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https://www.readbyqxmd.com/read/28532613/the-practice-of-evidence-based-medicine-involves-the-care-of-whole-persons
#1
W Scott Richardson
In this issue of the Journal, Dr. Fava posits that evidence-based medicine (EBM) was bound to fail. I share some of the concerns he expresses, yet I see more reasons for optimism. Having been on rounds with both Drs. Engel and Sackett, I reckon they would have agreed more than they disagreed. Their central teaching was the compassionate and well-informed care of sick persons. The model that emerged from these rounds was that patient care could be both person-centered and evidence-based, that clinical judgment was essential to both, and the decisions could and should be shared...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28481831/outcome-of-pediatric-critical-care-medicine-abstracts-presented-at-north-american-academic-national-meetings
#2
Sonali Basu, Murray M Pollack
OBJECTIVES: Pediatric critical care medicine abstracts presented at North American national academic meetings have not been followed up to determine their publication outcomes. Our objective was to determine the following: 1) the proportion of these presentations that are published in peer-reviewed journals within 5 years; 2) the impact of trainee status on time to and success of publication; and 3) the quality of the research as reflected in the publishing journal's impact factor. DESIGN: Four years of abstracts (2007-2011) were reviewed from the American Academy of Pediatrics, Pediatric Academic Societies, and Society of Critical Care Medicine national meetings...
May 5, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28424835/-future-of-emergency-medicine-in-germany-2-0
#3
REVIEW
A Gries, M Bernhard, M Helm, J Brokmann, J-T Gräsner
In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment...
April 19, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28411354/preventing-the-complications-associated-with-the-use-of-dermal-fillers-in-facial-aesthetic-procedures-an-expert-group-consensus-report
#4
REVIEW
Fernando Urdiales-Gálvez, Nuria Escoda Delgado, Vitor Figueiredo, José V Lajo-Plaza, Mar Mira, Francisco Ortíz-Martí, Rosa Del Rio-Reyes, Nazaret Romero-Álvarez, Sofía Ruiz Del Cueto, María A Segurado, Cristina Villanueva Rebenaque
BACKGROUND: The use of dermal fillers in minimally invasive facial aesthetic procedures has become increasingly popular of late, yet as the indications and the number of procedures performed increase, the number of complications is also likely to increase. Paying special attention to specific patient characteristics and to the technique used can do much to avoid these complications. Indeed, a well-trained physician can also minimize the impact of such problems when they do occur. METHODS: A multidisciplinary group of experts in aesthetic treatments reviewed the main factors associated with the complications that arise when using dermal fillers...
April 14, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28411289/evaluating-automated-rules-for-rapid-response-system-alarm-triggers-in-medical-and-surgical-patients
#5
Santiago Romero-Brufau, Bruce W Morlan, Matthew Johnson, Joel Hickman, Lisa L Kirkland, James M Naessens, Jeanne Huddleston
BACKGROUND: The use of rapid response systems (RRS), which were designed to bring clinicians with critical care expertise to the bedside to prevent unnecessary deaths, has increased. RRS rely on accurate detection of acute deterioration events. Early warning scores (EWS) have been used for this purpose but were developed using heterogeneous populations. Predictive performance may differ in medical vs surgical patients. OBJECTIVE: To evaluate the performance of published EWS in medical vs surgical patient populations...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28384249/a-systematically-structured-review-of-biomarkers-of-dying-in-cancer-patients-in-the-last-months-of-life-an-exploration-of-the-biology-of-dying
#6
Victoria Louise Reid, Rachael McDonald, Amara Callistus Nwosu, Stephen R Mason, Chris Probert, John E Ellershaw, Séamus Coyle
BACKGROUND: The Neuberger review made a number of recommendations to improve end of life care, including research into the biology of dying. An important aspect of the biology of dying is the identification of biomarkers as indices of disease processes. Biomarkers have the potential to inform the current, limited understanding of the dying process and assist clinicians in recognising dying, in particular how to distinguish dying from reversible acute deterioration. OBJECTIVES: To critically appraise the literature on biological factors that may be used as prognostic indicators in advanced cancer patients and to identify candidate biomarkers of the dying process that can be measured serially in cancer patients' bodily fluids...
2017: PloS One
https://www.readbyqxmd.com/read/28315043/the-intensive-care-medicine-clinical-research-agenda-in-paediatrics
#7
REVIEW
Mark J Peters, Andrew Argent, Marino Festa, Stéphane Leteurtre, Jefferson Piva, Ann Thompson, Douglas Willson, Pierre Tissières, Marisa Tucci, Jacques Lacroix
BACKGROUND: Intensive Care Medicine set us the task of outlining a global clinical research agenda for paediatric intensive care (PIC). In line with the clinical focus of this journal, we have limited this to research that may directly influence patient care. METHODS: Clinician researchers from PIC research networks of varying degrees of formality from around the world were invited to answer two main questions: (1) What have been the major recent advances in paediatric critical care research? (2) What are the top 10 studies for the next 10 years? RESULTS: (1) Inclusive databases are well established in many countries...
March 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28125823/effect-of-a-handover-tool-on-efficiency-of-care-and-mortality-for-interhospital-transfers
#8
Cecelia N Theobald, Neesha N Choma, Jesse M Ehrenfeld, Stephan Russ, Sunil Kripalani
BACKGROUND: Interhospital transfer is frequent, and transferred patients experience delays in the provision of care and higher mortality rates when compared to patients directly admitted. The interhospital handover is a key opportunity to improve care but has not been evaluated. OBJECTIVE: To determine the effect of a universal handover tool on timeliness of care, length of stay (LOS), and mortality among interhospital transfer patients. DESIGN, SETTING, AND PATIENTS: Retrospective cohort of patients transferred to an academic medical center between July 1, 2009 and December 31, 2010 with interrupted time-series design...
January 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28116010/an-analysis-of-the-top-cited-articles-in-emergency-medicine-education-literature
#9
Brendan W Munzer, Jeffery Love, Barbara L Shipman, Brendan Byrne, Stephen J Cico, Robert Furlong, Sorabh Khandelwal, Sally A Santen
INTRODUCTION: Dissemination of educational research is critical to improving medical education, promotion of faculty and ultimately patient care. The objective of this study was to identify the top 25 cited education articles in the emergency medicine (EM) literature and the top 25 cited EM education articles in all journals, as well as report on the characteristics of the articles. METHODS: Two searches were conducted in the Web of Science in June 2016 using a list of education-related search terms...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28109324/reporting-of-critical-care-trial-abstracts-a-comparison-before-and-after-the-announcement-of-consort-guideline-for-abstracts
#10
Akira Kuriyama, Naomi Takahashi, Takeo Nakayama
BACKGROUND: An extension of the Consolidated Standards of Reporting Trials (CONSORT) statement provides a checklist of items to improve the reporting quality of abstracts of randomized controlled trials (RCTs). However, authors of abstracts in some fields have poorly adhered to this guideline. We did an extensive literature survey to examine the quality of reporting trial abstracts in major critical care journals before and after announcement of the CONSORT guideline for abstracts. METHODS: We reviewed abstracts of RCTs published in four major critical care journals with publication dates ranging from 2006 to 2007 (pre-CONSORT) and from 2011 to 2012 (post-CONSORT): Intensive Care Medicine (ICM), Critical Care (CC), American Journal of Respiratory and Critical Care Medicine (AJRCCM), and Critical Care Medicine (CCM)...
January 21, 2017: Trials
https://www.readbyqxmd.com/read/27977013/acupuncture-in-the-neonatal-intensive-care-unit-using-ancient-medicine-to-help-today-s-babies-a-review
#11
K L Chen, I Quah-Smith, G M Schmölzer, R Niemtzow, J L Oei
Acupuncture has been used for thousands of years in Eastern medicine for a variety of conditions and illnesses, including pain. Neonatal intensive care, on the other hand, is a relatively new branch of medicine that has emerged as the pivotal influence in increasing survival of critically ill newborn infants only within the last 50 years. Unfortunately, pain is an inevitable part of treatment in a neonatal intensive care unit (NICU). The control and prevention of pain remains a major issue for clinicians despite recognition and understanding of the myriad of short- and long-term problems that are associated with both pain and its treatment within the NICU environment...
December 15, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27925423/the-johns-hopkins-venous-thromboembolism-collaborative-multidisciplinary-team-approach-to-achieve-perfect-prophylaxis
#12
REVIEW
Michael B Streiff, Brandyn D Lau, Deborah B Hobson, Peggy S Kraus, Kenneth M Shermock, Dauryne L Shaffer, Victor O Popoola, Jonathan K Aboagye, Norma A Farrow, Paula J Horn, Hasan M Shihab, Peter J Pronovost, Elliott R Haut
Venous thromboembolism (VTE) is an important cause of preventable harm in hospitalized patients. The critical steps in delivery of optimal VTE prevention care include (1) assessment of VTE and bleeding risk for each patient, (2) prescription of risk-appropriate VTE prophylaxis, (3) administration of risk-appropriate VTE prophylaxis in a patient-centered manner, and (4) continuously monitoring outcomes to identify new opportunities for learning and performance improvement. To ensure that every hospitalized patient receives VTE prophylaxis consistent with their individual risk level and personal care preferences, we organized a multidisciplinary task force, the Johns Hopkins VTE Collaborative...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27925422/preventing-hospital-acquired-venous-thromboembolism-improving-patient-safety-with-interdisciplinary-teamwork-quality-improvement-analytics-and-data-transparency
#13
REVIEW
Anneliese M Schleyer, Ellen Robinson, Roxana Dumitru, Mark Taylor, Kimberly Hayes, Ronald Pergamit, Daphne M Beingessner, Mark C Zaros, Joseph Cuschieri
BACKGROUND: Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. OBJECTIVE: To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27923680/the-100-most-cited-manuscripts-in-emergency-abdominal-surgery-a-bibliometric-analysis
#14
Thomas Ellul, Nicholas Bullock, Tarig Abdelrahman, Arfon G M T Powell, Jolene Witherspoon, Wyn G Lewis
BACKGROUND: The number of citations a scientific article receives provides a good indication of its impact within any given field. This bibliometric analysis aimed to identify the 100 most cited articles in Emergency Abdominal Surgery (EAS), to highlight key areas of interest and identify those that have most significantly shaped contemporary clinical practice in this newly evolving surgical specialty. This is of increasing relevance as concerns grow regarding the variable and suboptimal outcomes in Emergency General Surgery...
January 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/27818329/liberation-from-mechanical-ventilation-in-critically-ill-adults-executive-summary-of-an-official-american-college-of-chest-physicians-american-thoracic-society-clinical-practice-guideline
#15
Gregory A Schmidt, Timothy D Girard, John P Kress, Peter E Morris, Daniel R Ouellette, Waleed Alhazzani, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miguel Ferrer, Gilles L Fraser, Michelle Ng Gong, Catherine L Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, William D Schweickert, Curtis N Sessler, Thomas Strøm, Kevin C Wilson, Jonathon D Truwit
BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and the American College of Chest Physicians (CHEST). METHODS: A multidisciplinary panel posed six clinical questions in a population, intervention, comparator, outcomes (PICO) format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach...
January 2017: Chest
https://www.readbyqxmd.com/read/27805800/early-detection-prevention-and-mitigation-of-critical-illness-outside-intensive-care-settings
#16
Gabriel J Escobar, R Phillip Dellinger
Patients who deteriorate outside the intensive care unit (ICU) are known to have elevated mortality and morbidity. Rapid response teams (RRTs) were developed to address such deterioration. It has not been possible to establish that RRTs employing manual detection methods have definitively improved hospital outcomes. Because of this, automated early detection systems based on data from modern electronic medical records have been developed. This article attempts to establish a conceptual framework for early detection, prevention, and mitigation of critical illness in hospitalized patients outside the ICU...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27805799/early-detection-of-critical-illness-outside-the-intensive-care-unit-clarifying-treatment-plans-and-honoring-goals-of-care-using-a-supportive-care-team
#17
Russ Granich, Zoe Sutton, Yan S Kim, Megan Anderson, Helen Wood, John E Scharf, Arona Ragins, Gabriel J Escobar
Given the high mortality experienced by patients who deteriorate outside the intensive care unit, issues related to patient preferences around escalation of care are common. However, the literature on early warning systems (EWSs) provides limited information on how respecting patient preferences can be incorporated into clinical workflows. In this report, we describe how we developed workflows for integrating supportive care with an automated EWS in the context of a 2-hospital pilot. We used the Institute for Healthcare Improvement's Plan-Do-Study-Act approach to achieve consensus with clinicians and administrators...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27805797/data-that-drive-closing-the-loop-in-the-learning-hospital-system
#18
Vincent X Liu, John W Morehouse, Jennifer M Baker, John D Greene, Patricia Kipnis, Gabriel J Escobar
The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture to drive improvements in the quality of health care. The inpatient setting, one of the most costly and impactful domains of healthcare, is an ideal setting in which to use data and information technology to foster continuous learning and quality improvement. The rapid digitization of inpatient medicine offers incredible new opportunities to use data from routine care to generate new discovery and thus close the virtuous cycle of learning...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27781970/sgem-hot-off-the-press-ultrasound-during-critical-care-simulation-a-randomized-crossover-study
#19
Paul McKenna, Brent Thoma, Ken Milne, Chris Bond
As part of the Canadian Journal of Emergency Medicine's (CJEM) developing social media strategy, 1 we are collaborating with the Skeptics' Guide to Emergency Medicine (SGEM) to summarize and critically appraise the current emergency medicine (EM) literature using evidence-based medicine principles. In the "Hot Off the Press" series, we select original research manuscripts published in CJEM to be featured on the SGEM website/podcast 2 and discussed by the study authors and the online EM community. A similar collaboration is underway between the SGEM and Academic Emergency Medicine...
January 2017: CJEM
https://www.readbyqxmd.com/read/27762608/official-executive-summary-of-an-american-thoracic-society-american-college-of-chest-physicians-clinical-practice-guideline-liberation-from-mechanical-ventilation-in-critically-ill-adults
#20
Gregory A Schmidt, Timothy D Girard, John P Kress, Peter E Morris, Daniel R Ouellette, Waleed Alhazzani, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miguel Ferrer, Gilles L Fraser, Michelle Ng Gong, Catherine L Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, William D Schweickert, Curtis N Sessler, Thomas Strøm, Kevin C Wilson, Jonathon D Truwit
BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society and the American College of Chest Physicians. METHODS: A multidisciplinary panel posed six clinical questions in a Population, Intervention, Comparator, and Outcomes format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the certainty in the evidence (i...
January 1, 2017: American Journal of Respiratory and Critical Care Medicine
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