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

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


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.

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

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

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.


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.

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