ahrq

Case Reports Serve a Place in Dentistry

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An interesting article titled “CASE REPORTS HAILED” appears in JADA in September 2014, written by Enihomo Obadan, Elsbeth Kalenderian, and Rachel B. Ramoni. The article discusses an article in an earlier 2014 JADA article that featured an interesting case report. The authors state “Almost becoming a lost art in the biomedical literature, case reports still hold tremendous opportunities for learning in dentistry. In addition to the obvious learning potential for the individual dental professional, the entire professional body advances in giant strides when there is cross-organizational learning among dental clinics through information sharing.” The authors then discuss how adverse dental events being reported by dentists would help make dental treatments safer for all. The authors feels this helps promote a culture of safety, as long as there is no fear of retribution when the report occurs by the dentists. The … Read more

Dietary Goals of the United States

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I have previously written about  Dr. McDougall through finding his newsletter in a Google Search where he discussed how to protect yourself from abusive doctors. See http://blog.teethremoval.com/how-to-protect-yourself-from-abusive-doctors/. Earlier this year I also discussed in a post some of Dr. McDougalls thought’s on Food, Children, and Diet where he wrote to governor Rick Scott of Florida claiming that various food industries are engaged in child abuse. In his newsletter from October 2012, he discussed former democratic senator George McGovern and his McGovern report from 1977 where guideline for eating were developed, http://www.drmcdougall.com/misc/2012nl/oct/mcgovern.htm. Dr. McDougall says that the McGovern report says “…there is a great deal of evidence and it continues to accumulate, which strongly implicates and, in some instances, proves that the major causes of death and disability in the United States are related to the diet we eat…What are the … Read more

Controversy Over Spinal Fusion

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Debate over spinal fusion surgery continues to occur. A recent article tiled “Spinal fusions serve as a case study for debate over when certain surgeries are necessary,” appears in the Washington Post written by Peter Whoriskey and Dan Keating and published on October 27, 2013. (Note I have previously mentioned some of the controversy over spinal fusion in the post Tips to Prevent Medical Errors – AHRQ) The article mentions that spinal fusions being performed in the U.S. has risen over the years and that around half of the surgeries they reviewed don’t meet expert consensus on when the surgery should be performed. This article discusses a surgeon at a Florida hospital who was earning well over a million a year performing spinal fusions on patients. Auditors at the hospital began to wonder if all the cases were necessary and … Read more

How to Determine If a Clinical Practice Guideline is Trustworthy

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An interesting article titled “How to Decide Whether a Clinical Practice Guideline Is Trustworthy,” written by David F. Ransohoff, MD Michael Pignone, MD, MPH, and Harold C. Sox, MD appears in JAMA, January 9, 2013,Vol 309, No. 2, pp. 139 -140. The article mentions how many controversies have arose recently over cancer screening guidelines. The article mentions how in 2008 Congress gave the Institute of Medicine (IOM) of the National Academies with developing standards for objective, scientifically valid, and consistent approaches to developing practice guidelines. Well as I mentioned in this blog post Tips to Prevent Medical Errors – AHRQ Congress actually gave the Agency for Health Care Policy and Research (AHCPR) in 1989 evidence-based, clinical-practice guidelines. However, the medical device industry and several doctors organizations opposed this as it was threatening to limit their profits and found a sympathetic ear … Read more

Unnecessary Medical Care and Over Used Tests: The Choosing Wisely Campaign

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The Choosing Wisely Campaign is an initiative which I believe I first heard about in late 2010 launched by the ACR (American College of Radiation as the Imaging Wisely Campaign) The Imagely Wisely Campaign was designed to have people aware of the fact that certain medical imaging tests such as CT exams were sometimes over used and did not always have to be used in some instances. It seems that the Choosing Wisely Campaign was launched by the ABIM Foundation which is an organization designed to advance medical professionalism to improve patient care. In April 2012 the Choosing Wisely Campaign released some lists of tests and procedures commonly done in 9 medical professions that should be questioned.  In February 2013 an additional 18 lists of tests or procedures were released. The press release is located at http://www.choosingwisely.org/wp-content/uploads/2013/02/021513_CW-Phase-II-Press-Release-FINAL.pdf On the website … Read more