Reflux esophagitis risk not associated with NAFLD, study suggests | Fatty liver index may help identify those at risk of colorectal adenomas | Perianal fistula treatment with stem cells shows lasting benefit
December 13, 2017
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A study in the Journal of Gastroenterology and Hepatology found no link between nonalcoholic fatty liver disease and an elevated risk of incident reflux esophagitis after adjusting for body mass index and other variables. "NAFLD is not independently associated with the risk of the development of reflux esophagitis, but rather reflux esophagitis is primarily the consequence of increased BMI commonly associated with NAFLD," researchers wrote.
Research in the journal Diseases of the Colon & Rectum found a high fatty liver index may indicate a higher risk of colorectal adenomas. The noninvasive method, which is used to predict nonalcoholic fatter liver disease, can help screen out those who may need a colonoscopy to detect the presence of the precancerous colon polyps.
A European study presented at the World Congress of Gastroenterology at ACG2017 found that stem cell treatment of perianal fistulas in patients with Crohn's disease produced better outcomes at 52 weeks than those reported at 26 weeks. Researchers said the Cx601 cells "are a revolutionary step forward."
A new acid blocker, vonoprazan, prevented ulcer recurrence among patients taking aspirin and NSAIDs, according to two studies in the journal Gut. The drug does not require an enteric-coated formulation, and its strong and long-lasting inhibition of gastric acid secretion may make it more effective than proton pump inhibitors, according to lead author Takashi Kawai.
The Medicare Payment Advisory Commission says the CMS' Merit-based Incentive Payment System should be replaced by a voluntary program under which clinicians could choose to participate in a value-based reimbursement system scored on population-based measures and claims data. The proposal comes after many health care providers said they are unprepared for the financial and administrative requirements of the Medicare Access and CHIP Reauthorization Act's Quality Payment Program.
Senators from both parties agreed during a committee hearing on high drug prices that they need to clamp down on patent "evergreening" and other techniques that drugmakers use to extend monopolies and prevent generic competition. The hearing centered on a recent report from the National Academies of Sciences, Engineering and Medicine, which called for measures including ending pay-for-delay deals that put competition on hold, allowing HHS to negotiate drug prices and permitting exclusion of certain drugs from formularies when cheaper drugs could offer similar clinical benefits.
Reimbursement models that pay for value instead of volume may create problems for physicians if patients have socioeconomic issues that prevent them from complying with treatment regimens. Jeremy Long, M.D., said physicians need to build trust with these patients to get them to talk about nonmedical issues that can affect care, and Jay Bhatt, chief medical officer of the American Hospital Association, said connecting patients to community resources takes some effort but is a good way to start.
The Health Management Academy and the Center for Connected Medicine at the University of Pittsburgh Medical Center surveyed 35 of the largest US health systems and found that although most are not getting reimbursed for virtual care or remote patient monitoring, more than 70% of those not receiving reimbursement think that will change in 2018, and many are continuing to implement telehealth programs. "Health systems are highly focused on becoming consumer-centric organizations, and view the integration of telehealth/virtual care/remote monitoring as part of the journey to putting consumers first," the report says.
A survey commissioned by the University of Utah Health and conducted by Leavitt Partners found that when it comes to achieving high-value care, patients are more concerned with affordability and convenience, while physicians focus on relationships and outcomes. "A lot of those things that patients value like the ability to schedule an appointment or a convenient location, those are what traditionally physicians would view as patient experience, but patients would actually say those are indicators of quality (of care)," said Bob Pendleton, chief medical quality officer at the University of Utah Health.
ACG and the Louisiana Gastroenterology Society invite you to join Course Directors Ronald A. Leo, MD, and Daniel L. Raines, MD, FACG, for the ACG/LGS Regional Postgraduate Course from March 9-11, 2018, in New Orleans. The program kicks off Friday evening with a Welcome Reception and Keynote Presentation Dinner, followed by a full day of clinical education on Saturday. On Sunday, a new half-day program focuses on practice management and supplemental pursuits. Learn more and register.
Registration is open for the biennial ACG Board of Governors/ASGE Best Practices Course, Jan. 27-28, Caesars Palace, Las Vegas. Join Course Co-Directors Dr. Costas H. Kefalas, Dr. Douglas G. Adler and Dr. Shivangi T. Kothari, who have invited leading experts who will delve into common and not-so-common GI and hepatology disorders. Arrive one day early, Jan. 26, to attend ACG's IBD School, a daylong immersion in IBD management, combined with a clinical update on new therapeutic and monitoring approaches, led by Course Co-Directors Dr. Sunanda V. Kane and ACG President-Elect and Trustee Dr. David T. Rubin. ACG and ASGE members can attend IBD School for only $99. Learn more and register.