Health Care Utilization and Pain Outcomes Following Early Imaging for Low Back Pain in Older Adults.

Background: Professional societies have provided inconsistent guidance regarding whether older patients should receive early imaging for low back pain, in the absence of clinical indications. The study assesses the implications of early imaging by evaluating its association with downstream utilization in an elderly population.

Methods: Patients were included if they had a Medicare Advantage plan, had claims-based evidence of low back pain in 2014, and lacked conditions justifying early imaging.

Prior Authorization for Elective Diagnostic Catheterization: The Value of Reviewers in Cases with Clinical Ambiguity.

Background: In many situations, evidence-based guidelines cannot provide definitive guidance on the appropriateness of diagnostic catheterization. One specialty benefit management company has taken a 2-step approach to address this ambiguity by evaluating the appropriateness of diagnostic catheterization orders using a rule-based decision support system, and then having reviewers provide input through the consult system of a nondenial prior authorization program that involves peer discussion.

Objective: To describe the outcomes of a 2-step approach to evaluating the appropriateness of elective diagnostic catheterization orders.

Determinants of outcomes following outpatient placement of implantable cardioverter defibrillators in a Medicare Advantage population.

Background: Recipients of ICD are likely to have several risk factors that could interfere with successful use of implantable cardioverter defibrillators (ICDs).

Hypothesis: Age, sex, and factors indicated in claims are associated with one-year mortality and complications after ICD placement.

Methods: Adult Medicare Advantage patients who underwent outpatient ICD implantation from January 2014 to September 2015 were included.

An exploration of the association between ischemic etiology and the likelihood of heart failure hospitalization following cardiac resynchronization therapy.

Background: Myocardial scarring resulting from cardiomyopathy with ischemic etiology may interfere with effective lead placement during implantation of multi-lead cardioverter-defibrillators for cardiac resynchronization therapy (CRT-D). Extensive scarring is known to be associated with poorer physiological and survival outcomes in patients who undergo CRT-D.

Hypothesis: Ischemic CRT-D recipients respond as well as nonischemic recipients, using hospital admission for heart failure (HF) as a measure of response.

Use of an electrotactile vestibular substitution system to facilitate balance and gait of an individual with gentamicin-induced bilateral vestibular hypofunction and bilateral transtibial amputation.

Background And Purpose: This case report describes the use of an electrotactile vestibular substitution system (ETVSS; BrainPort Balance Device, Wicab, Inc., Middleton, WI) to facilitate balance and gait of an individual with bilateral vestibular hypofunction and bilateral transtibial amputation.

Case Description: A 69-year-old man with a 2.