Today’s Top Story

House subcommittee may be prepared to move forward with October transition to ICD-10.
MedPage Today reports on a recent hearing of the U.S. House of Representatives Energy and Commerce Health Subcommittee to discuss ICD-10 implementation. The publication notes that comments from subcommittee members appeared to generally support the Oct. 1, 2015, deadline to transition Medicare from the existing ICD-9 diagnosis coding system to ICD-10. ICD-10 was originally planned to take effect in October 2013, but the deadline has twice been pushed back. One witness testified that the last implementation delay cost the healthcare industry $6.5 billion. However, a physician testifying at the hearing suggested that the unfunded mandate to transition to ICD-10 may have a negative effect on some physician practices. Read more…
Read more in AAOS Advocacy Now, including comments from Frederick M. Azar, MD, president of the American Association of Orthopaedic Surgeons…
Access the hearing materials…
On a related note, data from a survey published in the February issue of the Journal of the American Health Information Management Association find that, among those surveyed, the average ICD-10-related expenditures for a physician practice with six or fewer providers was $8,167, with average expenditures per provider of $3,430. The researchers surveyed 276 physician practices made up of six or fewer providers. Read the complete survey (PDF)…

Other News

Study: Fascia lata autograft patch procedure may be less effective for patients with massive RCTs and high-grade fatty degeneration of the supraspinatus and infraspinatus.
According to findings from a Japanese study published online in The American Journal of Sports Medicine (AJSM), an arthroscopic fascia lata autograft patch procedure may be less beneficial than other treatment options for massive rotator cuff tears (RCTs) with high-grade fatty degeneration of the supraspinatus and infraspinatus. The research team used the fascia lata autograft patch procedure to treat 45 consecutive patients with large to massive RCTs and who had high-grade fatty degeneration of the supraspinatus and either low-grade (group L) or high-grade (group H) fatty degeneration of the infraspinatus. At minimum 2-year follow-up, they found that patients in group L had a higher frequency of intact repairs than did those in group H, as assessed by magnetic resonance imaging. Both groups saw improvement in clinical scores, range of motion, and muscle strength ratios, however, at final follow-up, the mean Constant and ASES scores were significantly higher in group L than in group H, and there were significant between-group differences in the mean muscle strength ratio of the affected to healthy sides for both abduction and external rotation for abduction. Read the abstract…

Study: Research misconduct uncovered by FDA inspections rarely appears in published studies.
According to information published online in the journal JAMA Internal Medicine, research misconduct uncovered by the U.S. Food and Drug Administration (FDA) often goes unremarked in peer-reviewed literature. The researchers identified 57 published clinical trials for which an FDA inspection of the trial site had found significant evidence of at least one of the following problems: falsification or submission of false information, problems with adverse events reporting, protocol violations, inadequate or inaccurate recordkeeping, failure to protect the safety of patients and/or issues with oversight or informed consent, and other violations. Overall, they found that only 3 (4 percent) of 78 publications that resulted from trials in which FDA found significant violations mentioned the objectionable conditions or practices found during the inspection, and no corrections, retractions, expressions of concern, or other comments acknowledging the key issues identified by the inspection were subsequently published. The researchers note that FDA has no systematic method of communicating such findings to the scientific community. Read more…
Read the abstract…

Study suggests little significant advantage in tunnel aperture for either TP or OI tunneling technique during ACL reconstruction.
A Korean study published online in AJSM compares the impact of different tunneling techniques for anterior cruciate ligament (ACL) reconstruction. The authors conducted a randomized, controlled trial of 70 patients who underwent double-bundle ACL reconstruction using either the transportal (TP; n = 35) or outside-in (OI; n = 35) technique. They found no significant difference between groups in cross-sectional area of the tunnel aperture of either the femoral anteromedial (AM) or femoral posterolateral (PL) tunnel beween groups. In addition, the percentage of the tunnel filled by the graft and the graft center position were similar in both TP and OI groups. However, the PL graft center was positioned more perpendicular to the Blumensaat line in relation to the tunnel aperture center among patients in the OI group compared to those in the TP group. Read the abstract…

Study: Research into U.S. healthcare system reform often omits randomization.
Data from a study published in the Feb. 13 issue of the journal Science suggest that many studies designed to assess potential changes and improvements to the American healthcare system fall short of what is often considered the gold standard for scientific research—the randomized, controlled trial. The research team reviewed hundreds of studies published in academic journals and found that only 18 percent of studies into improving health care in the United States incorporated randomization. In contrast, 41 percent of such studies outside the United States used a randomized trial design, as did 86 percent of American drug studies, 36 percent of education studies in the United States, and 46 percent of studies of international development economics. Read more…
Read the abstract…

Google to incorporate input from medical community when displaying search results for certain conditions.
Wired reports that the Google search engine will soon incorporate vetted information fact-checked by physicians into search results for 400 commonly searched medical conditions. The company states that it will present the vetted sites at the top of its search results, and plans to expand the initiative to other conditions and to other countries. Search engines have at times been criticized for presenting controversial or incorrect information at the top of search results, as their search algorithms are often based largely on estimates of page popularity. Read more…

Texas.
According to The Texas Tribune, the Texas Medical Board is attempting to address rules for the use of telemedicine. On Jan. 16, the board issued an emergency rule that required physicians to have “face-to-face” contact with patients in order to prescribe drugs, but a few days later, courts issued a temporary restraining order against the rule, saying that “no imminent peril to public health, safety or welfare exists.” The board is now considering drafting a formal version of the rule, and some observers say the debate could prompt lawmakers to consider how broad the medical board’s rule-making authority should be when it comes to the practice of telemedicine. Read more…

Call for volunteers: Program Committees.
April 2 is the last day to submit your application for a position on an AAOS Program Committee. Members of program committees grade symposia in May and abstracts in June and July, and may serve as moderators for paper sessions at the AAOS Annual Meeting. The following openings are available:

  • Adult Reconstruction Hip (five member openings)
  • Adult Reconstruction Knee (12 members)
  • Foot & Ankle (two members)
  • Musculoskeletal Tumor & Metabolic Disease (one member)
  • Pediatrics (five members)
  • Practice Management/Rehabilitation (five members)
  • Shoulder & Elbow (eight members)
  • Spine (five members)
  • Sports Medicine/Arthroscopy (12 members)
  • Trauma (12 members)

Applicants for these positions must be active fellows or international affiliate members with a practice emphasis in the relevant area. Learn more and submit your application…(member login required)