IV bag

Amongst eligible patients, age and comorbidity do not predict for dose limiting toxicity from phase I chemotherapy

Amongst eligible patients, age and comorbidity do not predict for dose limiting toxicity from phase I chemotherapy

Dr. Noelle LoConte et al. sought to identify clinical and non-clinical factors which were associated with the development of dose-limiting toxicity in phase I studies. Over 200 charts were reviewed from 24 cytotoxic chemotherapy studies and Cumulative Illness Rating Score-Geriatrics (CIRS-G) score was not associated with dose-limiting toxicity. Several social and clinical factors may predict for development of dose-limiting toxicity.

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The diagnosis of diverticulitis in outpatients: On what evidence?

The diagnosis of diverticulitis in outpatients: On what evidence?

Investigators used electronic health record data to examine the clinical assessment generating the diagnostic label of diverticulitis in outpatients. They found that diverticulitis in the outpatient setting is often characterized by infrequent use of CT scans, lack of leukocytosis, and rare need for urgent surgery or early admission. Further study is needed as this diagnostic label seems to be commonly applied without objective evidence.

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Analysis of guidelines for screening diabetes mellitus in an ambulatory population

Analysis of guidelines for screening diabetes mellitus in an ambulatory population

This study compared the case-finding ability of current national guidelines for screening diabetes mellitus and characterized factors that affect testing practices in an ambulatory population. In this retrospective analysis, investigators found that compared with the American Diabetes Association (ADA) recommendations, the United States Preventive Services Task Force (USPSTF) guidelines result in a lower number of patients eligible for screening and decreased case-finding significantly. The number and type of risk factors predict diabetes, and lack of health insurance decreases testing.

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Physician assistants and nurse practitioners as a usual source of care

Physician assistants and nurse practitioners as a usual source of care

This article published in The Journal of Rural Health used Wisconsin Longitudinal study data to identify characteristics and outcomes of patients who primarily see physician assistants (PAs) or nurse practitioners (NPs). Populations served most by PA/NPs tend to live in rural areas and have public insurance or no insurance coverage. They are also more likely to be women, younger, and have lower extroversion scores. There were few differences in utilization and no reported differences in difficulties/delays in care or outcomes compared to patients that primarily see doctors. 

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Insurance disruption due to spousal Medicare transitions

Insurance disruption due to spousal Medicare transitions

In this study, researchers looked at the care of married women under age 65 from the Wisconsin Longitudinal Study. The authors found that despite consistent insurance coverage, the insurance disruption that accompanies a spouse's Medicare transition has adverse access and health care utilization consequences for women, including a greater probability of experiencing a change in usual clinic/provider, delaying filling medications or taking fewer medications than prescribed because of cost, going to the emergency room, and having lower average mental health scores than women who did not experience an insurance disruption. 

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