Remove Academics Remove Documentation/Coding Remove Outcomes
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Pulse oximeters overestimate O2 saturations in darker-skin patients; FDA acts (again)

PulmCCM

That task—requiring simultaneous measurements of oxygen saturation from pulse oximetry and arterial blood gases in hundreds or thousands of patients—will likely fall to academic clinicians, who were the first to identify and report the potential scale of the problem. Draft Guidance Document Wong et al. Nature (news).

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Three patients with chest pain and “normal” ECGs: which had OMI? Which were normal? And how did the Queen of Hearts perform?

Dr. Smith's ECG Blog

Written by Jesse McLaren Three patients presented with acute chest pain and ECGs that were labeled by the computer as completely normal, and which was confirmed by the final cardiology interpretation (which is blinded to patient outcome) also as completely normal. The reliability of these ECGs should be based on patient outcome.

EKG/ECG 119
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Issue #4: The Latest in Critical Care, 6/12/23

PulmCCM

TTM2 found no improvement in survival or neurologic outcome among patients randomized to cooling to a target of 33 °C, as compared to controls receiving fever prevention (e.g. Use code PULMCCM15 and get 15% off when you register online. Elsevier explained that their fees are justified to maintain open access (i.e.

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Sepsis alerts work! Just not in the patients who fire the alerts

PulmCCM

A cluster randomized trial using all-cause mortality as an outcome was always needed to determine whether EMR alerts improve outcomes for suspected severe infection. This led the authors to speculate that qSOFA parameters were being documented more diligently on the wards randomized to screening.

Sepsis 45
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emDOCs Videocast: EBM Update – Inhaled Corticosteroids for Asthma in the ED

EMDocs

5 urban academic EDs, attending charts. Primary outcome: Prescription of ICS on ED discharge from the index visit Secondary outcomes: ICS prescription rates in high-risk subgroups Rates of outpatient follow-up within 30 days of an ED visit for asthma Variation in ICS prescription rates among attending ED physicians.

Outcomes 105
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The Expert Witness re-visits a chest pain Malpractice case using the Queen of Hearts

Dr. Smith's ECG Blog

Her first set of vitals were documented: BP 116/57 Pulse 94bpm Respiratory rate 24/min O2 sat 90% on room air Temp 97F She had been cleaning a Jeep in the sun, and was sunburned. The physician documented “normal sinus rhythm”. The physician documented that she was “improved” and the patient was discharged. The family sued.

EKG/ECG 92
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A Brilliant Comment Makes the Study of the Week

Sensible Medicine

On yesterday’s podcast , I talked with Bobby Yeh, an academic cardiologist who made a compelling case for enhancing credibility of observational research. Another problem, which is possibly surmountable, is the conflation of what one can call “patient outcomes” versus “doctor outcomes.”