Today’s Top Story
Study: Mortality risk may increase for up to 3 weeks following injury for some lower severity trauma patients.
Data from a study conducted in Europe and published in the Aug. 1 issue of the journal Computers in Biology and Medicine suggest that, for hospitalized trauma patients with lower severity of injury, risk of mortality may peak between 14 and 21 days after injury. The research team reviewed data from the European Trauma Audit and Research Network database and developed and validated a system of non-stationary Markov models for the handling of missed outcomes. Based on an analysis of the entire dataset, they found that the coefficient of mortality monotonically decreased over time. But a stratified analysis found that the coefficient of mortality was a non-monotonic function of time after injury, with estimated maxima at the second and third weeks.
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Other News
Study: Lack of guidelines linked to variations in treatment for acetabular fractures in older adults.
A study published in the September issue of the Journal of Orthopaedic Trauma examines variation in treatment for acetabular fractures in older adults. The researchers conducted a retrospective, observational study of 269 patients aged 60 years or older who were admitted to one of 15 level-I trauma centers for treatment of a displaced acetabular fracture. They found that 60 percent of fractures (n = 162) were treated surgically, and that younger age (<80 years), injury from high-energy mechanism, fractures with femoral head impaction, and fractures without hip congruency were significantly associated with increased likelihood of surgical treatment. However, they also noted significant site variation in surgical versus nonsurgical treatment even after accounting for such factors. The researchers note that currently, no treatment guidelines exist for acetabular fractures in older adults. They argue that understanding factors that drive treatment decisions may be important in designing future trials to determine the best treatment for such fractures.>
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Polypharmacy an area of concern for older patients.
A Kaiser Health Network article looks at the issue of polypharmacy among older patients. “An increasing number of elderly patients nationwide are on multiple medications to treat chronic diseases, raising their chances of dangerous drug interactions and serious side effects,” the writer states. She notes that drugs are often prescribed by different providers who may not communicate well with each other. In addition, physicians may send hospitalized patients home with changes or additions to their medications, leaving patients with uncertainty regarding what to take and when. A study conducted in 2013 found that nearly one-fifth of patients discharged had prescription-related medical complications during their first 45 days at home, with about 35 percent of those complications being preventable and 5 percent life-threatening.
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FDA to hold meeting to discuss off-label use of medications.
STAT reports that the U.S. Food and Drug Administration (FDA) will hold a public meeting Nov. 9–10, 2016, to discuss the dissemination of information to physicians regarding off-label use of medications. FDA regulations prohibit the promotion of medications for unapproved uses, but a 2012 ruling by a federal appeals court overturned the criminal conviction of a pharmaceutical sales representative who was prosecuted for encouraging physicians to prescribe a drug for off-label use. The court ruled that the representative’s speech was protected, since the information was truthful and not misleading. Since then, some manufacturers have argued that promotion of certain off-label uses is protected under the First Amendment. FDA is engaged in a comprehensive review of its regulations and policies governing firms’ communications about unapproved uses of approved and cleared medical products, and the input from the meeting will inform the agency’s policy development in this area.
The American Association of Orthopaedic Surgeons (AAOS) plans to attend this meeting and to submit written comments.
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Read the notice in The Federal Register…
CMS announces plans to release reports on 2015 PQRS feedback and quality and resource use.
The U.S. Centers for Medicare & Medicaid Services (CMS) has announced plans to release 2015 Physician Quality Reporting System (PQRS) Feedback Reports and 2015 Annual Quality and Resource Use Reports (QRURs). The 2015 PQRS feedback reports reflect data from Medicare Physician Fee Schedule claims received with dates of service from Jan. 1, 2015, to Dec. 31, 2015, that were processed into the National Claims History by Feb. 26, 2016. The feedback reports will include all measures reported by the National Provider Identifier for each submission mechanism used. The 2015 QRURs for solo practitioners and groups with 2 or more eligible practitioners will also be available in September 2016. The 2015 Annual QRURs will show how these providers performed in 2015 on the quality and cost measures used to calculate the 2017 Value Modifier.
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Insurer filings suggest trend to further narrow ACA exchange networks during 2017.
The Wall Street Journal reports that some insurers plan to accelerate moves toward limited network plans offered on Affordable Care Act (ACA) exchanges. An analysis of regulatory filings for 18 states and the District of Columbia finds that 75 percent of insurer offerings on healthcare exchanges in 2017 will likely be health-maintenance organizations or exclusive provider organizations. Preferred-provider organizations (PPOs) would make up the remaining 25 percent. Across the filings examined by McKinsey & Co., about 15 percent of exchange-eligible consumers may have no PPOs to choose from.
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AAOS updates privacy policy.
AAOS has updated its privacy policy to clarify that the policy applies to all AAOS mobile apps; to clarify that third-party software, programs, and services used in connection with the AAOS website may collect data about the website visitors; and to more clearly define the types of end user data that may be collected and how that data may be used. The revisions also include a notice that AAOS Annual Meeting registrants may opt-in to the release of their email addresses to exhibitors through the lead retrieval system in use on the exhibit floor. Finally, the updated policy identifies the opt-out mechanisms for AAOS electronic newsletters.
View the complete privacy policy…
