News You Can Use

Preoperative medical testing in medicare patients undergoing cataract surgery

by jmiller on April 16, 2015

“Routine preoperative testing is not recommended for patients undergoing cataract surgery, because testing neither decreases adverse events nor improves outcomes. Preoperative testing before cataract surgery occurred frequently and was more strongly associated with provider practice patterns than with patient characteristics.  Furthermore, the results showed no difference in the prevalence of testing as compared with 20 years ago, before the introduction of guidelines stating that routine properative testing for cataract surgery was not necessary.  (NEJM, April 16). Click here to read full text.

New hypertension guidelines: One size fits most?

by jmiller on April 10, 2015

“The report of the panel appointed to the eight Joing National Committee on prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC8) is more evidence-based and focused than its predecessors, outlining a management strategy that is simpler and, in some instances, less aggressive.  It has both strengths and weaknesses.  This article reviews the major components.  Click here to read full text.

Should patients stop taking aspirin for primary prevention?

by jmiller on April 10, 2015

“Based on the current available evidence, the US Food and Drug Administration recently issued a Consumer Update that does not support aspirin for primary prevention and warns patients about the risk of serious bleeding complications.  Moreover, current guidelines and consensus panels for aspirin in primary prevention differ from one another, making it challenging for clinicians to determine which patients would benefit. One message is clear in the most current clinical guidelines, namely, that routine use of aspirin for primary prevention is not recommended.”  (Cleve Clin J, April)  Click here to read full-text.

Sciatica

by jmiller on March 27, 2015

This review article (NEJM, March 25) provides an update on the anatomy of the sciatic nerve; symptoms and examination findings’ imaging and electrological testing; nonspinal causes; conservative treatment; surgical treatment caused by lumbar disk disease; surgical techniques; and  guidelines and systematic reviews.  Click here to read full text.

Application of “Less is More” to low back pain DDDD

by jmiller on March 3, 2015

“An initiative of the National Physicians Alliance, the project titled “Promoting Good Stewardship in Clinical Practice”, developed a list of the top 5 activities in primary care for which changes in practice could lead to higher-quality care and better use of finite clinical resources.  One of the top 5 recommendations was “Don’t do imaging for low back pain within the first 6 weeks unless red flags are present.”  This article presents data that support this recommendation.  (Arch Intern Med, July 2012) Click here to read full-text

Olive oil consumption and risk of CHD and/or stroke: a meta-analysis of case-control, cohort and intervention studies

by jmiller on March 3, 2015

“Increasing evidence suggests that the Mediterranean diet can reduce the risk of CVD,  Olive oil is the hallmark of this dietary pattern.  Available studies support an inverse association of olive oil consumption with stroke (and with stroke and CHD combined), but no significant association with CHD.”  (Br J Nutr April 2015)   Click here to read full text.

Wanted: Your scholarly activities

by Medical Staff Office on January 29, 2015

For a period covering the past few years, we have begun to  compile a compendium of scholarly activities carried out by our medical staff. These activities include:

- peer-reviewed grants
- peer-reviewed publications and abstracts
- posters and presentations
- textbooks or invited reviews
- panels at professional society meetings
- invited lectures and similar efforts

Use this link to see the results of the first effort dating back  to 2012. You will find this .pdf format to be searchable by name or key word, but not sortable.

The compendium is available  from either the Medical Staff homepage  or by the public from the Research Institute page.

It is, of course, a never-completed task as new accomplishments occur regularly. We likely are missing much suitable information. Please take the time to supplement our compendium with your own information if we have not included it.

You can  supply us with the information missing by using this form to add a new activity or edit a previously submitted publication (please indicate edit). This form gets submitted to the Medical Staff Office and we will amend the existing compendium.

Please call 443-481-4150 with any questions.

The rise of the medical scribe industry: implications for the advancement of electronic health record

by jmiller on January 16, 2015

Use of medical scribes – unlicensed individuals hired to enter information into the EHR under clinician supervision – has increased substantially.  This article addresses the risks engendered by the rise of a medical scribe industry and its potential for becoming integral to US health care delivery.  Despite scribes’ reported value, this industry should be viewed as what it is: a workaround or adaptation to the suboptimal state of today’s EHRs.  The use of scribes can pose potential risks to patients if they are allowed to enter orders into the EHR.  Further, it should not be a substitute for much-needed EHR innovation and transition to more highly effective and more functionally efficient EHR systems.  Click here to read full text.

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