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August 2018 Briefing - Pulmonology

Here are what the editors at HealthDay consider to be the most important developments in Pulmonology for August 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Medical Bills in Collections Decrease With Patient Age

FRIDAY, Aug. 31, 2018 -- Medical collections decrease substantially with age, possibly because of increased health insurance coverage and incomes, according to a study published in the August issue of Health Affairs.

Abstract/Full Text (subscription or payment may be required)

14.6 Percent of U.S. Adults Used Marijuana in Past Year

FRIDAY, Aug. 31, 2018 -- Overall, 14.6 percent of U.S. adults report marijuana use in the past year, according to a research letter published online Aug. 28 in the Annals of Internal Medicine.

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No Meaningful Increase in Physician Compensation Last Year

THURSDAY, Aug. 30, 2018 -- There was no meaningful increase in physician compensation in 2017, and a decline in productivity was noted, according to the results of a survey conducted by AMGA Consulting.

Press Release
Survey (subscription or payment may be required)

MICs of Isoniazid, Rifampin May Predict Tuberculosis Relapse

THURSDAY, Aug. 30, 2018 -- In pretreatment isolates of Mycobacterium tuberculosis, higher minimum inhibitory concentrations (MICs) of isoniazid and rifampin below the standard resistance breakpoint are associated with increased risk of relapse, according to a study published in the Aug. 30 issue of the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Marketplace Premiums Increase More With Monopolist Insurers

WEDNESDAY, Aug. 29, 2018 -- Affordable Care Act Marketplace premiums increase more in areas with monopolist insurers, according to a study published in the August issue of Health Affairs.

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Chronic Vaping Exerts Biological Effects on Lungs

WEDNESDAY, Aug. 29, 2018 -- Chronic vaping exerts biological effects on the lung, some of which may be mediated by the propylene glycol/vegetable glycerin (PG/VG) base, according to a study published in the July 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Medical Practices Should Address Negative Online Reviews

TUESDAY, Aug. 28, 2018 -- Medical practice staff can effectively handle negative online reviews by staying calm and positive, looking for solutions, apologizing, and thanking the reviewers, according to an article published in Physicians Practice.

Abstract/Full Text

Poor Shared Decision-Making for Lung Cancer Screening

TUESDAY, Aug. 28, 2018 -- The quality of shared decision-making (SDM) about the initiation of lung cancer screening (LCS) is poor, according to a study published online Aug. 13 in JAMA Internal Medicine.

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Editorial (subscription or payment may be required)
Invited Commentary (subscription or payment may be required)

Artificial Intelligence Holds Promise in Medicine

TUESDAY, Aug. 28, 2018 -- Artificial intelligence (AI) in health care offers opportunities for early detection and triage, diagnostics and personalized medicine, and medical decision-making, according to an article published in Managed Healthcare Executive.

Abstract/Full Text

Alcohol Is Leading Risk Factor for Global Disease Burden

TUESDAY, Aug. 28, 2018 -- Globally, alcohol use is a leading risk factor for disease burden, according to research published online Aug. 23 in The Lancet.

Abstract/Full Text
Editorial

Experts Address Loss of the National Guideline Clearinghouse

TUESDAY, Aug. 28, 2018 -- The demise of the National Guideline Clearinghouse (NGC) in July 2018 is likely to impact evidence-based health care around the world, according to an Ideas and Opinions piece published online Aug. 28 in the Annals of Internal Medicine.

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Prevalence of E-Cigarette Use 4.5 Percent in U.S. Adults

MONDAY, Aug. 27, 2018 -- The prevalence of electronic cigarette (e-cigarette) use among U.S. adults is 4.5 percent, with higher prevalence among those aged 18 to 24 years, according to a study published online Aug. 28 in the Annals of Internal Medicine.

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Editorial (subscription or payment may be required)

Most Research Participants Not Concerned About Data Sharing

MONDAY, Aug. 27, 2018 -- Few participants in clinical trials have strong concerns about the risks of data sharing, according to a special article recently published in the New England Journal of Medicine.

Abstract/Full Text

Care Coordination Strategies Aid in Multiple Chronic Diseases

MONDAY, Aug. 27, 2018 -- Care coordination strategies can be beneficial for older patients with multiple chronic diseases, according to a review published in the Aug. 27 issue of CMAJ, the journal of the Canadian Medical Association.

Abstract/Full Text (subscription or payment may be required)
Editorial

AMA Adopts Policy Promoting Health Equity As a Goal

FRIDAY, Aug. 24, 2018 -- The American Medical Association (AMA) House of Delegates has adopted a policy that sets health equity as a goal for the U.S. health care system, according to a report published in the organization's AMA Wire.

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Frailty in Middle-Aged With Multimorbidity Tied to Mortality

THURSDAY, Aug. 23, 2018 -- For middle-aged individuals with multimorbidity, frailty is significantly associated with mortality, according to a study published in the July issue of The Lancet Public Health.

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Editorial

Most Surgical Residents Want Financial Education

THURSDAY, Aug. 23, 2018 -- Surgical residents feel strongly that personal financial education should be offered during medical training, according to a study published in the August issue of the Journal of the American College of Surgeons.

Abstract/Full Text

Long-Term PPI Use Linked to Pneumonia Risk in Older Adults

THURSDAY, Aug. 23, 2018 -- Among older adults in primary care, use of proton pump inhibitors (PPIs) is associated with greater risk of pneumonia in the second year of treatment, according to a study published in the July issue of the Journal of the American Geriatrics Society.

Abstract/Full Text

Small Practices Also at Risk for Data Breaches

WEDNESDAY, Aug. 22, 2018 -- Data breaches can happen to small medical practices, but staff can take steps to prevent them, according to an article published in Medical Economics.

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Strategy Outlined for Shooter Incident in Health Care Facility

WEDNESDAY, Aug. 22, 2018 -- Adhering to a "secure, preserve, fight" strategy is recommended for health care professionals working with a vulnerable patient population, according to a Medicine and Society piece published in the Aug. 9 issue of the New England Journal of Medicine.

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Teen Smoke Exposure Tied to Increase in Related Symptoms

WEDNESDAY, Aug. 22, 2018 -- Non-smoking adolescents with tobacco smoke exposure (TSE) have increased risk of TSE-related symptoms, according to a study published online Aug. 6 in Pediatrics.

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National Provider Identifiers Are Vulnerable to Theft

WEDNESDAY, Aug. 22, 2018 -- National Provider Identifiers (NPIs) are vulnerable to identity theft, according to an article published in Physicians Practice.

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Advantages for HDHP Enrollees in Large Versus Small Firms

WEDNESDAY, Aug. 22, 2018 -- Workers in small firms are more likely to have higher deductible levels and lack employer contributions to help pay for out-of-pocket expenses compared to workers in larger firms, according to a study published in the August issue of Health Affairs.

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Similar Outcomes for Rural, Urban Cancer Patients in SWOG Trials

WEDNESDAY, Aug. 22, 2018 -- Rural and urban cancer patients with uniform care access through participation in a SWOG (formerly the Southwest Oncology Group) treatment trial have similar outcomes, according to a study published online Aug. 17 in JAMA Network Open.

Abstract/Full Text
Editorial

Doctors Often Not Discussing Risk Factors With Patients

TUESDAY, Aug. 21, 2018 -- Patients report that doctors are routinely not discussing known risk factors for common causes of death, according to a survey conducted by ImagineMD.

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Plan to Relax Coal-Fired Power Plant Rules Could Up Mortality

TUESDAY, Aug. 21, 2018 -- The Trump administration's plan to relax pollution rules for coal-fired power plants will increase carbon emissions and cause up to 1,400 premature deaths a year, according to details released Tuesday.

The New York Times Article
EPA News Release

Pennsylvania Case Could Affect Evidence for Malpractice Defense

TUESDAY, Aug. 21, 2018 -- The Pennsylvania Supreme Court has agreed to hear a case that could affect what evidence physicians may present in defense during medical malpractice suits, according to an article published in the American Medical Association's AMA Wire.

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Wildfire Smoke Causing Poor Air Quality in U.S. Pacific Northwest

MONDAY, Aug. 20, 2018 -- Smoke from wildfires will cause poor air quality in parts of the U.S. Pacific Northwest this week, officials warn.

AP News Article
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NYU Becomes First Medical School to Cover All Tuition

MONDAY, Aug. 20, 2018 -- The NYU School of Medicine has announced that it is offering full-tuition scholarships to all current and future students in its M.D. degree program, regardless of need or merit.

Press Release

Experts Offer Tips for Provider Appeal of Denied Medical Claims

MONDAY, Aug.20, 2018 -- Knowing payer policies and regulatory requirements is critical to appealing denials, according to an article published in Medical Economics.

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Little Global Development Assistance for Adolescent Health

MONDAY, Aug. 20, 2018 -- Development assistance for adolescent health (DAAH) makes up a small proportion of total development assistance for health, according to a study published online Aug. 10 in JAMA Network Open.

Abstract/Full Text

Heat-Driven Air Conditioning May Contribute to Additional Deaths

MONDAY, Aug. 20, 2018 -- In what can be described as a vicious catch-22, approximately 5 to 9 percent of exacerbated air-pollution-related deaths will be due to increases in power sector emissions from the extra air conditioning use resulting from climate change, according to a study published online July 3 in PLOS Medicine.

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Many Children With Asthma Do Not Have Medications Ready

MONDAY, Aug. 20, 2018 -- Many low-income urban preschool-aged children with asthma do not meet the criteria for home medication readiness, according to a study published online Aug. 7 in Pediatrics.

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Declines in Life Expectancy in Many High-Income Countries

MONDAY, Aug. 20, 2018 -- Life expectancy has declined in recent years in some high-income countries, and in the United States, midlife mortality has increased due to several causes, according to two studies published online Aug. 15 in The BMJ.

Abstract/Full Text - Ho and Hendi
Abstract/Full Text - Woolf
Editorial

Tobacco Content Still Common on U.K. Prime-Time Television

MONDAY, Aug. 20, 2018 -- Audiovisual tobacco content remains common in prime-time U.K. television programs and is virtually unchanged from 2010, according to a study published online Aug. 13 in Tobacco Control.

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Comments Open on End of NIH Review for Gene Therapy Studies

FRIDAY, Aug. 17, 2018 -- A U.S. National Institutes of Health oversight panel will no longer review all applications for gene therapy experiments. Instead, the panel will assume an advisory role, while the U.S. Food and Drug Administration will assess gene therapy experiments and products as it does with other treatments and drugs. The proposed change will take effect after a public comment period which runs through Oct. 16.

AP News Article
NIH Statement
Comment on Regulations

Residents' Sleep Deteriorates During Training

FRIDAY, Aug. 17, 2018 -- First-year residents experience worsening sleep duration and quality as well as daytime sleepiness, according to a study published in the June issue of the Journal of General Internal Medicine.

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Editorial (subscription or payment may be required)

E-Cigarette Vapor Condensate Toxic to Alveolar Macrophages

FRIDAY, Aug. 17, 2018 -- Electronic cigarette (e-cigarette) vapor condensate (ECVC) is significantly more toxic to alveolar macrophages than e-cigarette liquid (ECL), according to a study published online Aug. 13 in Thorax.

Abstract/Full Text

QI Program Can Up Outcomes for Neonatal Abstinence Syndrome

FRIDAY, Aug. 17, 2018 -- Significant improvements in neonatal abstinence syndrome (NAS) outcomes can result from a comprehensive quality improvement (QI) program, according to a study published in the August issue of the Journal of Perinatology.

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Practice Names, Logos Should Be Carefully Designed

THURSDAY, Aug. 16, 2018 -- Practice names and logos should be carefully designed to emphasize what is unique about a practice, according to a blog post published in Physicians Practice.

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NIH Panel Will No Longer Review Gene Therapy Experiments

THURSDAY, Aug. 16, 2018 -- A U.S. National Institutes of Health oversight panel will no longer review all applications for gene therapy experiments, according to a perspective piece published online Aug. 15 in the New England Journal of Medicine.

Abstract/Full Text
NIH Statement

ACA Coverage Gains Include Workers Without Insurance

THURSDAY, Aug. 16, 2018 -- After the expanded coverage provisions of the Affordable Care Act (ACA) were implemented in 2014, self-employed individuals and wage earners without employer-sponsored health coverage offers had coverage gains equal to or greater than those of people not employed, according to a report published in the August issue of Health Affairs.

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Steps Provided for Discharging Patient From Practice

THURSDAY, Aug. 16, 2018 -- Certain steps should be taken when discharging a patient for failure or inability to meet financial obligations, according to an article published in Physicians Practice.

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Patient Portals Don't Appear to Have Much Traction

THURSDAY, Aug. 16, 2018 -- Patient portals have not taken off as expected, according to an article published in Medical Economics.

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Rate of Pediatric Emergencies in Ambulatory Practices Identified

WEDNESDAY, Aug. 15, 2018 -- The rate of pediatric emergency medical services (EMS) transports from ambulatory practices is 42 per 100,000 children per year, according to a study published in the August issue of Pediatrics.

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Broad Genetic Testing for NSCLC May Not Improve Survival

WEDNESDAY, Aug. 15, 2018 -- Broad-based genomic sequencing does not improve survival compared to routine genetic testing among patients with advanced non-small-cell lung cancer (NSCLC), according to a study published in the Aug. 7 issue of the Journal of the American Medical Association.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Labetalol Use Up for Patients With Preeclampsia and Asthma

WEDNESDAY, Aug. 15, 2018 -- Higher rates of β-blocker use are seen among women with preeclampsia and asthma, according to a study published in the July issue of Obstetrics & Gynecology.

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E-Cigarette Smoking Tied to Later Marijuana Use in Teens

TUESDAY, Aug. 14, 2018 -- Teenagers' use of any tobacco products, including electronic cigarettes (e-cigarettes), is associated with subsequent marijuana use, according to a study published in the August issue of Pediatrics.

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6 Factors Related to Inclusion in Health Care Workplace ID'd

TUESDAY, Aug. 14, 2018 -- There are six broad factors that can affect inclusion within health care organizations, according to a study published online Aug. 3 in JAMA Network Open.

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Editorial

Physicians With Medicine/Psych Training Can Help Complex Cases

TUESDAY, Aug. 14, 2018 -- Physicians boarded in both medicine and psychiatry can offer a way to address some of the challenges associated with caring for medical patients with psychiatric comorbidities, according to an article published in Psychiatric Times.

Abstract/Full Text

Four Pros to Integrating EHR, Practice Management Software

MONDAY, Aug. 13, 2018 -- Consolidating electronic health records and practice management software allows practices to save time and money, make fewer mistakes, and reduce the risk of privacy breaches, according to an article published in Physicians Practice.

Abstract/Full text

C. difficile Tied to Increased Graft Loss in Solid Organ Recipients

MONDAY, Aug. 13, 2018 -- For solid organ transplant (SOT) recipients, Clostridium difficile infection (CDI) is associated with increased graft loss, according to a study published in the July issue of the American Journal of Transplantation.

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FDA Warns Against Long-Term Azithromycin Use for Some

MONDAY, Aug. 13, 2018 -- The U.S. Food and Drug Administration is warning patients with cancers of the blood or lymph nodes who undergo a donor stem cell transplant not to take azithromycin, as long-term use of the antibiotic has been associated with increased risk of cancer relapse.

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MedWatch Reporting

Will Lunar and Planet Dust Be Health Concerns of the Future?

FRIDAY, Aug. 10, 2018 -- Dust could pose a health hazard if astronauts start spending extended periods of time on the Moon, Mars, or other airless planets, according to a study published recently in GeoHealth.

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Bundling Doesn't Cut Medicare Payments for Medical Conditions

FRIDAY, Aug. 10, 2018 -- Bundling of payments for five common medical conditions is not associated with changes in Medicare payments per episode or health outcomes, according to a study published in the July 19 issue of the New England Journal of Medicine.

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AMA Adopts Policy on Augmented Intelligence

FRIDAY, Aug. 10, 2018 -- The American Medical Association (AMA) House of Delegates has adopted a policy on augmented intelligence, according to a report published in the association's AMA Wire.

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AMA Adopts Policy to Advance Gender Equity in Medicine

THURSDAY, Aug. 9, 2018 -- The American Medical Association (AMA) House of Delegates has adopted a new policy to study, act for, and advocate to advance gender equity in medicine, according to a report published in the association's AMA Wire.

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Cyber Insurance Recommended for All Physician Practices

WEDNESDAY, Aug. 8, 2018 -- The growing threat of hacking is increasing the number of physicians buying cyber insurance, according to an article published in Medical Economics.

Abstract/Full Text

Steps Taken to Increase Use of Electronic Tools in Medicine

WEDNESDAY, Aug. 8, 2018 -- Additional codes have been approved by the Current Procedural Terminology (CPT) Editorial Panel for chronic care remote physiologic monitoring and internet consultations, according to a report published by the American Medical Association (AMA).

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AMA Proposes Policy Opposing Medicaid 'Lockout' Provisions

TUESDAY, Aug. 7, 2018 -- A new policy opposing lockout provisions that block Medicaid patients from the program for lengthy periods and instead supporting allowing patients to reapply immediately for redetermination was adopted by the American Medical Association (AMA) House of Delegates during the AMA's annual meeting in Chicago, according to an article published in the association's AMA Wire.

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AMA Calls for Greater Electronic Cigarette Regulation

TUESDAY, Aug. 7, 2018 -- The American Medical Association (AMA) has adopted several policies to improve the regulation of tobacco products, including electronic cigarettes (e-cigarettes), according to an article published in the association's AMA Wire.

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Routine X-Ray Not Needed After US-Guided Central Line Insertion

TUESDAY, Aug. 7, 2018 -- Pneumothorax and catheter misplacement after ultrasound-guided central venous catheter (CVC) insertion are rare and thus do not justify post-procedural chest X-ray (CXR), according to a study published in the July issue of CHEST.

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Death Records Estimate 1,139 Deaths Due to Hurricane Maria

TUESDAY, Aug. 7, 2018 -- Based on death records following Hurricane Maria, the hurricane-related mortality burden of excess deaths through December 2017 is estimated to be 1,139, higher than the official death toll of 64, according to a research letter published online Aug. 2 in the Journal of the American Medical Association.

Abstract/Full Text

Biomarker Panel May Improve Lung Cancer Risk Assessment

MONDAY, Aug. 6, 2018 -- Biomarker-based risk profiling has the potential to improve lung cancer risk assessment, according to a study published online July 12 in JAMA Oncology.

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Rifampin Effective for Latent Tuberculosis in Children

MONDAY, Aug. 6, 2018 -- In children with latent tuberculosis, a regimen of four months of rifampin has better rates of completion than nine months of isoniazid, with similar safety profiles, according to a study published in the Aug. 2 issue of the New England Journal of Medicine.

Abstract/Full Text

Some Bacteria Now More Tolerant of Alcohol-Based Sanitizers

FRIDAY, Aug. 3, 2018 -- Some types of bacteria are developing tolerance of alcohol-based hand sanitizers used in hospitals, according to a study published in the Aug. 1 issue of Science Translational Medicine.

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Variation in Specialty Drug Coverage Across Health Plans

FRIDAY, Aug. 3, 2018 -- There is considerable variation in specialty drug coverage across commercial health plans, according to a study published in the July issue of Health Affairs.

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Skin Appears to Be Key Pathway for Absorption of BBQ Fumes

FRIDAY, Aug. 3, 2018 -- Dermal absorption is a more important pathway than inhalation for the intake of low-molecular-weight polycyclic aromatic hydrocarbons (PAHs) during barbecuing, according to a study published recently in Environmental Science & Technology.

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CDC: E-Cigarette Sales in the United States Climb As Prices Fall

FRIDAY, Aug. 3, 2018 -- There was a large increase in sales of electronic cigarettes (e-cigarettes) and related products in the United States in recent years as their prices fell, according to a study published online Aug. 2 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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FDA Statement
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Rifampin Similar to Isoniazid for Preventing Active Tuberculosis

FRIDAY, Aug. 3, 2018 -- A four-month regimen of rifampin is similar to a nine-month regimen of isoniazid for the prevention of active tuberculosis, according to a study published in the Aug. 2 issue of the New England Journal of Medicine.

Abstract/Full Text

Groups Urge CMS to Reconsider Suspending Risk Adjustment

FRIDAY, Aug. 3, 2018 -- In a letter sent to Administrator Seema Verma of the Centers for Medicare & Medicaid Services (CMS), medical organizations are urging reconsideration of the decision to suspend payments to insurers as required under the Affordable Care Act's risk-adjustment program.

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Health Affairs Announces Launch of New Three-Year Initiative

THURSDAY, Aug. 2, 2018 -- A council on health care spending and value has been established by the journal Health Affairs.

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Three Financial Metrics Can Improve Practice Performance

THURSDAY, Aug. 2, 2018 -- By understanding three indices and metrics, physicians can change the financial outcome of their medical practice, according to a report published in Medical Economics.

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NIH Releases Large-Scale Dataset of CT Images

THURSDAY, Aug. 2, 2018 -- To help improve detection accuracy of lesions, the National Institutes of Health (NIH)'s Clinical Center has made available a large-scale dataset of 32,000 annotated lesions identified on computed tomography (CT) images.

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E-Cigarettes Don't Seem to Aid Smoking Cessation Efforts

THURSDAY, Aug. 2, 2018 -- Electronic cigarette (e-cigarette) use is most common among current smokers, according to a study published online July 20 in JAMA Network Open.

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New Short-Term Health Plans Have Large Coverage Gaps

THURSDAY, Aug. 2, 2018 -- There are large coverage gaps in short-term health plans that were approved Wednesday by the Trump administration, and are described by critics as "junk insurance."

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How Doctors Receive Feedback Is Key for Antimicrobial Programs

THURSDAY, Aug. 2, 2018 -- Anticipation of how providers will receive feedback is important for antimicrobial stewardship programs to consider in informing educational messaging, according to a study published online June 7 in Infection Control & Hospital Epidemiology.

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National Guideline Clearinghouse Offline Due to Funding Cuts

WEDNESDAY, Aug. 1, 2018 -- The National Guideline Clearinghouse (NGC) and National Quality Measures Clearinghouse (NQMC) websites were taken down on July 16 when funding for these federal databases ended, according to an announcement by the Agency for Healthcare Research and Quality (AHRQ).

Announcement
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Steps Can Be Taken by Doctors to Minimize Risk of Lawsuits

WEDNESDAY, Aug. 1, 2018 -- Targeted steps can be taken to minimize future risks of lawsuits, according to an article published in Physicians Practice.

Abstract/Full Text

Telemedicine Cuts Inter-Hospital ICU Transfers of Critically Ill

WEDNESDAY, Aug. 1, 2018 -- Telemedicine is associated with a decrease in inter-hospital intensive care unit (ICU) transfers, according to a study published in the July issue of CHEST.

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Posted: September 2018


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