POCUS may surpass chest X-ray for pulmonary edema detection in HF | CEUS shows promise for pediatrics | Investigation: 10 years in, EHRs fail to live up to their promise
March 19, 2019
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Clinical Advancements in Sonography
POCUS may surpass chest X-ray for pulmonary edema detection in HF
Lung ultrasound at the point of care demonstrated better sensitivity than chest X-ray for pinpointing pulmonary edema in acute decompensated heart failure, researchers reported in JAMA Network Open. Guidelines include chest X-ray among the possible tools for diagnostic workup, but the modality returns false-negative results in one-fifth of cases, so ultrasound might be a better choice, according to the authors.
AuntMinnie (free registration) (3/15) 
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CEUS shows promise for pediatrics
Contrast-enhanced ultrasound has gained traction for adult echocardiography, and interest is emerging in other areas, including pediatrics, write pediatric radiologist Dr. Ryne Didier and radiology fellow Anush Sridharan, both of Children's Hospital of Philadelphia. They outline possible directions for using the modality to benefit children and say the Center for Pediatric Contrast Ultrasound at CHOP will educate clinicians and encourage work in this area.
DOTMed (free registration) (3/19) 
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Technology Update
Investigation: 10 years in, EHRs fail to live up to their promise
The digitization of health records in the US was supposed to improve the quality and value of health care by providing real-time access to the information needed to optimize decisions and improve outcomes, but 10 years after legislation fast-tracked the move to EHRs, even the architects of the effort agree the US' $36 billion investment has not delivered as expected. Although nearly all hospitals have EHRs, the systems are difficult to use, interoperability is poor, and an investigation by Kaiser Health News and Fortune has uncovered reports of patient deaths, injuries and close calls tied to software glitches, user error and other problems.
Fortune/Kaiser Health News (3/18) 
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Practice News
Study: Cancer imaging rates similar with, without palliative care
Patients in palliative care programs and those not in palliative care programs received similar numbers of advanced oncology imaging procedures in the last three months of life, according to a study in BMJ Supportive & Palliative Care. The findings were based on a review of data for 3,784 patients
Radiology Business (3/5) 
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More physicians are experiencing burnout
Researchers found that the rate of physicians who reported burnout rose from 40.6% in 2014 to 45.6% in 2017, which was associated with upturns in exhaustion and cynicism during the same period. The findings in JAMA Network Open also showed the highest burnout risk among early-career physicians, or those who have worked 10 years or less since training.
Physician's Briefing/HealthDay News (3/15) 
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Patient Care in Medicine
Research identifies types of breast cancer most likely to recur
Breast cancer patients whose tumors were ER-positive/HER2-negative have a 20-year recurrence risk of 42% to 55%, and patients with triple-negative tumors have a risk of recurrence within five years, according to a study published in Nature. Though experts cautioned that more research is needed, the findings could be used to help guide treatment decisions in the future and develop new therapies.
HealthDay News (3/13) 
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Teen adiposity may up odds of later renal cancer
Men who were overweight or obese in adolescence were more likely to develop renal cell carcinoma, compared with those who had normal weight as teens, with every unit increase in teen body mass index associated with a 6% higher RCC risk, Swedish researchers reported in the International Journal of Cancer. The findings showed that childhood socioeconomic and health status, cognitive function, blood pressure, erythrocyte sedimentation rate and muscle strength weren't tied to later RCC risk.
Physician's Briefing/HealthDay News (3/15) 
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Cardiology groups issue new guidance on aspirin use for heart disease
The American Heart Association and the American College of Cardiology have released a revised recommendation that says most people never previously diagnosed with heart disease should not take aspirin to prevent heart attacks and other heart disease, releasing a set of "primary prevention" guidelines during a recent ACC conference. The recommendation was based on findings from studies that showed an increased risk of bleeding in aspirin users, particularly gastrointestinal bleeding, although the drug is still recommended for prevention of heart attacks in those previously diagnosed with cardiovascular illnesses.
USA Today (3/18),  The Wall Street Journal (tiered subscription model) (3/17) 
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Frequent intake of sugary drinks linked to greater early death risk
A study in the journal Circulation found that frequent intake of sugary beverages was associated with higher risk of early death due to cardiovascular disease and cancer. Women who drank sodas, juice and sports drinks more than twice a day had a 63% higher risk of premature death compared with women who drank less than one a month.
CNN (3/18) 
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Legislative & Regulatory Update
MedPAC proposes payment hike, single incentive program for hospitals
As part of its March report to Congress, the Medicare Payment Advisory Commission proposed increasing payments to acute-care hospitals by 2%, rather than the 2.8% hike expected under existing law, with the remaining 0.8% to be used to reward participants under a single quality incentive program. Amid concerns that hospitals are losing money under Medicare, the panel also proposed eliminating $1 billion in penalties incurred by hospitals annually under two incentive programs, and replacing the four current incentive programs with a single program.
Healthcare Finance (3/15),  Modern Healthcare (tiered subscription model) (3/15) 
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Lack of effort bends me out of shape.
Bernadette Locke-Mattox,
first woman to serve as assistant coach for a men's NCAA Division I basketball team

NCAA's March Madness basketball tournament is March 19 to April 8, and March is Women's History Month

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