Editorial: Defunct Gadgets and Changing Times

As I was surfing the Internet to look for credible sites for a healthcare statistics course I was teaching, I came across a nostalgic topic: technology “gadgets” whose demise is being brought about by the “super cellphones” that a lot of us have begun to carry. Listed among the almost-defunct included Personal Digital Assistants (PDAs), “landline” telephones, and MP3 players (Sorrel, November 17, 2008). Struck by the rapid turnaround in what were either very popular and/or long-standing electronic items, I checked a related website that marked the decline of cassette tapes, zip disks, 5-¼ and 3-½ inch floppy disks, and CDs as media storage (Sorell, June 19, 2008). I began to wonder—surely healthcare has made some “flying leaps” like this as well. After searching through the archives of several healthcare journals, the following “breaking news” items were found that may stir a few fond (or not so fond) memories.

FAXING TO THE PHARMACY

A 1989 news item in the American Journal of Nursing (Drug Watch/Nursing Decisions) asked the question of whether the reader's hospital had “jumped onto the digital facsimile bandwagon” (p. 1646) as far as faxing medication orders to the pharmacy. The major advantages cited were eliminating phone calls (except the ones to fax the orders, of course), turnaround time, and reduction of transcription errors (Now if we could only eliminate that pesky transcription onto the medication administration record, life would be perfect).

IBUPROFEN AS AN ALTERNATIVE MEDICATION FOR FEVERS IN CHILDREN

As reported in the Clinical News section of the November 1989 American Journal of Nursing, recent studies did not recommend the use of ibuprofen in children under 12 years of age. However, a new study was reported that was conducted at the Columbus Children's Hospital in Ohio and that found ibuprofen to be a good alternative to acetaminophen for fever reduction in a sample of children aged 2 through 11 years. (Of course, now we have chewable ibuprofen tablets that are recommended for children aged two and older).

ZIDOVUDINE APPROVED FOR PEDIATRIC USE

In a 1990 Clinical News report, it was announced that use of zidovudine (a nucleoside reverse transcriptase inhibitor [NRTI]) was approved by the Federal Food and Drug Administration (FDA) for treatment of AIDS in children aged three months and older (Katzin). This decision was made after four years of clinical trials involving approximately 200 children. (In 2007, it was reported that two new animal studies Hong, et al., 2007; Walker, et al., 2007 found increased rates of tumors with gene changes that frequently occur in human cancer and two human studies that described the induction of mutations and large-scale chromosomal damage in red blood cells of newborns exposed to NRTIs in utero Escobar et al., 2007; Witt et al., 2007. The question now arises of the long-term effect of NRTIs on children.).

AMOXICILLIN THERAPY NOT RECOMMENDED IN CHILDREN UNDER TWO YEARS WITH ACUTE OTITIS MEDIA

A British Medical Journal article reported a randomized, controlled clinical trial of 240 children that demonstrated that amoxicillin therapy did not decrease the duration of pain or crying in children under the age of two years. In addition, otoscopy results at Day 11 and tympanometry findings at six weeks were comparable in the two groups (Damoiseaur, van Balen, Hoes, & de Melker, 2000). (And what is the current practice at your institution?)

These older “healthcare news clips” certainly allow one to think about how far we have come and the speed (or lack thereof) at which we are traveling. We can only hope that the speed of translating clinical evidence into practice will someday match the speed of our translating electronic technology into everyday life.