Value-based Care
Choosing Wisely International Top 10 recommendations
3 Aug, 2017 | 14:01h | UTCChoosing Wisely: An International Campaign to Combat Overuse, with new Top 10 recommendations (free) (RT @ChooseWiselyCA and @CADTH_ACMTS see Tweet with infographic)
See more on the Choosing Wisely initiative in our April 5 issue (see #6)
Choosing Wisely has prioritized 10 recommendations for limiting overuse internationally.
Effectiveness of oral glucosamine for knee and hip osteoarthritis
3 Aug, 2017 | 14:03h | UTCSubgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trail bank – Annals of Rheumatic Diseases (link to abstract – $ for full-text) (RT @PhysioMeScience see Tweet)
“Currently, there is no good evidence to support the use of glucosamine for hip or knee OA”
Pushing Hospitals To Reduce Readmissions Hasn’t Increased Deaths
27 Jul, 2017 | 16:38h | UTCAssociation of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge – JAMA (link to abstract – $ for full-text)
Commentaries: Pushing Hospitals To Reduce Readmissions Hasn’t Increased Deaths – NPR (free) AND Reduction in Hospital Readmission Rate Not Associated With Increased Risk of Death Following Discharge – The JAMA Network (free) AND Lower Readmissions Not Linked to Post-Discharge Mortality Risk – MedPage Today (free registration required) AND Study: Reducing readmissions does not harm patients – Becker’s Hospital Review (free)
Witch Metrics in Hospital Quality Should Patients Pay Attention To?
25 Jul, 2017 | 00:45h | UTCWitch Metrics in Hospital Quality Should Patients Pay Attention To? – The New York Times (10 articles per month are free)
Reducing Smoking Rates for Patients Facing Surgery
25 Jul, 2017 | 00:35h | UTC2017 ACS Quality and Safety Conference: “Strong for Surgery” Shows Promise in Reducing Smoking Rates for Patients Facing Surgery – American College of Surgeons, via NewsWise (free)
“Study suggests big drop in smoking rates when surgeons help patients quit before their operations”.
Enhanced recovery pathway for colorectal surgical patients improves outcomes, reduces cost
25 Jul, 2017 | 00:10h | UTCAmerican College of Surgeons (ACS) 2017 Quality and Patient Safety Conference: Enhanced recovery pathway for colorectal surgical patients improves outcomes, reduces cost – ACS, via EurekAlert (free)
Related guideline: Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons (free)
See other Enhanced Recovery After Surgery (ERAS) Guidelines and Reviews in our collection and in the ERAS Society Website.
“Successful protocol shortens hospital stays, reduces patients’ risk of complications, and cuts costs up to $11,000 per procedure”
Surrogate endpoints in oncology: when are they acceptable for regulatory and clinical decisions, and are they currently overused?
23 Jul, 2017 | 19:41h | UTC
High-value care a focus at Hospital Medicine 2017
23 Jul, 2017 | 15:46h | UTCHigh-value care a focus at Hospital Medicine 2017 – ACP Internist (free)
What carcinoembryonic antigen level should trigger further investigation during colorectal cancer follow-up?
23 Jul, 2017 | 14:37h | UTCSource: ACP Journal Wise ($)
“The results suggest that (1) CEA testing should not be used alone as a triage test; (2) in year 1, testing frequency should be increased (to monthly for 3 months and then every 2 months); (3) the threshold for investigating a single test result should be raised to 10 µg/l; (4) after the second CEA test, decisions to investigate further should be made on the basis of the trend in CEA levels; (5) the optimal threshold for investigating the CEA trend falls over time; and (6) continuing smokers should not be monitored with CEA testing”.
Implant Survival After Minimally Invasive Anterior or Anterolateral Vs. Conventional Posterior or Direct Lateral Approach
23 Jul, 2017 | 13:01h | UTCImplant Survival After Minimally Invasive Anterior or Anterolateral Vs. Conventional Posterior or Direct Lateral Approach: An Analysis of 21,860 Total Hip Arthroplasties from the Norwegian Arthroplasty Register (2008 to 2013) – The Journal of Bone and Joint Surgery (link to abstract – $ for full-text)
Commentary: Implant survival for minimally invasive vs. open hip surgery: 4 key notes – Spine Review (free)
Source: EvidenceAlerts (free resource to find articles of interest in all specialties)
“There were no significant differences among the surgical approaches with regard to the 2 and 5-year survival rates or RR of revision due to any cause”
Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis
23 Jul, 2017 | 13:22h | UTCSource: ACP Journal Wise ($)
“A national screening programme for atrial fibrillation is likely to represent a cost-effective use of resources, with systematic opportunistic screening more likely to be cost-effective than systematic population screening”
Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults
23 Jul, 2017 | 12:53h | UTCSource: Video Laryngoscopy Does Not Improve First-Pass Success in ICU Patients – Journal Watch ($)
“The VL technique did not increase the first-attempt success rate during EI in ICU patients compared with DL. These findings do not support routine use of VL in ICU patients”.
Effectiveness of Pharmacist Intervention to Reduce Medication Errors and Health-Care Resources Utilization After Transitions of Care
22 Jul, 2017 | 20:16h | UTCEffectiveness of Pharmacist Intervention to Reduce Medication Errors and Health-Care Resources Utilization After Transitions of Care: A Meta-analysis of Randomized Controlled Trials – Journal of Patient Safety (link to abstract – $ for full-text)
Source: Hospital Medicine Virtual Journal Club (free resource to find articles of interest)
Pharmacist transition of care intervention seems to be an effective strategy to reduce medication errors after hospital discharge and to reduce subsequent emergency room visits.
An evidence-based, point-of-care tool to guide completion of asthma action plans in practice
22 Jul, 2017 | 21:03h | UTCRelated: Asthma self-management programmes can reduce unscheduled care – NIHR Signal (free) AND Original article: Systematic meta-review of supported self-management for asthma: a healthcare perspective – BMC Medicine (free)
Source: ACP Journal Wise ($ resource to find articles of interest)
“Researchers create practical algorithm for completing asthma action plans” (RT @PCRSUK see Tweet)
Laminar airflow in surgery might not reduce surgical site infections
21 Jul, 2017 | 18:18h | UTCLaminar airflow in surgery might not reduce surgical site infections – NIHR Signal (free)
Original article: Effect of laminar airflow ventilation on surgical site infections: a systematic review and meta-analysis – The Lancet Infectious Diseases (link to abstract – $ for full-text)
Hepatology: Five Things Physicians and Patients Should Question
21 Jul, 2017 | 00:26h | UTCNew Choosing Wisely Canada List: Hepatology: Five Things Physicians and Patients Should Question (free) (RT @ChooseWiselyCA see Tweet)
See more on the Choosing Wisely initiative in our April 5 issue (see #6).
American Society of Clinical Oncology Position Statement On Addressing the Affordability of Cancer Drugs
21 Jul, 2017 | 00:23h | UTCPosition statement: American Society of Clinical Oncology Position Statement On Addressing the Affordability of Cancer Drugs (free PDF)
Commentaries: ASCO Offers Path to Addressing Affordability of Cancer Drugs in New Position Statement – ASCO Post (free) AND ASCO Tackles Affordability of Cancer Drugs – Physician’s First Watch (free) AND ASCO Advocates Value in Drug Pricing – MedPage Today (free registration required) AND ASCO Addresses High Cost of Cancer Drugs – Medscape (free registration required)
Comprehensive geriatric assessment and optimization in vascular surgery
20 Jul, 2017 | 00:02h | UTCRandomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery – British Journal of Surgery (link to abstract – $ for full-text)
Source: ACP Journal Club ($ resource to find articles of interest)
In this RCT, a comprehensive preoperative geriatric assessment and optimization before vascular surgery was associated with shorter length of hospital stay, lower incidence of complications, and patients were less likely to be discharged to a higher level of dependency.
Predicting all-cause risk of 30-day hospital readmission using artificial neural networks
18 Jul, 2017 | 23:01h | UTCPredicting all-cause risk of 30-day hospital readmission using artificial neural networks – PLOS One (free)
Source: Hospital Medicine Virtual Journal Club (free resource to find articles of interest)
Editorial: WHO downgrades status of oseltamivir
16 Jul, 2017 | 12:45h | UTCEditorial: WHO downgrades status of oseltamivir – The BMJ (free)
“@WHO downgrades status of oseltamivir. BMJ editorial discusses important lessons from the Tamiflu story” (RT @bmj_latest see Tweet)
Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes
16 Jul, 2017 | 12:44h | UTCInsulin pumps not much better than multiple injections for intensive control of type 1 diabetes – NIHR Signal (free)
Original article: Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE) – The BMJ (free)
Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery
16 Jul, 2017 | 12:41h | UTCSee other Enhanced Recovery After Surgery (ERAS) Guidelines and Reviews in our collection and in the ERAS Society Website.
Surgery for early prostate cancer may not save lives
16 Jul, 2017 | 12:40h | UTCFollow-up of Prostatectomy versus Observation for Early Prostate Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Long-term, surgery for localized prostate cancer offers little extra benefit – Reuters (free) AND No Benefit with Surgery for Low-Risk Prostate Cancer – MedPage Today (free registration required) AND Prostatectomy for Localized Prostate Cancer Doesn’t Improve Long-Term Survival – Physician’s First Watch (free) AND Surgery for Early Prostate Cancer May Not Save Lives – Washington University in St. Louis, via NewsWise (free)
“Most men just as likely to survive with limited or no treatment” (from NewsWise)
Positive airway pressure doesn’t reduce cardiovascular events and death in adults with sleep apnea
12 Jul, 2017 | 15:01h | UTCAssociation of Positive Airway Pressure With Cardiovascular Events and Death in Adults With Sleep Apnea: A Systematic Review and Meta-analysis – JAMA (link to abstract – $ for full-text)
Commentaries: More Doubt Cast on CPAP for Reducing CVD Risk in Sleep Apnea Patients – MedPage Today (free registration required) AND Positive airway pressure doesn’t reduce heart risk with sleep apnea – Reuters (free)
“PAP for obstructive sleep apnea improves quality of life but not CV events or BP with up to 5 years of follow up” (RT @AnilMakam see Tweet)
Electrocardiograms in Low-Risk Patients Undergoing An Annual Health Examination
11 Jul, 2017 | 19:22h | UTCElectrocardiograms in Low-Risk Patients Undergoing An Annual Health Examination – JAMA Internal Medicine (link to abstract – $ for full-text)
Commentaries: More than 20% of low-risk patients receive an ECG as part of annual health exam – Institute for Clinical Evaluative Sciences (ICES) (RT @ICESOntario and @ChooseWiselyCA see Tweet) (free) AND ECGs Common in Low-Risk Patients After Annual Health Exam, Leading to More Cardiac Care – American College of Cardiology, Latest in Cardiology (free) Routine ECG With Annual Physical Questioned – MedPage Today (free registration required)