Storm begins to coat Chicago area with snow

CAPTIONS

Tears
A tear drops from the eye of DePaul University student Sam Henning as she is hit by a stiff breeze on West Wacker Drive. Tears protest eyes from drying out in cold, windy weather. (John J. Kim, Chicago Tribune /February 19, 2013)

Staff report

12:51 a.m. CST, February 22, 2013

Between and inch-and-a-half and two-and-a-half inches of snow has fallen across much of the Chicago region, though the snow is expected to turn to freezing drizzle in the next couple hours.

Meteorologists have scaled back their predictions on snow fall totals from the storm, though.

Illinois State Police described conditions as "horrible" and have responded to about 15 crashes already.

State Police are in a "snow plan" and aren't responding to accidents without injuries - those are supposed to be reported later.

"It will be tapering off from the south in the next couple hours, possibly some freezing drizzle across whole area," said Mark Ratzer, meteorologist for the National Weather Service. "We may end up coming in a little less."

The city of Chicago has sent 199 plows to work clearing main thoroughfares, according to the streets and sanitation department.

Check back for more information.

chicagobreaking@tribune.com

Twitter: @ChicagoBreaking

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Facebook blocks access to NBC.com after reports site is infected

BOSTON (Reuters) - Facebook Inc has blocked users from accessing the NBC.com website following reports that the site is infected with a computer virus.

Facebook users were told "This link has been reported as abusive" on Thursday when they attempted to access the NBC.com website.

Several security bloggers warned on Thursday that the site was infected with malicious software, advising computer users to avoid the site.

Officials with NBC could not immediately be reached for comment.

(This story is corrected with changes in paragraph 3 to Thursday from Tuesday)

(Reporting By Jim Finkle and Jennifer Saba; Editing by Gary Hill)

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A 1-2 knockout: McIlroy, Woods lose in Match Play

MARANA, Ariz. (AP) — Rory McIlroy and Tiger Woods knocked out in the first round of the Match Play Championship? Not many would have given that a snowball's chance in the desert.

Almost as surprising as the freakish snowstorm on Dove Mountain was the sight of golf's two biggest stars heading to the airport, only the second time in the 15-year history of this wild tournament that No. 1 and No. 2 didn't last more than a day.

Shane Lowry of Ireland chipped in twice and drilled a fairway metal to 3 feet to seize control, and then knocked out McIlroy with a bunker shot to 4 feet to save par on the final hole. Just as the shock was wearing off, Charles Howell III came up with kind of shots he's used to seeing Woods make in the clutch — a wedge that stopped inches from the cup on the 15th hole, and a 25-foot birdie on the 16th that carried him to a 2-and-1 victory.

"It's definitely a day I'm going to remember," said Lowry, the third player in the last four years to eliminate the No. 1 seed in the opening round.

"I had nothing to lose," Howell said.

The biggest loser Thursday might have been NBC Sports, which lost the two biggest draws.

Not even Phil Mickelson can save the day. He's not playing this year.

Howell had not faced Woods in match play since he was 17 and lost to him in the third round of the 1996 U.S. Amateur. He said he had never beaten him even in the dozens of casual games they played over the years at Isleworth before Woods moved away to south Florida.

What a time to change that losing streak.

Howell, who qualified for this World Golf Championship for the first time in five years, played a fabulous round in cold conditions. They matched scores 10 times in 14 holes before Howell came through with back-to-back birdies.

"In this format, match play is crazy," Howell said. "He's Tiger Woods. I was lucky to hang in there."

The final matches were played in near darkness, and they could have stopped after 15 holes. Woods wanted to play on, even though Howell had the momentum. Woods was 2 under for the day, and neither of them made a bogey.

"We both played well," Woods said. "He made a couple of more birdies than I did. He played well, and he's advancing."

McIlroy, the No. 1 player in the world, built a 2-up lead early in the match until Lowry rallied and grabbed the momentum by chipping in for birdie on the par-5 11th to avoid falling behind, chipping in from behind the 12th green for birdie and then ripping a fairway metal to within a few feet for a conceded eagle on the 13th to go 2 up.

Lowry missed a short par putt on the 14th, only for McIlroy to give away the next hole with a tee shot into the desert and a bunker shot that flew over the 15th green and into a cactus. But the two-time major champion hung tough, coming up with a clutch birdie on the 16th to stay in the game.

McIlroy nearly holed his bunker on the 18th, and Lowry followed with a steady shot out to 4 feet and calmly sank the putt.

"Deep down, I knew I could beat him," Lowry said. "There's a reason I'm here, and this is match play."

For McIlroy, more questions are sure to follow him to Florida for his road to the Masters. He now has played only 54 holes in the first two months of the season, missing the cut in Abu Dhabi and losing in the first round at Dove Mountain.

"You want to try and get as far as you can, but I guess that's match play," McIlroy said. "I probably would have lost by more if I had played someone else in the field. It wasn't a great quality match. But it would have been nice to get through and just get another day here and another competitive round under my belt."

The only other time the top two seeds lost in the opening round was in 2002, when Woods and Phil Mickelson lost at La Costa.

Luke Donald nearly made it the top three seeds except for a clutch performance. He holed a 10-foot birdie putt to halve the 17th hole and stay tied with Marcel Siem of Germany. Donald then birdied the 18th from 7 feet to win the match.

Louis Oosthuizen, the No. 4 seed, rallied to get past Richie Ramsay of Scotland.

The opening round was halted Wednesday after 3½ hours because of a freak snowstorm that covered Dove Mountain with nearly 2 inches. It continued to snow at times overnight, and it took nearly five hours to clear snow from the golf course for the tournament to resume.

Turns out, snow wasn't the only surprise.

"I had to play extremely well to have a chance, and I still kept waiting for that Tiger moment," Howell said.

It never came.

Woods missed short birdie chances at the 10th and 11th, but the real damage came on the 15th when he went long of the green with a wedge in hand. Howell also missed a pair of short putts on the back nine, but he came up big with the putt on the 16th.

"Really, I didn't even realize I was 2 up with two to go until I got right to the tee on 17, and it actually threw me for a bit because I never maybe was really in the moment and didn't quite realize how things were," Howell said. "And as far as beating Tiger Woods, it shows you that match play is crazy. I did have to play a good round. But yeah, it's a bit hard to believe I'm sitting here today."

Howell and Lowry will have to wait until Friday to find out their opponents.

Carl Pettersson was 1 up on Rickie Fowler through 17 holes when they stopped because of darkness. The winner gets Lowry, who will be fighting some history. Of the previous three players to beat the No. 1 seed in the opening round, all of them lost in the second round.

Howell gets either Gonzalo Fernandez-Castano or Francesco Molinari, who were all square through 15 holes.

In other matches:

— Ernie Els lost in the opening round for the sixth time. He missed a 3-foot par putt on the 16th hole that would have given him the lead, and he missed a 5-foot par putt on the 18th hole to lose to Fredrik Jacobson.

— Russell Henley, two months into his rookie season, defeated the hottest player in the field when he took down Charl Schwartzel, who had won twice and finished no worse than fifth in his last six tournaments worldwide.

— Rafael Cabrera Bello beat Lee Westwood in 19 holes after Westwood missed a 6-foot par putt on the last hole.

The opening round of the Match Play is typically the best day in golf. This one took two days, and it was unlike any other.

Nearly 2 inches of snow covered Dove Mountain on Wednesday, and with more snow overnight, nothing had changed when players began arriving Thursday morning. There already was a two-hour delay when they arrived.

"There was a guy building a snowman this morning at 8, and they said they were going off at 10:30," Henley said. "I figured it was going to be awhile"

No one had an easier day than Bo Van Pelt.

Having won six straight holes to go 5 up before snow suspended play on Wednesday, Van Pelt finally got back on the golf course and struck all of two shots — an 8-iron and a 45-foot putt. He won the 13th hole with a par to complete a 6-and-5 win over John Senden of Australia.

And then there was Sergio Garcia. He was one putt away from winning when play stopped Wednesday. He three-putted from 12 feet to lose the hole, and on the 18th hole, Thongchai Jaidee made a 6-foot birdie to send the match into overtime.

On the first extra hole, Garcia removed his cap and was putting his golf ball and tees in the bag as Jaidee settled over a 10-foot birdie. The putt ran around the back edge of the cup, giving Garcia life. He made birdie on the par-5 second hole to win in 20 holes.

So instead of hitting one shot Thursday, he had to play 19 of them. Garcia's was the first match of the tournament. It took him about 30 hours to finish.

"It's weirdness, I guess," Garcia said. "I guess at the end of the day, I was pleased to get through."

That's one thing McIlroy and Woods can't say.

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APNewsBreak: Govs to hear Oregon health care plan

SALEM, Ore. (AP) — Oregon Gov. John Kitzhaber will brief other state leaders this weekend on his plan to lower Medicaid costs, touting an overhaul that President Barack Obama highlighted in his State of the Union address for its potential to lower the deficit even as health care expenses climb.

The Oregon Democrat leaves for Washington, D.C., on Friday to pitch his plan that changes the way doctors and hospitals are paid and improves health care coordination for low income residents so that treatable medical problems don't grow in severity or expense.

Kitzhaber says his goal is to win over a handful of other governors from each party.

"I think the politics have been dialed down a couple of notches, and now people are willing to sit down and talk about how we can solve the problem" of rising health care costs, Kitzhaber told The Associated Press in a recent interview.

Kitzhaber introduced the plan in 2011 in the face of a severe state budget deficit, and he's been talking for two years about expanding the initiative beyond his state. Now, it seems he's found people ready to listen.

Hospital executives from Alabama visited Oregon last month to learn about the effort. And the U.S. Department of Health and Human Services announced Thursday that it's giving Oregon a $45 million grant to help spread the changes beyond the Medicaid population and share information with other states, making it one of only six states to earn a State Innovation Model grant.

Kitzhaber will address his counterparts at a meeting of the National Governors Association. His talk isn't scheduled on the official agenda, but a spokeswoman confirmed that Kitzhaber is expected to present.

"The governors love what they call stealing from one another — taking the good ideas and the successes of their colleagues and trying to figure out how to apply that in their home state," said Matt Salo, director of the National Association of Medicaid Directors.

There's been "huge interest" among other states in Oregon's health overhaul, Salo said, not because the concepts are brand new, but because the state managed to avoid pitfalls that often block health system changes.

Kitzhaber persuaded state lawmakers to redesign the system of delivering and paying for health care under Medicaid, creating incentives for providers to coordinate patient care and prevent avoidable emergency room visits. He has long complained that the current financial incentives encourage volume over quality, driving costs up without making people healthier.

Obama, in his State of the Union address this month, suggested that changes such as Oregon's could be part of a long-term strategy to lower the federal debt by reigning in the growing cost of federally funded health care.

"We'll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn't be based on the number of tests ordered or days spent in the hospital — they should be based on the quality of care that our seniors receive," Obama said.

The Obama administration has invested in the program, putting up $1.9 billion to keep Oregon's Medicaid program afloat over the next five years while providers make the transition to new business models and incorporate new staff and technology.

In exchange, though, the state has agreed to lower per-capita health care cost inflation by 2 percentage points without affecting quality.

The Medicaid system is unique in each state, and Kitzhaber isn't suggesting that other states should adopt Oregon's specific approach, said Mike Bonetto, Kitzhaber's health care policy adviser. Rather, he wants governors to buy into the broad concept that the delivery system and payment models need to change.

That's not a new theory. But Oregon has shown that under the right circumstances massive changes to deeply entrenched business models can gain wide support.

What Oregon can't yet show is proof the idea is working — that it's lowering costs without squeezing on the quality or availability of care. The state is just finishing compiling baseline data that will be used as a basis of comparison.

One factor driving the Obama administration's interest in Oregon's success is the president's health care overhaul. Under the Affordable Care Act, millions more Americans will join the Medicaid rolls after Jan. 1, and the health care system will have to be able to absorb the influx of patients in a logistically and financially sustainable way.

The federal government will pay 100 percent of the costs for those additional patients in the first three years before scaling back to 90 percent in 2020 and beyond.

"There are a lot of governors who are facing the same challenges we're facing in Oregon," Kitzhaber said. "They recognize that the cost of health care is something they're going to have to get their arms around."

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Winfrey, 'Beasts' actress honored at Essence lunch

BEVERLY HILLS, Calif. (AP) — Nine-year-old Oscar nominee Quvenzhane Wallis toted a plush, dog-shaped purse with jeweled handles as she rubbed shoulders with Oprah Winfrey and Alfre Woodard.

The star of best-picture contender "Beasts of the Southern Wild" was among the honorees Thursday at Essence magazine's sixth annual Black Women in Hollywood awards luncheon.

Standing on a step so she could speak at the podium, Quvenzhane thanked God, "Beasts" director Behn Zeitlin and "my baby sitter that was on set."

Quvenzhane is the youngest best-actress nominee in Oscar history and one of only 10 African-Americans ever recognized in the category.

Winfrey was teary-eyed as she took the stage after being introduced by the graduating class of her namesake Leadership Academy for Girls in South Africa.

"I am humbled by this day," she said. "There's nothing better than being honored by your own."

Essence President Michelle Ebanks said the afternoon's honorees "are changing the very definition of power" with their presence in Hollywood.

Woodard said she always recognized herself in the pages of Essence and recalled that when she and actresses C.C.H. Pounder and Loretta Divine first arrived in Hollywood, "they didn't know what to do with (us)."

"We were young and gifted and looking way the hell black," Woodard said. "And we still have our original noses!"

Actress Gabrielle Union moved the audience as she accepted the Fierce & Fearless award. Union said she had long pretended to be fierce and fearless but actually reveled in gossip and "took joy in people's pain and tap-danced on their misery." She said she posed for photos in such a way to "minimize my blackness" and didn't speak out against racism in school or in Hollywood when she was younger.

"Real fearless and fierce women admit mistakes and work to correct them," she said. "We stand up and we use our voices for things other than self-promotion. We don't stand by and let racism and sexism and homophobia run rampant on our watch. Real fierce and fearless women celebrate and compliment other women and we recognize and embrace the notion that their shine in no way diminishes our light, and actually makes our light shine brighter."

Actress Naomie Harris, who plays Eve Moneypenny in "Skyfall," was among those touched by Union's words.

"I'm in the place you were," Harris said as she accepted the Shining Star award. "I feel as though I have traveled thousands of miles to actually listen to that speech, to learn, to be inspired and to be reminded of who I am."

Writer-producer Mara Brock-Akil cried throughout her acceptance speech, saying, "All I ever wanted to do was tell our story."

Other stars attending the luncheon at the Beverly Hills Hotel included Blair Underwood, Laila Ali, Star Jones, Jill Scott and Tracee Ellis Ross.

Grammy-winning singer Miguel performed his winning hit, "Adore," and rapper-actor Common did an impromptu freestyle during a brief technical difficulty, working the names of the six honorees into a quick rap.

___

AP Entertainment Writer Sandy Cohen can be reached at http://www.twitter.com/APSandy .

___

Online:

http://www.essence.com

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United takes Dreamliner off schedule until June

The All Nippon Airways Dreamliner 787 arrives at Mineta San Jose International Airport. (Gary Reyes/San Jose Mercury News/MCT / January 22, 2013)

Staff and wire report

1:35 p.m. CST, February 21, 2013

The parent company of United Airlines says it is taking the Boeing 787 off its schedule through June 5 for all but one of its routes.

United Continental Holdings Inc. said it still plans to use the 787 on its flights between Denver and Tokyo's Narita airport starting May 12. It had aimed to start that route on March 31.

United, currently world's largest airline and the only U.S. customer for the 787, said the timing of that reinstatement will depend on resolution of the Dreamliner's current issues.

The 50 Dreamliners in commercial service were grounded worldwide last month after a series of battery-related incidents including a fire on board a parked plane in the United States and an in-flight problem on another jet in Japan. United had only been flying the plance since November.

Sources told Reuters earlier this week that Boeing Co. has found a way to fix the battery problems that involves increasing the space between the lithium ion battery cells.

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Tribune exclusive: 'We were just regular parents who were slapped in the face'

The parents of slain teen Hadiya Pendleton talk about her life and death and the issues raised after she died. (Chris Walker/Chicago Tribune)

11:57 p.m. CST, February 20, 2013

Hadiya Pendleton’s parents haven’t had much time to reminisce about their daughter’s life and death before Wednesday, when they sat down for an exclusive interview with the Tribune.

Cleopatra Cowley-Pendleton recalled getting the phone call on Jan. 29 that her 15-year-old daughter had been shot, and rushing to the hospital only to find out it was too late, her daughter was dead.

A whirlwind of activity followed as Hadiya became a national symbol of gun violence and her parents traveled to Washington for President Barack Obama’s State of the Union speech.

“I’m not going to be extremely political, but if I can help someone else not go through what we’ve gone through, then I have to do what I can,” Cowley-Pendleton said. “These are the cards we have been dealt. If these are the shoes I need to walk in, I don’t mind walking in them.”

To read the full story, you must be a digitalPlus member.

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Sony seeks head start over Microsoft with new PlayStation

NEW YORK (Reuters) - Sony Corp said it will launch its next-generation PlayStation this year, hoping its first video game console in seven years will give it a much-needed head start over the next version of Microsoft's Xbox and help revive its stumbling electronics business.

The new console will have a revamped interface, let users stream and play video games hosted on servers, and allow users to play while downloading titles as well as share videos with friends. Its new controller, dubbed DualShock 4, will have a touchpad and a camera that can sense the depth of the environment in front of it.

Sony, which only displayed the controller but not the console, said on Wednesday the PlayStation 4 would be available for the year-end holiday season and flagged games from the likes of Ubisoft Entertainment SA and Activision Blizzard Inc, whose top executives also attended the glitzy launch event.

It did not disclose pricing or an exact launch date.

Sony's announcement comes amid industry speculation that Microsoft Corp is set to unveil the successor to its Xbox 360 later this summer. The current Xbox 360 beats the seven-year-old PlayStation 3's online network with features such as voice commands on interactive gaming and better connectivity to smartphones and tablets.

But all video game console makers are grappling with the onslaught of mobile devices into their turf.

Tablets and smartphones built by rivals such as Apple Inc and Samsung Electronics Co Ltd already account for around 10 percent of the $80 billion gaming market. Those mobile devices, analysts predict, will within a few years be as powerful as the current slew of game-only consoles.

"It looks good and had a lot of great games but the industry is different now," Billy Pidgeon, an analyst at Inside Network Research, said of the new PlayStation.

"It'll be a slow burn and not heavy uptake right away."

MIGRATION TO MOBILE

Console makers will also have to tackle flagging video game hardware and software sales, which research firm NPD group says have dropped consistently every month over the last year as users migrate to free game content on mobile devices.

PlayStation 4 will have an app on Android and Apple mobile devices that connects to console games and can act as a second screen, Jack Tretton, President and CEO of Sony Computer Entertainment of America, said in an interview.

"Playstation 4 ... really connects every device in the office and the smartphone and the tablet out there in the world," Tretton said.

The console, which has been in development for the last five years, will have 8 GB of memory and will instantly stream game content from the console to Sony's handheld PlayStation Vita through a feature called "Remote Play," the company said.

"What Sony is banking on is the ease of the use of this system," Greg Miller, PlayStation executive editor at video game site IGN.com, said.

After six years, Sony PlayStation sales are just shy of Xbox's 67 million installed base and well behind the 100 million Wii consoles sold by Nintendo Co Ltd, according to analysts.

Tretton said it would be a big undertaking to manufacture and distribute the console in Sony's four major markets by the end of the year, adding that it would be a "phased rollout" that starts before the end of the year.

Sterne Agee analyst Arvind Bhatia predicted Sony would probably get a couple of million units of the PlayStation 4 out by the 2013 holiday season and 7 million or 8 million out a year later.

Sony also announced a strategic partnership with video game publisher Activision Blizzard to take its Diablo III game to the PlayStation 4 and PlayStation 3 consoles.

Activision's upcoming sci-fi shooter game "Destiny" in development by its Bungie Studio will also be available on PlayStation consoles.

(Editing by Gary Hill, Bernard Orr and Edwina Gibbs)

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Lakers beat Celtics 113-99 on emotional night

LOS ANGELES (AP) — Dwight Howard had 24 points and 12 rebounds in helping the Los Angeles Lakers to an emotional 113-99 victory over the Boston Celtics on Wednesday night in their first game since the death of owner Jerry Buss.

Kobe Bryant added 16 points, Steve Nash and Earl Clark had 14 apiece, and Metta World Peace 12 in a game that surely would have delighted Buss, who always loved to win but especially liked beating the Celtics.

The Lakers won their most recent NBA championship — and last under Buss — in 2010, defeating the Celtics 4-3 in the finals. Buss died Monday at 80 after an 18-month struggle with cancer that had forced him to watch his team's games on TV or an iPad instead of from his suite above the Staples Center court.

Paul Pierce scored 26 points for the Celtics, who fell to 8-17 on the road and lost their third in a row away from home. Courtney Lee added 20 points and Kevin Garnett had 12 on 6-of-14 shooting.

Howard's performance in the Lakers' first game since the All-Star break came on the eve of the NBA trade deadline. He has been the subject of rumors, but general manager Mitch Kupchak said this week that Howard wouldn't be going anywhere.

He was among seven Lakers in double figures on a night when they shot 51 percent, dominated the paint 54-30 and were 22 of 31 from the free throw line for one of the most complete games they've played in months.

Clark had a career-high 16 rebounds, and Antawn Jamison added 15 points off the bench for Los Angeles.

The Lakers improved to 26-29 and gained a split in the season series, having avenged a 116-95 loss to the Celtics on Feb. 7 when they trailed by 32 points.

Boston trailed by nine at the end of the first two quarters before the Lakers opened up a 75-57 lead early in the third. Typical of their balanced scoring throughout the game, World Peace, Bryant, Nash, Howard and Clark each contributed baskets in the 11-2 run.

Nash had seven assists, giving him 10,144 while passing Magic Johnson for sole possession of fourth place on the career list.

The Lakers shot 51 percent in the first half and had four players in double figures, helping them to a 64-55 lead. Howard was energetic in scoring 15 points and setting screens reminiscent of his days with Orlando. Bryant had 14 points, Nash 12 and World Peace 10.

Pierce carried the Celtics with 23 points on 9-of-15 shooting in the half, when they shot 49 percent.

Buss was remembered in a pregame video tribute featuring photos of him as a child all the way through him hoisting trophies marking the team's 10 NBA championships won under his ownership. Bryant fittingly spoke on behalf of the Lakers' players, having been acquired by the Lakers as a 17-year-old.

"He was a brilliant, incredible owner but an even better person," Bryant said of Buss. "His innovation transcended the game and we are all, all spoiled by his vision and his drive to win year after year after year."

There was a moment of silence in the darkened arena before the crowd broke up the quiet with chants of "Jerry, Jerry."

A memorial service for invited guests will be held Thursday at Nokia Theatre across the street from Staples Center. Buss will be buried in a private service on Friday.

NOTES: Lakers F Pau Gasol said he hopes to get off his crutches soon and return before the end of the regular season. He had surgery on his right foot after injuring it on Feb. 5. ... The Celtics signed free agent G-F Terrence Williams to a 10-day contract on Wednesday. He had been playing with Guangdong in the Chinese league, averaging 17.9 points, 3.4 rebounds and 4.1 assists in 29 games. ... Jeanie Buss accepted condolences on her father's passing from numerous well-wishers stopping by her seat before the game. ... Jack Nicholson and Dyan Cannon, longtime Lakers fans dating to the team's days at the Forum in Inglewood, were on hand.

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Doc groups issue list of overused tests, therapies

WASHINGTON (AP) — Don't be afraid to question your doctor and ask, "Do I really need that?"

That's the advice from leading medical groups who came up dozens of tests and treatments that physicians too often prescribe when they shouldn't.

No worrisome stroke signs? Then don't screen a healthy person for a clogged neck artery, the family physicians say. It could lead to risky surgery for a blockage too small to matter.

Don't routinely try heartburn medicine for infants with reflux, the pediatric hospitalists say. It hasn't been proven to work in babies, and could cause side effects.

Don't try feeding tubes in people with advanced dementia, say the hospice providers. Helping them eat is a better option.

These are examples of potentially needless care that not only can waste money and time, but sometimes can harm, says the warning being issued Thursday from medical specialty groups that represent more than 350,000 doctors.

Too many people "think that more is better, that more treatment, more testing somehow results in better health care," said Dr. Glen Stream, former president of the American Academy of Family Physicians, which contributed to the list. "That really is not true."

The recommendations are part of a coalition called Choosing Wisely, formed by the American Board of Internal Medicine Foundation. Participating medical societies were asked to identify five tests or treatments that are commonly overused in their specialty. The list is aimed at doctors and includes references to published studies. Consumers Reports and other consumer groups are publicizing the information in more patient-friendly terms.

Last year, the coalition listed 45 overused tests and treatments. It included some of the best known examples, such as too much imaging for back pain and repeating colonoscopies too frequently.

This year's list adds 90 more overused kinds of care. Some are the result of doctors' habits, hard to overcome despite new evidence, Stream said. Others come about because patients demand care they think they need.

Some other examples:

—Don't use opioid painkillers for migraines except as a last resort, say the neurologists. There are better, more migraine-specific drugs available without the addictive risk of narcotics. Plus, frequent use of opioids actually can worsen migraines, a concept known as rebound headache.

—Just because a pregnant woman misses her due date, don't race to induce labor if mom and baby are doing fine, say the obstetricians. Inducing before the cervix is ready often fails, leading to an unneeded C-section. "Just being due by the calendar doesn't mean your body says you're due," Stream notes.

—Don't automatically give a child a CT scan after a minor head injury, say the pediatricians. About half of children who go to the ER with head injuries get this radiation-heavy scan, and clinical observation first could help some who don't really need a CT avoid it.

—And don't leave an implanted heart-zapping defibrillator turned on when a patient is near death, say the hospice providers. This technology clearly saves lives by guarding against an irregular heartbeat. But if someone is dying of something else, or is in the terminal stages of heart disease, it can issue repeated painful shocks, to no avail. Yet fewer than 10 percent of hospices have formal policies on when to switch off the implants.

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