Today’s Top Story
Study: Barbotage plus SAIC may offer only short-term benefit compared to SAIC alone for rotator cuff calcific tendinitis.
Data from a study published online in The American Journal of Sports Medicine suggest no significant difference in mid-term outcomes between barbotage combined with corticosteroid injection in the subacromial bursa (SAIC) compared to isolated SAIC for treatment of calcific tendinitis of the rotator cuff. The researchers conducted a randomized, controlled trial of 48 patients. At mean 5.1-year follow-up, they found no significant difference in outcomes across cohorts in Constant score, Western Ontario Rotator Cuff Index, or Disabilities of the Arm, Shoulder and Hand score, nor significant difference in calcification location and size, and Gärtner classification. The researchers found no significant complications in either cohort, but note that four patients in the barbotage group and 16 patients in the no-barbotage group underwent additional treatment during the follow-up period. However, a previous study based on the same patient population reported superior clinical and radiological outcomes in the barbotage cohort at 1-year follow-up.
Read the abstract…

Other News

Study: Opioid prescriptions following surgery may increase risk of longer-term use in adolescents.
Findings to be presented at the annual meeting of the American Academy of Pediatrics suggest that post-surgical opioid pain medications prescribed after common procedures may become a pathway to continued, nonmedical opioid use by teens and young adults. Members of the research team reviewed data on nearly 90,000 privately insured opioid-naïve patients aged 13 to 21 years, who underwent one of 13 common surgeries for their age group, along with a control group. Following surgery, they found that the incidence of new persistent opioid use ranged from 2.7 percent to 15.2 percent across procedures (overall 4.8 percent), compared to 0.1 percent in the control group.
Read more…

Study: Claims-based criteria showed increasing incidence of sepsis, but more accurate clinical criteria suggest stability.
A study published in the Sept. 13 issue of The Journal of the American Medical Association reviews clinical data on sepsis and finds no change in incidence of sepsis over a 6-year period. The authors conducted a retrospective cohort study of 409 academic, community, and federal hospitals from 2009 through 2014. Based on clinical criteria, they identified 173,690 cases of sepsis among 2,901,019 adults, of which 26,061 (15.0 percent) died in the hospital and 10,731 (6.2 percent) were discharged to hospice. Over the study period, the authors found that sepsis incidence based on clinical criteria remained stable, but incidence based on insurance claims increased. They found that clinical criteria were more sensitive in identifying sepsis than claims, with comparable positive predictive value.
Read the complete study…
An accompanying editorial states that sepsis remains “a major public health issue at the global level,” and notes that the study underscores challenges in improving coding to accurately document the global burden of sepsis.”
Read more…

ED visits peaked during first year of ACA insurance expansion.
A report released by the U.S. Centers for Disease Control and Prevention finds that hospital emergency department (ED) visits increased to a record high of 141.4 million in 2014, the first year of insurance expansion under the Affordable Care Act (ACA). An article in Modern Healthcare notes that the data run counter to some predictions that ACA implementation would be associated with a reduction in ED use. Overall, only 4.3 percent of ED visits were linked to non-urgent presentations. The report also finds that Medicaid and Children’s Health Insurance Program beneficiaries accounted for 34.9 percent of ED visits during 2014, followed by privately insured individuals (34.6 percent), Medicare beneficiaries (17.5 percent), and the uninsured (11.8 percent).
Read more…(registration may be required)

Study: U.S. military surgeons have performed more than 9,000 humanitarian procedures in Afghanistan.
According to a research letter published online in the journal JAMA Surgery, 5,786 civilians in Afghanistan underwent a total of 9,428 surgical procedures performed by U.S. military personnel between Jan. 1, 2002, and March 21, 2013. Of those, 2,853 patients (49.3 percent) were treated for conditions classified as non–war-related, and 1,446 procedures (29.8 percent) were for musculoskeletal injury. The researchers base their findings on information from the Patient Administration Systems and Biostatistics Activity database.
Read more…

CMS releases more information on new Medicare cards.
The U.S. Centers for Medicare & Medicaid Services (CMS) has released images of its newly designed Medicare card. The new card contains a unique, randomly assigned number that replaces the current Social Security-based number. The agency plans to begin mailing the new cards to Medicare beneficiaries in April 2018, in order to meet a statutory deadline for replacing all existing Medicare cards by April 2019. CMS plans to provide Healthcare providers with secure tools to allow them to look up the new Medicare numbers when needed, and is planning a 21-month transition period, during which providers and suppliers will be able to use both current Medicare numbers and the newly assigned numbers.
Read more…
Learn more about the new Medicare cards…

Last call: Pain Management Best Practices Inter-Agency Task Force.
AAOS seeks to nominate a member to the HHS Pain Management Best Practices Inter-Agency Task Force. The task force will provide advice and recommendations for development of best practices for pain management and prescribing pain medication, and a strategy for disseminating such best practices to relevant federal agencies and the public. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted to Kyle Trivedi by Sept. 18, 2017, at 11:59 p.m. CT, at
Learn more and submit your application…(member login required)