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Physician Performance reviews

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https://www.readbyqxmd.com/read/28453637/automated-identification-of-implausible-values-in-growth-data-from-pediatric-electronic-health-records
#1
Carrie Daymont, Michelle E Ross, A Russell Localio, Alexander G Fiks, Richard C Wasserman, Robert W Grundmeier
Objective: Large electronic health record (EHR) datasets are increasingly used to facilitate research on growth, but measurement and recording errors can lead to biased results. We developed and tested an automated method for identifying implausible values in pediatric EHR growth data. Materials and Methods: Using deidentified data from 46 primary care sites, we developed an algorithm to identify weight and height values that should be excluded from analysis, including implausible values and values that were recorded repeatedly without remeasurement...
April 26, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28447927/unexpected-positive-prospective-crossmatches-in-organ-transplant
#2
REVIEW
Judith Desoutter, Marie-Joelle Apithy, Nicolas Guillaume
Preformed donor-specific antibodies against human leukocyte antigen can induce antibody-mediated rejection after organ transplant. Hence, future transplant recipients undergo pretransplant screening for preformed antibodies (ie, virtual crossmatch). Subsequently, prospective (analytic) crossmatching is performed using conventional, complement-dependent cytotoxicity assays and/or flow cytometry-based methods. The present article reviews factors that must be considered when unexpected, positive, prospective crossmatches are observed...
April 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28446417/the-value-of-vestibular-rehabilitation-in-patients-with-bilateral-vestibular-dysfunction
#3
Ethem Şahin, Mehmet Emre Dinç, Berna Yayla Özker, Canan Çöpürgensli, Mustafa Konaklıoğlu, Tuncay Özçelik
OBJECTIVE: The value of vestibular rehabilitation in patients with bilateral vestibular dysfunction was investigated. MATERIALS AND METHODS: This study assessed 17 patients (9 males, 8 females) with bilateral vestibular dysfunction. Vestibular rehabilitation continued for 1.5 months. Videonystagmography tests (including oculomotor testing, positional testing, and caloric tests), vestibular evoked myogenic potential (VEMP) testing, and computerized dynamic posturography were performed during the pre-, mid-, and post-treatment periods...
April 27, 2017: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/28445596/effectiveness-safety-and-acceptability-of-non-physician-provision-of-first-trimester-medical-termination-of-pregnancy-a-systematic-review
#4
S Sjöström, M Dragoman, S M Fønhus, B Ganatra, K Gemzell-Danielsson
BACKGROUND: Previous systematic reviews have concluded that medical termination of pregnancy (TOP) provided by non-physician providers may be as effective and safe as when provided by physicians. Medical treatment of incomplete miscarriage by non-physicians, and treated women's acceptability with non-physician providers of TOP has not previously been reviewed. OBJECTIVE: To review the effectiveness, safety and acceptability of non-physician provision of first trimester medical TOP including medical treatment for incomplete miscarriage...
April 26, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28445324/nurse-practitioner-physician-comanagement-of-primary-care-patients-the-promise-of-a-new-delivery-care-model-to-improve-quality-of-care
#5
Allison Andreno Norful, Kyleen Swords, Mickaela Marichal, Hwayoung Cho, Lusine Poghosyan
BACKGROUND: The U.S. primary care system is under tremendous strain to deliver care to an increased volume of patients with a concurrent primary care physician shortage. Nurse practitioner (NP)-physician comanagement of primary care patients has been proposed by some policy makers to help alleviate this strain. To date, no collective evidence demonstrates the effects of NP-physician comanagement in primary care. PURPOSE: This is the first review to synthesize all available studies that compare the effects of NP-physician comanagement to an individual physician managing primary care...
April 25, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28442312/expert-statements-on-the-standard-of-care-in-critically-ill-adult-patients-with-atypical-haemolytic-uraemic-syndrome
#6
REVIEW
Elie Azoulay, Paul Knoebl, José Garnacho-Montero, Katerina Rusinova, Gennadii Galstian, Philippe Eggimann, Fekri Abroug, Dominique Benoit, Michael von Bergwelt-Baildon, Julia Wendon, Marie Scully
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) presents similarly to thrombotic thrombocytopenic purpura (TTP), and other causes or conditions with thrombotic microangiopathy (TMA) such as DIC or sepsis. Similarity in clinical presentation may hinder diagnosis and optimal treatment selection in the urgent setting in the ICU. However, there is currently no consensus on the diagnosis or treatment of aHUS for ICU specialists. This review aims to summarise available data on the diagnosis and treatment strategies of aHUS in the ICU in order to enhance the understanding of aHUS diagnosis and outcomes in patients managed in the ICU...
April 22, 2017: Chest
https://www.readbyqxmd.com/read/28441921/acquired-hemophilia-a-a-review-of-recent-data-and-new-therapeutic-options
#7
Massimo Franchini, Stefania Vaglio, Giuseppe Marano, Carlo Mengoli, Sara Gentili, Simonetta Pupella, Giancarlo Maria Liumbruno
OBJECTIVES: Acquired hemophilia A (AHA) is a rare, but potentially life-threatening, bleeding disorder caused by an autoantibody against factor VIII that interferes with its coagulant function. METHODS: We performed a narrative review focusing on the diagnostic aspects of AHA and on the current treatment strategies with particular regard to new data and therapeutic developments. RESULTS: The management of this severe hemorrhagic disorder is based on the control of bleeding with the use of bypassing agents and on the utilization of a variety of immunosuppressant agents with the goal of eliminating the autoantibody permanently...
April 25, 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#8
Jung G Kim, Carl G Morris, Paul Ford
PROBLEM: Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. APPROACH: In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28440011/intensity-of-factor-viii-treatment-and-the-development-of-inhibitors-in-nonsevere-hemophilia-a-patients-results-of-the-insight-case-control-study
#9
A S van Velzen, C L Eckhardt, M Peters, F W G Leebeek, C Escuriola-Ettingshausen, C Hermans, R Keenan, J Astermark, C Male, K Peerlinck, S le Cessie, J G van der Bom, K Fijnvandraat
BACKGROUND: Inhibitor development is a major complication of treatment with factor VIII concentrates in hemophilia. Findings from studies among severe hemophilia A patients suggest that intensive treatment episodes increase the risk to develop inhibitors. OBJECTIVES: We set out to assess whether intensive treatment is also associated with an increased risk of inhibitor development among nonsevere hemophilia A patients. PATIENTS/METHODS: We performed a nested case-control study...
April 25, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28439437/supraglottic-airway-devices-the-search-for-the-best-insertion-technique-or-the-time-to-change-our-point-of-view
#10
Massimiliano Sorbello, Flavia Petrini
In the crowded world of supraglottic airway devices (SADs), many papers compare the easiness of insertion based on the different endpoints of an operator's satisfaction: first pass success, ventilation effectiveness, complications and morbidity. Proseal LMA(™) (Laryngeal Mask Airway, Teleflex Medical, Dublin, Ireland) has been extensively studied because on one hand it has a steeper learning curve and more complex insertion when compared with other SADs and on the other hand many alternative techniques are available to facilitate insertion...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28439353/improving-timely-resident-follow-up-and-communication-of-results-in-ambulatory-clinics-utilizing-a-web-based-audit-and-feedback-module
#11
Joel C Boggan, Aparna Swaminathan, Samantha Thomas, David L Simel, Aimee K Zaas, Jonathan G Bae
BACKGROUND: Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. OBJECTIVE: This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. METHODS: We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28438104/impact-of-a-scribe-program-on-patient-throughput-physician-productivity-and-patient-satisfaction-in-a-community-based-emergency-department
#12
Waqas Shuaib, John Hilmi, Joshua Caballero, Ijaz Rashid, Hashim Stanazai, Kerolos Tawfeek, Ahmed Amari, Alan Ajanovic, Alex Moshtaghi, Anjit Khurana, Hesham Hasabo, Abdulrehman Baqais, Arthur J Szczerba, Theodore J Gaeta
Previous literature on the impact of scribe programs varies and has mostly been reported from academic institutions or other clinics. We report the implementation of the scribe program in the emergency room of a community hospital and its impact on patient throughput, physician productivity, and patient satisfaction. We performed a quasi-experimental, before-and-after study measuring patient throughput metrics, physician productivity, and patient satisfaction. The intervention measuring the scribe implementation was divided into pre- and post-implementation periods...
April 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/28437802/surveillance-after-resection-of-pancreatic-ductal-adenocarcinoma-with-curative-intent-a-multicenter-survey-in-germany-and-review-of-the-literature
#13
Thomas J Ettrich, Lucas A Schulte, Natalie Eitel, Kristin Ettrich, Andreas W Berger, Lukas Perkhofer, Thomas Seufferlein
Background Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with high risk of relapse even after curative-intended resection. There are no evidence-based recommendations for surveillance in actual guidelines. Given this situation and as a basis for prospective studies, we wanted to determine the current practice of surveillance after pancreatic cancer resection in German institutions. Methods A web-based questionnaire was sent in 2015 to 300 German institutions (hospitals, outpatient clinics, and private practices) experienced in the care of patients with PDAC...
April 24, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28435919/spontaneous-spinal-epidural-hematoma-literature-review
#14
REVIEW
Jessica Figueroa, John G DeVine
Review the current literature regarding spontaneous spinal epidural hematomas (SSEHs) and report on the known risk factors, evaluation, and treatment of this rare entity. A literature search was performed using PubMed and Ovid to identify articles pertaining to SSEHs. Due to the rarity of the pathologic entity, only scattered case reports and associated reviews are available. SSEHs are a rare yet potentially life-altering event. The underlying risk factors are poorly understood, and SSEHs present with minimal or no antecedent trauma...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#15
Shahein Tajmir, Ali S Raja, Ivan K Ip, James Andruchow, Patricia Silveira, Stacy Smith, Ramin Khorasani
INTRODUCTION: While only 15-20% of patients with foot and ankle injuries presenting to urgent care centers have clinically significant fractures, most undergo radiography. We examined the impact of electronic point-of-care clinical decision support (CDS) on adherence to the Ottawa Ankle Rules (OAR), as well as use and yield of foot and ankle radiographs in patients with acute ankle injury. METHODS: We obtained institutional review board approval for this randomized controlled study performed April 18, 2012-December 15, 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435489/gender-differences-in-cdc-guideline-compliance-for-stis-in-emergency-departments
#16
Bryan G Kane, Alexander W D Guillaume, Elizabeth M Evans, Terrence E Goyke, Jessica K Eygnor, Lauren Semler, Stephen W Dusza, Marna Rayl Greenberg
INTRODUCTION: Sexually transmitted infections (STIs) are a common reason for emergency department (ED) visits. The objective of this study was to determine if there were gender differences in adherence to Centers for Disease Control and Prevention (CDC) STI diagnosis and treatment guidelines, as documented by emergency providers. METHODS: We performed a retrospective chart review to identify patients treated for urethritis, cervicitis, and pelvic inflammatory disease (PID) in the EDs of three hospitals in a Pennsylvania network during a calendar year...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435337/treatment-strategies-for-the-female-athlete-triad-in-the-adolescent-athlete-current-perspectives
#17
REVIEW
Jill Thein-Nissenbaum, Erin Hammer
Since the passage of Title IX in 1972, female sports participation has dramatically increased. The benefits of physical activity, including decreased risk for heart disease and diabetes as well as improved body image and self-esteem, far outweigh the risks. However, a select population of adolescent and young adult females may experience symptoms related to the female athlete triad (Triad), which refers to the interrelatedness of energy availability, menstrual function, and bone mineral density (BMD). These conditions often manifest clinically as disordered eating behaviors, menstrual irregularity, and stress fractures; an individual may suffer from 1 or all of the Triad components simultaneously...
2017: Open Access Journal of Sports Medicine
https://www.readbyqxmd.com/read/28435313/evidence-and-consensus-recommendations-for-the-pharmacological-management-of-pain-in-india
#18
REVIEW
Gur Prasad Dureja, Rajagopalan N Iyer, Gautam Das, Jaishid Ahdal, Prashant Narang
Despite enormous progress in the field of pain management over the recent years, pain continues to be a highly prevalent medical condition worldwide. In the developing countries, pain is often an undertreated and neglected aspect of treatment. Awareness issues and several misconceptions associated with the use of analgesics, fear of adverse events - particularly with opioids and surgical methods of analgesia - are major factors contributing to suboptimal treatment of pain. Untreated pain, as a consequence, is associated with disability, loss of income, unemployment and considerable mortality; besides contributing majorly to the economic burden on the society and the health care system in general...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28431770/aortic-stenosis-and-non-cardiac-surgery-a-systematic-review-and-meta-analysis
#19
Chun Shing Kwok, Rodrigo Bagur, Muhammad Rashid, Ronit Lavi, Mario Cibelli, Mark A de Belder, Neil Moat, David Hildick-Smith, Peter Ludman, Mamas A Mamas
BACKGROUND: Aortic stenosis (AS) poses a perioperative management dilemma to physicians looking after patients who require non-cardiac surgery. The objective of this review is to investigate mortality and adverse cardiovascular events in patients with and without AS who underwent non-cardiac surgery. METHODS: We searched MEDLINE and EMBASE for studies that evaluated mortality and adverse cardiovascular events in patients with and without AS who underwent non-cardiac surgery...
April 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28431589/t2-relaxometry-helps-prognosticate-seizure-outcome-in-patients-with-solitary-cerebral-cysticercosis
#20
Aaron de Souza, Atchayaram Nalini, Jitender Saini, Kandavel Thennarasu
OBJECTIVE: Correlate serial T2 relaxometry (T2R) values with long term seizure outcome in patients with solitary cerebral cysticercosis (SCC) in order to establish its usefulness as a prognostic marker in these patients. METHODS: Patients with new-onset seizures due to SCC were imaged serially using a pre-determined MRI protocol at enrolment and after 3, 6, 12 and 24months. T2 relaxometry was performed using a dual echo sequence with maps generated manually from the measured image intensities at the level of the lesion...
May 15, 2017: Journal of the Neurological Sciences
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