Sunday, October 26, 2014

Policy Question - Elizabeth Caniano

Question: What action, if any, should the National Institute of Arthritis and Musculoskeletal and Skin Diseases take to encourage research and innovation in diagnostic tools and therapeutics for Vitamin D deficiency?  

Client: The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), an NIH Institute funding public-health minded research on conditions like Vitamin D deficiency. It issues a range of grant awards to academic and industrial researchers, and early state small businesses for the development of commercial biomedical technologies. 

There is increasing evidence that a majority of Americans have insufficient levels of Vitamin D, a hormone essential for calcium absorption, bone development and overall muscle health.  Recent research on vitamin D deficiency has linked Vitamin D deficiencies beyond commonly-associated musculoskeletal conditions, to heart and metabolic diseases, immune deficiencies, and certain cancers [1].

A 2014 US Preventative Task Force investigating diagnostic and treatment capacities for Vitamin D deficiency could not make a recommendation for or against routine Vitamin D screenings by physicians, citing: unclear evidence of the effectiveness of dietary supplements; varying parameters for Vitamin D deficiency; and unsophisticated diagnostic tools that do account for factors like ethnicity in affecting individual Vitamin D requirements. ( For example, current blood diagnostic tests will underestimate Vitamin D levels among African Americans and people who are obese, as they store Vitamin D in more readily accessible levels, and thus do not require as high circulating blood levels as others.) The panel reinforced the current clinical recommendation of physician-initiated Vitamin D tests for “at risk” patients, such as those with advanced age, osteoporosis, among other conditions and backgrounds [2].

But given the supposed high prevalence of this condition, how might NIAMS encourage research and innovation on more effective ways to gauge vitamin D deficiency (in terms of standards and appropriate diagnostic tools for different populations), or the research and development of more effective  supplements?


2 comments:

  1. Hi Elizabeth,
    In your policy question, I have a deeper understanding of the importance of vitamin D, although I have known the superficial function of it. The client of your analysis is well matched with the problem as NIAMS is an NIH Institute which minded research on conditions like Vitamin D deficiency. Just as you have mentioned that the lack of walking under the sun, it is a cause of the low level of Vitamin D, which may be a hint that healthy people should often be under the sun to avoid the bad condition. Maybe it is a way not solving the problem but will be good for the current situation. I hope my opinion will do some help.

    Yulong

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  2. You have designed a good question and provided relevant references that highlight the problem of vitamin D deficiency. Considering that a large number of people are affected by VitaminD deficiency in US and all over the world, this is really an important question to pursue.

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