NFL: Colts clinch playoff berth with win against Chiefs

The Indianapolis Colts crowned their remarkable turnaround by clinching an AFC wild-card playoff berth with a 20-13 victory over the Kansas City Chiefs on Sunday.
The Colts, who tied for the NFL's worst record last season at 2-14, improved to 10-5 with their win over the 2-13 Chiefs.
Rookie quarterback Andrew Luck, who the Colts claimed with the top pick in the NFL Draft thanks to their woeful record, hit a leaping Reggie Wayne in the back of the end zone for the winning seven-yard touchdown pass with 4:08 left in the game.
That connection capped a 73-yard drive that marked their NFL record-tying seventh fourth-quarter comeback victory.
Luck set the league record for passing yards in a season for a rookie, finishing the game with 4,183 yards to eclipse the mark of 4,051 yards last season by Cam Newton of the Carolina Panthers with one regular season game still to play.
"I'm very proud to be a part of this team, to be associated with a playoff team. What a great win for us," Luck told reporters. "We've been in that situation before when we've been down or tied.
"It was a great all-around effort on that last drive."
The Colts bucked even longer odds this year, learning they would have to carry on without head coach Chuck Pagano, who left after three games to go through treatment for leukemia.
Pagano, who was replaced by interim coach Bruce Arians (9-3 with the team), has been cleared by doctors to return to the team and is expected to be back on the sidelines next week.
"I can't say enough about the guys in the locker room, mission accomplished." said Arians.
"We set out to extend this season for Chuck. Now he can come back Monday and not be in the stressful time that we were in. He can get back into the flow of things at his pace."
Luck, who completed 17-of-35 passes for 205 yards including five to Wayne for 81 yards, was one of a group of Colts players who shaved their heads in solidarity with Pagano, whose hair fell out during his cancer treatments.
"It means the world," Luck said about Pagano's return. "I'm glad we could get this win for him so he can come back knowing we'll be in the postseason."
The Colts close the regular season against the visiting AFC South champion Houston Texans (12-3).

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Bengals book playoff spot with win over Steelers

Josh Brown booted a 43-yard field goal with four seconds left to play to earn the Cincinnati Bengals a 13-10 win over the Pittsburgh Steelers and a ticket to the National Football League playoffs on Sunday.
The victory was the Bengals' (9-6) first over their bitter AFC North rivals in six meetings and eliminated the Steelers (7-8) from post-season contention spoiling the holiday mood for the capacity crowd who had arrived at Heinz Field expecting to kick off the Christmas holidays with a win.
"It's very satisfying, quite honestly," Brown told reporters. "I've had some bad runs against Pittsburgh, including a bad game with the Rams last year, so really I just needed to exercise some demons.
"It's a good Christmas."
The outcome marks the first since 2006 that the Steelers will enter the final game of the regular season with no chance to make the playoffs while the Bengals earned back-to-back post-season berths for the first time in 30 years.
"It was not our day, not our year, not enough physical play at the moment," said Steelers coach Mike Tomlin. "It sounds like a broken record but the reality, as we sit here, we accept responsibility for it. ...
"It's disheartening because we had chances."
As is typical when the Steelers and Bengals clash, the meeting was a bruising defensive battle, the Cincinnati defense accounting for the Bengals' only touchdown when Leon Hall intercepted Ben Roethlisberger in the opening quarter and returned the ball 17 yards for the score.
Roethlisberger connected with Antonio Brown on a 60-yard touchdown in the third quarter to get Pittsburgh back into the contest but made a critical mistake with 14 seconds to play, throwing his second interception that was returned to the Steelers 46.
Bengals quarterback Andy Dalton then hooked up with A.J. Green on a 21-yard pass to set up Brown's game-winning kick.
Pittsburgh had a chance to take control with 1:47 left on the clock when Shaun Suisham lined up to attempt a 53-yard field goal into the teeth of Heinz Field's notorious swirling winds. But the kick fell short, giving the Bengals the ball.
Brown had missed on a 56-yard attempt on the previous series as both teams struggled to generate offence.
Roethlisberger, who was intercepted in overtime in last Sunday's loss to the Dallas Cowboys, completed 14-of-28 passes for 220 yards but was under pressure all afternoon from a tenacious Bengals pass rush that sacked the Pittsburgh quarterback four times.
Pittsburgh's top-ranked defense surrendered just 14 yards rushing while Dalton completed just 24-of-41 attempts for 278 yards with no touchdowns and two interceptions. Almost half of Dalton's completions went to Green, who hauled in 10 catches for 116 yards.
"It's a big win for the city of Cincinnati," said Bengals coach Marvin Lewis. "We did a good job of hanging in there and not flinching and making big plays.
"There were a lot of big plays today. A lot of guys came up with big plays.
"That's what you have to keep having all the time.

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Column: NFL's 'nice little story' gets even better

The Colts were a nice little story six weeks ago.
That's when a team that started 1-2 and had "rebuilding" written all over it responded to the loss of rookie coach Chuck Pagano with one of those how-did-they-do-it winning streaks — and that was supposed to be that. Considering the Colts finished 2-14 a year ago, then said goodbye to Peyton Manning and turned the rest of the roster upside-down, the season was already a success.
Fans in Indianapolis knew can't-miss rookie quarterback Andrew Luck was bound to improve, but explaining the 4-1 run after Pagano left the team to deal with leukemia was tough enough, especially because there was precious little room elsewhere for improvement. The Colts still can't run the ball, and they still start rookies at nearly every one of the skill positions. The defense? Don't ask.
Yet the story just got better.
Indianapolis was outgained by more than 200 yards Sunday in Kansas City. The Colts lost the time-of-possession battle but still won 20-13 and locked up an improbable playoff spot.
"Mission accomplished," Colts interim coach Bruce Arians said, as though he expected as much. "That's all I can say. It's a fantastic feeling."
And the story is about to get better still.
Pagano has been cleared to return, perhaps as early as Monday. He might have been the only guy in the entire organization who was expecting great things when he took over, but an entire squad and staff have come over to his side in his absence.
Arians, who stepped in for his close pal and consulted Pagano throughout his ordeal, is a candidate for coach of the year. And Luck, who threw for a modest 205 yards and a touchdown, still made up a lot of ground in his race against similarly impressive first-year quarterback starters Robert Griffin III of Washington and Russell Wilson of Seattle because of something he didn't do — throw a costly interception.
Even the much-maligned defense got into the act, with Darius Butler picking off Brady Quinn's pass and returning it for a touchdown five plays into the game, and whole unit rising up to stuff Quinn on a quarterback sneak late in the game, turning the ball back over to Luck in time for a rookie-record seventh winning drive.
"Whenever teams go for it on fourth down, the defense takes it personal," Indianapolis end Dwight Freeney said.
If the defensive stand was a surprise, what Luck did with the opportunity wasn't. The Colts' running game is still little more than a chance for Luck to catch his breath, and despite the emergence of receivers T.Y. Hilton and Dwayne Allen, just about everybody in Arrowhead Stadium was looking at veteran wideout Reggie Wayne. So was Luck, who saw him cut through a seam in the middle of the defense, then fired a high, hard pass that Wayne latched onto in the end zone for a 7-yard score.
Luck owns the rookie records for most yards, most 300-yard games, most winning drives, and the strike to Wayne put him closer to the rookie record of 26 touchdown passes set by none other than Manning. And just like Manning, to whom Luck was often compared before the season, the rookie knew exactly what to say about all of them.
"I think it definitely means something. After the season I'll have a chance to reflect back on it. Obviously, it is nicer to be in the playoffs and know that," Luck said, "but it is nice to have a couple records that I'm sure will be broken in the next year."
What he said next, though, came as something of a surprise.
"I think we were confident in the locker room from day one. I remember going in, trying to gauge the feel of what it was going to be like. Guys were confident on this team, like Reggie Wayne who had never missed a playoff until that year. Dwight Freeney, Robert Mathis, those guys are winners, they know how to win, so I think they imparted some of that magic, if you will, on some of the younger guys, the newer guys.
"It was a confident bunch, we never prepared to lose a game, we always prepared to win, and I guess that worked out."
It's still a mystery exactly how, but Luck wasn't going to spend much more time dwelling on that than he did on accumulating records.
"I guess it will be an extra special Christmas," he said, referring to Pagano's return. "There will be a lot of emotions when he comes through the door. It's funny, there are probably 10 guys who have never met Chuck on the team, but I think they will be emotional too because I'm sure they feel like they know him, too, because his presence is felt so much in the building out here, and wherever we go.

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Luck sets rookie record, rookie PK sets NFL mark

Andrew Luck has broken the NFL rookie record for yards passing, and rookie kicker Blair Walsh has broken the league mark for 50-yard plus field goals in a season.
On a Sunday featuring a slew of records, Luck topped Cam Newton's year-old mark for yards passing in the first half of Indianapolis' win at Kansas City. Newton's record was 4,051 yards. Luck entered the game needing 74 yards to break the mark. He finished with 205 yards and now has 4,183 yards with a game against Kansas City remaining in the regular season.
"Yes, it definitely means something," Luck said of the record. "And after the season I'll have a chance to look back and reflect on it. It's nice; obviously it's nicer to be in the playoffs but it's nice to have a couple records, which I'm sure will be broken in the next year."
Minnesota's Walsh kicked a 56-yard field goal in the second quarter against Houston, giving him a record ninth field goal of 50 yards or more.
Also, Redskins kicker Kai Forbath set the NFL record for consecutive field goals to begin a career with 17 straight. He had field goals of 45 and 42 yards in the first half against the Eagles. New Orleans' Garrett Hartley had 16 straight.
On Saturday, Detroit's Calvin Johnson broke Jerry Rice's single-season yards receiving record, and is at 1,892 with a game left. He also became the only NFL player with 100 yards receiving in eight straight games, and with 10-plus receptions in four straight games.

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Anthony leads Knicks over Timberwolves

Carmelo Anthony took over in the last two minutes to carry the New York Knicks to a 94-91 victory over the Minnesota Timberwolves on Sunday.
Anthony, who was ejected during Friday's loss to the Chicago Bulls, finished with 33 points, scoring 19 in the fourth quarter, as the Knicks came from behind to secure the home win.
"We didn't want to look back at this game later in the season and say this was a game we shouldn't have lost," Anthony told reporters. "We picked it up defensively in the second half and we won the game."
New York trailed for virtually the entire game before Anthony went on an 8-0 run in the final two minutes to put the Knicks up by four.
Anthony scored the Knicks' last 12 points to seal the win.
"That was kind of an MVP performance at the end. He stepped up and made the plays," said New York coach Mike Woodson. "When he got that fifth foul called, it's like a light went off and he made the plays big-time."
J.R. Smith scored 19 off the bench for New York (20-7) while Tyson Chandler had 16 and nine rebounds as the Knicks maintained their 5 1/2 game lead in the Atlantic Division.
Nikola Pekovic recorded 21 points and 17 rebounds to lead the Timberwolves (13-12), who were missing All Star Kevin Love due to an eye ailment.
Minnesota went up by nine at half-time and led by 11 midway through the third before New York made their move.
Chandler scored 10 in the third quarter as the Knicks cut the deficit to two heading into the fourth.
New York are still without forward Amar'e Stoudemire, who has been out the entire season with a knee injury but has recently started practicing with the team.
Despite his absence, the Knicks are off to a strong start and have a 5 1/2-game lead in the Atlantic Division.

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Alexza's agitation drug gets FDA approval

Alexza Pharmaceuticals Inc said the U.S. health regulators approved Adasuve, making it the first treatment for schizophrenia and bipolar disorder that can be inhaled. Adasuve, which delivers an older antipsychotic drug called loxapine, passes through the lungs and into the bloodstream faster than a typical pill. Loxapine is available as an oral drug for schizophrenia. The company said the product will include a boxed safety warning about potentially dangerous side effects including the potential for fatal bronchial spasms in people with asthma or chronic obstructive pulmonary disorder and a higher risk of death in elderly people with dementia-related psychosis. Adasuve use will be restricted to mitigate the potential harm of bronchial spasms, Alexza said. The FDA also required Alexza to conduct a large post- marketing clinical trial of patients to assess the real-world use of the drug. "We believe that the ability to deliver medications rapidly and non-invasively will be important for patients and the professionals who care for them," Chief Executive Thomas King said in the statement. Three injectable drugs, Bristol-Myers Squibb's Abilify, Eli Lilly's Zyprexa and Pfizer Inc's Geodon, are currently approved to calm patients with schizophrenia or bipolar disorder. Adasuve, Alexza's most advanced drug, will be available for commercial launch early in the third quarter of 2013, the company said. Earlier this month, European health regulators recommended approval of Adasuve. The FDA denied approval to Adasuve in May, after it found deficiencies at the company's Mountain View, California manufacturing facility during an inspection. The company's shares fell 12 percent in the after market trading after the trade was halted at $5.79 before the drug- approval announcement.

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Predicting who's at risk for violence isn't easy

It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes. Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say. But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings. "They're yellow flags. They only become red flags once the blood is spilled," he said. Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known. Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.) Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said. Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed. "In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy." The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through." In a guidelines for families, the academy lists several risk factors for violence, including: —Previous violent or aggressive behavior —Being a victim of physical or sexual abuse —Guns in the home —Use of drugs or alcohol —Brain damage from a head injury Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn. Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence. Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others. According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms. Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them. Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment. And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state. All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment. Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school. Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care. Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.

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Hepatitis C tests continue after NH tech's arrest

Hospitals across the country recommended hepatitis C testing for about 7,900 patients last summer after a traveling medical worker was accused of stealing drugs and infecting patients with tainted syringes in New Hampshire. But five months later, nearly half of those who were possibly exposed to the liver-destroying disease in other states have yet to be tested. Described by prosecutors as a "serial infector," David Kwiatkowski is accused of stealing syringes of the powerful painkiller fentanyl from the cardiac catheterization lab at New Hampshire's Exeter Hospital and replacing them with saline-filled syringes tainted with his own blood. In jail since his arrest in July, he pleaded not guilty to 14 federal drug charges earlier this month and is expected to go to trial next fall. Before April 2001, when he was hired in New Hampshire, Kwiatkowski worked as a traveling cardiac technologist in 18 hospitals in seven states, moving from job to job — despite being fired twice over allegations of drug use and theft. Thirty-two people in New Hampshire have been diagnosed with the same strain of hepatitis C that Kwiatkowski carries, along with six in Kansas, five in Maryland and one in Pennsylvania. At least 3,700 people outside New Hampshire have yet to be tested, hospitals and public health officials told The Associated Press. For example, in Michigan, where Kwiatkowski grew up and started his career, about 2,300 patients at five hospitals were notified that they may have been exposed to hepatitis C by Kwiatkowski. As of early December, only about 500 had gone in for testing, none of whom were diagnosed with a strain linked to the New Hampshire outbreak, according to the Michigan Department of Community Health. In Pennsylvania, 2,280 patients at the University of Pittsburgh Medical Center Presbyterian were notified that they should get tested, but only 840 have, one of whom was diagnosed with a matching strain of hepatitis C. Kwiatkowski was fired a few weeks into his temporary job at UPMC in 2008 after a co-worker accused him of swiping a fentanyl syringe from an operating room and sticking it down his pants. Citing a lack of evidence, hospital authorities didn't call police, and neither the hospital nor the medical staffing agency that placed him in the job informed the national accreditation organization for radiological technicians. Within days, Kwiatkowski was starting a new job at the Baltimore VA Medical Center, where one patient also has since been diagnosed with hepatitis C linked to Kwiatkowski. Though the VA center initially said it had identified 168 patients who may have been exposed, that number was later lowered, and 68 patients ultimately were tested. Two other Maryland hospitals where Kwiatkowski worked also have completed their testing, with no diagnosed cases of hepatitis C matching Kwiatkowski. But at the fourth, The Johns Hopkins Hospital in Baltimore, four patients have been diagnosed with the strain of disease linked to Kwiatkowski. About 500 of the 1,567 patients notified by Johns Hopkins have yet to be tested, according to hospital spokeswoman Kim Hoppe. Kwiatkowski had been referred by a staffing agency that assured Johns Hopkins that it had followed a vigorous vetting process, Hoppe said. He worked there for two 13-week stints, from July 2009 to January 2010. Saint Francis Hospital in Poughkeepsie, N.Y., where Kwiatkowski worked in late 2007 and early 2008, notified and tested 31 patients without finding any linked cases to Kwiatkowski. In Kansas, nearly all of the 416 patients who may have been exposed at Hays Medical Center have been tested and six have been diagnosed with infections linked to the New Hampshire outbreak. There have been no cases linked to Kwiatkowski in Arizona, where about 300 patients from two hospitals have been asked to get tested and about 280 have done so. Kwiatkowski worked at Maryvale Hospital in Phoenix in 2009 and the Arizona Heart Hospital in 2010. He was fired from the latter job after 10 days after a co-worker found him passed out in a bathroom stall with a stolen fentanyl syringe floating in the toilet. That incident was reported to police, Kwiatkowski's staffing agency, a state regulatory board and the national accreditation organization, but the accreditation group dropped its inquiry after learning police hadn't filed charges. Days later, Kwiatkowski landed a new job filling in for striking technicians at Temple University Hospital in Philadelphia. That hospital has recommended testing for 312 patients but won't say how many have followed through or have been diagnosed with hepatitis C. A hospital spokesman referred questions to the city health department, which did not return calls. Testing also is still under way in the last place Kwiatkowski worked before heading to New Hampshire — Houston Medical Center in Warner Robins, Ga. According to the hospital, fewer than 100 people have yet to be tested, and there haven't been any cases yet linked to Kwiatkowski. In New Hampshire, where about 3,300 patients were tested, Kwiatkowski is charged with seven counts of illegally obtaining drugs and seven counts of tampering with a consumer product, though prosecutors have said further charges are possible. Although New Hampshire cannot charge him for possible violations in other states, it can use evidence gathered in those jurisdictions in its trial, U.S. Attorney John Kacavas said. Other states are waiting to see the outcome of New Hampshire's case before deciding whether to file charges, he said. "We continue to reach out to other states affected by this matter," Kacavas said this week. "Other health organizations and departments continue to do their work in their states, but nothing has changed in the sense that our prosecution will go forward. At this point, we are the only prosecution in the country, and we'll see how it rolls out.

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FDA warns doctors of counterfeit Botox

Federal regulators have warned more than 350 medical practices that Botox they may have received from a Canadian supplier is unapproved and could be counterfeit or unsafe. The Food and Drug Administration said in a letter sent last month, a letter released publicly last week, that batches of the wrinkle treatment shipped by suppliers owned by pharmacy Canada Drugs have not been approved by the FDA and that the agency cannot assure their effectiveness or their safety. The FDA said Canada Drugs was previously tied to shipping unapproved and counterfeit cancer drugs. The agency warned doctors about buying drugs from sources other than licensed U.S. pharmacies. It is the fifth warning the agency has made this year about foreign suppliers providing unapproved drugs. In February, the agency warned 19 medical practices that they had received a counterfeit version of the cancer drug Avastin. On three more occasions the FDA issued similar warnings about counterfeit Avastin and Altuzan, another brand name for the same drug. The alerts were also primarily targeted at drugs distributed by Canada Drugs. A request for comment from the drug distributor was not immediately returned. Drug shortages increased the financial incentives for some pharmacies to provide counterfeit or illegally imported drugs. The drugs subject to warnings have all been injectable treatments typically distributed through medical practices and not directly to patients. In October, the FDA ordered operators of about 4,100 websites to immediately stop selling unapproved medications to U.S. consumers. The vast majority of those sites were operated by Canada Drugs. The site was still operating Friday. Genuine Botox is made by Allergan Inc., based in Irvine, Calif. Avastin is made by Roche Holding AG's Genentech unit.

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Little change in overtreatment at doctors' offices

Although some Americans are getting more of beneficial treatments that were underused in the past, including drugs for heart disease, others are still being overtested or overtreated for a range of conditions, according to a new study. Researchers found U.S. doctors' offices made progress on six of nine "quality indicators" for recommended and underused therapies but only scaled back on two of 11 unnecessary and potentially harmful health services. Those findings reflect a growing concern over skyrocketing health care costs - and the realization that doctors and hospitals are going to have to find places where services can be scaled back. "We all know that we need to do something about it, and one component of the high health care costs is the overuse and misuse of therapies and interventions," said Dr. Amir Qaseem, director of clinical policy at the American College of Physicians. It's not about getting rid of services that are too expensive, he told Reuters Health, but evaluating what current tests and treatments may offer little value for certain patients. For example, two overuse indicators included in the new analysis are screening men age 75 and up for prostate cancer and screening women 75 and older for breast cancer. "For men who are getting screened over the age of 75, the likely benefit doesn't happen within a patient's lifetime," Qaseem said, because prostate cancer is often very slow-growing. And that's assuming prostate specific antigen (PSA) tests are beneficial at all. Regardless of a man's age, however, the tests can still lead to invasive biopsies that come with side effects such as a risk of incontinence and impotence. "We really need to start looking at some of these services that may be harmful," added Qaseem, who wasn't involved in the new research. The findings are based on nationally representative studies of adult care in outpatient offices, conducted by the Centers for Disease Control and Prevention. Data came from 79,083 office visits in 1998-1999 and 102,980 visits in 2008-2009. During that span, the use of many recommended therapies improved. For example, 28 percent of people with coronary artery disease were given aspirin in 1998-1999, compared to almost 65 percent a decade later. Likewise, the use of statins more than doubled in those same patients, from 27 percent to 59 percent. In people with diabetes, statin prescriptions increased from 12 percent to 36 percent. However, there was little change in rates of unnecessary and overused services, including some types of cancer screening for older adults or x-rays and urine tests done as part of a general check-up. Two of those overuse indicators improved: cervical cancer screening for women over 65 dropped from 3 percent to 2 percent, and unnecessary antibiotic prescribing for asthma flare-ups fell from 22 percent to 7 percent. On the other hand, rates of prostate cancer screening for older men increased, from between 3 and 4 percent to almost 6 percent, according to findings published Monday in the Archives of Internal Medicine. The lead author on the study from New York's Mount Sinai School of Medicine, Dr. Minal Kale, said the set of quality indicators her team used doesn't necessarily represent all tests and treatments provided in outpatient care. And she added that the overuse of medical services is a complicated issue. "Culturally, there's a lot of resistance to limiting access to health care services because it quickly becomes politicized," Kale told Reuters Health. "The question about overuse really needs to come back to quality. It's about quality of the care that we're delivering to patients." The goal, she said, is to "increase the value and the quality of our health care system while also paying attention to the costs."

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