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Updated CHEST Guidelines for Antithrombotic Therapy of VTE
May 23, 2016
Clinical question: What are the current recommendations for antithrombotic therapy in various venous thromboembolism (VTE) scenarios? Background: VTE is commonly encountered with a multitude of therapeutic options.
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Tamsulosin Can Be Used as Expulsive Therapy for Some Ureteric Stones
May 23, 2016
Clinical question: Is tamsulosin efficacious as an expulsive therapy for distal ureter stones ≤10 mm in diameter? Background: Ureteric calculi are a common reason for hospital admission, and use of medical expulsive therapy during observation periods for small caliber stones has gained much atten
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Prevalence, Characteristics of Physicians Prone to Malpractice Claims
May 20, 2016
Clinical question: Do claim-prone physicians account for a substantial share of all paid malpractice claims? Background: Many studies have compared physicians who have multiple malpractice claims against them with colleagues who have few or no claims against them and have identified systemic diff
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Association of Frailty on One-Year Postoperative Mortality Following Major Elective Non-Cardiac Surgery
May 20, 2016
Clinical question: What is the association of preoperative frailty on one-year postoperative mortality? Background: Frailty is an aggregate expression of susceptibility to poor outcomes owing to age and disease-related deficits that accumulate with multiple domains.
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Should Patients Who Develop Postoperative Atrial Fibrillation Start Anticoagulation?
May 8, 2016
Case A 66-year-old man with diabetes mellitus type 2 and hypertension underwent left total knee replacement. Several hours after surgery, the patient developed atrial fibrillation (AF). He was asymptomatic, and reversible causes of AF were ruled out.
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Not All EDs Adopt Interventions to Improve Flow, Decrease Crowding
May 6, 2016
Clinical question: What is the relationship between crowding in the ED and the number of interventions adopted by the ED to address this? Background: ED crowding results in long waits, prolonged lengths of stay, and delays in providing treatments, which can result in adverse events.
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Close INR Monitoring Might Prevent Adverse Events
May 6, 2016
Clinical question: What is the appropriate frequency of INR monitoring in the hospital and its relationship to the risk of over-anticoagulation and warfarin-related adverse events? Background: Warfarin use is a common cause of adverse drug events in hospitalized patients due to narrow therapeutic
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Establishing a Role for Polysomnography in Hospitalized Children
May 2, 2016
Clinical question: What is the role for inpatient polysomnograms for children with medical complexity? [caption id="attachment_13645" align="alignright" width="150"] Dr. Stubblefield[/caption] Background: Sleep-disordered breathing is more common in certain pediatric populations.
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Physicians, Residents, Students Can Learn High-Value, Cost-Conscious Care
April 29, 2016
Clinical question: What are the factors that promote education in delivering high-value, cost-conscious care? Background: Healthcare costs are increasing, with most recent numbers showing U.S. expenditures on healthcare of more than $3 trillion, almost 18% of the gross domestic product.
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Data Show Patients Are More Likely to Die at Night, on Weekends
April 29, 2016
Clinical question: Is there a clinical difference in rates of return of spontaneous circulation (ROSC) and survival to discharge in patients with in-hospital cardiac arrest (IHCA) depending on time of day and day of the week? Background: Current U.S.