BACKGROUND AND PURPOSE Physical therapists frequently make important point-of-care decisions for musculoskeletal injuries and conditions. In the Military Health System (MHS), these decisions may occur while therapists are deployed in support of combat troops, as well as in a more traditional hospital setting. Proficiency with the musculoskeletal examination, including a fundamental understandin...

Although heart rate (HR) is commonly recorded multiple times when blood pressure (BP) is measured, particularly when automatic devices are doing it in the clinic, at home, or during 24-hour ambulatory blood pressure monitoring (ABPM), many clinicians tend to ignore the HR unless it is extremely high or low. But perhaps this is inappropriate, because there is a great deal of information accumula...

OBJECTIVE The primary objective of this study is to evaluate clinician attitudes towards the treatment of cervical spondylotic myelopathy (CSM) in order to determine whether clinical equipoise exists for a segment of this patient population. The secondary objective is to examine the factors that influence treatment decisions. METHODS Cross-sectional internet-based survey of neurologists, neur...

The approval of potentially effective treatments for serious and life-threatening conditions represents a particularly difficult arena for drug developers, regulators and physicians. Hanging in the balance is the need to provide a timely treatment alternative to an otherwise untreatable and serious condition, while also assuring that the proposed treatment is sufficiently safe to preserve the o...

T HE phrase “cleared for surgery” is one that nearly every anesthesiologist has seen documented in the medical record of a patient presenting for surgery. Unfortunately, being “cleared for surgery” means very little to the scrutinizing anesthesiologist. More fundamentally, it is unclear why certain patients are referred to be “cleared” in the first place. In this issue of ANESTHESIOLOGY, Wijeys...

Automatically data-mining clinical practice patterns from electronic health records (EHR) can enable prediction of future practices as a form of clinical decision support (CDS). Our objective is to determine the stability of learned clinical practice patterns over time and what implication this has when using varying longitudinal historical data sources towards predicting future decisions. We t...

BACKGROUND Aerobic and anaerobic cultures from body fluids, abscesses, and wounds are ordered routinely. Prior studies have shown that the results of anaerobic blood cultures do not frequently lead to changes in patient management. METHODS We performed a retrospective chart review to determine whether positive results of anaerobic tissue and fluid cultures (excluding blood) affect physicians'...

The IDH1/2 gene mutations, ATRX loss/mutation, 1p/19q status, and MGMT promoter methylation are increasingly used as prognostic or predictive biomarkers of gliomas. However, the effect of their combination on radiation therapy outcome is discussable. Previously, we demonstrated that the IDH1 c.G395A; p.R132H mutation was associated with longer survival in grade II astrocytoma and GBM (Glioblast...

OBJECTIVE Computerized clinical reminder (CCR) systems can improve preventive service delivery by providing patient-specific reminders at the point of care. However, adherence varies between individual CCRs and is correlated to resolution time amongst other factors. This study aimed to evaluate how a proposed CCR redesign providing information explaining why the CCRs occurred would impact provi...