Adam Wachter, MD
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Better Reporting Needed to Accurately Estimate Medical Error as Cause of Death in U.S.
June 20, 2016
Clinical question: What is the contribution of hospital-based medical errors to national mortality in the U.S. compared to other causes listed by the Centers for Disease Control and Prevention (CDC)? Background: Medical error can contribute to patient mortality.
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Hospital Admission, Stroke Clinic Follow-up Improve Outcomes for Patients with Transient Ischemic Attack, Minor Ischemic Stroke
June 20, 2016
Clinical question: How do guideline-based care and outcomes of patients with transient ischemic attack (TIA) and minor ischemic stroke differ among patients admitted to the hospital and discharged from the ED, as well as in those referred versus not referred to stroke prevention clinics following di
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Left Atrial Appendage Closure Noninferior to Warfain for Cardioembolic Event Prophylaxis in Nonvalvular Afibrillation
March 3, 2015
Clinical question: Is mechanical, left atrial appendage (LAA) closure as effective as warfarin therapy in preventing cardioembolic events in patients with nonvalvular atrial fibrillation (Afib)? Background: Anticoagulation with warfarin has long been the standard therapy for prevention of thrombo
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Tramadol Associated with Increased Rate of Hypoglycemia
March 3, 2015
Clinical question: Does tramadol increase rates of hospitalization from hypoglycemia compared to other opioids? Background: As tramadol use has increased in the general population, there have been multiple reports of hypoglycemia after initiation of the painkiller, including in patients with no o
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Longer Surgeries Associated with Increased VTE Risk
March 3, 2015
Clinical question: Does duration of surgical procedure influence venous thromboembolism (VTE) risk? Background: The relationship between surgical procedure length and VTE risk has not been vigorously assessed, although it has been postulated that longer procedures are associated with increased VT
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Mortality, Readmission Rates Unchanged by Duty Hour Reforms
March 3, 2015
Clinical question: Did the 2011 Accreditation Council for Graduate Medical Education (ACGME) duty hour reforms change mortality rates or readmission rates at teaching hospitals? Background: The 2011 ACGME duty hour reforms maintained the 80-hour weekly work limit for medical residents, decreased
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Emergency Department Utilization May Be Lower for Attending-Only Physician Visits versus Supervised Visits
March 3, 2015
Clinical question: Does supervised learning in the ED lead to higher rates of resource utilization? Background: Care at academic medical centers might be more expensive than nonteaching hospitals because of the increased testing and resource utilization that occurs among learners.
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Physician Spending Habits During Residency Training Can Persist for Years
March 3, 2015
Clinical question: For primary care physicians (PCPs), does residency training area affect the pattern of physician spending after training is complete? Background: Regional and system-level variations in the intensity of medical services provided are common in the U.S.
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Malpractice Reform Does Not Change Physician Practice Patterns
March 3, 2015
Clinical question: Do malpractice reform policies shift physician practice patterns toward lower utilization of healthcare resources? Background: Physician-reported fears of lawsuits lead to defensive medicine practices, which contribute to high healthcare costs.
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Updated Guidelines for Management of Non-ST-Elevation Acute Coronary Syndrome
March 3, 2015
Clinical question: What is the recommended approach for management of non-ST-elevation acute coronary syndrome (NSTE-ACS)? Background: This is the first comprehensive update from the American Heart Association/American College of Cardiology (AHA/ACC) on NSTE-ACS since 2007 and follows a focused u