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Urinalysis Is Reliable Infection Predictor in Infants
October 6, 2015
Clinical question: In infants younger than three months of age with bacteremic urinary tract infection (UTI), how sensitive and specific are urinalysis (UA) findings? Background: Infants are commonly hospitalized with UTIs. The gold standard for diagnosis is considered to be urine culture.
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High-Flow Nasal Oxygen Therapy Noninferior to BiPAP in Post-Operative Respiratory Failure
October 6, 2015
Clinical question: In post-operative cardiothoracic surgery patients, is high-flow nasal oxygen therapy inferior to BiPAP for resolution of acute respiratory failure? Background: Acute respiratory failure is common following cardiothoracic surgery, and noninvasive ventilation often is used to avo
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Supplemental Oxygen During STEMI Might Increase Myocardial Injury
October 6, 2015
Clinical question: Does routine oxygen supplementation in patients with STEMI increase myocardial injury? Background: Because of physiologic and clinical studies conducted before the era of acute coronary intervention, supplemental oxygen routinely is administered to patients with STEMI, regardle
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Thrombectomy Within Eight Hours of Stroke Onset Reduces Post-Stroke Disability
October 6, 2015
Clinical question: Does thrombectomy, in conjunction with medical therapy, improve functional independence in patients with an acute proximal anterior stroke? Background: Revascularization of proximal anterior strokes with alteplase alone occurs less than 50% of the time.
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Interdisciplinary Team Care on General Medical Units Does Not Improve Patient Outcomes
October 6, 2015
Clinical question: Does interdisciplinary care on general medical wards improve patient outcomes? Background: Patients on general medical wards might experience errors and/or preventable deaths.
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Patient Satisfaction Scores, Objective Measures of Surgical Quality Have Positive Association
October 6, 2015
Clinical question: Is there an association between objective measures of surgical quality and patient satisfaction as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey? Background: The Centers for Medicare and Medicaid Services (CMS) has tied financi
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Extended Anticoagulation Therapy and Recurrent Rates of Venous Thromboembolism
October 6, 2015
Clinical question: Among patients with a first episode of unprovoked pulmonary embolism (PE), what are the benefits and harms of extending the duration of anticoagulation for secondary prophylaxis against recurrent VTE? Background: Optimal duration of anticoagulation after initial unprovoked PE i
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Wells Score Can’t Rule Out Deep Vein Thrombosis in Inpatient Setting
October 6, 2015
Clinical question: Should the Wells score be used for DVT risk stratification in the hospital? Background: The Wells score was derived to reduce lower extremity ultrasounds (LEUS) in the outpatient evaluation of DVTs.
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Antibiotic Therapy, Appendectomy for Uncomplicated Acute Appendicitis
October 6, 2015
Clinical question: Is antibiotic therapy noninferior to appendectomy for treatment of uncomplicated acute appendicitis? Background: Previous randomized clinical trials have compared antibiotic therapy versus appendectomy for the treatment of uncomplicated, acute appendicitis.
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Social, System Factors Can Influence Decisions to Continue Patient Care
October 6, 2015
Clinical question: Why do healthcare providers work while sick? Background: Healthcare providers generally are aware of the risks of infection to hospitalized patients; however, despite this knowledge, several studies have revealed providers continue to work while ill. Study design: Mixed-meth