Here are what the editors at HealthDay consider to be the most important developments in Critical Care for September 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Physicians Often Don’t Address Their Burnout

FRIDAY, Sept. 28, 2018 (HealthDay News) — More than half of physicians experience burnout, and many do not seek treatment for burnout, according to a report published in the American Medical Association’s AMA Wire.

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Business Degree Increasingly Useful for Doctors

THURSDAY, Sept. 27, 2018 (HealthDay News) — Having a Master of Business Administration degree (M.B.A.) can help doctors with important, practice-related decisions, according to a report published recently in Physician Practice.

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80,000 Americans Died From Influenza Over Last Year

THURSDAY, Sept. 27, 2018 (HealthDay News) — Influenza was deadlier last season than it has been for at least four decades, killing 80,000 Americans. So said the head of the U.S. Centers for Disease Control and Prevention late Tuesday in an interview with the Associated Press.

AP News Article

Having Hospital Palliative Care Doesn’t Impact Tx Intensity

THURSDAY, Sept. 27, 2018 (HealthDay News) — For adult patients in the intensive care unit (ICU), the availability of hospital-based palliative care is not associated with in-hospital treatment intensity, according to a study published in the September issue of the Annals of the American Thoracic Society.

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Time to Defib Not Linked to Survival in Pediatric IHCA

THURSDAY, Sept. 27, 2018 (HealthDay News) — For pediatric patients with in-hospital cardiac arrest (IHCA), time to first defibrillation attempt is not associated with survival, according to a study published online Sept. 21 in JAMA Network Open.

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Practices Should Set Rules for Staff Social Media Use

THURSDAY, Sept. 27, 2018 (HealthDay News) — Medical practices can take steps to avoid problems related to use of social media by staff members, according to an article published in Medical Economics.

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Burnout, Career Choice Regret Prevalent in U.S. Residents

WEDNESDAY, Sept. 26, 2018 (HealthDay News) — Symptoms of burnout and career choice regret are prevalent among U.S. resident physicians, according to a study published in the Sept. 18 issue of the Journal of the American Medical Association.

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Critics Demand Stop to ‘Guinea Pig’ Sepsis Clinical Trial

TUESDAY, Sept. 25, 2018 (HealthDay News) — A major non-profit advocacy group is asking that a large government trial comparing treatments for sepsis be shut down.

The New York Times Article
Clovers Clinical Trial

In 2016, Proportion of Uninsured Americans Down to 10 Percent

TUESDAY, Sept. 25, 2018 (HealthDay News) — From 2013 to 2016 there was a reduction in uninsurance among Americans from 17 to 10 percent, according to a report published in September by the Robert Wood Johnson Foundation (RWJF) and the Urban Institute.

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Physician-Group ACOs Generate Medicare Savings

TUESDAY, Sept. 25, 2018 (HealthDay News) — Physician-group accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) generated significantly more savings for Medicare that grew from 2012 to 2015 compared with hospital-integrated ACOs, according to research published in the Sept. 20 issue of the New England Journal of Medicine.

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Heart Failure Patients Enrolled in Hospice Use Less Health Care

MONDAY, Sept. 24, 2018 (HealthDay News) — Patients with advanced heart failure enrolled in hospice have fewer emergency department visits, hospital days, and intensive care unit (ICU) stays, according to a study published in the September issue of JACC: Heart Failure.

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Actigraphy May Overestimate Sleep in ICU Setting

MONDAY, Sept. 24, 2018 (HealthDay News) — Using actigraphy as a measure of sleep, critically ill patients in the intensive care unit (ICU) show wide ranges of sleep quality and quantity, and actigraphy may estimate higher sleep durations than other measures, according to a review published in the September issue of the Annals of the American Thoracic Society.

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Dozens of Medical Groups Join Forces to Improve Diagnoses

FRIDAY, Sept. 21, 2018 (HealthDay News) — Every nine minutes, a patient in a U.S. hospital dies because a diagnosis was wrong or delayed — resulting in 80,000 deaths a year. That sobering estimate comes from the Society to Improve Diagnosis in Medicine (SIDM).

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Pediatric End-Stage Liver Disease Score Underestimates Mortality

FRIDAY, Sept. 21, 2018 (HealthDay News) — The Pediatric End-stage Liver Disease (PELD) score underestimates the actual probability of 90-day pretransplant mortality for children undergoing a primary liver transplant, according to a study published online Sept. 17 in JAMA Pediatrics.

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Research Links Doctor Burnout to Patient Safety Incidents

THURSDAY, Sept. 20, 2018 (HealthDay News) — Physician burnout is associated with increased risk of patient safety incidents, poorer quality of care due to low professionalism, and reduced patient satisfaction, according to a review published online Sept. 4 in JAMA Internal Medicine.

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Hospitals Charge 479 Percent of Cost of Drugs on Average

THURSDAY, Sept. 20, 2018 (HealthDay News) — On average, hospitals mark up drugs by 479 percent of their cost, according to a report from The Moran Company, commissioned by the Pharmaceutical Research and Manufacturers of America (PhRMA).

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Residents Should Take Advantage of Paid Time Off

THURSDAY, Sept. 20, 2018 (HealthDay News) — Although there are many demands on residents, taking advantage of paid vacation time is one of the perks and should be maximized, according to an article published in the American Medical Association’s AMA Wire.

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Patient Health Information Often Shared Electronically

WEDNESDAY, Sept. 19, 2018 (HealthDay News) — The most common electronically sent and received types of patient health information (PHI) include laboratory results and medication lists, according to a report published Aug. 15 by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.

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Opioid Deaths 1999 to 2015 May Be Dramatically Underestimated

WEDNESDAY, Sept. 19, 2018 (HealthDay News) — States may be greatly underestimating the effect of opioid-related overdose deaths because of incomplete cause-of-death reporting, according to a study recently published in Public Health Reports.

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Global Prevalence of Insufficient Activity 27.5 Percent

WEDNESDAY, Sept. 19, 2018 (HealthDay News) — In 2016 the age-standardized prevalence of insufficient physical activity was 27.5 percent, according to a study published in the October issue of The Lancet Global Health.

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Scribes Improve Physician Workflow, Patient Interaction

TUESDAY, Sept. 18, 2018 (HealthDay News) — Use of medical scribes is associated with decreased physician documentation burden, improved work efficiency, and improved patient interactions, according to a study published online Sept. 17 in JAMA Internal Medicine.

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Compliance With Requirement to Report Results on EUCTR Is Poor

TUESDAY, Sept. 18, 2018 (HealthDay News) — Half of trials on the European Union Clinical Trials Register (EUCTR) are non-compliant with the European Commission’s requirement that all trials post results to the registry within 12 month of completion, according to a study published online Sept. 13 in The BMJ.

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Drug Prices Increase More Than Expected After Shortages

TUESDAY, Sept. 18, 2018 (HealthDay News) — Prices for drugs under shortage increase more than twice as quickly as expected in the absence of a shortage, according to a research letter published online Sept. 18 in the Annals of Internal Medicine.

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Factors Predictive of Escalated Care in Infant Bronchiolitis ID’d

MONDAY, Sept. 17, 2018 (HealthDay News) — Variables have been identified that predict escalated care for infants with bronchiolitis, according to a study published in the September issue of Pediatrics.

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Association Health Plans Can Help Small Businesses Offer Coverage

MONDAY, Sept. 17, 2018 (HealthDay News) — Association health plans (AHPs) will provide small businesses with more choices, access, and coverage options, although critics warn that they may undermine the Affordable Care Act (ACA) marketplace, according to an article published in Managed Healthcare Executive.

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Small Reduction in Lung Function With Tx De-Escalation in COPD

FRIDAY, Sept. 14, 2018 (HealthDay News) — A de-escalation from triple therapy to indacaterol/glycopyrronium may lead to a small reduction in lung function in non-frequently exacerbating patients with chronic obstructive pulmonary disease (COPD) but no difference in exacerbations, according to a study published in the Aug. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Recommendations Issued for Enhancing ICU Diagnostic Safety

FRIDAY, Sept. 14, 2018 (HealthDay News) — Identifying and reducing diagnostic errors in the intensive care unit (ICU) should be a top priority, according to a perspective article published in the Aug. 1 issue of the Annals of the American Thoracic Society.

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Situation Framing, Language Can Influence Decision-Making

FRIDAY, Sept. 14, 2018 (HealthDay News) — How a situation is framed and the language used to describe risks can influence patients’ decision-making, according to an article published in Physicians Practice.

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Firearm Deaths Up Globally From 1990 to 2016

THURSDAY, Sept. 13, 2018 (HealthDay News) — Firearm deaths increased globally between 1990 and 2016, according to a study published in the Aug. 28 issue of the Journal of the American Medical Association.

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AHA: Resistant Hypertension Diagnosis, Tx Guidelines Updated

THURSDAY, Sept. 13, 2018 (HealthDay News) — A correct diagnosis of resistant hypertension is necessary to avoid overmedicating, according to a scientific statement from the American Heart Association published online Sept. 13 in Hypertension.

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Gains in Insurance Coverage Seen for Lesbian, Gay, Bisexual Adults

THURSDAY, Sept. 13, 2018 (HealthDay News) — Lesbian, gay, and bisexual (LGB) adults report continued problems affording care despite coverage gains offered by the Affordable Care Act, according to a study published in the August issue of Health Affairs.

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Six-Step Analysis Can Help Improve Practice Logistics

WEDNESDAY, Sept. 12, 2018 (HealthDay News) — A six-step analysis can help redesign and improve the outpatient health care process, according to a study recently published in the Journal of Evaluation in Clinical Practice.

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Residents Working Long Hours Can Increase Alertness

WEDNESDAY, Sept. 12, 2018 (HealthDay News) — Medical residents can take steps to maintain their energy and alertness during long shifts, according to an article published in the American Medical Association’s AMA Wire.

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Medicaid Work Requirements Don’t Impact Many Enrollees

TUESDAY, Sept. 11, 2018 (HealthDay News) — Medicaid work requirements will only impact a small proportion of persons and may only generate minimal savings, according to two research letters published online Sept. 10 in JAMA Internal Medicine.

Abstract/Full Text – Goldman
Abstract/Full Text – Silvestri
Editorial

Data Age in Clinical Trials Is About Three Years at Publication

TUESDAY, Sept. 11, 2018 (HealthDay News) — The median data age in clinical trials in journals with a high impact factor is about three years at publication, according to a study published in the Aug. 10 issue of JAMA Network Open.

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Many Opportunities for Doctors Using Twitter

MONDAY, Sept. 10, 2018 (HealthDay News) — Doctors can use Twitter to build networks and learn more about research in real time, according to a blog post published by Penn Medicine News.

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NICU Antibiotic Use Rates Declined From 2013 to 2016

MONDAY, Sept. 10, 2018 (HealthDay News) — Antibiotic use rates (AURs) in neonatal intensive care units (NICUs) are declining, but practice variation is still largely unexplained, according to a study published in the September issue of Pediatrics.

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Physician Burnout Rates Vary by Medical Specialty

MONDAY, Sept. 10, 2018 (HealthDay News) — Nearly half of physicians report being burned out, but rates vary substantially by medical specialty, according to an article published in AMA Wire.

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Docs, Consumers Agree on Benefits of Virtual Care

MONDAY, Sept. 10, 2018 (HealthDay News) — Physicians and consumers agree on the benefits of virtual care, but physician adoption of virtual care technologies is low, according to a report on the Deloitte 2018 Survey of U.S. Physicians.

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Physician Assistants Match Medical Residents in ICU Skills

FRIDAY, Sept. 7, 2018 (HealthDay News) — Physician assistants (PAs) exhibit equal performance on clinical skills as medical residents (MRs) with six to 24 months of experience in the intensive care unit (ICU), according to a study recently published in the Journal of Evaluation in Clinical Practice.

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Greater CAD Incidence, Heart Mass in Firefighter Cardiac Arrests

FRIDAY, Sept. 7, 2018 (HealthDay News) — Most cardiac fatalities among firefighters have evidence of coronary heart disease and increased heart mass, according to a study published online Sept. 5 in the Journal of the American Heart Association.

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Personalized Weighting Could Enhance Hospital Rating Tools

FRIDAY, Sept. 7, 2018 (HealthDay News) — The weighting systems that underlie hospital performance rating tools should incorporate the needs, values, and preferences of patients, according to a perspective article published in the Aug. 30 issue of the New England Journal of Medicine.

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Better Training Needed to Boost LGBTQ Patient Health Care

THURSDAY, Sept. 6, 2018 (HealthDay News) — High-quality health care needs to be provided to lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients, and improved training is necessary to deliver that care, according to a report published in the American Medical Association’s AMA Wire.

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Hospital Groups Launch Own Generic Drug Company

THURSDAY, Sept. 6, 2018 (HealthDay News) — Three U.S. health care foundations and seven hospital groups have formed a generic drug company to combat high prices and chronic shortages of medicines.

AP News Article

Widespread Statin Use Not Recommended in Old, Very Old

THURSDAY, Sept. 6, 2018 (HealthDay News) — Statin use is not associated with reduced risk of atherosclerotic cardiovascular disease (CVD) or all-cause mortality among older adults without type 2 diabetes, according to a study published online Sept. 5 in The BMJ.

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Public Service Loan Forgiveness Program Has Uncertain Future

WEDNESDAY, Sept. 5, 2018 (HealthDay News) — Uncertainty surrounds the future of the Public Service Loan Forgiveness (PSLF) program, according to an Ideas and Opinions article published online Aug. 28 in the Annals of Internal Medicine.

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~3,000 Excess Deaths Estimated Due to Hurricane Maria

WEDNESDAY, Sept. 5, 2018 (HealthDay News) — The total excess mortality attributed to Hurricane Maria is estimated at 2,975 deaths, according to a report issued by George Washington University.

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Patient Distressed by Overturn of California End of Life Option Act

TUESDAY, Sept. 4, 2018 (HealthDay News) — The decision to overturn the End of Life Option Act has added stress and anxiety to terminally ill patients, including those with amyotrophic lateral sclerosis (ALS), according to a patient testimonial published online Sept. 4 in the Annals of Internal Medicine.

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Enrollment in High-Deductible Health Plans Up From ’07 to ’17

TUESDAY, Sept. 4, 2018 (HealthDay News) — Enrollment in high-deductible health plans (HDHPs) has increased among adults with employment-based insurance coverage, according to an August data brief published by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.

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Relapse-Free Cure From MDR-TB Higher Than Anticipated

TUESDAY, Sept. 4, 2018 (HealthDay News) — The frequency of relapse-free cure from multidrug-resistant tuberculosis (MDR-TB) is higher than previously anticipated, according to a study published in the Aug. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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