MD, CM, FRCPC, Montreal, Quebec, Canada

    Karin M. Lindholm, DO, Hailey, Idaho

    Steven C. Schachter, MD, Boston, Massachusetts

    G. Frederick Wooten Jr., MD, Charlottesville, Virginia


    Joyce E. Schleis, RN, BSN, IBCLC, Lactation, Boise, Idaho

    Gayle Stauffer, RN, Boise, Idaho


    Rebecca H. Allen, MD, MPH, Providence, Rhode Island

    Divya Gupta, MD, Gynecologic Oncology New York, New York

    Kirtly Jones, MD, Reproductive Endocrinology, Salt Lake City, Utah

    Kevin C. Kiley, MD, FACOG, Albany, New York

    Femi Olatunbosun, MB, FRCSC, FACOG, Reproductive Endocrinology, Saskatoon, Saskatchewan, Canada

    Deborah A. Penava, MD, FRCSC, MPH, London, Ontario, Canada

    Rebecca S. Uranga, MD, Meridian, Idaho

    Occupational Therapy

    Jody Bradbury, OT, CHT, Certified Hand Therapist, Boise, Idaho

    Ophthalmology and Optometry

    Carol L. Karp, MD, Miami, Florida

    Douglas Rett, OD, FAAO, Boston, Massachusetts

    Christopher Joseph Rudnisky, MD, BMs, MPH, FRCSC, Edmonton, Alberta, Canada


    Davide Bardana, MD, FRCSC, Sports Medicine, Kingston, Ontario, Canada

    Freddie H. Fu, MD, Pittsburgh, Pennsylvania

    Robert B. Keller, MD, Biddeford, Maine

    Kenneth J. Koval, MD, Orthopaedic Trauma, Lebanon, New Hampshire

    Patrick J. McMahon, MD, Sports Medicine, Pittsburgh, Pennsylvania

    Herbert von Schroeder, MD, MSc, FRCSC, Hand and Microsurgery, Toronto, Ontario, Canada


    Donald R. Mintz, MD, FRCSC, Vancouver, British Columbia, Canada

    Charles M. Myer III, MD, Pediatric Otolaryngology, Cincinnati, Ohio


    Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC, Montreal, Quebec, Canada

    Susan Kim, MD, Boise, Idaho

    Stephen H. LaFranchi, MD, Pediatric Endocrinology, Portland, Oregon

    Martha K. Nicholson, MD, Walnut Creek, California

    Louis Pellegrino, MD, Neurodevelopmental Disabilities, Developmental and Behavioral Pediatrics, Syracuse, New York

    John Pope, MD, Pediatric Hospitalist, Phoenix, Arizona

    Frederick P. Rivara, MD, MPH, Seattle, Washington


    Margaret Hetherington, PharmD, Kingston, Ontario, Canada

    Theresa O'Young, PharmD, Clinical Pharmacist, Seattle, Washington

    Physical Medicine and Rehabilitation

    Margaret M. Doucette, DO, Wound Care and Hyperbaric Medicine, Boise, Idaho

    Nancy E. Greenwald, MD, Boise, Idaho

    Richard D. Zorowitz , MD, Baltimore, Maryland

    Physical Therapy

    Mary McVicars Heckel, PT, MAPT, CLT-LANA, CWS, Boise, Idaho

    Joan Rigg, PT, OCS, Orthopaedic Physical Therapy, Boise, Idaho

    Plastic and Reconstructive Surgery

    Keith A. Denkler, MD, Larkspur, California

    Podiatry and Podiatric Surgery

    Gavin W.G. Chalmers, DPM, FACFAS, Vancouver, British Columbia, Canada

    Barry L. Scurran, DPM, Fremont, California


    W. Stewart Agras, MD, FRCPC, Palo Alto, California

    David A. Brent, MD, Child and Adolescent Psychiatry, Pittsburgh, Pennsylvania

    Evan Eyler, MD, MPH, Adolescent and Psychosomatic Medicine, Burlington, Vermont

    Alfred J. Lewy, MD, PhD, Portland, Oregon

    Steven Locke, MD, Psychosomatic Medicine and Behavioral Health, Wayland, Massachusetts

    Fred R. Volkmar, MD, Pediatric Psychiatry, New Haven, Connecticut

    Myron F. Weiner, MD, Geriatric Psychiatry, Dallas, Texas

    Lisa S. Weinstock, MD, Mount Kisco, New York

    Sidney Zisook, MD, San Diego, California


    Jessica Hamblen, PhD, Post-Traumatic Stress Disorder, White River Junction, Vermont

    Christine R. Maldonado, PhD, Behavioral Health, Boise, Idaho

    Timothy Stockwell, PhD, Public Policy, Victoria, British Columbia, Canada


    Hasmeena Kathuria, MD, Critical Care and Sleep Medicine, Boston, Massachusetts

    Mark A. Rasmus, MD, Critical Care and Sleep Medicine, Boise, Idaho

    R. Steven Tharratt, MD, FACP, FCCP, Pulmonology and Critical Care Medicine, Toxicology, Sacramento, California


    Ronald C. Chen, MD, MPH, Radiation Oncology, Chapel Hill, North Carolina

    Myo Min Han, MD, Nuclear Medicine, Oakland, California

    Howard B. Schaff, MD, Diagnostic Radiology, Boise, Idaho

    Respiratory Therapy

    Catherine O'Malley, RRT, Chicago, Illinois


    Richa Dhawan, MD, Shreveport, Louisiana

    Nancy Ann Shadick, MD, MPH, Boston, Massachusetts

    Speech and Language Pathology

    Ann W. Kummer, PhD, CCC-SLP, Cincinnati, Ohio


    Kenneth Bark, MD, General and Colorectal Surgery, Utica, Michigan

    Laura S. Dominici, MD, Breast Surgical Oncology, Boston, Massachusetts

    Jeffrey Gilbertson, MD, Vascular Surgery, Boise, Idaho

    Vikram S. Iyer, MD, FRCSC, General and Vascular Surgery, Hamilton, Ontario, Canada

    John Loeser, MD, FAANS, Neurological Surgery, Seattle, Washington

    Michael M. Murr, MD, Gastrointestinal Surgery, Tampa, Florida

    David C. Stuesse, MD, Cardiac and Thoracic Surgery, Boise, Idaho

    David A. Szalay, MD, Vascular Surgery, Hamilton, Ontario, Canada

    Ali Tavakkoli, MD, Bariatric Surgery, Boston, Massachusetts

    Brad W. Warner, MD, Pediatric Surgery/Critical Care, St. Louis, Missouri

    Christian G. Zimmerman, MD, FACS, MBA, Neurological Surgery, Boise, Idaho


    Peter Anderson, MD, FRCS), Pediatric Urology, Halifax, Nova Scotia, Canada

    Avery L. Seifert, MD, FACS, Boise, Idaho

    Christopher G. Wood, MD, FACS, Houston, Texas

    Last updated: March 2017

    Healthwise Content Development Team


    Christine Calhoun, MPH

    Bill Coffey

    Jeannette Curtis, BS

    Deborah Dakins, BA

    Adam Husney, MD

    Patrick Kilby, BA

    Judi Marsh, MBA

    Katy Magee, MA

    Monica Rhodes, BA

    Medical Directors

    Christine Maldonado, PhD

    Heather Quinn, MD

    Kathleen Romito, MD

    Content Strategy, Special Projects, Technical Architecture, & Operations

    Kathleen M. Ariss, MS

    Kacy Laragan Banks, BS, CPCS

    Bill Burns, MA

    Maria G. Essig, MS

    Carrie Henley, BA

    Christopher Hess, BA

    Paul Lehnert, MA

    Kim Oliver, BS

    Bradley Steele

    Maija Teppola

    Kristie Woolsey

    Medical Writers

    Bill Amos, JD

    Colleen Cronin, MA

    Patrice Dodd, MA

    Eileen Ellig, BJ

    Marianne Flagg, BA

    Lila Havens, MA

    Nathaniel Hoffman, MA

    Ryan Powers, MFA

    Fran Valentine, BA

    Clinical & Medical Content Specialists-US & Canadian Medicine

    Jennifer Adams, MLS

    Jan Anderson, RN

    Julie Beauregard, MLIS

    Carolyn Brzezicki, RN, MS

    Bets Davis, MFA

    Shannon Erstad, RPT, MBA, MPH

    Sara Fuller, MPH, CHES

    Arlene Hull, MS, CES

    Jan Nissl, RN, BS

    Robin Parks, MS, MSTC

    Chad Parmet, BA

    Echo Savage, MA

    Associate Editors

    Terrina Coffer, BA

    Michele Cronen

    Denele Ivins, BA

    Tracy Landauer, BA

    Rebecca Whitaker, BA

    Visual Content & Multimedia

    Eleanor Bailey, MA

    Paul Bush, BS

    Angela Heileson, BFA

    Brian Igeleman, BA

    Casey Miller, BA

    Tamara Shores, MA

    Mike Ulrich, BFA

    Samantha Zimmerman

    Medical Research Library

    Karri Alderson, MLIS

    Localization, Print, & Translation

    Lucia Alzaga, MA, ATA

    Victoria Banales, MA, PhD, ATA

    Doug Dana, BA

    Tara Records, BS, CLPM

    Jeff Walk, BA

    Last updated: March 2018

    Healthwise® Knowledgebase Editorial Policy and Processes

    The field of medicine changes constantly. Each day headlines reveal new ways to diagnose, treat, or prevent health problems. Through a comprehensive topic development process, the Healthwise® Knowledgebase content is regularly updated to keep pace with the changes in medicine and medical practice.

    Content Written by Healthwise

    Healthwise develops content through the collaborative efforts of content and medical teams using a comprehensive research and review process.

    The Healthwise content team includes full-time professional medical researchers, writers, and editors who have extensive experience in scientific research and medical writing. They work closely with members of the Healthwise medical team, including the chief medical officer, the medical director, the associate medical directors, and the Healthwise Medical Review Board.

    The Healthwise Medical Review Board includes more than 220 health professionals and medical specialists who review Healthwise content from a specialist's point of view. Their credentials include board certification, licensure/registration and/or certification, academic appointments at leading medical schools, involvement in research, and publication in peer-reviewed journals and medical textbooks. Most important, they share the Healthwise commitment to empowering patients with reliable health information and building strong patient-provider relationships.

    Healthwise content starts with evidence-based information. Content team members are experts at presenting balanced, unbiased perspectives without influence from commercial interests. Our Conflict of Interest policy enforces our editorial integrity: "All Healthwise personnel should avoid situations where their personal interests could conflict, or reasonably appear to conflict, with the interests of Healthwise. In this regard, personnel must avoid any outside financial interest that might influence, or appear to influence, their corporate decisions or actions."

    Topic Development Process

    There are four primary steps in the development process: planning, research, writing, and review.

    • Writers, editors, and associate medical directors work together to plan the topic.
    • Medical librarians develop a research packet for each topic based on extensive research and evaluation of biomedical literature. Research packets include evidence-based journal and database search results, gold standard textbook chapters, guideline statements, and outcome studies, as well as consumer health information.
    • Writing and review cycles include collaboration among medical directors and other clinicians. Writers and editors also collaborate to ensure that the content is in plain language, follows literacy standards, and meets user-centered learning theory and behavior-change principles.
    • An associate medical director and at least one specialist review topics during the development process. They ensure accuracy and consistency with current practice standards and identify areas of important development. These independent medical reviewers ensure that Healthwise® Knowledgebase topics contain accurate, unbiased information.

    New Topic Development

    Healthwise selects new topics on the basis of several criteria, including requests from consumers and organizations using the Healthwise® Knowledgebase, prevalence of the condition, and the potential of shared decision-making for consumers who have the condition.

    Updating Topics

    Healthwise updates topics when warranted by changes in medical practice. The content and medical teams continually review medical news sources and journals so they can quickly identify changes that affect the practice of medicine. When important changes occur, we update topics and include them in the next quarterly release of the Healthwise® Knowledgebase. In addition, Healthwise reviews and updates topics on a regular basis.

    Organizations and people using the Healthwise® Knowledgebase may suggest changes or additions to topics. Healthwise considers these recommendations during the topic development process and includes them in our updates if they meet our standard criteria and pass the medical review process. If a suggested change applies only to a particular sponsoring organization's readers, and if it passes medical review, then we may make the change for that organization's customized version of the Healthwise® Knowledgebase. Any change to the Healthwise® Knowledgebase must first pass medical review.

    The last revised date is at the bottom of every topic page and in the credits section of each topic.

    Citing the Evidence

    The Healthwise® Knowledgebase contains thousands of unique references to help readers find more information on topics. Our processes and policies ensure that entry points of content give readers reasonable access to references. We include citations that:

    • Support statistics, particularly those that play a key role in decision making.
    • Support outcomes, effectiveness, or risk data.
    • Identify testing or treatment recommendations or guidelines.
    • Support prevalence data.

    Also, for all self-assessment or risk analysis tools in the Healthwise® Knowledgebase, we provide information that describes the source of the tool, the scientific basis for the tool, how the tool is maintained on the website, the evaluation process, and the last revised date.

    Content Written by Third Parties

    Cerner Multum, Inc., Drug Reference (not included in all systems)

    The drug reference included in the Healthwise® Knowledgebase is provided by Cerner Multum, Inc., of Denver, Colorado.

    Multum updates daily. New information is incorporated into a database as soon as it appears in the literature or in product labeling. Doctors and pharmacists review the new information and make any necessary changes. Multum conducts weekly Current Content searches on all of its drugs, and it surveys all key periodicals. All leaflets are reviewed by one or more practicing clinical specialists. Healthwise receives monthly updates from Multum. The updates are included in the quarterly releases of the Healthwise® Knowledgebase.

    Conflict of Interest Policy: Multum's content is authored by full-time associates with no affiliations with drug companies. Consultants who work with the information in other capacities are required to have no conflicts of interest.

    The date of the last update is at the end of each topic.

    National Cancer Institute (NCI) Topics

    NCI Physician Data Query (PDQ®) topics in the Healthwise® Knowledgebase are provided by the National Cancer Institute, National Institutes of Health, Public Health Service, Department of Health and Human Services.

    All PDQ cancer information summaries are peer-reviewed and updated monthly by six editorial boards of oncology specialists in adult treatment, pediatric treatment, supportive care, complementary and alternative medicine, screening, prevention, and cancer genetics. They review current literature from more than 70 biomedical journals, evaluate its relevance, and synthesize it into concise, clear summaries. Healthwise receives monthly updates from the National Cancer Institute. The updates are included in the quarterly releases of the Healthwise® Knowledgebase.

    Conflict of Interest Policy: PDQ Editorial Board members are selected by the editor-in-chief of each board. Potential biases or conflicts of interest are discussed as part of the selection process.

    The date of the last update is at the end of each topic.

    AISLE7 TM/Healthnotes®

    Headquartered in Portland, Oregon, Healthnotes, Inc., dba AISLE7 is the premier provider of reliable, easy-to-use health, food, and lifestyle information.

    Each year AISLE7 reviews tens of thousands of articles and more than 600 medical and scientific journals to ensure that the content stays current, factual, and balanced. Citations identify the source, the authors, and where and when the information was first published. The AISLE7 editorial team includes medical doctors, pharmacists, chiropractors, naturopaths, and dietitians. The Medical Advisory Board includes medical doctors and experts affiliated with leading medical schools, such as the Robert Wood Johnson Medical School.

    Healthwise receives quarterly updates from AISLE7. The updates are included in the quarterly releases of the Healthwise®Knowledgebase.

    The date of the last review is at the end of each topic.

    Last updated: November 2016

    Healthwise Quality Standards

    Healthwise is committed to providing consumers with high-quality health information so that they can make wise health decisions in partnership with their doctors. We adhere to the following principles:

    • We will create health information that is in the consumer's best interest.
    • We will not allow commercial interests to determine our content.
    • We pledge to protect the privacy of individuals using our website.
    • We provide referenced, frequently updated, evidence-based health information.
    • We will not knowingly post or publish health content that contains false or misleading claims or promotes ineffective or dangerous products.

    Healthwise ensures compliance with these principles through internal review and URAC accreditation.

    Last updated: November 2015

    Date adopted: May 2005

    Healthwise Advertising Policy

    Healthwise does not include advertisements in the Healthwise® Knowledgebase; however, sponsoring organizations may include advertisements outside but adjacent to Healthwise® Knowledgebase content. These advertisements may have been selected based upon the specific topic being viewed. Advertisements are controlled by the sponsoring organization. For more information, check the advertisement policy of the sponsoring organization.

    Last updated: August 2007

    Date adopted: August 2000

    Healthwise Ownership and Funding Disclosure

    Healthwise is committed to producing quality health information for consumers so that they can make wise decisions with their doctors. Healthwise health information is not determined by commercial interests.

    Healthwise is a 501(C)(3) nonprofit organization.

    Healthwise receives revenue from the following sources:

    • Sale of self-care guides
    • Licensing of health content and software products to hospitals, health plans, employers, health websites and other organizations. Healthwise may receive revenue based on advertising and e-commerce revenue that is generated on our clients' websites.
    • Grants from foundations and government agencies
    • Other sources that account for minimal revenues

    Last updated: August 2007

    Date adopted: August 2000

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      Lorie Mills, RHIT, CCS, director of Coding and CDI at Forrest General Hospital, co-authored an educational article for coders and other health information professionals titled AMI Documentation: Red Flags for CDI and Coding, which was published by American Health Information Management Association’s (AHIMA) website HIM Body of Knowledge.
      July 11, 2019