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https://www.readbyqxmd.com/read/28226416/the-contribution-of-the-emergency-department-to-opioid-pain-reliever-misuse-and-diversion-a-critical-review
#1
REVIEW
Tatyana Lyapustina, Renan Castillo, Elise Omaki, Wendy Shields, Eileen McDonald, Richard Rothman, Andrea Gielen
Prescription opioid pain reliever (OPR) misuse and diversion is an important and growing public health problem in the United States that is responsible for significant morbidity and mortality. Emergency physicians are among the top prescribers of OPRs, yet the relative contribution of emergency department (ED) OPR prescriptions to the overall opioid abuse epidemic remains unclear. This study critically reviews seven peer-reviewed studies that specifically identified the ED as a source of OPRs. Of the OPRs prescribed in the ED, approximately 10% are associated with indicators of inappropriate prescribing, and approximately 42% may ultimately be misused; of the OPRs that are diverted, approximately 10% originate from an ED prescription...
February 22, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28210564/more-misinformation-on-breast-cancer-screening
#2
COMMENT
Daniel B Kopans
Unfortunately, a great deal of misinformation has accumulated in the breast cancer screening literature that is based on flawed analyses in an effort to reduce access to screening. Quite remarkably, much of this has come from publications in previously highly respected medical journals. In several papers the intervention (mammography screening) is faulted yet the analyses provided no data on who participated in mammography screening, and which cancers were detected by mammography screening. It is remarkable that a highly respected journal can fault an intervention with no data on the intervention...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28183412/graduate-medical-education-accelerated-change
#3
Mark David Linville, J Edward Bates
Graduate medical education (GME) is a critical link in the educational chain for physicians. Graduating from a strict apprenticeship model, GME has become a highly structured educational system whose peer-review organization provides an intentional and direct approach to ensuring that GME not only addresses the public's expectations of the profession but also positions itself to be a foundational structure in the outcomes-focused healthcare environment of the nation. GME is currently in a state of accelerated change-grounded in both educational and patient outcomes...
February 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28160771/a-realist-review-of-shared-medical-appointments-how-for-whom-and-under-what-circumstances-do-they-work
#4
Susan R Kirsh, David C Aron, Kimberly D Johnson, Laura E Santurri, Lauren D Stevenson, Katherine R Jones, Justin Jagosh
BACKGROUND: Shared medical appointments (SMAs) are doctor-patient visits in which groups of patients are seen by one or more health care providers in a concurrent session. There is a growing interest in understanding the potential benefits of SMAs in various contexts to improve clinical outcomes and reduce healthcare costs. This study builds upon the existing evidence base that suggests SMAs are indeed effective. In this study, we explored how they are effective in terms of the underlying mechanisms of action and under what circumstances...
February 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28152888/the-benefits-of-clinical-pathways-cp-for-radiation-oncology-in-a-large-cancer-care-network
#5
Sushil Beriwal, Hans Benson, Zach Lorinc, Amanda Barry, Kathleen Lokay
: 148 Background: UPMC CancerCenter and the University of Pittsburgh Cancer Institute (UPMC) created a radiation oncology CP program (now incorporated separately as Via Pathways) in 2003 to standardize care at 19 radiation sites. The program exists to ensure consistency and rapid adoption of best evidence-based care in a large, integrated NCI-designated comprehensive cancer center. METHODS: The web-based CP portal integrates with electronic medical records to provide point-of-care patient-specific decision support...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152845/standardizing-architecture-and-governance-of-radiology-clinical-checklist-development
#6
Priyanka Jain, Deanna Langer, David Kwan, Julian Dobranowski
: 193 Background: To improve quality of radiology reporting, Cancer Care Ontario's (CCO) Cancer Imaging Program established synoptic radiology reporting as a priority area. Program goals are to implement standardized radiology reports across the province, improving communication between referring and interpreting physicians and providing a standardized foundation for staging data collection and population health research. Although there are libraries of structured radiology clinical checklists, development methodologies quality vary...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152839/development-of-a-radiation-oncology-specific-prospective-data-registry-for-clinical-research-and-quality-improvement-a-clinical-workflow-based-solution
#7
Pin-Chieh Wang, Darlene Verittupong, Weber Shao, Susan Ann McCloskey, Vincent Basehart, Michael L Steinberg, Patrick Kupelian
: 197 Background: The computerized 'paperless' medical recording system has transformed the modern health information system and serves as an idea platform for cancer registry development, particularly in a specialty like radiation oncology, where technological advances generate unprecedented amounts of data. METHODS: From May 2011 to May 2015, physicians prospectively inputted data on patients seen during consultation in the Department of Radiation Oncology at UCLA...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28125369/payer-perspectives-on-patient-reported-outcomes-in-health-care-decision-making-oncology-examples
#8
Andrew P Brogan, Carla DeMuro, Amy M Barrett, Denise D'Alessio, Vasudha Bal, Susan L Hogue
BACKGROUND: Health authorities and payers increasingly recognize the importance of patient perspectives and patient-reported outcomes (PROs) in health care decision making. However, given the broad variety of PRO endpoints included in clinical programs and variations in the timing of PRO data collection and country-specific needs, the role of PRO data in reimbursement decisions requires characterization. OBJECTIVES: To (a) determine the effect of PRO data on market access and reimbursement decisions for oncology products in multiple markets and (b) assess the effect of PRO data collected after clinical progression on payer decision making...
February 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28121599/health-information-technology-dos-and-don-ts-for-today-and-tomorrow
#9
Jaan Sidorov, Akash Randhar
The challenges include not overburdening physicians and fitting into an increasingly complex, multilayered informatics ecosystem. Innovative health care entities that neglect health care's reliance on evidence-based medicine and go to market without the benefit of any peer review do so at their own peril.
January 2017: Managed Care
https://www.readbyqxmd.com/read/28115438/family-medicine-education-in-rural-communities-as-a-health-service-intervention-supporting-recruitment-and-retention-of-physicians-advancing-rural-family-medicine-the-canadian-collaborative-taskforce
#10
REVIEW
Trina Larsen Soles, C Ruth Wilson, Ivy F Oandasan
OBJECTIVE: To develop a pan-Canadian rural education road map to advance the recruitment and retention of family physicians in rural, remote, and isolated regions of Canada in order to improve access and health care outcomes for these populations. COMPOSITION OF THE TASK FORCE: Members of the task force were chosen from key stakeholder groups including educators, practitioners, the College of Family Physicians of Canada education committee chairs, deans, chairs of family medicine, experts in rural education, and key decision makers...
January 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28107850/application-of-magic-in-healthcare-a-scoping-review
#11
REVIEW
Michael T Lam, Helen R Lam, Lalit Chawla
STUDY DESIGN: Scoping review. INTRODUCTION: The art and science of magic traces back to ancient days. Physicians are often compared to magicians metaphorically. Nonetheless, there exist various genuine applications of magic in the healthcare setting. PURPOSE: To explore and summarize the literature reporting the applications of magic tricks or any derived techniques in healthcare or clinical environments. METHODS: A literature search was performed on ten databases: Medline, Embase, CINAHL, Cochrane Central, Cochrane Database of Systematic Reviews, PEDro, Scopus, the International Index to Performing Arts, General OneFile and Newstand, to identify references related to the application of magic in healthcare...
February 2017: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/28104314/breast-prostate-and-thyroid-cancer-screening-tests-and-overdiagnosis
#12
Minsoo Jung
The purpose of this study was to examine overdiagnosis and overtreatment related to cancer screening and to review relevant reports and studies. A comprehensive search of peer-reviewed and gray literature was conducted for relevant studies published between January 2000 and December 2015 reporting breast, prostate, and thyroid cancer screening tests and overdiagnosis. This study revealed no dichotomy on where screening would lower risk or cause overdiagnosis and overtreatment. Many screening tests did both, that is, at population level, there were both benefit (decreased disease-specific mortality) and harm (overdiagnosis and overtreatment)...
December 20, 2016: Current Problems in Cancer
https://www.readbyqxmd.com/read/28101848/open-access-to-scientific-articles-a-review-of-benefits-and-challenges
#13
Bo-Christer Björk
The Internet has fundamentally changed the publishing of scholarly peer reviewed journals, and the way readers find and access articles. Digital access is nowadays the norm, in particular for researchers. The Internet has enabled a totally new business model, Open Access (OA), in which an article is openly available in full text for anyone with Internet access. This article reviews the different options to achieve this, whether by journals changing their revenue structures from subscription to publishing charges, or authors utilizing a number of options for posting OA versions of article manuscripts in repositories...
January 18, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28091834/using-twitter-to-assess-the-public-response-to-the-united-states-preventive-services-task-force-guidelines-on-lung-cancer-screening-with-low-dose-chest-ct
#14
Siddharth Khasnavis, Andrew B Rosenkrantz, Vinay Prabhu
To use Twitter to assess the immediate public response to the United States Preventive Services Task Force (USPSTF) 2013 draft guidelines on lung cancer screening with low-dose chest CT (LDCT). The number of tweets including the phrases "lung cancer screening," "lung CT," "chest CT," "low dose computed tomography," "low dose CT," or "LDCT" was recorded for 6 days before and after guidelines release. A systematic sample of 172 tweets from the week following release was coded for user type, tweet opinion, linked article source, and article opinion...
January 13, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28087291/primary-care-perspectives-on-hepatitis-c-virus-screening-diagnosis-and-linking-patients-to-appropriate-care
#15
Edward Lebovics, Richard Torres, Lucinda K Porter
Enormous progress has been made in recent years toward effectively treating and curing patients with chronic hepatitis C (CHC). However, at least half of the possible 7 million individuals infected with hepatitis C virus (HCV) in the US remain undiagnosed. The formidable task of increasing the number of patients diagnosed, and subsequently linked to appropriate care has fallen to primary care clinicians, who are mandated by some US States to offer screening to individuals born between 1945 and 1965 (the Baby Boomer Generation)...
January 10, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28070707/value-based-assessment-of-radiology-reporting-using-radiologist-referring-physician-two-way-feedback-system-a-design-thinking-based-approach
#16
Faiq Shaikh, Kenneth Hendrata, Brian Kolowitz, Omer Awan, Rasu Shrestha, Christopher Deible
In the era of value-based healthcare, many aspects of medical care are being measured and assessed to improve quality and reduce costs. Radiology adds enormously to health care costs and is under pressure to adopt a more efficient system that incorporates essential metrics to assess its value and impact on outcomes. Most current systems tie radiologists' incentives and evaluations to RVU-based productivity metrics and peer-review-based quality metrics. In a new potential model, a radiologist's performance will have to increasingly depend on a number of parameters that define "value," beginning with peer review metrics that include referrer satisfaction and feedback from radiologists to the referring physician that evaluates the potency and validity of clinical information provided for a given study...
January 9, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28063462/going-digital-a-narrative-overview-of-the-clinical-and-organisational-impacts-of-ehealth-technologies-in-hospital-practice
#17
Justin Keasberry, Ian A Scott, Clair Sullivan, Andrew Staib, Richard Ashby
Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes.Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool...
January 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28052179/sensitivity-for-diagnosing-group-a-streptococcal-pharyngitis-from-manufacturers-is-10-higher-than-reported-in-peer-reviewed-publications
#18
Raj Vachhani, Toral Patel, Robert M Centor, Carlos A Estrada
OBJECTIVES: Meta-analyses based on peer-reviewed publications report a sensitivity of approximately 85% for rapid antigen streptococcus tests to diagnose group A streptococcal (GAS) pharyngitis. Because these meta-analyses excluded package inserts, we examined the test characteristics of rapid antigen streptococcal tests and molecular methods that manufacturers report in their package inserts. METHODS: We included tests available in the US market (Food and Drug Administration, period searched 1993-2015) and used package insert data to calculate pooled sensitivity and specificity...
January 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28048826/su-f-p-03-management-of-time-to-treatment-inititation-case-for-an-electronic-whiteboard
#19
N Adnani
PURPOSE: To determine if data mining of an electronic whiteboard improves the management of the Time to Treatment Initiation (TTI) in radiation oncology. METHODS: An electronic whiteboard designed to help in managing the planning workflow and improves communication regarding patient planning progress was used to record the dates at which each phase of the planning process began or completed. These are CT Sim date, Plan Start, Physician Review, Physicist Review, Approval for Treatment Delivery, Setup or Verification of Simulation...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047477/su-g-tep4-06-an-integrated-application-for-radiation-therapy-treatment-plan-directives-management-and-reporting
#20
M Matuszak, C Anderson, C Lee, K Vineberg, M Green, K Younge, J Moran, C Mayo
PURPOSE: With electronic medical records, patient information for the treatment planning process has become disseminated across multiple applications with limited quality control and many associated failure modes. We present the development of a single application with a centralized database to manage the planning process. METHODS: The system was designed to replace current functionalities of (i) static directives representing the physician intent for the prescription and planning goals, localization information for delivery, and other information, (ii) planning objective reports, (iii) localization and image guidance documents and (iv) the official radiation therapy prescription in the medical record...
June 2016: Medical Physics
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