Today’s Top Story
Study: Checklist-based quality program linked to reduction in mortality following inpatient surgery.
Data from a study published online in the journal Annals of Surgery suggest that implementation of a checklist-based surgical quality improvement program may reduce mortality following inpatient surgery. The authors drew information from a state-wide all-payer discharge claims database to compare 30-day postoperative mortality rates after inpatient surgery. Overall, 14 hospitals completed participation in a voluntary checklist-based quality program The authors found that the risk-adjusted 30-day mortality among completers was 3.38 percent in 2010 and 2.84 percent in 2013, compared to other hospitals (n = 44) in which 30-day mortality was 3.50 percent in 2010 and 3.71 percent in 2013.
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FDA issues warnings regarding use of codeine and tramadol in pediatric patients.
The U.S. Food and Drug Administration (FDA) has issued a safety communication restricting the use of codeine and tramadol in children. The agency states that such drugs carry serious risks, including slowed or difficult breathing and death, and appear to be a greater risk in children younger than 12 years. FDA states that tramadol and codeine should not be used in children younger than 12 years, and should be limited in some older children. The agency is adding a contraindication (its strongest warning) to the drug labels of codeine and tramadol, alerting that codeine should not be used to treat pain or cough and tramadol should not be used to treat pain in children younger than 12 years. In addition, FDA is adding:
- A new contraindication to the tramadol label warning against its use in children younger than 18 years to treat pain after surgery to remove the tonsils and/or adenoids.
- A new warning to the drug labels of codeine and tramadol to recommend against their use in adolescents between 12 and 18 years who are obese or have other conditions that may increase the risk of serious breathing problems.
- A strengthened warning to mothers that breastfeeding is not recommended when taking codeine or tramadol medicines, due to the risk of serious adverse reactions in breastfed infants.
Study: Patients with opioid use disorder linked to high mortality rates.
A study published online in the Journal of Addiction Medicine suggests that patients with opioid use disorder (OUD) may be at increased risk of morbidity and mortality. The researchers reviewed mortality data on 2,576 OUD patients treated at a single system. They found 465 confirmed deaths (18.1 percent), corresponding to a crude mortality rate of 48.6 per 1000 person-years and standardized mortality ratio of 10.3. Leading causes of mortality included drug overdose and disorder (19.8 percent), cardiovascular diseases (17.4 percent), cancer (16.8 percent), and infectious diseases (13.5 percent).
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The U.S. Department of Health and Human Services has announced plans to provide $485 million in grants to help states and territories combat opioid addiction. The funding is expected to support an array of prevention, treatment, and recovery services.
Study: Female patients may experience greater pain and sensitization after primary MOM hip resurfacing.
According to a study published in the April 19 issue of The Journal of Bone & Joint Surgery, female patients may experience more pain and metal sensitization than male patients after primary metal-on-metal (MOM) hip resurfacing arthroplasty. The research team reviewed data on 1,038 male and 1,575 female patients with idiopathic joint pain following total joint arthroplasty who were referred for in vitro metal-sensitivity testing. They found that the median lymphocyte stimulation index (SI) among males was 2.8 (mean 5.4) compared with median 3.5 (mean 8.2) among females. In addition, 49 percent of females had an SI of ≥4 (reactive) compared with 38 percent of males, and the implant-related level of pain was also significantly higher among females compared with males.
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Study: Including lab test cost information in EHR may not affect clinician ordering behavior.
A study published online in the journal JAMA Internal Medicine suggests that displaying fee information for inpatient laboratory tests in electronic health record (EHR) systems may not affect overall clinician ordering behavior. The authors conducted a randomized clinical trial covering 98,529 patients (142,921 admissions) across three hospitals, comparing a 1-year pre-intervention period against a 1-year intervention period, during which inpatient laboratory test groups were randomly assigned to display Medicare allowable fees for inpatient laboratory tests in the EHR. They found no significant changes in overall test ordering behavior in the intervention group compared to the control group.
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Call for volunteers: Voting panel for Management of Osteoarthritis of the Hip AUC.
The Appropriate Use Criteria (AUC) Section seeks AAOS fellows to participate on the voting panel for the Management of Osteoarthritis of the Hip AUC. The voting panel will participate in two rounds of voting, in which it will rate the appropriateness of various treatments for patients who have osteoarthritis of the hip. Voting panel members will be required to attend a 1-day, in-person meeting in Rosemont, Ill. Nominees for the voting panel are required to complete the AAOS conflict of interest enhanced disclosure form online. If you are interested in participating on the voting panel for this AUC topic, please contact Mary DeMars, by Monday, May 22, 2017, at:
Call for volunteers: CMS panel on MIPS outcome measures.
AAOS seeks to nominate members to the U.S. Centers for Medicare & Medicaid Services (CMS) Technical Expert Panel on Development and Reevaluation of Outpatient Outcome Measures for the Merit-based Incentive Payment System (MIPS). The agency is developing and reevaluating quality measures to assess quality of care provided by MIPS-eligible clinicians. The goal of the panel is to inform the development and reevaluation of outpatient outcome measures. Applicants for this position must be active members, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, each applicant must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, a letter of interest highlighting his or her expertise in the subject area, and a nomination form (available from the email below) All supporting materials must be submitted by Monday, May 8, 2017 at 11:59 p.m. CT, to Kyle Shah, at firstname.lastname@example.org.
Learn more and submit your application…(member login required)