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Readmission rates following hospitalization for heart failure may be related to the quality of care coordination and continuity. Van Spall and colleagues randomized 2494 adults hospitalized for heart failure and found that implementation of a patient-centered transitional care model, compared with usual care, did not improve clinical outcomes.
A surgeon who begins a procedure before finishing a prior procedure may be less available to address surgical complications. In a retrospective cohort study of 66 430 surgical procedures, Sun and colleagues found that overlapping surgery was not associated with differences in in-hospital mortality or postoperative complication rates, but was associated with increased surgery length.
Author Audio Interview
Myelosuppression is an adverse event associated with the use of thiopurines for the treatment of inflammatory bowel disease. Walker and colleagues and the IBD Pharmacogenetics Study Group conducted genetic studies on 1077 patients treated with thiopurine drugs and found that variants in NUDT15 were associated with increased risk of thiopurine-induced myelosuppression.
Chronic obstructive pulmonary disease (COPD) is characterized by incompletely reversible airflow obstruction with dyspnea, cough, and excessive sputum production. Riley and Sciurba review the clinical management of COPD with long-acting maintenance bronchodilators, inhaled corticosteroids, and pulmonary rehabilitation.
Author Audio Interview and CME
In this JAMA Guide to Statistics and Methods, Saver and Lewis compare the “number needed to treat,” which expresses the clinical benefit of a therapy from the perspective of a patient, vs “benefit per hundred patients treated,” which expresses clinical benefit from the perspective of a physician.
In this JAMA Clinical Guidelines Synopsis of a 2018 guideline developed by the American Heart Association and the American College of Cardiology, Alenghat and Davis discuss the management of blood cholesterol for patients at risk of atherosclerotic cardiovascular disease. An Editorial by Peterson and Greenland notes that this update bases treatment recommendations on more precise estimates of cardiovascular risk.
Related Article and Editorial
Highlights. JAMA. 2019;321(8):719–721. doi:10.1001/jama.2018.15212
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