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A Unified Approach to Health Data Exchange: A Report From the US DHHS.
JAMA
January 2025
Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT, Washington, DC.
Importance: Health information technology, such as electronic health records (EHRs), has been widely adopted, yet accessing and exchanging data in the fragmented US health care system remains challenging. To unlock the potential of EHR data to improve patient health, public health, and health care, it is essential to streamline the exchange of health data. As leaders across the US Department of Health and Human Services (DHHS), we describe how DHHS has implemented fundamental building blocks to achieve this vision.
View Article and Find Full Text PDFIrradiated Homologous Costal Cartilage Grafts in Complex Functional Septorhinoplasty.
Facial Plast Surg
January 2025
Department of Rhinology and Facial Plastic Surgery, Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
Optimal results in complex nasal reconstruction, particularly in the context of post-traumatic and revision septorhinoplasty, often require the use of cartilage grafts to provide additional structural support to the nose. While autologous costal cartilage (ACC) has been traditionally used, this can be limited by donor site morbidity, increased operative time, and in some cases, lack of suitable cartilage for grafting. There has been a trend towards using irradiated homologous costal cartilage (IHCC) as an alternative source of graft material.
View Article and Find Full Text PDFCoding intensity variation in Medicare Advantage.
Health Aff Sch
January 2025
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, United States.
Enrollment in Medicare Advantage (MA) plans rose to over 50% of eligible Medicare patients in 2023. Payments to MA plans incorporate risk scores that are largely based on patient diagnoses from the prior year, which incentivizes MA plans to code diagnoses more intensively. We estimated coding inflation rates for individual MA contracts using a method that allows for differential selection into contracts based on patient health.
View Article and Find Full Text PDFEligibility Criteria of Randomized Clinical Trials in Critical Care Medicine.
JAMA Netw Open
January 2025
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.
Importance: Eligibility criteria for randomized clinical trials (RCTs) are designed to select clinically relevant patient populations. However, not all eligibility criteria are strongly justified, potentially excluding marginalized groups, and limiting the generalizability of trial findings.
Objective: To summarize and evaluate the justification of exclusion criteria in published RCTs in critical care medicine.
Delivering Guideline-Concordant Care for Patients With High-Risk HPV and Normal Cytologic Findings.
JAMA Netw Open
January 2025
Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston.
Importance: As US health care systems shift to human papillomavirus (HPV)-based cervical cancer screening, more patients are receiving positive high-risk non-16/18 genotype HPV results and negative for intraepithelial lesion or malignancy (NILM) cytological findings. Risk-based management guidelines recommend 2 consecutive negative annual results to return to routine screening.
Objective: To quantify patterns of surveillance testing and associated outcomes for patients after an HPV-positive results and NILM cytologic findings.
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