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Coronary CT Angiography, Perfusion Imaging Effective for Evaluating Patients With Chest Pain
November 4, 2015
Clinical question: When evaluating the intermediate-risk patient with chest pain, should coronary computed tomography angiography (CCTA) be used instead of myocardial perfusion imaging (MPI)? Background: CCTA has been shown in prior randomized controlled trials to save time and money compared to
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ED Lung Ultrasound Useful for Differentiating Cardiogenic from Noncardiogenic Dyspnea
November 4, 2015
Clinical question: Is lung ultrasound a useful tool for helping to diagnose acute decompensated heart failure (ADHF)? Background: Lung ultrasound is an emerging bedside tool that has been promoted to help evaluate lung water content to help clinicians differentiate ADHF from other causes of dyspn
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Chemotherapy Does Not Improve Quality of Life with End-Stage Cancer
November 3, 2015
Clinical question: Does palliative chemotherapy improve quality of life (QOL) in patients with end-stage cancer, regardless of performance status? Background: There is continued debate about the benefit of palliative chemotherapy at the end of life.
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Post-Operative Transfusions after Noncardiac Surgery Associated with Increased Adverse Outcomes
October 29, 2015
Clinical question: Do transfusions affect post-operative outcomes after noncardiac surgery? Background: Studies have demonstrated that a restrictive transfusion strategy is probably superior to a liberal transfusion strategy in many clinical settings.
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Easing the Grieving Process for Families of Patients Dying in the ICU
October 29, 2015
Clinical question: Can we dignify death in the ICU and ease the grieving process by soliciting wishes from patients, families, and care team members? Background: The death of the critically ill patient in the ICU can be dehumanizing and overwhelming for the patient’s family and friends, leading t
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Pediatric Trigger Tool Helps Identify Inpatient Pediatric Harm
October 29, 2015
Clinical question: Can a trigger tool identify harms for hospitalized children? Background: An estimated 400,000 people die annually in the United States as a result of hospital-associated harm.
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Left Atrial Appendage Closure Favorable Over Warfarin for Atrial Fibrillation
October 29, 2015
Clinical question: Is there a favorable risk-benefit ratio for left atrial appendage closure (LAAC) compared to warfarin for prevention of stroke, systemic embolism, and cardiovascular death in nonvalvular atrial fibrillation? Background: LAAC with the WATCHMAN device was shown to be noninferior
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Urinalysis Is Reliable Infection Predictor in Infants
October 6, 2015
Clinical question: In infants younger than three months of age with bacteremic urinary tract infection (UTI), how sensitive and specific are urinalysis (UA) findings? Background: Infants are commonly hospitalized with UTIs. The gold standard for diagnosis is considered to be urine culture.
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High-Flow Nasal Oxygen Therapy Noninferior to BiPAP in Post-Operative Respiratory Failure
October 6, 2015
Clinical question: In post-operative cardiothoracic surgery patients, is high-flow nasal oxygen therapy inferior to BiPAP for resolution of acute respiratory failure? Background: Acute respiratory failure is common following cardiothoracic surgery, and noninvasive ventilation often is used to avo
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Supplemental Oxygen During STEMI Might Increase Myocardial Injury
October 6, 2015
Clinical question: Does routine oxygen supplementation in patients with STEMI increase myocardial injury? Background: Because of physiologic and clinical studies conducted before the era of acute coronary intervention, supplemental oxygen routinely is administered to patients with STEMI, regardle
