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[Ann Emerg Med.] False-negative FAST examination: associations with patient outcomes

...patient characteristics are most commonly associated with a false negative FAST exam and 2) are false negative FAST exams associated with any negative outcomes? The authors analyzed demographic, injury, and outcomes data for 332 patients with pathological intra-abdominal fluid and found that 49% had a false negative FAST exam. Analysis revealed that while severe head injury was positively associated with a false negative FAST (odds ratio [OR] 4.9;...

Patients who utilize online health services make greater use of in-person services

...r similar research in Kaiser clinics (4-5) and could be used to argue that online services have less cost-cutting potential than previously thought. Furthermore, since Kaiser practices are integrated delivery systems – which received the most optimistic outlook for HCIT savings in the CBO report cited above – these results may actually be amplified in unintegrated health settings. However, these findings may also indicate fewer barriers in access...

Physician recourse to online reviews may be futile

...lity. Second, physician use of contracts prohibiting patients from posting online comments may backfire. Medical non-disclosure agreements (NDAs) are contracts that prospective patients sign that either restrict a patient’s ability to post any review at all, or effectively make any online commentary intellectual property belonging to the physician. Thus, when a physician seeks to respond to negative reviews, they are able to employ the less burden...

Steep decline in atherosclerosis among US soldiers observed

...or Operation Iraqi Freedom/New Dawn between October 2001 and August 2011. Service members were aged 18-59 and 98.3% male. The primary outcome measured was prevalence of coronary atherosclerosis in US service members. This was determined to be 8.5% (95% CI, 7.6%-9.4%). Increased prevalence of coronary atherosclerosis showed the strongest association with age >30. Statistically significant associations were also made with education level that was n...

Direct-access online care model may effectively manage chronic atopic dermatitis

...thors showed comparable improvement in outcomes for both the in-person and online-care groups. The study’s strength was its randomized control trial design; however, the generalizability was limited as this was a relatively small study that looked at patients with only one chronic skin disease with similar burden of disease. Click to read the study in JAMA Dermatology Relevant Reading: Care Partners and Online Patient Portals In-Depth [randomized...

Development and validation of PEN-FAST clinical prediction tool for possible penicillin allergy

...confirmatory allergy testing. 2. Using a score cut-off of 3 points, the PEN-FAST prediction tool had a high negative predictive probability in ruling out true penicillin allergy in both the internal and external validation cohorts. Evidence Rating Level: 2 (Good) Study Rundown: Patient-reported allergies to penicillin are common but often do not reflect true allergies when further investigated with skin-prick or other confirmatory testing. History...

Parental stress linked to higher rates of child obesity and fast food consumption

...addition, the study highlights the link between parental stress and child fast-food consumption. While the data from this study were all self-reported and there was only one measure for perceived stress, the large and diverse sample population strengthens these findings. The results highlight the potential value of increasing services that target parental stress reduction, particularly among parents who are black, Hispanic, or have a high school...

Acute care surgery service improves outcomes, saves cost

...osts decreased from $12,526 to $9,348 (p<0.0001). Initially however, in ACS-1, the re-operation rate doubled (3.6% to 6.4%) and the mortality rate tripled (1.4% to 4.1%) before the trends reversed in ACS-3. Also, pre-ACS had nine surgeons who performed 256+/- 130 operations annually and after ACS the range was between a low of 256 and a high of 282. Also to note, no new surgeons started practice at this facility during the study years. ©2012-2014...

Price transparency leads to lower claims payments by patients and insurers

...arch. The study authors ultimately found that individuals who searched for services using a price transparency service prior to receiving care had lower claims payments made by themselves and/or their insurer. Limitations of this study are largely due to its retrospective design, which did not allow researchers to determine patient motivation behind either choosing or not choosing to use the price transparency service or choosing or not choosing t...

Transvaginal ultrasound is the best diagnostic method for ectopic pregnancy

...ical motion tenderness (SN 45%, SP 91%, LR 4.9), peritoneal findings (SN 23-27%, SP 94-95%, LR 4.2-4.5), adnexal mass (SN 9%, SP 96%, LR 2.4), and adnexal tenderness (SN 61%, SP 65%, LR 1.9) were significant, as each finding increased the likelihood of ectopic pregnancy. Of note, however, normal findings on physical exam did not decrease the likelihood of an ectopic pregnancy. Among diagnostic modalities, transvaginal sonography was the single bes...

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