Study links POEM to low rate of adverse events | Study questions accuracy of FIT in patients at high risk for CRC | Advanced fibrosis risk high in relatives of patients with NAFLD, cirrhosis
June 21, 2017
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Clinical Updates
Study links POEM to low rate of adverse events
Data from 1,826 peroral endoscopic myotomy procedures to treat achalasia showed a 7.5% overall prevalence of adverse events, researchers report in the American Journal of Gastroenterology. The multicenter case-control study found predictors of adverse events included sigmoid-type esophagus, endoscopist experience, use of a triangular tip knife and use of an electrosurgical current different from spray coagulation.
Healio (free registration) (6/19) 
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Study questions accuracy of FIT in patients at high risk for CRC
A meta-analysis of 12 studies on the diagnostic accuracy of FIT for CRC and advanced neoplasia in high-risk patients found that the tests had an average 93% sensitivity and 91% specificity for CRC, but only an average 48% sensitivity for advanced neoplasia with 93% specificity. The analysis was published in JAMA Internal Medicine.
MedPage Today (free registration) (6/20) 
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Advanced fibrosis risk high in relatives of patients with NAFLD, cirrhosis
A study in the Journal of Clinical Investigation found first-degree relatives of patients with nonalcoholic fatty liver disease plus cirrhosis had a twelvefold increased risk of advanced liver fibrosis, compared with the general population. The findings were based on noninvasive imaging-based quantification of liver fat and liver fibrosis in 65 patients and relatives and 138 controls.
Family Practice News (6/19) 
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Study links IBS-D with immune system exhaustion
Immune system exhaustion may be associated with diarrhea-predominant irritable bowel syndrome, researchers report in the journal Gut. All IBS-D patients studied showed the same type of exhaustion in their T cells, making the cells less responsive to stimulation and causing them to secrete fewer mediators and divide less.
ScienceDaily (6/20) 
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Legal & Regulatory
CMS Releases Proposed CY 2018 MIPS and APMs Requirements
Yesterday, CMS released the CY 2018 Medicare Quality Payment Program proposed regulation. This regulation outlines the proposed requirements for the Merit-based Incentive Payment System (MIPS), as well as for qualified or "advanced" alternative payment models (APMs) under MACRA. ACG will soon provide a detailed summary of the rule and its potential impact to clinical GI. Access a top-line summary, which was emailed to ACG members last night.
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Republicans aim to release health care bill text this week, vote before recess
GOP senators and aides said they expect the Senate to finish writing health care legislation later this week, and a vote is likely next week. Portions of the legislation have been sent to the Congressional Budget Office, and a report on how the provisions would affect insurance coverage and the federal budget could come early next week, although it's not clear whether Republicans have the votes to pass the bill.
Politico (6/20),  The Wall Street Journal (tiered subscription model) (6/19),  The Hill (6/19) 
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ACG Note: Stay up to date with the latest on health care reform legislation and public policy developments affecting clinical GI with ACG's "This Week in Washington, DC."
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Practice News
MedPAC report suggests MIPS may not help patients, clinicians
A Medicare Payment Advisory Commission report said commissioners are looking at revising the Quality Payment Program because its Merit-based Incentive Payment System may not help people choose a clinician or help practitioners change their practices to improve value. MedPAC also made recommendations on ways to improve the Medicare Part B drug program.
MedPage Today (free registration) (6/16) 
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ACG Note: While the MedPAC reports are mandated by Congress, these reports are just recommendations to Congress and CMS. It is worth noting that MedPAC concludes what ACG Governors and ACG members have been educating Congress and CMS all along. Please read ACG's most recent MACRA Tidbit for the Week for more.
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Hospitals could bear burden of complying with EHR requirements
The CMS' proposal to ease some EHR requirements under the Medicare Access and CHIP Reauthorization Act would only benefit physicians and still require hospitals to comply with the meaningful use requirements. EHR vendors are not yet ready with their products, putting hospitals on a tight deadline to implement certified systems once they are available.
Modern Healthcare (tiered subscription model) (6/20) 
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Business & Market Trends
DHS memo cites health care sector's vulnerability to cyberattacks
The health care sector is one of the industries that is "highly vulnerable" and "frequently targeted" by ransomware attacks, according to a memo issued by the Department of Homeland Security's National Protection and Programs Directorate Office of Cyber and Infrastructure Analysis. The document also said organizations face an increased risk of being targeted by ransomware because of the proliferation of individual internet-connected devices.
Federal Computer Week (6/19) 
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Patient's Perspective
Survey examines consumers' views on virtual doctor visits
The Advisory Board's Virtual Visits Consumer Choice Survey showed that up to 77% of approximately 5,000 consumers surveyed have expressed interest in seeing doctors virtually, while 19% have already participated in virtual doctor visits. Researchers also found several consumer concerns with virtual visits, including the quality of health care and the inability of providers to treat or diagnose patients virtually.
Healthcare Informatics online (6/19) 
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ACG News
Receive the Self-Assessment Test, print version, when you register for the WCOG at ACG2017 Postgraduate Course
Back by popular demand, all registered attendees of the Postgraduate Course at WCOG at ACG2017 will receive the two-volume Self-Assessment Test (SAT), print version, at no additional charge. The SAT includes approximately 300 questions and answers that will test your knowledge and help you prepare for recertification. You can earn additional CME and MOC when you complete the SAT. You can purchase access to an online version of the Self-Assessment Test when you register. Registration for the two-day Postgraduate Course is open. Review the Postgraduate Course. Register here. Make your hotel reservations here.
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Registration for the ACG/VGS/ODSGNA Regional PG Course is now open
Join colleagues at the ACG/VGS/ODSGNA Regional PG Course, Sept. 9-10, at the Williamsburg Lodge in Williamsburg, VA. The course is ideal for the clinician who wants a comprehensive update but doesn't want to spend valuable time away from the office. The agenda will feature presentations on eosinophilic esophagitis, Barrett's esophagus, polypectomy, colon cancer screening options, the role of the microbiome in IBS, liver disorders, ERCP, EUS, IBD, and practice management. In addition, the keynote lecture, Ergonomics and Endoscopy, will provide valuable pearls to incorporate into practice. The program will also feature a special Nursing Breakout Session on Saturday afternoon. Review the course brochure here. Register here.
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