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Quality metrics seek to slash unneeded CT scans

A set of 11 performance measures recently released for public comment aims to reduce the potential radiation harm from unnecessary medical imaging. The proposed quality metrics come as new research shows a fivefold rise in computed tomography scans among children seen in emergency departments. If approved, the measures could be used for pay-for-performance and board maintenance-of-certification programs. The metrics were developed by the American Medical Association-convened Physician Consortium for Performance Improvement, the American Board of Medical Specialties, the American Board of Radiology and the American College of Radiology. More than 62 million CT scans are ordered annually, compared with 3 million in 1980, according to research cited in the draft measure set. Between 30% and 40% of diagnostic imaging is clinically inappropriate or unnecessary. The metrics would gauge how well ordering physicians, radiologists, clinics and hospitals do in following evidence-based g ...

Doubt cast on effectiveness of universal MRSA screening

The struggle to limit the spread of methicillin-resistant Staphylococcus aureus in hospitals just got a little more complicated. Some research has supported the screening of all patients admitted to intensive care units for MRSA and taking additional infection-control precautions if they are colonized or infected. Lawmakers in 10 states, alarmed about the rising incidence of MRSA in the last decade, have mandated that hospitals implement this costly "active surveillance" approach. But it's not that simple, according to a study published April 14 in The New England Journal of Medicine ( Researchers screened more than 5,400 patients at 10 ICUs for MRSA and vancomycin-resistant enterococcus, asking health professionals to clean their hands, wear gloves and don gowns when entering the rooms of any colonized or infected patients. The control efforts also were implemented for any patients colonized or infected in the year before admission. For ...

Phone, email service offers tips on drug abuse screening

Primary care physicians who are critical in identifying and treating substance abuse problems now have a new means to help them in that effort from the National Institute on Drug Abuse and the American Society of Addiction Medicine. Doctors often report discomfort in addressing such issues with patients because they have limited training on the subject, said Gaya Dowling, PhD, acting chief of the Science Policy Branch in NIDA's Office of Science Policy and Communications. The institute promotes using science to combat drug abuse and addiction. On April 8, NIDA and the American Society of Addiction Medicine launched a free phone and email service to help primary care physicians implement drug screening in their practices. The service, called the Physician Clinical Support System for Primary Care, offers doctors guidance on what to do if a screen indicates that a patient smokes or uses illegal drugs or prescription medications for nonmedical reasons ( The ...