Issue 23 / 30 June 2014

FEAR of missing out, or “FOMO”, is a recently described phenomenon of anxiety over events or activities in which one does not participate — the perceived importance of which is amplified by social media postings of those who do take part.

Fortunately, this is an affliction to which I have remained relatively immune, rarely getting around to checking the latest updates in these media and thus happily unaware. When it comes to health care, however, it seems some groups may be missing out in a big way.

This week, we feature a news story on new research suggesting women may be missing out on life-saving cardiac devices because the guidelines for their use are based on evidence largely obtained from the study of men. Local experts were divided on the issue, but admitted that women are often underrepresented in heart failure trials for the simple reason that they tend to develop the condition much later than men, thus missing out on the age and comorbidity inclusion limits for these studies.

Can we do more to prevent missing melanoma diagnosis in high risk patients? This was a question addressed in a new Australian study published in JAMA Dermatology, which compared twice yearly total body photography (TBP) with full body examinations plus sequential digital dermoscopy imaging (SDDI) in people at extreme high risk of melanoma.

Though the study precluded a control arm for comparison, a large number of malignant lesions were detected by both methods. In our lead story in InSight this week, experts say these findings lend support to recommendations for more intensive surveillance of high-risk individuals, arguing that the costs of screening are far outweighed by the costs of treating advanced disease.

And what of the health of people in the developing world? While vertical public health programs may already be in place in these countries to treat specific diseases, are populations missing out on adequate health care because primary care can’t cope with demand?

In our third news story we talk to the author of an MJA editorial, Professor Michael Kidd, who argues that Australian practitioners can and should do more to help strengthen primary care networks in countries in need.

In our News in brief section this week, there are a few things “missing”.

When it comes to the complex task of conducting clinical research, a new analysis of US Food and Drug Administration warning letters suggests many stakeholders are missing vital steps in the process, though there were some trends towards improvement over time.

And in the case of occult atrial fibrillation after cryptogenic stroke, new evidence suggests a diagnosis is less likely to be missed if prolonged rhythm monitoring is implemented.

Some more positive news did emerge this week, however. Prospective research in Finnish children showed that exposure to a pet dog kept indoors was associated with a reduced likelihood of developing preclinical or clinical type 1 diabetes.

We already know pet ownership is associated with a range of health benefits, including a reduction in blood pressure and an increase in levels of physical activity.

So for those of us without one, it might just be time to offer a home to a furry friend before we miss out.


Dr Christine Gee is a deputy medical editor of the MJA and acting medical editor of MJA InSight. Dr Ruth Armstrong is on leave.

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