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Healthwise Helps You Make Better Health Decisions
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.
Healthwise benefits from readers' input to keep our content helpful. Send us your comments by contacting your sponsoring organization or by emailing Healthwise at email@example.com. 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.
Last updated: March 2011
Healthwise Medical Review Board
The Healthwise Medical Review Board is directed by our chief medical officer, Dr. Martin J. Gabica, and our medical directors, Dr. Adam C. Husney and Dr. Kathleen Romito, all board-certified family medicine physicians. Dr. Catherine Serio provides leadership on behavioral health issues for all Healthwise products. There is also a panel of board-certified associate medical directors who are involved in the planning and the regular and routine review of content written by Healthwise.
Chief Medical Officer: Martin J. Gabica , MD, Family Medicine, Boise, Idaho
Medical Director: Adam C. Husney , MD, Family Medicine, Boise, Idaho
Medical Director: Kathleen Romito , MD, Family Medicine, Boise, Idaho
Behavioral Health Specialist: Catherine Serio , PhD, Psychology, Boise, Idaho
Associate Medical Directors:
The Healthwise Medical Review Board also includes more than 200 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 Associate Medical Directors, 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:
John R. Hughes , MD, Addiction Psychiatry, Burlington, Vermont
James R. McKay , PhD, Addiction, Philadelphia, Pennsylvania
Peter Monti , PhD, Alcohol and Addiction, Providence, Rhode Island
Allergy and Immunology
Thomas B. Casale , MD, Omaha, Nebraska
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
Larry A. Latson , MD, Pediatric Cardiology and Critical Care, Cleveland, Ohio
John A. McPherson , MD, FACC, FSCAI, Interventional Cardiology, Nashville, Tennessee
John M. Miller , MD, Electrophysiology, Indianapolis, Indiana
Carl E. Orringer , MD, Clinical Lipidology, Cleveland, Ohio
Rakesh K. Pai , MD, FACC, Electrophysiology, Boise, Idaho
George J. Philippides , MD, FACC, Boston, Massachusetts
Christine Goertz , DC, PhD, Davenport, Iowa
Complementary and Alternative Medicine
Marc S. Micozzi , MD, PhD, Rockport, Massachusetts
Arden G. Christen , DDS, MSD, MA, FACD, Indianapolis, Indiana
William F. Hohlt , DDS, Orthodontics, 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
Amy McMichael , MD, Winston-Salem, North Carolina
Alexander H. Murray , MD, FRCPC, Halifax, Nova Scotia, Canada
Diet and Nutrition
Colleen Gobert , PhD, RD, Registered Dietitian, London, Ontario, Canada
Rhonda O'Brien , MS, RD, CDE, Dietitian and Certified Diabetes Educator, Boise, Idaho
Ruth Schneider , RD, MPH, Dietitian, Boise Idaho
William H. Blahd, Jr , MD, FACEP, New York, New York
Sean P. Bush , MD, FACEP, Envenomation Specialist, Loma Linda, California
William M. Green , MD, FACEP, Sexual Abuse, Sacramento, California
David Messenger , BSc, MD, FRCPC, FCCP, Critical Care Medicine, Kingston, Ontario, Canada
H. Michael O' Connor , MD, MMEd, FRCPC, Kingston, Ontario, Canada
Endocrinology, Diabetes, and Metabolism
Alan C. Dalkin , MD, Charlottesville, Virginia
Jennifer Hone , MD, Santa Barbara, California
Lois Jovanovic , MD, Gestational Diabetes, Santa Barbara, California
Matthew I. Kim , MD, Boston, Massachusetts
David C.W. Lau , MD, PhD, FRCPC, Calgary, Alberta, Canada
William S. Marras , PhD, CPE, Bioengineering and Ergonomics, Columbus, Ohio
Heather O. Chambliss , PhD, FACSM, Exercise Science, Memphis, Tennessee
Richard B. Kreider , PhD, FACSM, FASEP, Exercise Physiology, Waco, Texas
Thomas M. Bailey , MD, CCFP, Victoria, British Columbia, Canada
Patrice Burgess , MD, FAAFP, Boise, Idaho
Christine H. Fordyce , MD, Geriatrics, Seattle, Washington
Michael W. Foutz , MD, Kuna, Idaho
Martin J. Gabica , MD, Boise, Idaho
Adam C. Husney , MD, Boise, Idaho
Sarah Marshall , MD, Sacramento, California
Joy Melnikow, MD, MPH, Sacramento, California
Rosalia Richardson , MD, Boise, Idaho
Kathleen Romito , MD, Boise, Idaho
Steven L. Schneider , MD, Boise, Idaho
David S. Smith , MD, West Bend, Wisconsin
Donald Sproule , MD, CM, CCFP, FCFP, Montreal, Quebec, Canada
Andrew Swan , MD, CCFP, FCFP, Victoria, British Columbia, Canada
Peter J. Kahrilas , MD, Chicago, Illinois
Jerome B. Simon , MD, FRCPC, FACP, Kingston, Ontario, Canada
Jerry S. Trier , MD, Boston, Massachusetts
Arvydas D. Vanagunas , MD, FACP, FACG, Chicago, Illinois
Siobhan M. Dolan , MD, MPH, Medical Genetics, Bronx, New York
Carla J. Herman , MD, MPH, Albuquerque, New Mexico
Elizabeth A. Phelan , MD, MS, Seattle, Washington
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
Martin H. Steinberg , MD, Hematology, Boston, Massachusetts
Douglas A. Stewart , MD, FRCPC, Medical Oncology, Calgary, Alberta, Canada
Gregory T. Everson , MD, Transplant Hepatology, Englewood, Colorado
Steven L. Flamm , MD, Gastroenterology, Chicago, Illinois
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
William L. Atkinson , MD, MPH, Medical Epidemiology, Atlanta, Georgia
W. David Colby , IV, MSc, MD, FRCPC, Travel Medicine and Tropical Diseases, London, Ontario, Canada
Christine Hahn , MD, Medical Epidemiology, Boise, Idaho
Jeanne Marrazzo , MD, MPH, Prevention Epidemiology, Seattle, Washington
Peter Shalit , MD, PhD, Internal Medicine, Seattle, Washington
Stanford T. Shulman , MD, Pediatric Infectious Diseases, Chicago, Illinois
Devika Singh , MD, MPH, Seattle, Washington
Dennis L. Stevens , MD, PhD, Boise, Idaho
Raymond A. Strikas , MD, MPH, FACS, Atlanta, Georgia
Tina E. Bronner , MD, San Diego, California
Claudia A. Finkelstein , MD, Seattle, Washington
Carmen Lewis, MD, MPH, Preventive Medicine, Epidemiology, Chapel Hill, North Carolina
Brigid McCaw , MD, MPH, MS, FACP, Family Violence, Oakland, California
Brian O'Brien , MD, FRCPC, Halifax, Nova Scotia, Canada
Anne C. Poinier , MD, Boise, Idaho
E. Gregory Thompson , MD, Boise, Idaho
William M. Gilbert , MD, Sacramento, California
Kim E. Dow , MD, FRCPC, Kingston, Ontario, Canada
Jennifer Merchant , MD, Boise, Idaho
Michael Mallea , MD, Boise, Idaho
Mitchell H. Rosner , MD, Charlottesville, Virginia
Tushar J. Vachharajani , MD, FASN, FACP, Clemmons, North Carolina
David N. Alexander , MD, Los Angeles, California
Colin H. Chalk , MD, CM, FRCPC, Montreal, Quebec, Canada
Barrie J. Hurwitz , MB, MRCP, FCP(SA), Durham, North Carolina
Karin M. Lindholm , DO, Boise, Idaho
Benjamin Natelson , MD, East Orange, New Jersey
Steven C. Schachter , MD, Boston, Massachusetts
Peter J. Whitehouse , MD, PhD, Cleveland, Ohio
G. Frederick Wooten Jr. , MD, Charlottesville, Virginia
Kathryn Earhart , RN, CWOCN, Wound Ostomy Continence, Boise, Idaho
Mary Moe Robbins , RNC, IBCLC, Lactation Consultant, Newcastle, California
Rebecca H. Allen , MD, MPH, Providence, Rhode Island
Ross S. Berkowitz , MD, Gynecologic Oncology, Boston, Massachusetts
Philip D. Darney , MD, Reproductive Sciences, San Francisco, California
Divya Gupta , MD, Gynecologic Oncology New York, New York
Kevin Holcomb , MD, Gynecologic Oncology, New York, New York
Kirtly Jones , MD, Reproductive Endocrinology, Salt Lake City, Utah
Femi Olatunbosun , MB, FRCSC, FACOG, Reproductive Endocrinology, Saskatoon, Saskatchewan, Canada
Deborah A. Penava , MD, FRCSC, MPH, London, Ontario, Canada
George F. Sawaya , MD, San Francisco, California
Peter M. Rabinowitz , MD, MPH, Occupational and Environmental Medicine, New Haven, Connecticut
Steven T. Charles , MD, Vitreoretinal Surgery, Memphis, Tennessee
Carol L. Karp , MD, Miami, Florida
Christopher Joseph Rudnisky , MD, BMs, MPH, FRCSC, Edmonton, Alberta, Canada
Jill Ann Smith , MD, Newton, Massachusetts
Davide Bardana , MD, FRCSC, Sports Medicine, Kingston, Ontario, Canada
Michael R. Baumgaertner , MD, Northford, Connecticut
Timothy Bhattacharyya , MD, Orthopaedic Trauma, Bethesda, Maryland
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
David Pichora , MD, FRCSC, Trauma, Hand and Microsurgery, Kingston, Ontario, Canada
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
Corinne L. Fligner , MD, Anatomic, Clinical and Forensic Pathology, Seattle, Washington
Thomas Emmett Francoeur , MDCM, CSPQ, FRCPC, Montreal, Quebec, Canada
Susan Kim , MD, Boise, Idaho
Georgeanna J. Klingensmith , MD, Pediatric Endocrinology, Aurora, Colorado
Stephen H. LaFranchi , MD, Pediatric Endocrinology, Portland, Oregon
Chuck Norlin , MD, Salt Lake City, Utah
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
David A. Fleckenstein , MPT, Boise, Idaho
Mary McVicars Heckel , PT, MAPT, CLT-LANA, CWS, Boise, Idaho
Mary Virginia Keely , MS, PT, OCS, FAAOMPT, Orthopaedic Physical Therapy, Aptos, California
Joan Rigg , PT, OCS, Orthopaedic Physical Therapy, Boise, Idaho
Plastic and Reconstructive Surgery
Keith A. Denkler , MD, Larkspur, California
Adam D. Schaffner , MD, FACS, Otolaryngology, New York, New York
Podiatry and Podiatric Surgery
Gavin W.G. Chalmers , DPM, FACFAS, Vancouver, British Columbia, Canada
Barry L. Scurran , DPM, Fremont, California
W. Stewart Agras , MD, FRCP©), Palo Alto, California
David A. Axelson , MD, Child and Adolescent Psychiatry, Pittsburgh, Pennsylvania
David A. Brent , MD, Child and Adolescent Psychiatry, Pittsburgh, Pennsylvania
Evan Eyler , MD, MPH, Adolescent and Psychosomatic Medicine, Burlington, Vermont
Peter Hauser , MD, Portland, Oregon
Alfred J. Lewy , MD, PhD, Portland, Oregon
Steven Locke , MD, Psychosomatic Medicine and Behavioral Health, Wayland, Massachusetts
Miklos F. Losonczy , MD, PhD, East Orange, New Jersey
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
Sue Barton , PhD, PsyD, Behavioral Health, Sacramento, California
Stephanie Bender-Kitz , PhD, Aging and Long-Term Care, Boise, Idaho
J. David Carroll , PhD, Milwaukee, Wisconsin
Jessica Hamblen , PhD, Post-Traumatic Stress Disorder, White River Junction, Vermont
Catherine Serio , PhD, Behavioral Health, Boise, Idaho
Timothy Stockwell , PhD, Public Policy, Victoria, British Columbia, Canada
Stephen I. Sulzbacher , PhD, Clinical Psychology, Seattle, Washington
Edward Z. Tronick , PhD, Developmental Psychology, Boston, Massachusetts
Robert L. Cowie , MB, ChB, MD, MSc, FCP[SA], MFOM, Respiratory Medicine, Calgary, Alberta, Canada
Susanna A. McColley , MD, Pediatric Pulmonology, Chicago, Illinois
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
Ken Y. Yoneda , MD, Critical Care Medicine, Sacramento, California
Myo Min Han , MD, Nuclear Medicine, Oakland, California
Howard B. Schaff , MD, Diagnostic Radiology, Boise, Idaho
Kenneth B. Sutherland , MD, FRCPC, Kingston, Ontario, Canada
Ernest L. Abel , PhD, Detroit, Michigan
Catherine O'Malley , RRT, Chicago, Illinois
Richa Dhawan , MD, Shreveport, Louisiana
Nancy Ann Shadick , MD, MPH, Boston, Massachusetts
Stanford M. Shoor , MD, Palo Alto, California
Robert M. Kroll , PhD, Speech Pathology, Toronto, Ontario, Canada
Kenneth Bark , MD, General and Colorectal Surgery, Utica, Michigan
Jeffrey Gilbertson , MD, Vascular Surgery, Boise, Idaho
Mark G. Luciano , MD, Pediatric Neurosurgery, Cleveland, Ohio
C. Dale Mercer , MD, FRCSC, FACS, Kingston, Ontario, Canada
Michael M. Murr , MD, Gastrointestinal Surgery, Tampa, Florida
Brent T. Shoji , MD, Boston, Massachusetts
David C. Stuesse , MD, Cardiac and Thoracic Surgery, Boise, Idaho
David A. Szalay , MD, Vascular Surgery, Hamilton, Ontario, Canada
Ali Tavakkolizadeh , MD, Bariatric Surgery, Boston, MA
Brad W. Warner , MD, Pediatric Surgery/Critical Care, St. Louis, Missouri
Christian G. Zimmerman , MD, FACS, MBA, Neurological Surgery, Boise, ID
Peter Anderson , MD, FRCS), Pediatric Urology, Halifax, Nova Scotia, Canada
J. Curtis Nickel , MD, FRCSC, Kingston, Ontario, Canada
Avery L. Seifert , MD, FACS, Boise, Idaho
Christopher G. Wood , MD, FACS, Houston, Texas
Last updated: February 2013
Healthwise Content Development Team
Senior Vice President
Karen Baker, MHS
Vice President of Content
Christine Calhoun, MPH
Kerry V. Cooke, BA
Jeannette Curtis, BS
Carrie Henley, BA
Patrick Kilby, BA
Katy Magee, MA
Judi Marsh, MBA
Susan Van Houten, RN, MBA
Senior Clinical Consultants
Carolyn Brzezicki, RN, MS
Judy Dundas, BA, BSN
Senior Special Project Manager
Kathleen M. Ariss, MS
Bill Amos, JD
Nancy Bateman, BS
Deborah Dakins, BA
Eileen Ellig, BJ
Marianne Flagg, BA
Kathe Gallagher, MSW
Christopher Hess, BA
Paul Lehnert, MA
Ryan Powers, MFA
Ellie Rodgers, BA
Cynthia Tank, BA
Lila Havens, MA
Elizabeth Rodgers, BA
Colleen Cronin, MA
Medical Content Specialists
Bets Davis, MFA
Shannon Erstad, RPT, MBA, MPH
Maria G. Essig, MS
Debra Golonka, MPH
Sandy Jocoy, RN, BA
Jan Nissl, RN, BS
Robin Parks, MS, MSTC
Monica Rhodes, BA
Christine Maldonado, PhD
Terry Smith, PhD
Arlene Hull, MS, CES
Jennifer Adams, MLS
Doug Dana, BA
John Kubisiak, BS
Denele Ivins, BA
Tracy Landauer, BA
Pat Truman, MA
Terrina Vail, BA
Colleen Brennan, MA
Research Library Manager
Liisa Rogers, MSW, MLIS
Library Technical Specialist
Karri Alderson, MLIS
Bill Coe, BS
Jennifer Farnum, MLS
Steve Graepel, MS
Last updated: October 2011
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.
See What's New in the Healthwise® Knowledgebase for the current release.
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.
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.
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:
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.
National Organization for Rare Disorders, Inc. (NORD)
The National Organization for Rare Disorders, Inc., of Danbury, Connecticut, provides topics on rare diseases for the Healthwise® Knowledgebase.
The NORD topics are updated on an ongoing basis as new information. In addition, all topics are periodically reviewed to ensure that all information remains current and accurate. Healthwise receives quarterly updates from NORD. The updates are included in the quarterly releases of the Healthwise® Knowledgebase.
Conflict of Interest Policy: NORD uses independent sources such as the National Institutes of Health and U.S. Food and Drug Administration for its information on standard and investigational therapies. It does not rely on commercial sources for anything other than brief notices that clinical trials are in progress. NORD does not ask researchers at academic institutions directly involved in studies of particular therapeutics to provide or review information related to treatment of the disease in question. When a report is written by a physician or other medical professional rather than by one of NORD's own writers, NORD has it reviewed by an MD or PhD with appropriate expertise at a different institution. To obtain input from more than one medical perspective, NORD does not allow a report to be reviewed by someone who has participated in research or clinical activities with the author of the report. NORD's staff regularly reviews several medical journals and, if any discrepancies in opinion related to information in a report are found, members of the Medical Advisory Committee provide guidance.
The date of the last update is at the end of each topic.
American Self-Help Clearinghouse Information
The American Self-Help Group Clearinghouse, of Cedar Knolls, New Jersey, provides information on self-help groups.
Healthwise receives semiannual updates from the American Self-Help Clearinghouse. The updates are included in the quarterly releases of the Healthwise® Knowledgebase. The content verification date is at the end of each listing.
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: February 2011
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:
Healthwise ensures compliance with these principles through internal review and URAC accreditation.
Last updated: May 2009
Date adopted: May 2005
Healthwise helps people make better health decisions. Healthwise is committed to respecting the privacy of individuals. Healthwise collects usage information to improve the usefulness of our products. The collected information is not personal; it is anonymous and does not identify individuals. Healthwise uses only aggregate information for reporting and improving performance. Healthwise may choose a third-party service to collect and maintain this site usage information. Healthwise may disclose this aggregate information to some organizations when required by law or to comply with legal processes. Healthwise does not release, trade, or sell any individual-identifying information about usage of a Healthwise product to people or organizations outside of Healthwise. Healthwise products may have the look and feel of a sponsoring organization's website. However, the Healthwise product you are using is hosted on servers of Healthwise. All Healthwise information can be identified by the Healthwise logo that is visible at the bottom of each health topic. Consumers should review the privacy policies of the sponsoring organization's website.
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Last updated: October 22, 2009
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:
Last updated: August 2007
Date adopted: August 2000
not medical advice This product is for informational purposes only. This information does not replace professional medical advice, diagnosis, or treatment. If you have questions regarding a medical condition, always seek the advice of your physician or other qualified health professional. Developments in medical research may impact this information. If you think you may have a medical emergency, call your doctor or 911 immediately.
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jurisdiction You expressly agree that exclusive jurisdiction for any dispute relating to your use of this product resides in the courts of the State of Idaho governed by the substantive laws of the State of Idaho, without respect to its conflict of laws principles. If any provision of these Terms is found to be invalid by any court having competent jurisdiction, the invalidity of that provision shall not affect the validity of the remaining provisions, which shall remain in full force. If the liability limitation is so deemed invalid, Healthwise, our suppliers, or any third parties mentioned in the product shall be liable only to the extent of actual damages incurred by you, not to exceed U.S. $2,500. No waiver of any of these Terms shall be deemed a further or continuing waiver.
claims Any claims arising from your use of this product must be brought within one year from the date of the event giving rise to the action occurred. Remedies under these Terms are exclusive and are limited to those expressly provided for in these Terms.
information from suppliers for content that may be included in product
SELF-HELP CLEARINGHOUSE. By retrieving and/or utilizing information from the American Self-Help Clearinghouse database, you agree to hold harmless American Self-Help Clearinghouse, its owners, and employees from any and all liability arising directly or indirectly from your use of information contained in the database. You be the judge. The Self-Help Clearinghouse does not evaluate or rate the individual self-help groups, which are contained in the database. Therefore, Self-Help Clearinghouse's listing of a self-help group does not constitute an endorsement of that group. Neither does omission signify disapproval. We include groups in our database based upon a report of their organizations as being focused upon no-fee mutual aid; i.e., members helping one another. The use of any information is entirely the responsibility of the reader. You are the ultimate judge in deciding whether the group is appropriate to your needs. You can send for and review literature or call the phone contact. Self-help means more control, and more responsibility, in your hands.
NATIONAL CANCER INSTITUTE. Healthwise has an agreement with The National Cancer Institute ("NCI") for the use of the Physician Data Query (PDQ®) data files ("NCI Content") in which the following provisions must be met. You shall accommodate these provisions in its use of the Healthwise material.
i. PDQ is a registered trademark of the NCI and must be so referenced in all published material pertaining to PDQ files. The PDQ name must always be used in any public reference to the data files. Healthwise shall include the Software and you shall not alter or delete the notice making users aware at the point of initially entering the PDQ files that the source of the data provided is the NCI's PDQ files.
ii. Healthwise shall include the Software and you shall not alter or delete the following use restrictions (and any updates thereto) in the User License Agreement document and in all updated versions thereof and online in the system "help" message for use restrictions: "Some material in Physician Data Query (PDQ®) is from copyrighted publications of the respective copyright claimants. Users of PDQ are referred to the publication data appearing in the bibliographic citations, as well as to the copyright notices appearing in the original publication, all of which are hereby incorporated by reference."
iii. You agree that, because use of the PDQ data for insurance reimbursement decisions is contrary to the nature of the database, which is designed as a research tool and not to reflect possible treatment options, you are not to use it for reimbursement decision purposes.
The information in the NCI content may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
NORD'S RARE DISEASE DATABASE. The information provided in this report is not intended for diagnostic purposes. It is provided for information purposes only. This information is presented for further understanding that could lead to the prevention, treatment, and/or cure of rare disorders. NORD recommends that affected individuals seek the advice or counsel of his or her own personal physician(s). It is possible that the title of the topic is not the name you selected. Please check the SYNONYMS listing to find the alternate name(s) and disorder subdivision(s) covered by this report. The disease entry is based upon medical information available through the date at the end of the topic. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about the disorder.
NORD is a private charity. This information is meant to assist patients, their families, educators and health care providers in the understanding, possible prevention, treatment and/or cure of rare disorders. We advise you also to check the "Synonyms" listing to find alternate name(s) and disorder subdivision(s), and with the agencies listed in the "Resources" section for the most current information about this disorder.
Last updated: April 28, 2011
Multum End-User License Agreement
The third party drug information (the "Service"), that may be included in the Healthwise products is for use by United States and Canadian residents only. The Service is a service provided to you by Cerner Multum ("Multum"). The Service and the Healthwise products are separate products provided by separate entities. Every effort has been made to ensure that the information provided in the Service is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive. The Service does not endorse drugs, diagnose patients, or recommend therapy. The Service is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and provide consumers with drug specific information. Healthcare practitioners should use their professional judgment in using the information provided. The Service is not a substitute for the care provided by licensed healthcare practitioners and consumers are urged to consult with their healthcare practitioner in all instances. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information the Service provides.
Disclaimer of Warranties
THE END-USER ACKNOWLEDGES THAT THE SERVICE IS PROVIDED ON AN "AS IS" BASIS. EXCEPT FOR WARRANTIES WHICH MAY NOT BE DISCLAIMED AS A MATTER OF LAW, MULTUM MAKES NO REPRESENTATIONS OR WARRANTIES WHATSOEVER, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO REPRESENTATIONS OR WARRANTIES REGARDING THE ACCURACY OR NATURE OF THE CONTENT OF THE SERVICE, WARRANTIES OF TITLE, NONINFRINGEMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. The END-USER acknowledges that updates to the Service are at the sole discretion of Multum. Multum makes no representations or warranties whatsoever, express or implied, with respect to the compatibility of the Service, or future releases thereof, with any computer hardware or software, nor does Multum represent or warrant the continuity of the features or the facilities provided by or through the Service as between various releases thereof. Any warranties expressly provided herein do not apply if: (i) the END-USER alters, mishandles or improperly uses, stores or installs all, or any part, of the Service, (ii) the END-USER uses, stores or installs the Service on a computer system which fails to meet the specifications provided by Multum, or (iii) the breach of warranty arises out of or in connection with acts or omissions of persons other than Multum.
Assumption of Risk, Disclaimer of Liability, Indemnity
THE END-USER ASSUMES ALL RISK FOR SELECTION AND USE OF THE SERVICE AND CONTENT PROVIDED THEREON. MULTUM SHALL NOT BE RESPONSIBLE FOR ANY ERRORS, MISSTATEMENTS, INACCURACIES OR OMISSIONS REGARDING CONTENT DELIVERED THROUGH THE SERVICE OR ANY DELAYS IN OR INTERRUPTIONS OF SUCH DELIVERY. THE END-USER ACKNOWLEDGES THAT MULTUM: (A) HAS NO CONTROL OF OR RESPONSIBILITY FOR THE END-USER'S USE OF THE SERVICE OR CONTENT PROVIDED THEREON, (B) HAS NO KNOWLEDGE OF THE SPECIFIC OR UNIQUE CIRCUMSTANCES UNDER WHICH THE SERVICE OR CONTENT PROVIDED THEREON MAY BE USED BY THE END-USER, (C) UNDERTAKES NO OBLIGATION TO SUPPLEMENT OR UPDATE CONTENT OF THE SERVICE, AND (D) HAS NO LIABILITY TO ANY PERSON FOR ANY DATA OR INFORMATION INPUT ON THE SERVICE BY THE END-USER TO THE SERVICE. MULTUM SHALL NOT BE LIABLE TO ANY PERSON (INCLUDING BUT NOT LIMITED TO THE END-USER AND PERSONS TREATED BY OR ON BEHALF OF THE END-USER) FOR, AND THE END-USER AGREES TO INDEMNIFY AND HOLD MULTUM HARMLESS FROM ANY CLAIMS, LAWSUITS, PROCEEDINGS, COSTS, ATTORNEY'S FEES, DAMAGES OR OTHER LOSSES (COLLECTIVELY, "LOSSES") ARISING OUT OF OR RELATING TO (A) THE END-USER'S USE OF THE SERVICE OR CONTENT PROVIDED THEREON OR ANY EQUIPMENT FURNISHED IN CONNECTION THEREWITH AND (B) ANY DATA OR INFORMATION INPUT ON THE SERVICE BY END-USER, IN ALL CASES INCLUDING BUT NOT LIMITED TO LOSSES FOR TORT, PERSONAL INJURY, MEDICAL MALPRACTICE OR PRODUCT LIABILITY. FURTHER, WITHOUT LIMITING THE FOREGOING, IN NO EVENT SHALL MULTUM BE LIABLE FOR ANY SPECIAL, INCIDENTAL, CONSEQUENTIAL, OR INDIRECT DAMAGES, INCLUDING DAMAGES FOR LOSS OF PROFITS, LOSS OF BUSINESS, OR DOWN TIME, EVEN IF MULTUM HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. THE INFORMATION CONTAINED WITHIN THE SERVICE HAS BEEN DEVELOPED FOR USE BY PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS WHO RELY ON THEIR CLINICAL DISCRETION AND JUDGMENT IN DIAGNOSIS AND TREATMENT. THE INFORMATION CONTAINED WITHIN THE SERVICE IS NOT INTENDED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS OR TREATMENT. AS BETWEEN THE END-USER AND MULTUM, THE END-USER HEREBY ASSUMES FULL RESPONSIBILITY FOR INSURING THE APPROPRIATENESS OF USING AND RELYING UPON THE INFORMATION IN VIEW OF ALL ATTENDANT CIRCUMSTANCES, INDICATIONS, AND CONTRAINDICATIONS.
Liability of Multum to the END-USERS
Under no circumstances shall Multum be liable to the END-USER or any other person for any direct, indirect, exemplary, special or consequential damages arising out of or relating to the END-USER's use of or inability to use the Service or the content of the Service provided thereon or any equipment furnished in connection therewith. Multum's total liabilities in connection with this Agreement, whether arising under contract or otherwise, are limited to the fees received by Multum under this Agreement specifically relating to the END-USER's service or product which is the subject of the claim.
Last updated: March 2011
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