Evaluating Billing Code Distributions in the Emergency Department Following the Implementation of the New Documentation Guidelines.

Objectives: Changes to the Current Procedural Terminology (CPT) evaluation and management (E/M) documentation guidelines implemented on January 1, 2023, were primarily meant to address dissatisfaction with the prior system; however, it was not known how the changes might alter billing distributions. In this study, we compare the proportion of visits for each E/M code before and after the enactment of the changes across 5 emergency departments (EDs) to determine the effects on billing.

Methods: This was a retrospective, observational analysis of all ED visits for patients over 18 years across 5 EDs from January 1 to March 31 in the years 2021, 2022, and 2023.

A methyltransferase-independent role for METTL1 in tRNA aminoacylation and oncogenic transformation.

Amplification of chromosomal material derived from 12q13-15 is common in human cancer and believed to result in overexpression of multiple collaborating oncogenes. To define the oncogenes involved, we overexpressed genes recurrently amplified in human liposarcoma using a zebrafish model of the disease. We found several genes whose overexpression collaborated with AKT in sarcomagenesis, including the tRNA methyltransferase METTL1.

Trend of Representation of Women in Gastroenterology, Hepatology, and Endoscopy Conferences in Asia.

Objectives: Despite progress in promoting gender equality, gender bias remains a significant obstacle for women and hinders their academic advancement. We aim to survey and critically analyze women's representation in conferences and changes over time in various regions of Asian countries.

Methods: An international survey was conducted with representatives from East Asia (Hong Kong, China, and Japan), South Asia (India and Pakistan), and Southeast Asia (Vietnam and Thailand).

Role of 5-aminosalicylic acid in ulcerative colitis management in 8 Asian territories: a physician survey.

Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice.

Confidence in Prescribing Practices: Perspectives of Senior Medical Students and Recent Graduates at Qatar University.

Purpose: This study aimed to determine the perceptions of senior medical students and recent graduates from College of Medicine (CMED) at Qatar University regarding their undergraduate education and training related to prescribing, their confidence in achieving the learning outcomes specified in the curriculum and their preparedness to prescribe in practice.

Patients And Methods: This was a cross-sectional web-based survey with qualitative elements, utilizing a 22-item pre-validated questionnaire developed through a multi-phase iterative process. The survey was administered to all senior medical students (year 4-6) and recent graduates of CMED at Qatar University.

Impact of a Clinical Decision Support System on CT Pulmonary Angiography Yield and Utilization in Hospitalized Patients.

Purpose: The aims of this study were to determine whether point-of-order clinical decision support (CDS) based on the Wells criteria improves CT pulmonary angiography (CTPA) yield and utilization in hospitalized patients in an enterprise-wide health system and to identify yield-related factors.

Methods: This retrospective, institutional review board-approved, cross-sectional study in an urban, multi-institution health system included hospitalized patients undergoing CTPA 12 months before and after CDS implementation (entire cohort). The χ test was used to compare pulmonary embolism (PE) yield in patients in whom providers overrode versus followed CDS alerts after CDS implementation.

Consent to advanced imaging in antenatal pulmonary embolism diagnostics: Prevalence, outcomes of nonconsent and opportunities to mitigate delayed diagnosis risk.

Background: Nonconsent to pulmonary vascular (or advanced) imaging for suspected pulmonary embolism (PE) in pregnancy can delay diagnosis and treatment, increasing risk of adverse outcomes. We sought to understand factors associated with consent and understand outcomes after nonconsent.

Methods: This retrospective cohort study was undertaken across 21 community hospitals from October 1, 2021, through March 31, 2023.

Risk factors for infection after carbapenem-resistant Acinetobacter baumannii colonization.

Purpose: Predicting infection risk in carbapenem-resistant Acinetobacter baumannii (CRAB) colonized patients may help in improving timely appropriate antibiotic therapy. This study aims to explore risk factors for developing infections in hospitalized patients with previous CRAB colonization.

Methods: We performed an observational retrospective cohort study at ASST Sette Laghi-Varese Hospital between January 2020 and December 2022.

CT Pulmonary Angiogram Clinical Pretest Probability Tool: Impact on Emergency Department Utilization.

Objective: Currently, CT pulmonary angiogram (CTPA) for evaluating acute pulmonary embolism (PE) in emergency departments (EDs) is overused and with low yields. The goal of this study is to assess the impact of an evidence-based clinical decision support (CDS) tool, aimed at optimizing appropriate use of CTPA for evaluating PE.

Methods: The study was performed at EDs in a large health care system and included nine academic and community hospitals.

Prospective Validation of a Prediction Model for the Diagnosis of Acute Pancreatitis.

Importance: While most patients with acute pancreatitis (AP) fulfill diagnostic criteria with characteristic abdominal pain and serum lipase levels of at least 3 times the upper limit of normal (reference range) at presentation, early imaging is often used for confirmation. A prior prediction model and corresponding point-based score were developed using nonimaging parameters to diagnose AP in patients presenting to the emergency department (ED).

Objective: To evaluate the performance of the prediction model to diagnose AP in a prospective patient cohort.

Tools for measuring curriculum integration in health professions' education: a systematic review.

Background: Curriculum integration is an important educational concept widely implemented by various educational institutions, particularly within the healthcare field. Its significance lies in enhancing the preparation of future healthcare professionals. The assessment of these integrated curricula is imperative to guarantee their effectiveness.

Clinical and genetic investigation of 14 families with various forms of short stature syndromes.

Skeletal dysplasias are a heterogeneous group of disorders presenting mild to lethal defects. Several factors, such as genetic, prenatal, and postnatal environmental may contribute to reduced growth. Fourteen families of Pakistani origin, presenting the syndromic form of short stature either in the autosomal recessive or autosomal dominant manner were clinically and genetically investigated to uncover the underlying genetic etiology.

Estimating the size and scope of the academic emergency physician workforce.

Background: Academic emergency medicine (EM) is foundational to the EM specialty through the development of new knowledge and clinical training of resident physicians. Despite recent increased attention to the future of the EM workforce, no evaluations have specifically characterized the U.S.

Fewer emergency department alarms is associated with reduced use of medications for acute agitation.

Background And Objectives: Patient monitoring systems provide critical information but often produce loud, frequent alarms that worsen patient agitation and stress. This may increase the use of physical and chemical restraints with implications for patient morbidity and autonomy. This study analyzes how augmenting alarm thresholds affects the proportion of alarm-free time and the frequency of medications administered to treat acute agitation.

Measuring Emergency Department Workload Perception Using Electronic Medical Record Measures of Patient Volume and Acuity.

Background: Workload in the emergency department (ED) fluctuates and there is no established model for measurement of clinician-level ED workload.

Objective: The aim of this study was to measure perceived ED workload and assess the relationship between perceived workload and objective measures of workload from the electronic medical record (EMR).

Methods: This study was conducted at a tertiary care, academic ED from July 1, 2020 through April 13, 2021.

Financial Viability of the No Surprises Act Independent Dispute Resolution Process: Radiology and Other Hospital-Based Specialties.

The federal No Surprises Act (NSA), designed to eliminate surprise medical billing for out-of-network (OON) care for circumstances beyond patients' control, established the independent dispute resolution (IDR) process to settle clinician-payer payment disputes for OON care. The purpose of our study was to assess the fraction of OON claims for which radiologists and other hospital-based specialists can expect to at least break even when challenging payer-determined payments through the NSA IDR process, as a measure of the process's financial viability. This retrospective study extracted claims from a national commercial database (Optum's deidentified Clinformatics Data Mart) for hospital-based specialties occurring on the same day as in-network emergency department (ED) visits or inpatient stays from January 2017 to December 2021.

Entropy removal of medical diagnostics.

Shannon entropy is a core concept in machine learning and information theory, particularly in decision tree modeling. To date, no studies have extensively and quantitatively applied Shannon entropy in a systematic way to quantify the entropy of clinical situations using diagnostic variables (true and false positives and negatives, respectively). Decision tree representations of medical decision-making tools can be generated using diagnostic variables found in literature and entropy removal can be calculated for these tools.

Correction to: Developing Leadership Skills in Pharmacy Education.

[This corrects the article DOI: 10.1007/s40670-022-01532-x.].

Racial Differences in Triage for Emergency Department Patients with Subjective Chief Complaints.

Black and Hispanic patients are frequently assigned lower acuity triage scores than White patients. This can lead to longer wait times, less aggressive care, and worse outcomes. In this study we aimed to determine whether these effects are more pronounced for patients with subjective complaints.

Biotechnology content in pharmacy curricula: Focus on Arab Countries.

Introduction: Pharmaceutical biotechnology involves using the principles of biotechnology to develop drugs. With the rapid increase in biopharmaceutical products being developed and approved for use, educating pharmacy students about biotechnological products becomes paramount. However, there is a scarcity in the literature exploring biotechnology content in pharmacy education.

Accuracy of physician gestalt in prediction of significant abdominal and pelvic injury in adult blunt trauma patients.

Objective: Focusing on potential missed injury rates and sensitivity of low-risk of injury predictions, we sought to evaluate the accuracy of physician gestalt in predicting clinically significant injury (CSI) in the abdomen and pelvis among blunt trauma patients presenting to the emergency department (ED).

Methods: We collected gestalt data on physicians caring for adult blunt trauma patients who received abdominal/pelvic computed tomography (CT) at three Level I and one Level II trauma centers. The primary outcome of CSI was defined as injury on abdominal/pelvic CT requiring hospitalization or intervention.