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https://www.readbyqxmd.com/read/28538984/accuracy-of-medical-claims-for-identifying-cardiovascular-and-bleeding-events-after-myocardial-infarction-a-secondary-analysis-of-the-translate-acs-study
#1
Patricia O Guimarães, Arun Krishnamoorthy, Lisa A Kaltenbach, Kevin J Anstrom, Mark B Effron, Daniel B Mark, Patrick L McCollam, Linda Davidson-Ray, Eric D Peterson, Tracy Y Wang
Importance: Pragmatic clinical trial designs have proposed the use of medical claims data to ascertain clinical events; however, the accuracy of billed diagnoses in identifying potential events is unclear. Objectives: To compare the 1-year cumulative incidences of events when events were identified by medical claims vs by physician adjudication and to assess the accuracy of bill-identified events using physician adjudication as the criterion standard. Design, Setting, and Participants: This post hoc analysis of a clinical trial assessed the medical claims forms and records for all rehospitalizations at 233 US hospitals within 1 year of the index acute myocardial infarction (MI) of 12 365 patients enrolled in the Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) study between April 1, 2010, and October 31, 2012...
May 24, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28537754/development-of-a-standardized-kalamazoo-communication-skills-assessment-tool-for-radiologists-validation-multisource-reliability-and-lessons-learned
#2
Stephen D Brown, Elizabeth A Rider, Katherine Jamieson, Elaine C Meyer, Michael J Callahan, Carolynn M DeBenedectis, Sarah D Bixby, Michele Walters, Sara F Forman, Pamela H Varrin, Peter Forbes, Christopher J Roussin
OBJECTIVE: The purpose of this study was to develop and test a standardized communication skills assessment instrument for radiology. MATERIALS AND METHODS: The Delphi method was used to validate the Kalamazoo Communication Skills Assessment instrument for radiology by revising and achieving consensus on the 43 items of the preexisting instrument among an interdisciplinary team of experts consisting of five radiologists and four nonradiologists (two men, seven women)...
May 24, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28536719/insulin-bolus-calculator-in-a-pediatric-hospital-safety-and-user-perceptions
#3
Mohammad B Ateya, Ranjit Aiyagari, Colleen Moran, Kanakadurga Singer
BACKGROUND: Insulin dosing in hospitalized pediatric patients is challenging and requires dosing to be matched with the specific clinical and nutritional circumstances. We implemented a customized subcutaneous insulin bolus dose calculator tool integrated with the electronic health record to improve patient care. Here we describe this tool, its utilization and safety, and assess user satisfaction and perceptions of the tool. METHODS: Blood glucose results for all patients who received insulin with and without the calculator tool were compared to assess safety...
May 24, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28522918/combination-of-corticosteroids-and-5-aminosalicylates-or-corticosteroids-alone-for-patients-with-moderate-severe-active-ulcerative-colitis-a-global-survey-of-physicians-practice
#4
Shomron Ben-Horin, Jane M Andrews, Konstantinos H Katsanos, Florian Rieder, Flavio Steinwurz, Konstantinos Karmiris, Jae Hee Cheon, Gordon William Moran, Monica Cesarini, Christian D Stone, Doron Schwartz, Marijana Protic, Xavier Roblin, Giulia Roda, Min-Hu Chen, Ofir Har-Noy, Charles N Bernstein
AIM: To examine treatment decisions of gastroenterologists regarding the choice of prescribing 5-aminosalycilates (5ASA) with corticosteroids (CS) versus corticosteroids alone for patients with active ulcerative colitis (UC). METHODS: A cross-sectional questionnaire exploring physicians' attitude toward 5ASA + CS combination therapy vs CS alone was developed and validated. The questionnaire was distributed to gastroenterology experts in twelve countries in five continents...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28492523/evaluation-of-identifier-field-agreement-in-linked-neonatal-records
#5
E S Hall, K Marsolo, J M Greenberg
OBJECTIVE: To better address barriers arising from missing and unreliable identifiers in neonatal medical records, we evaluated agreement and discordance among traditional and non-traditional linkage fields within a linked neonatal data set. STUDY DESIGN: The retrospective, descriptive analysis represents infants born from 2013 to 2015. We linked children's hospital neonatal physician billing records to newborn medical records originating from an academic delivery hospital and evaluated rates of agreement, discordance and missingness for a set of 12 identifier field pairs used in the linkage algorithm...
May 11, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28460696/caring-for-kids-bridging-gaps-in-pediatric-emergency-care-through-community-education-and-outreach
#6
REVIEW
Ann Luckstead-Gosdin, Lori Vinson, Cynthia Greenwell, Jefferson Tweed
The Pediatric Emergency Services Network (PESN) was developed to provide ongoing continuing education on pediatric guidelines and pediatric emergency care to rural and nonpediatric hospitals, physicians, nurses, and emergency personnel. A survey was developed and given to participants attending PESN educational events to determine the perceived benefit and application to practice of the PESN outreach program. Overall, 91% of participants surveyed reported agreement that PESN educational events were beneficial to their clinical practice, provided them with new knowledge, and made them more knowledgeable about pediatric emergency care...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28455104/a-comparison-of-tuberculosis-diagnostic-systems-in-a-retrospective-cohort-of-hiv-infected-children-in-rio-de-janeiro-brazil
#7
Solange Gonçalves David, Kathryn L Lovero, Maria de Fátima B Pombo March, Thalita G Abreu, Antonio Ruffino Netto, Afranio L Kritski, Clemax C Sant'Anna
OBJECTIVES: The diagnosis of pediatric tuberculosis (TB) presents many challenges, and is further complicated in HIV-infected patients. While many diagnostic systems have been proposed, there is no pediatric TB diagnosis gold standard. The outcomes of four TB diagnostic systems in HIV-infected children were compared in this study. METHODS: A retrospective cohort study was conducted at a TB/HIV reference hospital in Rio de Janeiro. HIV-infected pediatric patients evaluated for TB from 1998 to 2010 were reassessed using four diagnostic systems: Kenneth Jones, 1969; Tidjani, 1986; Ben Marais, 2006; Brazilian Ministry of Health, 2010...
April 25, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28453186/emergency-physicians-are-able-to-detect-right-ventricular-dilation-with-good-agreement-compared-to-cardiology
#8
Matt A Rutz, Julie M Clary, Jeffrey A Kline, Frances M Russell
OBJECTIVE: Focused cardiac ultrasound (FOCUS) is a useful tool in evaluating patients presenting to the emergency department (ED) with acute dyspnea. Prior work has shown that right ventricular (RV) dilation is associated with repeat hospitalizations and shorter life expectancy. Traditionally, RV assessment has been evaluated by cardiologist-interpreted comprehensive echocardiography. The primary goal of this study was to determine the interrater reliability between emergency physicians (EPs) and a cardiologist for determining RV dilation on FOCUS performed on ED patients with acute dyspnea...
April 28, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28437573/using-internal-and-external-reviewers-can-help-to-optimise-neonatal-mortality-and-morbidity-conferences
#9
Michael-Andrew Assaad, Annie Janvier, Anie Lapointe
AIM: This study determined whether there was a difference in the conclusions reached by neonatologists in morbidity and mortality conferences based on their level of involvement in a case. METHODS: All neonatal deaths occurring between August 2014 and September 2015 at the neonatal intensive care unit of Sainte-Justine Hospital, Montreal, Quebec, Canada, were reviewed by internal physicians involved in the case and external physicians who were not. The reviewers were asked to identify positive and negative clinical practice items and provide written recommendations...
April 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28403889/muscle-mri-at-the-time-of-questionable-disease-flares-in-juvenile-dermatomyositis-jdm
#10
Rabheh Abdul-Aziz, Chack-Yung Yu, Brent Adler, Sharon Bout-Tabaku, Katherine E Lintner, Melissa Moore-Clingenpeel, Charles H Spencer
BACKGROUND: The course of JDM has improved substantially over the last 70 years with early and aggressive treatments. Yet it remains difficult to detect disease flares as symptoms may be mild; signs of rash and muscle weakness vary widely and are often equivocal; laboratory tests of muscle enzyme levels are often normal; electromyography and muscle biopsy are invasive. Alternative tools are needed to help decide if more aggressive treatment is needed. Our objective is to determine the effectiveness of muscle Magnetic Resonance Imaging (MRI) in detecting JDM flares, and how an MRI affects physician's decision-making regarding treatment...
April 12, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28375496/a-review-and-survey-of-neurosurgeon-hospital-relationships-evolution-and-options
#11
Dong H Kim, Bernard Duco, Daniel Wolterman, Charles Stokes, Rod Brace, Robert A Solomon, Nicholas Barbaro, Richard Westmark, David MacDougall, James Bean, Joanna O'Leary, Nicole Moayeri, Ralph G Dacey, Mitchel S Berger, Robert Harbaugh
As healthcare delivery shifts from fee-for-service, episodic care to pay for performance and population health, both hospitals and physicians are looking for new forms of integration. A number of regulations and restrictions govern physician relationships with hospitals. In this paper, we review the legal basis for such relationships and the options available. We also survey neurosurgeons and hospital executives to gain their perspective on the current situation and likely future. Two series of structured interviews were conducted with 10 neurosurgeons who work in a range of situations in diverse markets, and with Memorial Hermann Healthcare System senior executive leadership...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28351762/does-ulipristal-acetate-affect-surgical-experience-at-laparoscopic-myomectomy
#12
Lea Luketic, Lindsay Shirreff, Sari Kives, Grace Liu, Ramadan El Sugy, Nicholas Leyland, Meir Jonathon Solnik, Ally Murji
STUDY OBJECTIVE: To compare surgical experience of laparoscopic/robotic myomectomy in premenopausal patients pretreated with ulipristal acetate (UPA) with women not hormonally pretreated. DESIGN: A retrospective, multicenter cohort study of laparoscopic/robotic myomectomy procedure videos (Canadian Task Force Classification III). SETTING: Multiple university-affiliated tertiary care hospitals. PATIENTS: Fifty-five premenopausal women who underwent laparoscopic/robotic myomectomy for intramural myomas and were either pretreated with 3 months of UPA or had no hormonal pretreatment...
March 25, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28336681/accuracy-and-reliability-of-stroke-diagnosis-in-the-pediatric-emergency-department
#13
Mark T Mackay, Adriana Yock-Corrales, Leonid Churilov, Paul Monagle, Geoffrey A Donnan, Franz E Babl
BACKGROUND AND PURPOSE: Access to acute stroke interventions in the emergency department (ED) relies on correct clinical diagnosis. Our aims were to determine the accuracy and reliability of pediatric ED physician diagnosis of childhood stroke and other conditions presenting with brain attack symptoms. METHODS: Prospective study of consecutive children aged 1 month to 18 years presenting to the ED from June 2009 to December 2010 with focal neurological deficits...
March 23, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28332994/predicting-patient-specific-dosimetric-benefits-of-proton-therapy-for-skull-base-tumors-using-a-geometric-knowledge-based-method
#14
David C Hall, Alexei V Trofimov, Brian A Winey, Norbert J Liebsch, Harald Paganetti
PURPOSE: To predict the organ at risk (OAR) dose levels achievable with proton beam therapy (PBT), solely based on the geometric arrangement of the target volume in relation to the OARs. A comparison with an alternative therapy yields a prediction of the patient-specific benefits offered by PBT. This could enable physicians at hospitals without proton capabilities to make a better-informed referral decision or aid patient selection in model-based clinical trials. METHODS AND MATERIALS: Skull-base tumors were chosen to test the method, owing to their geometric complexity and multitude of nearby OARs...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28319491/breaking-down-the-objective-structured-clinical-examination-an-evaluation-of-the-helping-babies-breathe-osces
#15
Teresa L Seto, Meredith E Tabangin, Kathryn K Taylor, Srirama Josyula, Juan Carlos Vasquez, Beena D Kamath-Rayne
INTRODUCTION: Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation curriculum designed for low-resource settings. At the completion of the workshop, learners complete the following four assessments: a multiple-choice question (MCQ) test, bag-mask ventilation (BMV) checklist, and two objective structured clinical examinations (OSCEs). Objective structured clinical examinations are clinical performance assessments that evaluate learners' skills in simulated scenarios...
March 18, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28291092/measuring-patient-mobility-in-the-icu-using-a-novel-noninvasive-sensor
#16
Andy J Ma, Nishi Rawat, Austin Reiter, Christine Shrock, Andong Zhan, Alex Stone, Anahita Rabiee, Stephanie Griffin, Dale M Needham, Suchi Saria
OBJECTIVES: To develop and validate a noninvasive mobility sensor to automatically and continuously detect and measure patient mobility in the ICU. DESIGN: Prospective, observational study. SETTING: Surgical ICU at an academic hospital. PATIENTS: Three hundred sixty-two hours of sensor color and depth image data were recorded and curated into 109 segments, each containing 1,000 images, from eight patients. INTERVENTIONS: None...
April 2017: Critical Care Medicine
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
#17
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/28241211/families-as-partners-in-hospital-error-and-adverse-event-surveillance
#18
Alisa Khan, Maitreya Coffey, Katherine P Litterer, Jennifer D Baird, Stephannie L Furtak, Briana M Garcia, Michele A Ashland, Sharon Calaman, Nicholas C Kuzma, Jennifer K O'Toole, Aarti Patel, Glenn Rosenbluth, Lauren A Destino, Jennifer L Everhart, Brian P Good, Jennifer H Hepps, Anuj K Dalal, Stuart R Lipsitz, Catherine S Yoon, Katherine R Zigmont, Rajendu Srivastava, Amy J Starmer, Theodore C Sectish, Nancy D Spector, Daniel C West, Christopher P Landrigan, Brenda K Allair, Claire Alminde, Wilma Alvarado-Little, Marisa Atsatt, Megan E Aylor, James F Bale, Dorene Balmer, Kevin T Barton, Carolyn Beck, Zia Bismilla, Rebecca L Blankenberg, Debra Chandler, Amanda Choudhary, Eileen Christensen, Sally Coghlan-McDonald, F Sessions Cole, Elizabeth Corless, Sharon Cray, Roxi Da Silva, Devesh Dahale, Benard Dreyer, Amanda S Growdon, LeAnn Gubler, Amy Guiot, Roben Harris, Helen Haskell, Irene Kocolas, Elizabeth Kruvand, Michele Marie Lane, Kathleen Langrish, Christy J W Ledford, Kheyandra Lewis, Joseph O Lopreiato, Christopher G Maloney, Amanda Mangan, Peggy Markle, Fernando Mendoza, Dale Ann Micalizzi, Vineeta Mittal, Maria Obermeyer, Katherine A O'Donnell, Mary Ottolini, Shilpa J Patel, Rita Pickler, Jayne Elizabeth Rogers, Lee M Sanders, Kimberly Sauder, Samir S Shah, Meesha Sharma, Arabella Simpkin, Anupama Subramony, E Douglas Thompson, Laura Trueman, Tanner Trujillo, Michael P Turmelle, Cindy Warnick, Chelsea Welch, Andrew J White, Matthew F Wien, Ariel S Winn, Stephanie Wintch, Michael Wolf, H Shonna Yin, Clifton E Yu
Importance: Medical errors and adverse events (AEs) are common among hospitalized children. While clinician reports are the foundation of operational hospital safety surveillance and a key component of multifaceted research surveillance, patient and family reports are not routinely gathered. We hypothesized that a novel family-reporting mechanism would improve incident detection. Objective: To compare error and AE rates (1) gathered systematically with vs without family reporting, (2) reported by families vs clinicians, and (3) reported by families vs hospital incident reports...
April 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28230578/essential-and-nonessential-blood-testing-in-the-clinical-teaching-unit
#19
Cody Sherren, Andrew Day, Roy Ilan
OBJECTIVES: The aim of the study was to evaluate the essential and nonessential blood tests ordered on the internal medicine clinical teaching units (CTUs) at Kingston General Hospital. Our aim was to establish a baseline performance measure identifying appropriate use of laboratory tests that could be used to inform improvement over time. METHODS: For an 8-week period, 14 CTU attending physicians at Kingston General Hospital were surveyed. They were asked for each of their patients, "What blood tests do you consider to be essential for tomorrow morning to maintain appropriate care for this patient?" The following day, blood tests that were ordered were compared with the "essential" list previously given by the attending physicians...
February 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28224348/a-need-to-reconsider-guidelines-on-management-of-primary-spontaneous-pneumothorax
#20
Jiyoon Yoon, Parthipan Sivakumar, Kevin O'Kane, Liju Ahmed
BACKGROUND: The key guidelines in the management of primary spontaneous pneumothorax (PSP) include the 2010 British Thoracic Society (BTS) Pleural Disease guideline and 2001 American College of Chest Physicians (ACCP) Consensus Statement. Current recommendations are dependent on radiographic measures which differ between these two guidelines. The aim of this study is to compare size classification of PSP cases, according to BTS and ACCP guidelines, and to evaluate guideline compliance...
December 2017: International Journal of Emergency Medicine
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