By  | February 28, 2009 |  1
When we launched our hospitalist program in 1995, I dreamed that many of our faculty would become leaders in quality and patient safety. That dream has come true, but we now must leap over two hurdles: getting these superb physicians paid and promoted. I think we can do it, but there are a bunch of […]
By  | February 25, 2009 |  0
In this randomized trial of over 300 patients with vertebral fractures, patients were randomized to balloon kyphoplasty or non-surgical treatment and followed up for a year. Kyphoplasty was superior in physical function, pain, and quality of life scores at 1, 3, and 6 months, but the differences between the groups diminished by a year (abstract). Based […]
By  | February 24, 2009 |  0
In this observational study of almost 2000 patients at 50 sites worldwide, researchers found the mean radiation dose of coronary CTA was 12 mSv (millisieverts), which is comparable to a nuclear stress test or an abdominal/pelvic CT (abstract). However, they did find tremendous variability (5mSv-30mSv) depending on protocol used, which reminds us to consider radiation […]
By  | February 23, 2009 |  0
In this prospective single institution cohort of over 500 patients evaluated in the ED for chest pain, those at low risk for ACS (TIMI risk 0-2), underwent coronary CTA (1 group with immediate CTA and 1 group with CTA after short observation stay). Those with low risk CTA (calcium score <100 and no stenosis >50%) […]
By  | February 21, 2009 |  6
Thanks to White House budget director Peter Orszag, a Dartmouth Atlas aficionado, $1.1 billion found its way into the stimulus piñata for “comparative effectiveness” research. Terrific, but – to paraphrase Jack Nicholson – can we handle the truth? In other words, are we mature enough to use comparative effectiveness data to make tough decisions about […]
By  | February 19, 2009 |  0
Low dose “synergistic” gentamycin has been traditionally used in conjunction with anti-staph penicillins or vancomycin to treat staph aureus endocarditis, however the nephrotoxicity of this practice had not been evaluated. In this prospective cohort of safety data from a randomized trial of patients with staph aureus endocarditis, researchers found that 22% of those that received […]