Journal Club, 12/13/2017

Via Angela Yang:

Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis.
de Almeida JR, Al Khabori M, Guyatt GH, Witterick IJ, Lin VY, Nedzelski JM, Chen JM.
JAMA. 2009 Sep 2;302(9):985-93. doi: 10.1001/jama.2009.1243.
PubMed ID: 19724046
https://doi.org/10.1001/jama.2009.1243

How to read a systematic review and meta-analysis and apply the results to patient care: users’ guides to the medical literature.
Murad MH, Montori VM, Ioannidis JP, Jaeschke R, Devereaux PJ, Prasad K, Neumann I, Carrasco-Labra A, Agoritsas T, Hatala R, Meade MO, Wyer P, Cook DJ, Guyatt G.
JAMA. 2014 Jul;312(2):171-9. doi: 10.1001/jama.2014.5559.
PubMed ID: 25005654
https://doi.org/10.1001/jama.2014.5559

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Non-invasive Testing Vs Clinical Eval–Low Risk Chest Pain

Quoth Paolo: “No difference”

Noninvasive Cardiac Testing vs Clinical Evaluation Alone in Acute Chest Pain: A Secondary Analysis of the ROMICAT-II Randomized Clinical Trial.
Reinhardt SW, Lin C, Novak E, Brown DL.
JAMA Intern Med.
Published online November 14, 2017.
doi:10.1001/jamainternmed.2017.7360
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2663304

JAMA: Acute Extremity Pain in the ED, Opioid vs. Nonopoid Analgesic Pain Management

via Dr. Paolo:

Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department: A Randomized Clinical Trial
Andrew K. Chang, MD, MS; Polly E. Bijur, PhD; David Esses, MD; et al Douglas P. Barnaby, MD, MS; Jesse Baer, MD
JAMA. 2017;318(17):1661-1667. doi:10.1001/jama.2017.16190
https://jamanetwork.com/journals/jama/fullarticle/2661581

Rothman adds:

The associated editorial may also be of interest.

Opioid vs Nonopioid Acute Pain Management in the Emergency Department
Demetrios N. Kyriacou, MD, PhD
JAMA. 2017;318(17):1655-1656. doi:10.1001/jama.2017.16725
https://jamanetwork.com/journals/jama/fullarticle/2661559

Please also note that popular media is reporting (about as well/poorly as usual) about this study, mostly with very minor variations on the AP story.

Examples: https://news.google.com/news/story/dzQkeDa5_L-5SFM7R-uZfHJbcff9M?hl=en

EMTALA, adjusted for inflation (via E. Shaw)

Feds Increase EMTALA Penalties against Physicians and Hospitals

The Office of Inspector General recently doubled the potential monetary penalty for violations of EMTALA, added a new physician decision-making scenario subject to the penalty, and modified the factors considered in determining the amount of the penalty.

http://epmonthly.com/article/feds-increase-emtala-penalties-physicians-hospitals/

Robert A. Bitterman, MD, JD
Emergency Physicians Monthly
October 17, 2017