Background: The value of care, defined as the relationship of cost, harm, and benefit, has garnered increased focus in recent years. Program directors (PDs) can provide information about resident skill and institutional priorities related to high-value care.
Objective: The objective of the study was to evaluate changes between 2012 and 2014 in PD-reported resident skills and institutional priorities related to high-value care.
Methods: We performed annual surveys of US internal medicine PDs from 2012-2014 and evaluated responses to identical questions related to high care value. The survey was developed by the American College of Physicians and the Alliance for Academic Internal Medicine.
Results: Response rates were 235 of 378 (62.2%) in 2012, 213 of 380 (56.1%) in 2013, and 215 of 391 (54.9%) in 2014. The majority of PDs reported that balancing benefits, harms, and costs was (1) a teaching priority; (2) the subject of didactics; (3) discussed by residents; and (4) emphasized by institutional leadership. Approximately one-third reported that unnecessary ordering occurred most or all the time, with no changes in the survey period. When asked about resident ordering compared to 3 years ago, 42.5% (88 of 207) of PDs reported residents ordering fewer unnecessary tests most or all the time in 2014, compared to 28.1% (63 of 224) in 2012 (P = .002).
Conclusions: Internal medicine PDs reported high levels of institutional interest in and teaching of care value between 2012 and 2014, but responses for later years suggest improvement in trainees avoiding unnecessary testing.
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http://dx.doi.org/10.4300/JGME-D-15-00340.1 | DOI Listing |
Front Oncol
December 2024
Analysis of Circulating Tumor Cells, Laboratory of Analytical Chemistry, Department of Chemistry, University of Athens, Athens, Greece.
Introduction: Detection of mutations in primary tumors and liquid biopsy samples is of increasing importance for treatment decisions and therapy resistance in many types of cancer. The aim of the present study was to directly compare the efficacy of a relatively inexpensive ultrasensitive real-time PCR with the well-established and highly sensitive technology of ddPCR for the detection of the three most common hotspot mutations of , in exons 9 and 20, that are all of clinical importance in various types of cancer.
Patients And Methods: We analyzed 42 gDNAs from primary tumors (FFPEs), 29 plasma-cfDNA samples, and 29 paired CTC-derived gDNAs, all from patients with ER+ metastatic breast cancer, and plasma from 10 healthy donors.
Front Oncol
December 2024
Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China.
Background: This study aimed to develop and validate a multiregional radiomic-based composite model to predict symptomatic radiation pneumonitis (SRP) in non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiation therapy (SBRT).
Materials And Methods: 189 patients from two institutions were allocated into training, internal validation and external testing cohorts. The associations between the SRP and clinic-dosimetric factors were analyzed using univariate and multivariate regression.
Background Fragility fractures, often caused by osteoporosis, are a major public health concern among the growing population of the United Kingdom (UK). In addition to being a major source of illness and mortality, the rising incidence of osteoporosis places a heavy strain on healthcare systems if it is not adequately managed. In order to lower the risk of additional fractures, current guidelines place a strong emphasis on the timely evaluation and treatment of fragility fractures.
View Article and Find Full Text PDFObjective: To describe the anatomical and functional outcome of autologous internal limiting membrane (ILM) transplant with 27-gauge plus (27G+) three ports pars plana vitrectomy (PPV) in failed and recurrent full-thickness macular holes (MH) in a spectrum of pathologies.
Study Design: Observational cohort study Methods: Seven eyes of seven patients who had failed or recurrent MH were included from January 2017 to January 2022. A single vitreoretinal surgeon performed all surgeries using a 27G+ PPV system in a tertiary care hospital.
Cureus
December 2024
Department of Orthodontics, School of Dental Sciences, University Sains Malaysia, Kelantan, MYS.
Background and objectives A modified aligner appliance with nickel-titanium springs (MAA) is a relatively new appliance that has not received extensive attention in orthodontics. This study evaluated the patient-reported outcomes when orthodontic treatment was provided using a modified aligner appliance to treat mild lower incisor crowding. Materials and methods This prospective cohort study consisted of 42 patients (11 males and 31 females; mean age 21.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!