News
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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New Guidelines for Platelet Transfusions in Adults
March 3, 2015
Clinical question: What is the recommended approach to platelet transfusion in several common clinical scenarios? Background: The AABB (formerly American Association of Blood Banks) developed these guidelines from a recent systematic review on platelet transfusion. Synopsis: One strong recomme
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Shorter Treatment for Vertebral Osteomyelitis May Be as Effective as Longer Treatment
March 3, 2015
Clinical question: Is a six-week regimen of antibiotics as effective as a 12-week regimen in the treatment of vertebral osteomyelitis? Background: The optimal duration of antibiotic treatment for vertebral osteomyelitis is unknown.
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Hospitals Launch Bedside Procedure Services
March 3, 2015
A dedicated procedure team or service can give hospitals needed expertise without requiring a one-size-fits-all approach.
