Faculty Bibliography

In an ironic twist, probably no document has as much impact on the health of a population as does the death certificate. Data collected from the certificates have become the most widely used statistical tools to monitor serious diseases. While physicians have long been asked to certify the immediate cause of death and to list major ailments that contributed, the new certificate is intended to encourage physicians to expand the list of disorders. Dr. Harry Rosenberg of the Center for Health Statistics said that while his agency believes 'there is no evidence of deterioration' of the accuracy of the vital statistics, he admitted that the diagnoses listed on death certificates are 'far from perfect.' And he called the changes a step in the right direction in improving the quality of data from death certificates

While expressing hope that experiments would be carried out ''as rapidly as an orderly process permits'' because ''the proposal represents a very significant advance,'' the letter called for a delay until the committees received more data from the researchers. The key subcommittee was expected to meet expeditiously. Dr. [Jay Moskowitz] said in an interview that Dr. [James B. Wyngaarden]'s decision reflected the feeling of some members of the subcommittee, which met last July, that more data from animal experiments were needed before approval was given. ''They wanted the same experiments to be repeated on a larger number of animals,'' Dr. Moskowitz said. Another important factor in Dr. Wyngaarden's decision, Dr. Moskowitz said, was the desire of several committee members to have more time to evaluate the data presented earlier this month from slides ''without being in a darkened hall.''

The Nobel committee said that the work of the three researchers ''has had a more fundamental significance'' than their discovery of individual drugs. ''While drug development had earlier mainly been built on chemical modification of natural products, they introduced a more rational approach based on the understanding of basic biochemical and physiological processes,'' the committee said in its citation. Dr. Folke Sjoqvist, a professor of clinical pharmacology at the Karolinska Institute in Stockholm, which makes the Nobel award in physiology or medicine, said this year's winners had made ''a unique contribution to medicine for having discovered so many still-useful drugs.'' Asked why the award was made several decades after the discoveries, Dr. Sjoqvist told a news conference that the committee wanted to evaluate the long-term benefits and hazards of the drugs. Dr. Hitchings once noted that when he arrived at Tuckahoe in 1942 after training and teaching biochemistry at Harvard University in Cambridge, and Western Reserve University in Cleveland, ''I was the biochemistry department, a department of one.'' Ms. [Gertrude B. Elion] joined him in 1945. ''Our primary purpose was to learn more about how nucleic acids were put together,'' Dr. [George H. Hitchings] recalled yesterday

Dr. Harry M. Rosenberg of the Center for Health Statistics said that while his agency believes ''there is no evidence of deterioration'' of the accuracy of the vital statistics, he admitted that the diagnoses listed on death certificates are ''far from perfect.'' And he called the changes a step in the right direction in improving the quality of data from death certificates. ''Scientist after scientist has commented that death certificates are so unreliable that studies of the incidence and distribution of diseases should not be attempted using these data,'' the authors said. ''The results can only be either wrong and misleading or, at best, suspect.'' ''Practicing physicians must be persuaded that death certificate completion is important, and not just another bit of bureaucratic red tape,'' Dr. [Tobias Kircher] and Dr. [Robert E. Anderson] said in the Journal of the American Medical Association last year

Critics of mass screening programs for AIDS virus infection have argued that the risk of error is too high to justify routine screening of large populations at low risk of AIDS infection. They contend that the number of people falsely identified as infected may easily surpass the number of actual virus carriers detected. Reasons for Accuracy ''Because the test is a good one, the desire to use it is strong,'' said an editorial in the same issue by Dr. Robin Weiss and Dr. Samuel O. Thier of the Institute of Medicine of the National Academy of Sciences. ''Yet technology should not drive policy: the test should be used only when there are sound, well-articulated reasons for doing so and a reasonable prospect that testing will do more good than harm.'' Since 1985, the military has screened all civilian recruits for antibodies to the AIDS virus, a sign of infection. To determine the accuracy of its testing procedures, Dr. [Donald S. Burke]'s team reviewed 20 months of testing of recruits from rural parts of 36 states with low rates of infection with the AIDS virus

NEW YORK - Dr. Abraham L. Halpern, the psychiatrist who said Mike Tyson was not a manic-depressive after examining him Tuesday, said Thursday that he based his opinion on a 30-minute clinical interview and an hour of observing Tyson with his boxing manager and friends. Halpern said Dr. Henry McCurtis of Harlem Hospital, a psychiatrist who had previously treated Tyson, had told him in an 'extensive' discussion that he 'did not diagnose Tyson as manic-depressive.' Halpern said he was first asked to examine Tyson on Sept. 25 by Bill Cayton, Tyson's manager, on the recommendation of a friend, Dr. Ira Gelb, a cardiologist in New Rochelle, N.Y. A second call was made last Monday after Tyson was reported to have thrown furniture in his New Jersey home

[Mike Tyson] ''obviously knows about boxing, but he is 22 and not expert in all the other major areas of living,'' Dr. [Abraham L. Halpern] said. ''He is totally inexperienced and that adds to the problem.'' Consultation 'Desirable' Dr. Halpern said Dr. Henry McCurtis of Harlem Hospital, a psychiatrist who had previously treated Tyson, had told him in an ''extensive'' discussion that he ''did not diagnose Tyson as manic-depressive.'' Stopped Taking Lithium Because there may be many histories, and because physicians differ in their training and orientation, ''there is a lot of room for difference,'' said Dr. Jan Fawcett, an expert in manic-depression in Chicago who is not connected with Tyson's case. ''The hardest part is ruling it out,'' he said

Crucial improvements in laboratory testing enabled detectives of the International Olympic Committee to catch up with Canadian Ben Johnson last week in Seoul. Johnson was discovered to have stanozolol, a performance-enhancing drug that, in the past, has been one of the hardest to detect, in his system after winning the 100 meters. He was stripped of the gold medal in the biggest story of the Olympics. 'Stanozolol has long had a reputation for being either undetectable or difficult to detect, leading many athletes to chance taking it during training and stopping it a few days to weeks before a competition,' said Dr. Robert Dugal, a Canadian pharmacologist who is the chief medical officer of the IOC

''We are dealing with a cat-and-mouse game and the conspiracy of silence that surrounds the whole business,'' Dr. [Robert Dugal] said. ''It is an entirely different type of toxicology than what is used in medical practice. We separate all these substances, quantify them, determine ratios, make statistical analyses, and look at profiles instead of providing a single laboratory test result as is often done in medical practice.'' ''[Ben Johnson]'s profile was suppressed and the amounts of testosterone and a particular metabolite, epitestosterone, were about 5 nanograms per milliliter, and those results could have come about only by his having taken multiple doses of anabolic steroids, nothing else,'' Dr. Dugal said. ''If Ben Johnson's tests had shown only a suppressed steroid profile without the presence of stanozolol, no action would have been taken,'' because the only ground for disqualification is the finding of a banned drug, Dr. Dugal said.

The new wave of enthusiasm for internal mammary arteries reflects studies showing that these grafts can stay open much longer than those from leg veins. The studies have also found that patients who undergo such grafts live longer, take longer to develop recurrences of angina, have fewer heart attacks, fewer repeat bypass operations, and fewer complications than did those who had vein grafts