Free Online Course: Introduction to Health Technology Assessment

21Aug
2017

Too much medicine: Mapping the drivers of overdiagnosis to potential solutions

17Aug
2017

A National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents

17Aug
2017

Genetic counseling works as well over the phone as in person, study finds

15Aug
2017

Eliminating CK–MB Testing in Suspected Acute Coronary Syndrome

15Aug
2017

Self-management interventions for patients with COPD

14Aug
2017

Self-management interventions including action plans for patients with Chronic Obstructive Pulmonary Disease (COPD) – Cochrane Library (free)

Full review: Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease (link to summary – $ for full-text)

Related: Asthma self-management programmes can reduce unscheduled care – NIHR Signal (free)

Self-management interventions that include a COPD exacerbation action plan are associated with improvements in health-related quality of life and lower probability of respiratory-related hospital admissions.

 

What do hypnotics cost hospitals and healthcare?

10Aug
2017

What do hypnotics cost hospitals and healthcare? – F1000 Research (free)

Source: Hospital Medicine Virtual Journal Club

“A best estimate is that U.S. costs of hypnotic harms to healthcare systems are on the order of $55 billion, but conceivably might be as low as $10 billion or as high as $100 billion”.

 

Alternatives to hospital admission for people aged over 65 years

9Aug
2017

A systematic review to identify and assess the effectiveness of alternatives for people over the age of 65 who are at risk of potentially avoidable hospital admission – BMJ Open (free) (RT @NIHR_DC)

Alternatives to hospital admission for people aged over 65 years can be safe and reduce costs across a range of acute and chronic conditions.

 

Last Month in Oncology with Dr. Bishal Gyawali

5Aug
2017

Last Month in Oncology with Dr. Bishal Gyawali: July 2017 – ecancer News (free)

A critical review of the latest “breakthrough” articles in oncology.

 

Design Thinking for Doctors and Nurses

5Aug
2017

Cancer screening: concerns, controversy and evidence

3Aug
2017

Effectiveness of oral glucosamine for knee and hip osteoarthritis

3Aug
2017

Choosing Wisely International Top 10 recommendations

3Aug
2017

Choosing 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.

 

Pushing Hospitals To Reduce Readmissions Hasn’t Increased Deaths

27Jul
2017

Enhanced recovery pathway for colorectal surgical patients improves outcomes, reduces cost

25Jul
2017

American 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”

 

Witch Metrics in Hospital Quality Should Patients Pay Attention To?

25Jul
2017

Reducing Smoking Rates for Patients Facing Surgery

25Jul
2017

2017 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”.

 

Surrogate endpoints in oncology: when are they acceptable for regulatory and clinical decisions, and are they currently overused?

23Jul
2017

High-value care a focus at Hospital Medicine 2017

23Jul
2017

What carcinoembryonic antigen level should trigger further investigation during colorectal cancer follow-up?

23Jul
2017

What carcinoembryonic antigen level should trigger further investigation during colorectal cancer follow-up? A systematic review and secondary analysis of a randomised controlled trial – Health Technology Assessment (free)

Source: 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”.

 

Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis

23Jul
2017

Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis – Health Technology Assessment (free)

Source: 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”

 

Implant Survival After Minimally Invasive Anterior or Anterolateral Vs. Conventional Posterior or Direct Lateral Approach

23Jul
2017

Implant 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”

 

Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults

23Jul
2017

Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults: A Systemic Review and Meta-Analysis – Chest (free)

Source: 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”.

 

An evidence-based, point-of-care tool to guide completion of asthma action plans in practice

22Jul
2017

Effectiveness of Pharmacist Intervention to Reduce Medication Errors and Health-Care Resources Utilization After Transitions of Care

22Jul
2017

Effectiveness 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.

 

Laminar airflow in surgery might not reduce surgical site infections

21Jul
2017

Hepatology: Five Things Physicians and Patients Should Question

21Jul
2017

American Society of Clinical Oncology Position Statement On Addressing the Affordability of Cancer Drugs

21Jul
2017

Comprehensive geriatric assessment and optimization in vascular surgery

20Jul
2017

Randomized 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

18Jul
2017

Editorial: WHO downgrades status of oseltamivir

16Jul
2017

Editorial: 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

16Jul
2017

Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery

16Jul
2017

Surgery for early prostate cancer may not save lives

16Jul
2017

Positive airway pressure doesn’t reduce cardiovascular events and death in adults with sleep apnea

12Jul
2017

Association 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

11Jul
2017

Health Plans That Nudge Patients to Do the Right Thing

11Jul
2017

Health Plans That Nudge Patients to Do the Right Thing – New York Times (10 articles per month are free)

“What if health insurance was more generous in paying for things that actually work?” (RT @NYTHealth see Tweet)

 

Association of delay of urgent or emergency surgery with mortality and use of health care resources

10Jul
2017

The rise of antibiotic-resistant infections threaten economies

10Jul
2017

Effective Care for High-Need Patients

10Jul
2017

Effective Care for High-Need Patients: Opportunities for Improving Outcomes, Value, and Health (free PDF)

See also: News release (free) AND Executive summary (free PDF) AND Key Points (free PDF) AND Characteristics of Successful Care Models for High-Need Patients (free PDF)

Commentary: New NAM publication examines improving outcomes, reducing costs for ‘high-needs patients’ – National – National Academies of Sciences, Engineering, and Medicine, via EurekAlert (free)

See more resources on high-need, high-cost patients in our July 4th issue (see #2)

Source: STAT News Newsletter

“Nearly half of the nation’s spending on health care is driven by 5 percent of patients, and improving health outcomes and curbing spending in health care will require identifying who these high-needs patients are and providing coordinated services” (from EurekAlert)

 

Medication nonadherence may increase health care costs

8Jul
2017

Longitudinal Patterns of Medication Nonadherence and Associated Health Care Costs – Inflammatory Bowel Diseases (link to abstract – $ for full-text)

Commentary: Taking medications as prescribed important to control health care costs – Cincinnati Children’s Hospital Medical Center, via EurekAlert (free)

In this small study, patients with increasing nonadherence over time demonstrate more than a 3-fold increase in costs compared with adherent patients.

 

The Smart-Medicine Solution to the Health-Care Crisis

8Jul
2017

Viewpoint: The Smart-Medicine Solution to the Health-Care Crisis – The Wall Street Journal (by @EricTopol) (a few articles per month are free)

“Our health-care system won’t be fixed by insurance reform. To contain costs and improve results, we need to move aggressively to adopt the tools of information-age medicine”.

 

Displaying Lab Test Costs in Electronic Health Records Doesn’t Deter Doctors from Ordering Them

7Jul
2017

We’re not ready for the ‘silver tsunami’ of older adults living with câncer

5Jul
2017

New Choosing Wisely Canada List – Five Things Residents and Patients Should Question

5Jul
2017

Hospitalists’ Winning Abstracts Target High-Value Care

3Jul
2017

Hospitalists’ Winning Abstracts Target High-Value Care – Medscape (free registration required)

““High-value” care was a hot topic at this year’s #HM17” (RT @Medscape see Tweet)

 

Re-designing the pathway to surgery: better care and added value

3Jul
2017

Newer is not necessarily better

3Jul
2017

Waiting and watching with ‘Stage 0’ breast cancer put to nationwide test

3Jul
2017

Waiting and watching with ‘Stage 0’ breast cancer put to nationwide test – The Washington Post (a few articles per month are free)

“Treatment of early-stage breast cancer: is no treatment an option?” (RT @GemmaJacklyn see Tweet)

 

Redesigning Care for High-Cost, High-Risk Patients

3Jul
2017

Precision Medicine: the Promise vs. the Reality

29Jun
2017

Precision Medicine: the Promise vs. the Reality – Michigan University Health Lab (free) (RT @pash22 see Tweet)

“Scientists find great potential in using genetic sequencing to help direct targeted cancer therapy, but practicing oncologists see some important limitations”.

 

Hospital Visits by Nurse Practitioners Prevent Readmission

28Jun
2017

Free Online Course: Measuring and Valuing Health

28Jun
2017

Free Online Course: Measuring and Valuing Health – The University of Sheffield and FutureLearn (RT @Imperial_GHD see Tweet)

“Learn how Patient Reported Outcome Measures and Quality Adjusted Life Years can compare treatments and inform healthcare spending”.

 

Cardiovascular Testing and Clinical Outcomes in Emergency Department Patients With Chest Pain

28Jun
2017

A Reality Check for IBM’s AI Ambitions

28Jun
2017

A Reality Check for IBM’s AI Ambitions – MIT Technology Review (free) (RT @EricTopol see Tweet)

“IBM overhyped its Watson machine-learning system, but the company still could have the best access to the kind of data needed to make medicine much smarter”.

 

Asthma self-management programmes can reduce unscheduled care

27Jun
2017

Monitoring Medical Devices: Missed Warning Signs Within Existing Data

26Jun
2017

Viewpoint: Monitoring Medical Devices: Missed Warning Signs Within Existing Data – JAMA (free)

Related: The lap band for weight loss is a tale of medicine gone wrong – VOX (free) Reoperation and Medicare Expenditures After Laparoscopic Gastric Band Surgery – JAMA Surgery (link to abstract – $ for full-text) AND Safety, Effectiveness of Gastric Banding Called Into Question – Medscape (free registration required) AND 1 In 5 Gastric Band Surgeries Require Corrective Operations – American Council on Science and Health (free)

The authors use the example of gastric band surgery to discuss how available data may be used more appropriately for earlier detection of problems in the safety of medical devices.

 

Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates

26Jun
2017

Viewpoint: Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates – JAMA (free)

“Contact precautions are easy to use w a single patient, but burdensome when applied to an entire hospital” (RT @JAMA_current see Tweet)

This viewpoint suggests a more selective use of contact precautions for the control of endemic pathogens.

 

Point of view: Generalists key to improved hospital outcomes

26Jun
2017

Fiscal policies for the prevention of diseases

26Jun
2017

For Some, Pre-Hospice Care Can Be A Good Alternative To Hospitals

26Jun
2017

It’s time to disrupt the existing hospital business model

26Jun
2017

Respiratory medicine: Six things physicians and patients should question

26Jun
2017

Tamiflu: an expensive lesson in panic stockpiling

26Jun
2017

Rising Medical Costs Mean More Rough Times Ahead

25Jun
2017

Interesting initiative for improving quality and reducing readmissions from skilled nursing facilities

25Jun
2017

Necessity is the mother of invention: an innovative hospitalist-resident initiative for improving quality and reducing readmissions from skilled nursing facilities – Journal of Community Hospital Internal Medicine Perspectives (free) (RT @HMVJC see Tweet)

In this model of care, a hospitalist-led team, including the resident on the geriatrics rotation, followed patients discharged from the hospital to the skilled nursing facility, leading to significant decrease in readmission rates.

 

What happens when an expensive drug is approved based on a lower bar of proof?

25Jun
2017

Insurers Battle Families Over Costly Drug for Fatal Disease – The New York Times (10 articles per month are free)

“A new drug can cost over a million dollars, even though it’s unclear if it works. Now, insurers are refusing to pay” (RT @NYTHealth see Tweet)

 

How app culture is reviving the house call

25Jun
2017

What is people-centered care? And why does it matter?

23Jun
2017

WHO Framework on integrated people-centered health services (free resources)

Video: WHO – What is people-centered care? And why does it matter? Our new video explains! (free) (RT @WHO see Tweet)

“Integrated people-centered health services means putting the comprehensive needs of people and communities, not only diseases, at the center of health systems, and empowering people to have a more active role in their own health”.

 

Why We Overrate the Lifesaving Power of Cancer Tests

23Jun
2017

Concierge Medicine For $10 A Month? Yes, It’s Possible

23Jun
2017

Value-Based Care Alone Won’t Reduce Health Spending and Improve Patient Outcomes

22Jun
2017

Value-Based Care Alone Won’t Reduce Health Spending and Improve Patient Outcomes – Harvard Business Review (a few articles per month are free) (RT @pash22 see Tweet)

“We believe that value-based care, implemented using lean principles and in conjunction with an ongoing, community-wide effort to address social determinants of health, can reduce health spending and deliver on the promise of better health”

 

Performance Improvement: Phenytoin Toxicity

22Jun
2017

Performance Improvement: Phenytoin Toxicity – JAMA (free)

Interesting case of medication error and prevention of subsequent adverse events (RT @JAMA_current see Tweet)

 

Obstetrics and Gynaecology: Ten Things Physicians and Patients Should Question

21Jun
2017

Obstetrics and Gynaecology: Ten Things Physicians and Patients Should Question – Choosing Wisely (free) (RT @ChooseWiselyCA see Tweet)

“New Choosing Wisely recommendations list! @SOGCorg identifies 10 tests, treatments to question in obstetrics and gynecology”

 

The Challenge of Polypharmacy

21Jun
2017

Stanford Medicine launches health care trends report

21Jun
2017

Harnessing the Power of Data in Health – Stanford Medicine 2017 Health Trends Report (free PDF)

News release: Stanford Medicine launches health care trends report (free)

“Stanford Medicine launches report on health care trends” (RT @StanfordMed see Tweet)

 

Lean: Targeted Therapy for Care Delivery

21Jun
2017

Lean: Targeted Therapy for Care Delivery –  Journal of the National Comprehensive Cancer Network (free)

The possible benefits of applying the “Lean” approach to oncology care delivery.

 

Overuse of Chest CT in Patients With Stage I and II Breast Cancer

20Jun
2017

Overuse of Chest CT in Patients With Stage I and II Breast Cancer: An Opportunity to Increase Guidelines Compliance at an NCCN Member Institution – Journal of the National Comprehensive Cancer Network (free)

News release: NCCN Guidelines Compliance for Chest CT Reduces False Positives and Decreases Health Care Spending in Breast Cancer, Study Finds (free)

In this cohort 11% of patients with stage I and 36% of patients with stage II breast cancer underwent chest CT, despite NCCN Guidelines against the exam. “Nearly one-third of these patients were found to have pulmonary nodules, but only 1.3% were ever diagnosed with pulmonary metastases”

 

What will healthcare look like in 2030?

20Jun
2017

Simplifying Prenatal Care for Low-Risk Patients

20Jun
2017

How Mayo Clinic Is Simplifying Prenatal Care for Low-Risk Patients – Harvard Business Review (a few articles per month are free)

“Prenatal care model makes mothers-to-be active participants while reducing costs & time commitment” (RT @MayoClinic see Tweet)

 

Changes in Hospital Quality Associated with Hospital Value-Based Purchasing?

20Jun
2017

Why overtreatment and overdiagnosis can be bad for your health

20Jun
2017

Why overtreatment and overdiagnosis can be bad for your health – CBC Radio (free text and audio)

See more on the Choosing Wisely initiative in our April 5 issue, see #6.

“Choosing Wisely on CBC Sunday about overdiagnosis & importance of speaking with your doc about tests/treatments” (RT @ChooseWiselyCA see Tweet)

 

Why Providers May Fail to Reduce Wait Times

20Jun
2017

How Did Health Care Get to Be Such a Mess?

20Jun
2017

Opinion: How Did Health Care Get to Be Such a Mess? – The New York Times (10 articles per month are free)

Opinion over payment models in the U.S health care system.

 

Evolocumab for Treatment of High Cholesterol: Clinical Effectiveness

19Jun
2017

Perspectives on the Use of Clinical Pathways in Oncology Care

16Jun
2017

American Society of Health-System Pharmacists – Five Things Physicians and Patients Should Question

16Jun
2017

New Choosing Wisely List: American Society of Health-System Pharmacists – Five Things Physicians and Patients Should Question (free)

See more on the Choosing Wisely initiative in our April 5 issue, see #6.

“Great choosing wisely list from @ASHPOfficial. Great doctoring tips for physicians & trainees” (RT @AnilMakam see Tweet)

 

Too much medical care: bad for you, bad for health care systems

16Jun
2017

Hospitals Are Dramatically Overpaying for Their Technology

15Jun
2017

Hospitals Are Dramatically Overpaying for Their Technology – Harvard Business Review (a few articles per month are free)

“For years, hospitals have invested in sophisticated devices and IT systems that, on their own, can be awe-inspiring. Yet these technologies rarely share data, let alone leverage it to support better clinical care”.

 

Palliative care: A pathway to value-based care for nursing homes

12Jun
2017

Leading Quality in Changing Times

11Jun
2017

Leading Quality in Changing Times – NEJM Catalyst (free)

“4 principles for quality leaders in brave new world of population health” (RT @nejmcatalyst see Tweet)

 

Can Personalized Care Planning Improve Primary Care?

8Jun
2017

Small wearable devices may lead to big health care savings

8Jun
2017

Value-based drug pricing makes sense, but is difficult to pull off

8Jun
2017

WHO updates Essential Medicines List

7Jun
2017

#ASCO2017 – Biosimilar May Be As Effective as Trastuzumab for Early Breast Cancer

7Jun
2017

#ASCO2017 – Small studies get big headlines

7Jun
2017

#ASCO2017 – Small studies get big headlines at ASCO 2017 – HealthNewsReview (free)

“Claim – Biggest breakthrough in a decade”. “Reality – The trial included only 15 women; no survival outcomes measured” (RT @HealthNewsRevu see Tweet)

 

The Specialists’ Stranglehold on Medicine

7Jun
2017

#ASCO2017 – Survival in a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Cancer Treatment

5Jun
2017

#ASCO2017 – Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment – JAMA (free)

Commentaries: Quickly reporting cancer complications may boost survival – STAT News (free) AND If This Were a Drug, the Price Would Be $100,000 – Medscape (free registration required) AND How a simple tech tool can help cancer patients live longer – The Washington Post (free)

“For surveillance of cancer, digital tracking of patient-generated data improves survival”. “The cost of digital tracking is very low and > 5 months median survival improvement is more than cancer drugs that cost > $100,000” (RT @EricTopol see Tweets and Answers)

 

Engaging Patients in Patient Safety – a Canadian Guide

5Jun
2017
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