Antibiotic Therapy, Appendectomy for Uncomplicated Acute Appendicitis

Clinical question: Is antibiotic therapy noninferior to appendectomy for treatment of uncomplicated acute appendicitis? Background: Previous randomized clinical trials have compared antibiotic therapy versus appendectomy for the treatment of uncomplicated, acute appendicitis. Each of these studies had significant limitations, and appendectomy has remained the standard of care. Study design: Noninferiority, randomized clinical trial. Setting: Six… [Read More]

Social, System Factors Can Influence Decisions to Continue Patient Care

Clinical question: Why do healthcare providers work while sick? Background: Healthcare providers generally are aware of the risks of infection to hospitalized patients; however, despite this knowledge, several studies have revealed providers continue to work while ill. Study design: Mixed-method analysis of a cross-sectional survey. Setting: Large academic children’s hospital. Synopsis: Investigators completed 538 of… [Read More]


COPD Exacerbation Prevention: April 2015 CHEST Guidelines

Background The CHEST guidelines for the prevention of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) were developed through a collaboration between the American College of Chest Physicians (CHEST) and the Canadian Thoracic Society (CTS). They are the first evidence-based guidelines dedicated entirely to the prevention of AECOPD and largely exclude material related to the… [Read More]

Coronary Computed Tomography Angiography, Radionuclide Stress Testing Similar for Evaluation of Chest Pain

Clinical question: Is coronary computed tomography angiography better than stress testing for detecting coronary artery disease? Bottom line: For the evaluation of chest pain in intermediate-risk patients, coronary computed tomography angiography (CCTA) is comparable with myocardial perfusion imaging (MPI) in its ability to select patients for invasive management. Both modalities are also similar when it… [Read More]

Interdisciplinary Team Interventions Have Little Impact on Traditional Quality Measures

Clinical question: Do interdisciplinary team care interventions affect outcomes for hospitalized patients in general medical wards? Bottom line: Interdisciplinary team care interventions do not significantly affect oft-used quality measures such as length of stay, readmissions, or mortality. However, some experts question whether these measures are appropriate for assessing the effectiveness of such interventions. A small… [Read More]

Consumer Reports Rates Hospitals on Infection Control, Prevention

Consumer Reports included for the first time in its national hospital quality ratings a ranking of how well 3,000 hospitals are controlling common deadly infections such as methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile. The How Your Hospital Can Make You Sick report is based on information provided to the CDC between October 2013 and… [Read More]

Experimental Antibody May Reduce C. diff Recurrence

An experimental antibody developed by Merck & Co Inc was shown in pivotal studies to reduce by about 10 percentage points the risk that infection with Clostridium difficile will recur. In the United States, C. difficile infects nearly half a million people each year and contributes to around 29,000 deaths. The infection is treated with standard antibiotics, which also wipe out… [Read More]

Hospitalization in Lung Cancer Patients More Common Than Anticipated

NEW YORK – Chemotherapy-related hospitalization happens much more often in the real world than in drug trials, according to a new study. Patients with advanced lung cancer receiving chemotherapy in real-world settings were almost eight times more likely to be hospitalized during treatment than those participating in clinical trials. What’s more, very few clinical trials even report how often participants are… [Read More]

Nursing Home Residents Likely to Suffer Fractures

NEW YORK  – Older adults living in long-term care are more than twice as likely as their peers living at home to suffer a fracture, and a new guideline endorsed by the Scientific Advisory Council of Osteoporosis Canada explains how to reduce their risk. Residents of long-term care tend to be frailer and have more health problems than similar people… [Read More]

Online Refill Reduces Time Without Statins in Diabetes Patients

NEW YORK – Diabetes patients in the Kaiser Health System spent more days with their prescribed statins on hand if they used Kaiser’s online refill tool, a study shows. The researchers looked specifically at racial and ethnic minorities and found that while these groups had poorer medication adherence than white patients before using the online refills, using the online refills… [Read More]