Importance: Clinical productivity measures may incentivize clinical care to specific patient populations and thus perpetuate inequitable care. Before the 2021 Medicare physician fee schedule changes, outpatient dermatology encounters for patients who were younger, female, and races other than White systematically generated fewer work relative value units (wRVUs).
Objective: To examine the association of patient race, age, and sex with wRVUs generated by outpatient dermatology encounters after 2021.
Background: Microvascular thrombosis is key to the pathogenesis of calciphylaxis. C5b-9-mediated microvascular injury reflective of complement pathway activation could be a key pathophysiologic event.
Methods: We conducted a retrospective multicenter study of 24 patients who have had biopsy-supported calciphylaxis from the 2010-2022 data base from Emory where C5b-9 immunohistochemistry (IHC) had not been conducted and the 2019-2023 data base from Cornell where C5b-9 IHC was done as part of the routine calciphylaxis work up.
The American Academy of Dermatology launched DataDerm in 2016 as the clinical data registry platform of American Academy of Dermatology. DataDerm has evolved to be the largest database in the world containing information about dermatology patients, capturing information about their course of disease, associated therapeutic interventions, and health outcomes. As of December 31, 2022, DataDerm contained data from 14.
View Article and Find Full Text PDFImportance: Dermatologists prescribe more oral antibiotics per clinician than clinicians in any other specialty. Despite clinical guidelines that recommend limitation of long-term oral antibiotic treatments for acne to less than 3 months, there is little evidence to guide the design and implementation of an antibiotic stewardship program in clinical practice.
Objective: To identify salient barriers and facilitators to long-term antibiotic prescriptions for acne treatment.
Background: Medicare's legacy quality reporting programs were consolidated into the Merit-Based Incentive Payment System (MIPS) in 2015.
Purpose: The DataDerm registry of the American Academy of Dermatology was examined to understand the potential for and subsequent rate of improvement across 23 performance measures.
Methods: We examined the level of performance across 23 performance measures with at least 20 clinicians reporting on at least 50 patients' experience.
The delivery of dermatology services has undergone dramatic changes in the past century. The goals and timelines of care have evolved as have the diagnostic and therapeutic tools, resulting in the need to capture and manage information differently, both qualitatively and quantitatively. The predominant and basic office-based ambulatory care model has remained relatively unchanged.
View Article and Find Full Text PDFThe American Academy of Dermatology (AAD) launched DataDerm in 2016 as the clinical data registry platform of AAD. DataDerm has evolved to be the largest database containing information about dermatology patients in the world. As of December 31, 2021, DataDerm contained data from 13.
View Article and Find Full Text PDFWith more disease- and symptom-specific measures available and research pointing to increased usefulness, patient-reported outcome measures (PROMs) can be routinely used in clinical care. PROMs increase efficiency in healthcare, improve the clinician-patient relationship, and increase patient satisfaction with their care. PROMs can be administered before, during, and after clinic visits using paper-and-pencil, mobile phones, tablets, and computers.
View Article and Find Full Text PDFSAGE Open Med Case Rep
November 2022
Atezolizumab is a programmed cell death-ligand 1 antibody that modulates the immune system response and has shown great promise in treating malignancies. Cutaneous toxicities from immune checkpoint inhibitors are the most commonly reported immune-related adverse events, although toxicities related to immunotherapy are still being characterized. Herein, we present a novel case of inflamed actinic keratoses in a patient after receiving atezolizumab therapy that resolved without requirement of dose adjustment or discontinuation of treatment.
View Article and Find Full Text PDFAutoimmune toxicities, while common following treatment with cancer immunotherapies, are not well-characterized in patients treated with BRAF/MEK inhibitors. Emerging data suggest that autoimmune effects may be linked with superior responses to both treatment modalities; however, there is little evidence describing mechanisms of immune-related toxicity for patients on BRAF/MEK inhibitors. Here we describe the experience of a 59-year-old HLA-A2, A29, B27-positive male with recurrent/metastatic melanoma.
View Article and Find Full Text PDFGreater occipital nerve blocks and thermal ablations have been widely discussed as an efficacious treatment strategy for multiple difficult to treat conditions, including occipital neuralgia, migraines, and cervicogenic headaches. Nerve blocks have also recently been presented as a method of treating neuropathic itch in the upper extremities, where pruritus occurs without visible dermatologic manifestations. We report a case of refractory occipital scalp pruritus in a patient who had excellent although time-limited response to greater occipital nerve blocks but achieved durable symptom control with CT-guided greater occipital nerve ablation.
View Article and Find Full Text PDFThe American Academy of Dermatology launched DataDerm in 2016 as the clinical data registry platform of the American Academy of Dermatology. DataDerm has evolved to be the largest database containing information about dermatology patients in the world. As of December 31, 2020, DataDerm contained data from 11.
View Article and Find Full Text PDFThe utility of any database or registry depends on the completeness and accuracy of the data it contains. This report documents the validity of data elements within DataDerm, the clinical registry database of the American Academy of Dermatology. An external audit of DataDerm, performed by a third-party vendor, involved the manual review of 1098 individual patient charts from calendar year 2018 from 8 different dermatology practices that used 4 different electronic health records.
View Article and Find Full Text PDFImportance: Clinical productivity measures may be factors in financial incentives for providing care to specific patient populations and thus may perpetuate inequitable health care.
Objective: To identify the association of patient race, age, and sex with work relative value units (wRVUs) generated by outpatient dermatology encounters.
Design, Setting, And Participants: This cross-sectional study obtained demographic and billing data for outpatient dermatology encounters (ie, an encounter performed within a department of dermatology) from September 1, 2016, to March 31, 2020, at the Emory Clinic, an academic dermatologic practice in Atlanta, Georgia.