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Hospitalists Are Frontline Providers in Treating Venous Thromboembolism
March 3, 2015
Nearly half of all venous thromboembolism (VTE) events occur during or soon after hospitalizations.1 And who are the frontline providers diagnosing and managing VTE in the inpatient setting? “While VTE may not be the No.
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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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Children with Acute Hematogenous Osteomyelitis Have Similar Outcomes When Discharged with Oral Antibiotics versus Prolonged IV Antibiotics and Escape PICC Complications
March 3, 2015
Clinical question: After hospitalization for acute hematogenous osteomyelitis (AHOM), do children discharged with oral antibiotics have similar clinical outcomes compared to those discharged with home IV antibiotics? Background: AHOM occurs in one in 5,000 children yearly and makes up approximate
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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
