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https://www.readbyqxmd.com/read/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#1
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/28431536/-popping-nana-back-into-bed-a-qualitative-exploration-of-paramedic-decision-making-when-caring-for-older-people-who-have-fallen
#2
Paul Simpson, Ric Thomas, Jason Bendall, Bill Lord, Stephen Lord, Jacqueline Close
BACKGROUND: Older fallers constitute a large proportion of ambulance work, and as many as 25% are not transported to hospital following paramedic assessment. The objective of this study was to explore the decision making process used by paramedics when caring for older fallers. METHODS: A qualitative study was conducted using constructivist grounded theory methodology. Purposive sampling was used to recruit paramedics to participate in semi-structured interviews and focus groups...
April 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28426319/the-monetary-cost-of-sexual-assault-to-privately-insured-us-women-in-2013
#3
Ashley M Tennessee, Tamala S Bradham, Brandi M White, Kit N Simpson
OBJECTIVES: To determine whether privately insured female rape victims were billed for charges associated with a specific rape in the United States. METHODS: We examined 2013 de-identified patient data from Truven Analytics Health MarketScan database for an assault that occurred by using International Classification of Diseases, Ninth Revision, code E960.1. RESULTS: Analysis of insurance providers' payment patterns for 1355 incident events to female victims aged between 16 and 61 years revealed that victims remit, on average, 14% or $948 of the rape cost, whereas insurance providers pay 86% or $5789 of the total cost...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28419189/propensity-scores-with-misclassified-treatment-assignment-a-likelihood-based-adjustment
#4
Danielle Braun, Malka Gorfine, Giovanni Parmigiani, Nils D Arvold, Francesca Dominici, Corwin Zigler
Propensity score methods are widely used in comparative effectiveness research using claims data. In this context, the inaccuracy of procedural or billing codes in claims data frequently misclassifies patients into treatment groups, that is, the treatment assignment ($T$) is often measured with error. In the context of a validation data where treatment assignment is accurate, we show that misclassification of treatment assignment can impact three distinct stages of a propensity score analysis: (i) propensity score estimation; (ii) propensity score implementation; and (iii) outcome analysis conducted conditional on the estimated propensity score and its implementation...
April 17, 2017: Biostatistics
https://www.readbyqxmd.com/read/28414115/cost-analysis-of-a-surgical-consensus-guideline-in-breast-conserving-surgery
#5
Jennifer Yu, Leisha C Elmore, Amy E Cyr, Rebecca L Aft, William E Gillanders, Julie A Margenthaler
BACKGROUND: The SSO/ASTRO consensus statement was the first professional guideline in breast oncology to declare "no ink on tumor" as a negative margin in patients with stages I/II breast cancer undergoing breast conservation therapy (BCT). We sought to analyze the financial impact of this guideline at our institution using a historic cohort. STUDY DESIGN: We identified women undergoing re-excision following breast-conserving surgery for invasive breast cancer from 2010-2013 using a prospectively-maintained institutional database...
April 14, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28403462/medicaid-coverage-of-smoking-cessation-counseling-and-medication-is-underutilized-for-pregnant-women
#6
Taneisha S Scheuermann, Kimber P Richter, Lisette T Jacobson, Theresa I Shireman
Introduction: Policies to promote smoking cessation among Medicaid-insured pregnant women have the potential to assist a significant proportion of pregnant smokers. In 2010, Kansas Medicaid began covering smoking cessation counseling for pregnant smokers. Our aim was to evaluate the use of smoking cessation benefits provided to pregnant women as a result of the Kansas Medicaid policy change that provided reimbursement for physician-provided smoking cessation counseling. Methods: We examined Kansas Medicaid claims data to estimate rates of delivery of smoking cessation treatment to Medicaid-insured pregnant women in Kansas from fiscal year 2010 through 2013...
May 1, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28397270/sinus-procedures-in-the-medicare-population-from-2000-to-2014-a-recent-balloon-sinuplasty-explosion
#7
Nathaniel E Calixto, Twyla Gregg-Jaymes, Jonathan Liang, Nancy Jiang
OBJECTIVE: To describe sinus procedure trends from 2000 to 2014, particularly following the introduction of balloon sinuplasty Common Procedural Technology (CPT) codes in 2011. STUDY DESIGN: Retrospective review of Medicare billing data available to the public. METHODS: Procedure and beneficiary data from 2000 to 2014 and provider data from 2012 to 2014 were obtained online from the Centers for Medicare and Medicaid Services. Sinus CPT codes were classified as balloon sinus procedure (BSP) or nonballoon sinus procedure (nBSP)...
April 11, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28396027/risk-factors-for-community-associated-clostridium-difficile-infection-in-children
#8
Daniel J Adams, Matthew D Eberly, Michael Rajnik, Cade M Nylund
OBJECTIVE: To characterize the medication and other exposures associated with pediatric community-associated Clostridium difficile infections (CA-CDIs). STUDY DESIGN: We performed a case-control study using billing records from the US military health system database. CA-CDI cases included children 1-18 years of age with an outpatient International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic code for Clostridium difficile infection (CDI) from 2001 to 2013...
April 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28391419/do-consultants-follow-up-on-tests-they-recommend-insights-from-an-academic-inpatient-gastrointestinal-consult-service
#9
Benjamin E Cassell, Ted Walker, Saad Alghamdi, Jason Bill, Pierre Blais, Harold Boutté, Jeffrey W Brown, Gregory S Sayuk, C Prakash Gyawali
BACKGROUND: Inpatient care is a fundamental part of gastroenterology training and involves the recommendation, performance, and interpretation of diagnostic tests. However, test results are not always communicated to patients or treating providers. We determined the process of communication of test results and recommendations in our inpatient gastroenterology (GI) consult service. METHODS: Test recommendations on 304 consecutive new GI consults (age 60.2 ± 1...
April 8, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28390774/surgeon-leadership-in-the-coding-billing-and-contractual-negotiations-for-fenestrated-endovascular-aortic-aneurysm-repair-increases-medical-center-contribution-margin-and-physician-reimbursement
#10
Francesco Aiello, Jonathan Durgin, Vijaya Daniel, Louis Messina, Danielle Doucet, Jessica Simons, James Jenkins, Andres Schanzer
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28389293/smoking-cessation-counseling-improves-quality-of-care-and-surgical-outcomes-with-financial-gain-for-a-vascular-practice
#11
D A Moses, J H Mehaffey, D V Strider, M C Tracci, J A Kern, G R Upchurch
BACKGROUND: Cigarette smoking is strongly associated with atherosclerotic disease. It is incumbent upon vascular surgeons to provide smoking cessation counseling to their patients. The objective of this study was to determine the association of smoking cessation counseling (SCC) and improvement in quality of care. METHODS: As a quality project using retrospective data, the study received IRB exemption status. A retrospective review of prospectively maintained database from April 2014 through March 2015 of outpatient encounters in a vascular surgery clinic was performed of current smokers...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28383371/long-acting-reversible-contraceptive-placement-among-active-duty-u-s-army-servicewomen
#12
Anne K Erickson, D Alan Nelson, Jonathan G Shaw, Pooja D Loftus, Lianne M Kurina, Kate A Shaw
OBJECTIVE: To quantify uptake of long-acting reversible contraceptives (LARC)-intrauterine devices (IUDs) and hormonal implants-among U.S. Army active-duty female soldiers and identify characteristics associated with uptake. METHODS: This retrospective cohort study used the Stanford Military Data Repository, which includes all digitally recorded health encounters for active-duty U.S. Army soldiers from 2011 to 2014. We analyzed data from women aged 18-44 years to assess rates of LARC initiation using medical billing codes...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28378157/adherence-and-persistence-across-antidepressant-therapeutic-classes-a-retrospective-claims-analysis-among-insured-us-patients-with-major-depressive-disorder-mdd
#13
Katelyn R Keyloun, Ryan N Hansen, Zsolt Hepp, Patrick Gillard, Michael E Thase, Emily Beth Devine
BACKGROUND: Adherence and persistence to therapy, or how well a patient follows provider directions on frequency and time to discontinuation of prescribed medications, is associated with positive health outcomes, including decreased healthcare costs and patient mortality. A clear literature gap exists assessing adherence and persistence to antidepressants (ADs) in the major depressive disorder (MDD) population at clinically relevant time points and at the therapeutic class level. OBJECTIVE: This study assessed adherence and persistence to specific ADs, therapeutic classes, and AD therapy overall at multiple time points among US individuals from commercial, Medicare supplemental, and Medicaid insurance plans...
April 4, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28373160/genetic-analysis-of-venous-thromboembolism-in-uk-biobank-identifies-the-zfpm2-locus-and-implicates-obesity-as-a-causal-risk-factor
#14
Derek Klarin, Connor A Emdin, Pradeep Natarajan, Mark F Conrad, Sekar Kathiresan
BACKGROUND: UK Biobank is the world's largest repository for phenotypic and genotypic information for individuals of European ancestry. Here, we leverage UK Biobank to understand the inherited basis for venous thromboembolism (VTE), a leading cause of cardiovascular mortality. METHODS AND RESULTS: We identified 3290 VTE cases and 116 868 controls through billing code-based phenotyping. We performed a genome-wide association study for VTE with ≈9 000 000 imputed single-nucleotide polymorphisms...
April 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/28369475/national-trends-and-variability-in-blood-utilization-in-paediatric-cardiac-surgery
#15
Mohsen Karimi, Jill M Sullivan, Trudy Lerer, Carla Hronek
OBJECTIVES: Red blood cell transfusion is a common practice in paediatric cardiac surgery. Transfusion of red blood cells has been shown to be associated with an increase in morbidity in paediatric patients undergoing cardiac surgery. There is a huge variability in the practice of blood utilization within and across different practices. The aim of this study was to demonstrate the current variability and the trends over the past decade in blood usage among children's hospitals performing paediatric cardiac surgery...
March 28, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28365373/marijuana-and-acute-health-care-contacts-in-colorado
#16
George Sam Wang, Katelyn Hall, Daniel Vigil, Shireen Banerji, Andrew Monte, Mike VanDyke
Over 22 million Americans are current users of marijuana; half of US states allow medical marijuana, and several allow recreational marijuana. The objective of this study was to evaluate the impact marijuana has on hospitalizations, emergency department (ED) visits, and regional poison center (RPC) calls in Colorado, a medical and recreational marijuana state. This is a retrospective review using Colorado Hospital Association hospitalizations and ED visits with marijuana-related billing codes, and RPC marijuana exposure calls...
March 29, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28346253/a-retrospective-case-matched-cost-comparison-of-surgical-treatment-of-melanoma-and-nonmelanoma-skin-cancer-in-the-outpatient-versus-operating-room-setting
#17
Ryan P Johnson, Niraj Butala, Murad Alam, Naomi Lawrence
BACKGROUND: To date, no study has used authentic billing data in a case-control matched fashion to examine the cost of treating skin cancer in different settings. OBJECTIVE: To compare the cost of surgical treatment of skin cancer in the outpatient versus operating room setting using matched cases based on patient and skin cancer characteristics. METHODS: ICD-9 diagnosis codes for skin cancers were used to find patients who had a malignant excision current procedural terminology code in the operating room setting during 2010 to 2014...
March 23, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28336485/low-dose-computed-tomography-for-lung-cancer-screening-clinical-and-coding-considerations
#18
REVIEW
Yiwey Shieh, Martin Bohnenkamp
Lung cancer screening with low-dose computed tomography (LDCT) was shown to reduce lung cancer mortality in the National Lung Screening Trial, a large randomized-controlled trial of high-risk current and former smokers. Despite ongoing uncertainty over the effectiveness of LDCT in the real-world setting, the Centers for Medicare and Medicaid Services (CMS) decided to cover LDCT as a preventive service. As part of its national coverage determination, CMS set forth a series of requirements for reimbursement of LDCT, including a counseling and shared decision-making visit prior to a LDCT being ordered...
March 21, 2017: Chest
https://www.readbyqxmd.com/read/28335610/rheumatoid-forefoot-reconstruction-in-the-nonrheumatoid-patient
#19
Devon C Nixon, Richard M McKean, Sandra E Klein, Jeffrey E Johnson, Jeremy J McCormick
BACKGROUND: Recurrent pain and deformity following forefoot surgery can cause significant patient disability. In patients with rheumatoid arthritis, first metatarsophalangeal (MTP) joint arthrodesis with lesser metatarsal head resections-termed the rheumatoid forefoot reconstruction-has been shown to be a reliable operation for pain relief and deformity correction. Limited data, however, have been published on outcomes of the same forefoot reconstruction operation in the nonrheumatoid patient...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28334244/cognitive-screening-tests-versus-comprehensive-neuropsychological-test-batteries-a-national-academy-of-neuropsychology-education-paper%C3%A2
#20
Tresa M Roebuck-Spencer, Tannahill Glen, Antonio E Puente, Robert L Denney, Ronald M Ruff, Gayle Hostetter, Kevin J Bianchini
The American Medical Association Current Procedural Panel developed a new billing code making behavioral health screening a reimbursable healthcare service. The use of computerized testing as a means for cognitive screening and brief cognitive testing is increasing at a rapid rate. The purpose of this education paper is to provide information to clinicians, healthcare administrators, and policy developers about the purpose, strengths, and limitations of cognitive screening tests versus comprehensive neuropsychological evaluations...
March 10, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
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