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https://www.readbyqxmd.com/read/29667126/treatment-of-submassive-and-massive-pulmonary-embolism-a-clinical-practice-survey-from-the-second-annual-meeting-of-the-pulmonary-embolism-response-team-consortium
#1
Thomas M Todoran, Jay Giri, Geoffrey D Barnes, Rachel P Rosovsky, Yuchiao Chang, Michael R Jaff, Kenneth Rosenfield, Christopher Kabrhel
There is a paucity of robust clinical trial data to guide the treatment of acute pulmonary embolism (PE) thus the clinical guidelines rely heavily on expert opinion. Pulmonary Embolism Response Teams (PERT) have been developed to streamline the care of patients with acute PE. We conducted a survey among 100 experts in the field of PE during the second annual meeting of the PERT Consortium. Respondents were queried with respect to their demographic information, clinical practice questions and clinical vignettes...
April 17, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29667017/underestimated-prevalence-of-heart-failure-in-hospital-inpatients-a-comparison-of-icd-codes-and-discharge-letter-information
#2
Mathias Kaspar, Georg Fette, Gülmisal Güder, Lea Seidlmayer, Maximilian Ertl, Georg Dietrich, Helmut Greger, Frank Puppe, Stefan Störk
BACKGROUND: Heart failure is the predominant cause of hospitalization and amongst the leading causes of death in Germany. However, accurate estimates of prevalence and incidence are lacking. Reported figures originating from different information sources are compromised by factors like economic reasons or documentation quality. METHODS: We implemented a clinical data warehouse that integrates various information sources (structured parameters, plain text, data extracted by natural language processing) and enables reliable approximations to the real number of heart failure patients...
April 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29650707/errors-in-electronic-health-record-based-data-query-of-statin-prescriptions-in-patients-with-coronary-artery-disease-in-a-large-academic-multispecialty-clinic-practice
#3
Eric Y Shin, Patricia Ochuko, Kunal Bhatt, Brian Howard, Gerard McGorisk, Linda Delaney, Kristan Langdon, Marjan Khosravanipour, Andiran A Nambi, Allison Grahovec, Douglas C Morris, Penny Z Castellano, Leslee J Shaw, Laurence S Sperling, Abhinav Goyal
BACKGROUND: With the recent implementation of the Medicare Quality Payment Program, providers face increasing accountability for delivering high-quality care. Such pay-for-performance programs aim to leverage systematic data captured by electronic health record (EHR) systems to measure performance; however, the fidelity of EHR query for assessing performance has not been validated compared with manual chart review. We sought to determine whether our institution's methodology of EHR query could accurately identify cases in which providers failed to prescribe statins for eligible patients with coronary artery disease...
April 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29630159/growth-of-mobile-applications-in-dermatology-2017-update
#4
Hania K Flaten, Chelsea St Claire, Emma Schlager, Cory A Dunnick, Robert P Dellavalle
BACKGROUND: More than 80% of households in the US have a smartphone. Growth of mobile applications (apps) has grown in parallel with access to smartphones. Mobile health apps are used in medical fields, including dermatology. These apps allow patients to access information regarding dermatology conditions as well as access physicians via teledermatology. PURPOSE: To analyze changes in number of dermatology mobile apps since 2014 and discuss benefits and drawbacks of mobile application growth to dermatology...
February 15, 2018: Dermatology Online Journal
https://www.readbyqxmd.com/read/29618105/physician-time-burden-associated-with-querying-prescription-drug-monitoring-programs
#5
Marcus A Bachhuber, Brendan Saloner, Marc LaRochelle, Jessica S Merlin, Brandon C Maughan, Dan Polsky, Naum Shaparin, Sean M Murphy
Objective: Prescription drug monitoring programs (PDMPs) enable prescribers to review patient prescription histories, and their use is mandatory in many states. We estimated the cost of physicians retrieving PDMP patient reports compared with a model where a delegate (i.e., administrative staff) retrieves reports. Methods: We performed a cost analysis with a one-year time horizon, from the perspective of physicians' employers. We obtained specialty-specific estimates of controlled substance prescribing frequency from the National Ambulatory Medical Care Survey, 2012-2014...
March 30, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29615376/the-22-modifier-in-reimbursement-for-orthopedic-procedures-hip-arthroplasty-and-obesity-are-worth-the-effort
#6
Eric L Smith, David J Tybor, Hayley D Daniell, Laura A Naccarato, Mary E Pevear, Charles Cassidy
BACKGROUND: Orthopedic surgeons utilize the 22-modifier when billing for complex procedures under the American Medical Association's Current Procedural Terminology (CPT) for reasons such as excessive blood loss, anatomic abnormality, and morbid obesity, cases that would ideally be reimbursed at a higher rate to compensate for additional physician work and time. We investigated how the 22-modifier affects physician reimbursement in knee and hip arthroplasty. METHODS: We queried hospital billing data from 2009 to 2016, identifying all cases performed at our urban tertiary care orthopedic center for knee arthroplasty (CPT codes 27438, 27447, 27487, and 27488) and hip arthroplasty (CPT codes 27130, 27132, 27134, 27236)...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29608412/physicians-report-adopting-safer-opioid-prescribing-behaviors-after-academic-detailing-intervention
#7
Mary Jo Larson, Cheryl Browne, Ruslan V Nikitin, Nikki R Wooten, Sarah Ball, Rachel Sayko Adams, Kelly Barth
Background This study evaluated an educational intervention intended to increase physicians' use of patient prescription history information from the state prescription monitoring program (PMP) and their adoption of clinical behaviors consistent with opioid prescription guidelines to reduce patient risk. Methods Physician volunteers (n = 87) in community practices and Veterans Administration medical settings in South Carolina received an office-based, individualized, educational intervention (Academic Detailing) from a trained pharmacist who promoted three key messages about safer opioid prescribing...
April 2, 2018: Substance Abuse
https://www.readbyqxmd.com/read/29605976/clinical-practice-guidelines-for-irritable-bowel-syndrome-in-korea-2017-revised-edition
#8
REVIEW
Kyung Ho Song, Hye-Kyung Jung, Hyun Jin Kim, Hoon Sup Koo, Yong Hwan Kwon, Hyun Duk Shin, Hyun Chul Lim, Jeong Eun Shin, Sung Eun Kim, Dae Hyeon Cho, Jeong Hwan Kim, Hyun Jung Kim
In 2011, the Korean Society of Neurogastroenterology and Motility (KSNM) published clinical practice guidelines on the management of irritable bowel syndrome (IBS) based on a systematic review of the literature. The KSNM planned to update the clinical practice guidelines to support primary physicians, reduce the socioeconomic burden of IBS, and reflect advances in the pathophysiology and management of IBS. The present revised version of the guidelines is in continuity with the previous version and targets adults diagnosed with, or suspected to have, IBS...
April 30, 2018: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/29595721/trends-in-physician-payments-for-breast-reconstruction
#9
Clifford C Sheckter, Day Yi, Hina J Panchal, Shantanu N Razdan, Andrea L Pusic, Colleen M McCarthy, Peter G Cordeiro, Joseph J Disa, Babak Mehrara, Evan Matros
BACKGROUND: Prosthetic breast reconstruction rates have risen in the United States, whereas autologous techniques have stagnated. Meanwhile, single-institution data demonstrate that physician payments for prosthetic reconstruction are rising, while payments for autologous techniques are unchanged. This study aims to assess payment trends and variation for tissue expander and free flap breast reconstruction. METHODS: The Blue Health Intelligence database was queried from 2009 to 2013, identifying women with claims for breast reconstruction...
April 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29558879/geographic-distance-from-transplant-center-does-not-impact-pediatric-heart-transplant-outcomes
#10
Meghann McKane, Debra A Dodd, Bret A Mettler, Kari A Wujcik, Justin Godown
BACKGROUND: Many pediatric heart transplant recipients live a significant distance from their transplant center. This results in families either traveling long distances or relying on outside physicians to assume aspects of their care. Distance has been implicated to play a role in congenital heart disease outcomes, but its impact on heart transplantation has not been reported. The aim of this study was to assess the impact of distance on pediatric heart transplant outcomes. METHODS: The Scientific Registry of Transplant Recipients database was queried for all pediatric heart transplant recipients from large US children's hospitals (1987-2014)...
January 1, 2018: Progress in Transplantation
https://www.readbyqxmd.com/read/29523475/survey-on-the-contemporary-management-of-intraoperative-urethral-injuries-during-penile-prosthesis-implantation
#11
Stephanie J Sexton, Michael A Granieri, Aaron C Lentz
BACKGROUND: Intraoperative urethral injury is an uncommon event during the placement of a penile prosthesis, and alternative management strategies have been proposed with continuation of implantation after urethral injury. AIM: To evaluate surgeon practices in the management of intraoperative urethral injury. METHODS: An online survey was sent to the society listservs of the Genitourinary Reconstructive Surgeons (GURS) and the Sexual Medicine Society of North America (SMSNA)...
March 6, 2018: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29520747/physicians-perspectives-regarding-prescription-drug-monitoring-program-use-within-the-department-of-veterans-affairs-a-multi-state-qualitative-study
#12
Thomas R Radomski, Felicia R Bixler, Susan L Zickmund, KatieLynn M Roman, Carolyn T Thorpe, Jennifer A Hale, Florentina E Sileanu, Leslie R M Hausmann, Joshua M Thorpe, Katie J Suda, Kevin T Stroupe, Adam J Gordon, Chester B Good, Michael J Fine, Walid F Gellad
BACKGROUND: The Department of Veterans Affairs (VA) has implemented robust strategies to monitor prescription opioid dispensing, but these strategies have not accounted for opioids prescribed by non-VA providers. State-based prescription drug monitoring programs (PDMPs) are a potential tool to identify VA patients' receipt of opioids from non-VA prescribers, and recent legislation requires their use within VA. OBJECTIVE: To evaluate VA physicians' perspectives and experiences regarding use of PDMPs to monitor Veterans' receipt of opioids from non-VA prescribers...
March 8, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29505701/telediagnosis-of-oral-lesions-in-primary-care-the-estomatonet-program
#13
Vinicius Coelho Carrard, Michelle Roxo Gonçalves, Jéssica Rodriguez Strey, Carlos Pilz, Marco Antonio Trevizani Martins, Manoela Domingues Martins, Carlos Aita Schmitz, Rafael Gustavo Dal Moro, Otávio Pereira D'Ávila, Dimitris Rucks Varvaki Rados, Erno Harzheim, Marcelo Rodrigues Gonçalves
OBJECTIVE: The diagnosis of oral lesions are often challenging for primary health care providers, which explains the high number of referrals to specialist care. This favors increases in waiting lines and delays in diagnosis, contributing to high mortality rates from oral cancer. This study aimed to summarize the experience of the EstomatoNet, a telediagnosis program catering to primary care dentists and physicians from southern Brazil. STUDY DESIGN: This exploratory study included all queries received by EstomatoNet from June/2015 to December/2016...
March 5, 2018: Oral Diseases
https://www.readbyqxmd.com/read/29498155/effect-of-a-data-driven-intervention-on-opioid-prescribing-intensity-among-emergency-department-providers-a-randomized-controlled-trial
#14
Sean S Michael, Kavita M Babu, Christopher Androski, Martin A Reznek
OBJECTIVE: Little is known about accuracy of provider self-perception of opioid prescribing. We hypothesized that an intervention asking emergency department (ED) providers to self-identify their opioid prescribing practices compared to group norms-and subsequently providing them with their actual prescribing data-would alter future prescribing compared to controls. METHODS: This was a prospective, multi-center randomized trial in which all attending physicians, residents, and advanced practice providers at four EDs were randomly assigned to either no intervention or a brief data-driven intervention during which providers were: (1) asked to self-identify and explicitly report to research staff their perceived opioid prescribing in comparison to their peers, and then (2) given their actual data with peer group norms for comparison...
March 2, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29463355/prototype-development-of-a-tradespace-analysis-tool-for-spaceflight-medical-resources
#15
Erik L Antonsen, Robert A Mulcahy, David Rubin, Rebecca S Blue, Michael A Canga, Ronak Shah
INTRODUCTION: The provision of medical care in exploration-class spaceflight is limited by mass, volume, and power constraints, as well as limitations of available skillsets of crewmembers. A quantitative means of exploring the risks and benefits of inclusion or exclusion of onboard medical capabilities may help to inform the development of an appropriate medical system. A pilot project was designed to demonstrate the utility of an early tradespace analysis tool for identifying high-priority resources geared toward properly equipping an exploration mission medical system...
February 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29462083/tourniquet-usage-in-pre-hospital-care-and-resuscitation-of-pediatric-trauma-patients-pediatric-trauma-society-position-statement
#16
Aaron Cunningham, Marc Auerbach, Mark Cicero, Mubeen Jafri
BACKGROUND: Recent mass casualty events in the United States have highlighted the need for public preparedness to prevent death from uncontrolled hemorrhage. The Pediatric Trauma Society (PTS) reviewed the literature regarding pediatric tourniquet usage with the aim to provide recommendations about the utility of this adjunct for hemorrhage control in children. METHODS: Search terms "pediatric" and "tourniquet" were used to query the US National Library of Medicine National Institutes of Health for pertinent literature...
February 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29456375/assessment-of-queries-received-by-the-drug-information-center-at-king-saud-medical-city
#17
Dlal Abdulrahman Almazrou, Sheraz Ali, Jasser Ali Alzhrani
Background: The complexity of drug therapies has increased the need to evaluate the drug information scientifically. In this regard, the aim of drug information centers (DICs) is to promote rational use of drugs in a health-care setting. DI pharmacists play a vital role in providing the necessary and reliable information on drugs to promote the concept of rational drug use, eventually leading to a better patient outcome. The objective of the present study was to assess the drug-related queries received by the DIC at the King Saud Medical City (KSMC) from health-care professionals working in a large tertiary care setting...
October 2017: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/29435118/assessment-of-folate-receptor-alpha-and-beta-expression-in-selection-of-lung-and-pancreatic-cancer-patients-for-receptor-targeted-therapies
#18
Jiayin Shen, Yingwen Hu, Karson S Putt, Sunil Singhal, Haiyong Han, Daniel W Visscher, Linda M Murphy, Philip S Low
A number of folate receptor (FR) targeted small molecular drugs and monoclonal antibodies have been introduced into clinical trials to treat FR positive cancers. Because the therapeutic efficacy of these drugs depends prominently on the level of FR-α expression on the cancer cells, patients have been commonly selected for FR-targeted therapies based on the intensity of a folate-targeted radioimaging agent. Unfortunately, uptake of such imaging agents can be mediated by both major isoforms of the folate receptor, FR-α and FR-β...
January 12, 2018: Oncotarget
https://www.readbyqxmd.com/read/29409126/withdrawn-cranial-irradiation-for-preventing-brain-metastases-of-small-cell-lung-cancer-in-patients-in-complete-remission
#19
REVIEW
(no author information available yet)
BACKGROUND: Prophylactic cranial irradiation halves the rate of brain metastases in patients with small cell lung cancer. Individual randomized trials conducted on patients in complete remission were unable to clarify whether this treatment improves survival. OBJECTIVES: This study aims to test whether prophylactic cranial irradiation prolongs survival of patients with small cell lung cancer in complete remission. SEARCH METHODS: Published and unpublished trials were eligible...
February 6, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29397351/multidisciplinary-coordinated-care-for-type-2-diabetes-a-qualitative-analysis-of-patient-perspectives
#20
Seth A Berkowitz, Stephanie A Eisenstat, Lily S Barnard, Deborah J Wexler
AIMS: To explore the patient perspective on coordinated multidisciplinary diabetes team care among a socioeconomically diverse group of adults with type 2 diabetes. METHODS: Qualitative research design using 8 focus groups (n=53). We randomly sampled primary care patients with type 2 diabetes and conducted focus groups at their primary care clinic. Discussion prompts queried current perceptions of team care. Each focus group was audio recorded, transcribed verbatim, and independently coded by three reviewers...
January 31, 2018: Primary Care Diabetes
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