Philadelphia, Pa. (March 25, 2013) – Do the results of recent randomized trials justify the recent U.S. recommendation against yearly measurement of prostate-specific antigen (PSA) as a screening test for prostate cancer?  That’s the topic of debate in a special “point/counterpoint” section in the April issue of Medical Care.  The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The recommendation against routine PSA measurement relies too heavily on randomized trial data, according to an article by Ruth Etzioni, PhD, of Fred Hutchinson Cancer Research Center, Seattle, and colleagues.  They argue that modeling studies provide a truer picture of the long-term benefits of PSA screening.  But Dr Joy Melnikow of University of California, Davis, and colleagues disagree, asserting that randomized trials provide a sufficient level of certainty to recommend against PSA screening.

Point: Short-Term Trials Don’t Reflect Long-Term Risk

Last year, the U.S. Preventive Services Task Force recommended against routine PSA measurement to screen for prostate cancer.  The recommendation was mainly based on two recent studies—one conducted in Europe and one in the United States—in which men were randomly assigned to annual PSA screening or no screening.  Both studies concluded that annual screening did not reduce the risk of death from prostate cancer.

But randomized trials have important limitations as a basis for screening policies, according to Dr Etzioni and colleagues.  They note that screening trials generally provide short-term results, in contrast to the long-term results generated by population-wide screening programs.  They argue that taking the randomized trial data at face value “misrepresents the likely long-term population impact of PSA screening (relative to no screening) in the United States.”

Dr Etzioni and coauthors discuss the results of modeling studies that give a different picture of the benefits of PSA screening.  Based on those models, screening may explain 45 percent of recent declines in U.S. deaths from prostate cancer, while changes in treatment account for 33 percent.  When the randomized trial data are extrapolated to the U.S. population over the long term, the absolute reduction in deaths attributed to screening appears at least five times greater than in the original trial reports.

Modeling studies also suggest a lower rate of overdiagnosis—screening detection of slow-growing prostate cancers that otherwise would have caused no harm—than reported in the trials.  Dr Etzioni and colleagues conclude, “With a disease whose hallmark is a lengthy natural history, the harms of developing cancer screening policies based primarily on limited-duration screening trials may well outweigh the benefits.”

Counterpoint:  Trials Are Best Evidence on Screening Effects

But in their “Counterpoint” essay, by Dr Melnikow and colleagues notes that the U.S. and European trials provided 11 to 13 years’ follow-up in more than 250,000 individuals.  They also point out that the U.S. trial was highly representative of the population and showed no reduction in death resulting from annual PSA testing.  (Dr Melnikow and colleagues were members of the U.S. Preventive Services Task Force when the recommendation was made.)

They add that, because of “competing causes of death,” it becomes even less likely that a large reduction in deaths from prostate cancer will appear over long-term follow-up.  The chances of overdiagnosis and potential harms from screening are also likely to increase with continued aging.  Dr Melnikow and coauthors conclude, “Projections from models are subject to mistaken assumptions and investigator biases, and should not be accorded the same weight as evidence from randomized controlled trials.”

In an editorial response, Dr Etzioni’s group points out that modeling plays an essential role in addressing questions about the harms and benefits of screening.  “While we acknowledge the centrality of screening trials in the policy process,” they write, “we maintain that modeling constitutes a powerful tool for screening trial interpretation and screening policy development.”

The debate is “no mere academic exercise,” according to an editorial by Ronnie D. Horner, PhD, of University of Cincinnati Medical Center.  With the increased emphasis on disease prevention under health care reform, it is essential to offer those services most likely to represent value—including cancer screenings.  While there’s no easy answer, Dr Horner writes, “I am hopeful that this Point-Counterpoint exchange will initiate a discussion among healthcare scientists that will yield greater guidance for determining whether a health care service is, indeed, value health care.”

About Medical Care

Rated as one of the top ten journals in health care administration, Medical Care is devoted to all aspects of the administration and delivery of health care.  This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of health care.  Medical Care provides timely reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.  In addition, numerous special supplementary issues that focus on specialized topics are produced with each volume.  Medical Care is the official journal of the Medical Care Section of the American Public Health Association

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes.

LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2012 annual revenues of €3.6 billion ($4.6 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com

Philadelphia, Pa. (November 27, 2012) – A test to detect brain amyloid deposits associated with Alzheimer disease (AD) provides doctors with useful information on treatment and further testing for patients with cognitive impairment, according to a study published online by the journal Alzheimer Disease & Associated Disorders. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Positron emission tomography (PET) scans using a biomarker called florbetapir F18 can show amyloid plaques in the brain—a characteristic feature of AD.  “Amyloid imaging results altered physicians’ diagnostic thinking, intended testing and management of patients undergoing evaluation for cognitive decline,” according to the study by Dr Mark Mintun of Avid Pharmaceuticals, Philadelphia, and colleagues.

Is It Alzheimer Disease?  Florbetapir Scan Provides Evidence

The researchers designed a “real-world” study to determine how florbetapir would affect clinical management of patients with cognitive impairment.  While a florbetapir PET scan showing amyloid plaques doesn’t prove that AD is present, it provides a previously unavailable piece of evidence to support the diagnosis.

The study included 229 patients seen by neurologists or other specialists for evaluation of cognitive decline or impairment of uncertain etiology.  Before the florbetapir PET scan, doctors provided a provisional diagnosis, an estimate of their diagnostic confidence, and their plans for further testing and treatment.  The goal was to assess the value of florbetapir PET in making the final diagnosis and in providing doctors with useful information for clinical decision making.

The florbetapir PET scans showed amyloid deposits in 113 out of 229 patients.  The information provided led doctors to change their diagnosis in 55 percent of cases. 

When the provisional diagnosis was AD, imaging results led to a change in diagnosis in 37 percent of cases.  When the pre-scan diagnosis was either “indeterminate” or another cause of dementia, the diagnosis changed in over 60 percent of cases.   In either direction, the scans increased the physicians’ ratings of diagnostic confidence by about 20 percent.

Impact on Treatment and Testing Decisions

Florbetapir PET also provided useful information for treatment decision-making:  in 87 percent of patients, the results contributed to at least one change in the treatment plan.  The main impact was in deciding whether or not to use medications that are helpful in AD.  The scan results also affected decisions on further testing—in many cases, physicians dropped plans to perform additional brain imaging studies or neuropsychological tests.

Alzheimer disease is the most common cause of dementia, but the diagnosis can be challenging to make.  The only definitive way to diagnose AD is by autopsy examination of the brain after death.  Up to 20 percent of patients diagnosed with AD turn out not to have had AD on autopsy, while up to 40 percent of patients diagnosed with other causes of dementia have evidence of AD at autopsy.

Florbetapir PET is the first FDA-approved imaging that can estimate amyloid deposits in the brain of a living patient.  Previous studies have shown that the scans are accurate in identifying patients later shown to have AD at autopsy.

The new results show that florbetapir PET scans can have a significant effect in “real world” clinical evaluation of patients with cognitive impairment.  By strengthening the case for or against a diagnosis of AD, this test can have a significant impact on patient management—particularly related to the use of AD medications and the need for further testing.  Additional studies will be needed to confirm whether “clinical care that includes amyloid imaging will translate into better outcomes” for patients with cognitive impairment and possible AD.

About Alzheimer Disease & Associated Disorders

Alzheimer Disease & Associated Disorders is a leading international forum for reports of new research findings and new approaches to diagnosis and treatment. Contributions fall within all relevant scientific fields and clinical specialties, including neurobiology, neurochemistry, molecular biology, neurology, neuropathology, neuropsychology, psychiatry, gerontology, and geriatrics.

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com

Philadelphia, Pa. (September 4, 2012) – An educational program for parents helps to reduce pressure on children to eat—which may reduce the child’s risk of obesity, reports a study in the September Journal of Developmental & Behavioral Pediatrics, the official journal of the Society for Developmental and Behavioral Pediatrics.  The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Parents educated in an approach based on “division of responsibility” (DOR) for eating put less pressure on their children to eat certain foods, according to the new research, led by Dr. W. Stewart Agras of Stanford University.  The study adds to the evidence that the DOR approach can promote healthy development of appetite and eating behaviors in young children.

Education Takes Pressure off Tots’ Eating Behaviors

The study included 62 families with a toddler (aged two to four) considered at high risk of obesity—with at least one parent who was obese or overweight.  One group of parents was educated in the DOR concept, which takes a child-development approach to “parent/child feeding interactions.”  Dr Agras explains, “At the family level parent feeding practices, such as taking control over their child’s eating, appear to contribute to childhood overweight.”

In the DOR approach, parents take responsibility for providing and serving food, while children are responsible for deciding whether or not to eat and how much to eat.  “The primary principle is that crossing parent or child boundaries leads to feeding problems,” according to the authors.  The other group of parents was assigned to the National Institutes of Health’s “We Can” program, which seeks to promote healthy eating and increased physical activity.

At follow-up, parents educated in the DOR approach were putting less pressure on their child to eat, compared to those taught about the “We Can” program.  Two parental factors affected the pressure to eat:  “disinhibition,” reflecting the parents’ tendency to overeat, and hunger or food cravings in the parents.  Parents who learned about DOR put less pressure on their children to eat, regardless of their own disinhibition or hunger scores.

In contrast, for the “We Can” group, parents with low disinhibition and low hunger scores (that is, less control over eating and lower hunger/cravings) put more pressure on their children.  Thus an approach that teaches parents to promote consumption of healthy foods may have actually led to a decrease in positive feeding practices

Parents in the DOR group were less likely to restrict food choices in girls, although not in boys.  It may be that parents are more focused on girls’ eating patterns, “in line with the greater concern about female weight and shape,” the researchers write.

Children whose parents are obese or overweight are at risk of becoming obese themselves, possibly because the family environment reinforces “maladaptive” eating behaviors.  There’s evidence that parents becoming over-involved in their child’s eating behavior—such as taking excessive control over their child’s eating—contributes to childhood overweight.  Excessive parental control over eating may interfere with the child’s perceptions of hunger and feeling full (satiety).

Although the new study is only preliminary, it adds to the evidence that parents taught the DOR approach put less pressure on their child at mealtimes.  A larger study with longer follow-up will be needed to determine whether the changes lead to a lower risk of childhood overweight or obesity.  Dr Agras and colleagues add, “Efforts to increase consumption of healthy foods in toddlers should include counseling parents to model eating such foods and not to pressure children to eat them.”

About the Journal of Developmental & Behavioral Pediatrics

Written for physicians, clinicians, psychologists and researchers, each bimonthly issue of the Journal of Developmental & Behavioral Pediatrics (www.jrnldbp.com) is devoted entirely to the developmental and psychosocial aspects of pediatric health care. Each issue brims with original articles, case reports, challenging cases and reviews—the latest work of many of today’s best known leaders in related fields—that help professionals across disciplines stay current with the latest information in the field. Relevant areas covered include learning disorders, developmental disabilities, and emotional, behavioral, and psychosomatic problems.  Journal of Developmental & Behavioral Pediatrics is the official journal of the Society for Developmental and Behavioral Pediatrics.

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com

New York, NY (August 27, 2012) – Wolters Kluwer Health and the Crohn’s & Colitis Foundation of America, Inc. (CCFA) announced today an agreement to publish Inflammatory Bowel Diseases. Effective with the January 2013 issue, Lippincott Williams & Wilkins (LWW), part of Wolters Kluwer Health, will be the journal’s publisher of record.

Inflammatory Bowel Diseases® (IBD), the official journal of the CCFA, is the first journal dedicated exclusively to IBD. The journal covers topics of interest to the professional clinician or researcher in this burgeoning field with original, peer-reviewed articles in clinical and basic science areas, as well as invited in-depth reviews of key treatment issues and groundbreaking research. IBD covers the unique and important issues in pediatric IBD, as well as articles pertaining to adult patients.

“We are delighted to be selected by the highly regarded Crohn’s & Colitis Foundation of America as the publisher of IBD journal,” said Karen Abramson, President & CEO of Wolters Kluwer Health Medical Research. “IBD is a leading journal and critical resource among gastroenterology practitioners. Our partnership with the CCFA will help them to expand the journal’s reach and impact globally, and engage new and existing CCFA members through innovative publishing solutions and strategies.”

“The CCFA chose to partner exclusively with Wolters Kluwer Health and are excited about our partnership to elevate IBD’s impact globally,” said Marjorie Merrick, Vice President of Research and Scientific Programs at the CCFA.  “The LWW publishing team has taken a leadership position in innovating digital journal strategies, and we believe this is the best team to further develop and advance IBD as a leading resource accessible to our members and practitioners when and where they need access to inform clinical decisions and patient care.”

IBD is currently available for institutional access exclusively through Ovid’s medical research platform, OvidSP, used by more than 12,000 institutions globally. Ovid is part of Wolters Kluwer Health.

About CCFA

The Crohn’s & Colitis Foundation of America (CCFA) is the largest voluntary nonprofit health organization dedicated to finding cures for Inflammatory Bowel Diseases (IBD). CCFA’s mission is to cure Crohn’s disease and ulcerative colitis, and to improve the quality of life of children and adults who suffer from these diseases. The Foundation works to fulfill its mission by funding research, providing educational resources for patients and their families, medical professionals, and the public, and furnishing supportive services for those afflicted with IBD. For more information, visit www.ccfa.org,

About Wolters Kluwer Health and Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com

Philadelphia, Pa. (August 7, 2012) – Patients using cholesterol-lowering statin drugs may be at increased risk of developing age-related cataracts, according to a study - “Age-related Cataract Is Associated with Type 2 Diabetes and Statin Use”, in the August issue of Optometry and Vision Science, official journal of the American Academy of Optometry.  The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

While further research is needed to understand the true nature of the association, the additional risk of cataracts in statin users appears similar to that associated with type 2 diabetes, according to the study by Carolyn M. Machan, OD, and colleagues of University of Waterloo, Ont., Canada.

Statins and Diabetes Both Increase Cataract Risk

The study included nearly 6,400 patients seen at the optometry clinic at the University of Waterloo in 2007-08.  Of these, 452 patients had type 2 diabetes.  Statin treatment and diabetes were evaluated as possible risk factors for age-related cataracts, controlling for other factors including sex, smoking, and high blood pressure.

Fifty-six percent of patients with type 2 diabetes were taking statins, compared to 16 percent of those without diabetes.  Both diabetes and statin use were significantly associated with an increased rate of age-related cataracts.

With adjustment for other factors, diabetes was associated with an 82 percent increase in cataract risk and statin use with a 57 percent increase.  Statistically, the increase in cataract risk associated with statins was similar to that associated with diabetes.

The associations differed for different types of cataracts.  For one specific type long linked to diabetes (posterior subcapsular cataract), the association with diabetes was no longer significant after adjustment for statin treatment.

Despite the high rate of statin use among patients with diabetes, the two risk factors appeared independent of each other.  At older ages, the risk of cataracts increased fastest in diabetic patients who took statins and slowest in nondiabetic patients who did not take statins.  On average, cataracts developed 5.6 years earlier in diabetic patients who took statins, compared to nondiabetic patients who did not take statins.

Type 2 diabetes is a known risk factor for the development of age-related cataracts—a common vision problem caused by clouding of the crystalline lens of the eye.  Studies in animals have shown a clear link between long-term treatment with statins (at high doses) and cataracts.

The new study suggests that statins may also be linked to cataracts in humans.  The authors emphasize that the study can’t prove that statins play any role in causing cataracts, but suggest that such a link is biologically plausible.

While further studies are needed, Dr Machan and colleagues emphasize that the known benefits of statin treatment for patients with type 2 diabetes probably outweigh any increased risk of cataracts.  They believe their results will help to increase awareness of the risks of treatments for type 2 diabetes, and may encourage the development of alternative cholesterol-lowering drugs that are not associated with an increased risk of cataracts.

Anthony Adams, OD, PhD, Editor-in-Chief of Optometry and Vision Science, comments, “Considering the increase in the prevalence of diabetes and the corresponding increase in the use of statins, the authors feel these findings serve to encourage further research on the long-term effect of statins on the human crystalline lens.”

To read the article “Age-related Cataract Is Associated with Type 2 Diabetes and Statin Use”, please visit http://journals.lww.com/optvissci/Fulltext/2012/08000/Age_Related_Cataract_Is_Associated_with_Type_2.12.aspx 

About Optometry and Vision Science

Optometry and Vision Science, official journal of the American Academy of Optometry, is the most authoritative source for current developments in optometry, physiological optics, and vision science. This frequently cited monthly scientific journal has served primary eye care practitioners for more than 75 years, promoting vital interdisciplinary exchange among optometrists and vision scientists worldwide.

About the American Academy of Optometry

Founded in 1922, the American Academy of Optometry is committed to promoting the art and science of vision care through lifelong learning.  All members of the Academy are dedicated to the highest standards of optometric practice through clinical care, education or research.

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com

Philadelphia, Pa. (July 11, 2012) – Specific types of “mindfulness practices” including Zen meditation have research-proven benefits for patients with certain physical and mental health problems, according to a report in the July Journal of Psychiatric Practice.  The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

“An extensive review of therapies that include meditation as a key component—referred to as mindfulness-based practices—shows convincing evidence that such interventions are effective in the treatment of psychiatric symptoms and pain, when used in combination with more conventional therapies,” according to Dr William R. Marchand of the George E. Wahlen Veterans Affairs Medical Center and the University of Utah in Salt Lake City.

Mindfulness Techniques Show Health Benefits

Dr Marchand reviewed published studies evaluating the health benefits of mindfulness-based practices.  Mindfulness has been described as “the practice of learning to focus attention on moment-by-moment experience with an attitude of curiosity, openness, and acceptance.”  Put another way, “Practicing mindfulness is simply experiencing the present moment, without trying to change anything.”

The review focused on three techniques:

• Zen meditation, a Buddhist spiritual practice that involves the practice of developing mindfulness by meditation, typically focusing on awareness of breathing patterns.
• Mindfulness-based stress reduction (MBSR), a secular method of using Buddhist mindfulness, combining meditation with elements of yoga and education about stress and coping strategies.
• Mindfulness-based cognitive therapy (MBCT), which combines MBSR with principles of cognitive therapy (for example, recognizing and disengaging from negative thoughts) to prevent relapse of depression.

Dr Marchand found evidence that MBSR and MBCT have “broad-spectrum” effects against depression and anxiety and can also decrease general psychological distress.  Based on the evidence, MBCT can be “strongly recommended” as an addition to conventional treatments (adjunctive treatment) for unipolar depression.  Both MBSR and MBCT were effective adjunctive treatments for anxiety.

Research data also supported the effectiveness of MBSR to help reduce stress and promote general psychological health in patients with various medical and/or psychiatric illnesses.   On its own, MBSR was helpful in managing stress and promoting general psychological health in healthy people.  There was also evidence that Zen meditation and MBSR were useful adjunctive treatments for pain management. 

How do these practices work to affect mental and physical health?  Dr Marchand discusses recent research showing the impact of mindfulness practices on brain function and structure, which may in part account for their psychological benefits.  “These mindfulness practices show considerable promise and the available evidence indicates their use is currently warranted in a variety of clinical situations,” he concludes.

The article includes some proposed evidence-based guidelines for incorporating mindfulness-based practices into health care.  So far there’s little evidence on which patients are most likely to benefit, but Dr Marchand suggests that patient preferences and enthusiasm are a good guide.  He comments, “The most important considerations may be desire to try a mindfulness-based practice and willingness to engage in the regular practice of seated meditation.”

About Journal of Psychiatric Practice

Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs—readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients.  Mental health professionals will want access to this review journal­—for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field.  Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative “how to” tips for surviving in a managed care environment

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com