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Physician peer review

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https://www.readbyqxmd.com/read/28335776/challenges-and-strategies-to-improve-the-availability-and-geographic-accessibility-of-physicians-in-portugal
#1
Ana Paula Cavalcante de Oliveira, Gilles Dussault, Isabel Craveiro
BACKGROUND: Shortages of physicians in remote, rural and other underserved areas and lack of general practitioners limit access to health services. The aims of this article are to identify the challenges faced by policy and decision-makers in Portugal to guarantee the availability and geographic accessibility to physicians in the National Health Service and to describe and analyse their causes, the strategies to tackle them and their results. We also raise the issue of whether research evidence was used or not in the process of policy development...
March 23, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28319484/nonpharmacologic-management-of-hypertension-a-multidisciplinary-approach
#2
Cemal Ozemek, Shane A Phillips, Dejana Popovic, Deepika Laddu-Patel, Ibra S Fancher, Ross Arena, Carl J Lavie
PURPOSE OF REVIEW: Nonpharmacologic lifestyle modification interventions (LMIs), such as increasing physical activity, dietary modification, weight-loss, reducing alcohol consumption and smoking cessation, are effective strategies to lower resting blood pressures (BPs) in prehypertensive or hypertensive patients. However, the limited time shared between a physician and a patient is not adequate to instill an adoption of LMI. The purpose of this review is to therefore highlight evidence-based BP lowering, LMI strategies that can feasibly be implemented in clinical practices...
March 17, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28302637/protocol-for-determining-primary-healthcare-practice-characteristics-models-of-practice-and-patient-accessibility-using-an-exploratory-census-survey-with-linkage-to-administrative-data-in-nova-scotia-canada
#3
Emily Gard Marshall, Richard J Gibson, Beverley Lawson, Frederick Burge
INTRODUCTION: There is little evidence on how primary care providers (PCPs) model their practices in Nova Scotia (NS), Canada, what services they offer or what accessibility is like for the average patient. This study will create a database of all family physicians and primary healthcare nurse practitioners in NS, including information about accessibility and the model of care in which they practice, and will link the survey data to administrative health databases. METHODS AND ANALYSIS: 3 census surveys of all family physicians, primary care nurse practitioners (ie, PCPs) and their practices in NS will be conducted...
March 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28302548/availability-use-and-barriers-to-cardiac-rehabilitation-in-lmic
#4
Loheetha Ragupathi, Judy Stribling, Yuliya Yakunina, Valentin Fuster, Mary Ann McLaughlin, Rajesh Vedanthan
BACKGROUND: Cardiac rehabilitation (CR) is a cornerstone of secondary prevention of ischemic heart disease. It is critically important in low- and middle-income countries (LMIC), where the burden of ischemic heart disease is substantial and growing. However, the availability and utilization of CR in LMIC is not systematically known. OBJECTIVES: This study sought to characterize the availability, use, and barriers to the use of CR. METHODS: Electronic databases (Cochrane Library, EMBASE, PubMed, Web of Science) were searched from January 1, 1980 to May 31, 2013 for articles on CR in LMIC...
March 13, 2017: Global Heart
https://www.readbyqxmd.com/read/28284760/a-peer-review-process-as-part-of-the-implementation-of-clinical-pathways-in-radiation-oncology-does-it-improve-compliance
#5
Brian J Gebhardt, Dwight E Heron, Sushil Beriwal
PURPOSE: Clinical pathways are patient management plans that standardize evidence-based practices to ensure high-quality and cost-effective medical care. Implementation of a pathway is a collaborative process in our network, requiring the active involvement of physicians. This approach promotes acceptance of pathway recommendations, although a peer review process is necessary to ensure compliance and to capture and approve off-pathway selections. We investigated the peer review process and factors associated with time to completion of peer review...
January 19, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28283485/quit-emr-trial-a-prospective-observational-multicentre-study-to-evaluate-quality-and-24%C3%A2-hours-post-transport-morbidity-of-interhospital-transportation-of-critically-ill-patients-study-protocol
#6
Ulrich Strauch, Dennis C J J Bergmans, Joachim Habers, Jochen Jansen, Bjorn Winkens, Dirk J Veldman, Paul M H J Roekaerts, Stefan K Beckers
INTRODUCTION: It is widely accepted that transportation of critically ill patients is high risk. Unfortunately, however, there are currently no evidence-based criteria with which to determine the quality of various interhospital transport systems and their impact on the outcomes for patients. We aim to rectify this by assessing 2 scores which were developed in our hospital in a prospective, observational study. Primarily, we will be examining the Quality of interhospital critical care transportation in the Euregion Meuse-Rhine (QUIT EMR) score, which focuses on the quality of the transport system, and secondarily the SEMROS (Simplified EMR outcome score) which detects changes in the patient's clinical condition in the 24 hours following their transportation...
March 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28283118/a-protocol-to-develop-practice-guidelines-for-primary-care-medical-service-trips
#7
Christopher Dainton, Charlene H Chu, Henry Lin, William Cherniak, Lawrence C Loh
BACKGROUND: North American clinicians are increasingly participating in medical service trips (MSTs) that provide primary healthcare in Latin America and the Caribbean. Literature reviews have shown that the existence and use of evidence-based guidelines by these groups are limited, which presents potential for harm. OBJECTIVE: This paper proposes a 5-step methodology to develop protocols for diagnosis and treatment of conditions encountered by MST clinicians. METHODS: We reviewed the 2010 American College of Physicians guidance statement on guidelines development and developed our own adaptation...
September 2016: Annals of Global Health
https://www.readbyqxmd.com/read/28274216/primary-care-physicians-educational-needs-and-learning-preferences-in-end-of-life-care-a-focus-group-study-in-the-uk
#8
Lucy Ellen Selman, Lisa Jane Brighton, Vicky Robinson, Rob George, Shaheen A Khan, Rachel Burman, Jonathan Koffman
BACKGROUND: Primary care physicians (General Practitioners (GPs)) play a pivotal role in providing end of life care (EoLC). However, many lack confidence in this area, and the quality of EoLC by GPs can be problematic. Evidence regarding educational needs, learning preferences and the acceptability of evaluation methods is needed to inform the development and testing of EoLC education. This study therefore aimed to explore GPs' EoLC educational needs and preferences for learning and evaluation...
March 9, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28258898/prospective-qualitative-and-quantitative-analysis-of-real-time-peer-review-quality-assurance-rounds-incorporating-direct-physical-examination-for-head-and-neck-cancer-radiation-therapy
#9
Carlos E Cardenas, Abdallah S R Mohamed, Randa Tao, Andrew J R Wong, Mussadiq J Awan, Shirly Kuruvila, Michalis Aristophanous, G Brandon Gunn, Jack Phan, Beth M Beadle, Steven J Frank, Adam S Garden, William H Morrison, Clifton D Fuller, David I Rosenthal
PURPOSE: Our department has a long-established comprehensive quality assurance (QA) planning clinic for patients undergoing radiation therapy (RT) for head and neck cancer. Our aim is to assess the impact of a real-time peer review QA process on the quantitative and qualitative radiation therapy plan changes in the era of intensity modulated RT (IMRT). METHODS AND MATERIALS: Prospective data for 85 patients undergoing head and neck IMRT who presented at a biweekly QA clinic after simulation and contouring were collected...
November 19, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28244918/potential-financial-conflict-of-interest-among-physician-editorial-board-members-of-orthopaedic-surgery-journals
#10
Charles T Mehlman, Kanu Okike, Mohit Bhandari, Mininder S Kocher
BACKGROUND: The practice of medicine is based on evidence from peer-reviewed literature. As can occur with author-related funding, the integrity of the process by which manuscripts are reviewed, edited, and approved for publication may be at risk due to financial conflict of interest. The purpose of our study was to assess potential financial conflict of interest among physician editorial board members of orthopaedic surgery journals. METHODS: We identified the physician editorial board members of 15 orthopaedic surgery journals and searched the 2014 payments that were archived in the Centers for Medicare & Medicaid Services Open Payments system (mandated by the Physician Payments Sunshine Act)...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28242768/american-orthopaedic-foot-and-ankle-society-aofas-ankle-hindfoot-score-a-study-protocol-for-the-translation-and-validation-of-the-dutch-language-version
#11
Esther M M Van Lieshout, A Siebe De Boer, Duncan E Meuffels, P Ted Den Hoed, Cornelis H Van der Vlies, Wim E Tuinebreijer, Michael H J Verhofstad
INTRODUCTION: The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score is among the most commonly used instruments for measuring the outcome of treatment in patients who sustained a complex ankle or hindfoot injury. It combines a clinician-reported and a patient-reported part. A valid Dutch version of this instrument is currently not available. Such a translated and validated instrument would allow objective comparison across hospitals or between patient groups, and with shown validity and reliability it may become a quality of care indicator in future...
February 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28226416/the-contribution-of-the-emergency-department-to-opioid-pain-reliever-misuse-and-diversion-a-critical-review
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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. Using a customized interface established between an in-house registry and a commercially-available, hospital-based electronic medical record system (Epic Systems, Inc...
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
#19
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
#20
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
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