Journal of general internal medicine
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Administrative data algorithms (ADAs) to identify pneumonia cases are commonly used in the analysis of pneumonia burden, trends, etiology, processes of care, outcomes, health care utilization, cost, and response to preventative and therapeutic interventions. However, without a good understanding of the validity of ADAs for pneumonia case identification, an adequate appreciation of this literature is difficult. We systematically reviewed the quality and accuracy of published ADAs to identify adult hospitalized pneumonia cases. ⋯ ADAs for identification of adult pneumonia hospitalizations are highly heterogeneous, poorly validated, and at risk for misclassification bias. Greater standardization in reporting ADA accuracy is required in studies using pneumonia ADA for case identification so that results can be properly interpreted.
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Randomized Controlled Trial
Specific Disease Knowledge as Predictor of Susceptibility to Availability Bias in Diagnostic Reasoning: a Randomized Controlled Experiment.
Bias in reasoning rather than knowledge gaps has been identified as the origin of most diagnostic errors. However, the role of knowledge in counteracting bias is unclear. ⋯ Knowledge of features that discriminate between look-alike diseases reduced susceptibility to bias in a simulated setting. Reflecting further may be required to overcome bias, but succeeding depends on having the appropriate knowledge. Future research should examine whether the findings apply to real practice and to more experienced physicians.
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Undocumented immigration is often accompanied by multiple and complex stressors, which over time may increase the risk for chronic pain. ⋯ Among undocumented Latinx immigrants, chronic pain is significantly associated with psychological distress, older age, and trauma history. Given that undocumented immigrants have restricted access to healthcare and are at high risk for chronic pain, developing alternatives to facilitate access to chronic pain interventions and risk-reduction prevention are needed.
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A better understanding of the long-term health effects of combat injury is important for the management of veterans' health in the Department of Defense (DoD) and Veterans Affairs (VA) health care systems and may have implications for primary care management of civilian trauma patients. ⋯ Severe traumatic injury is associated with the subsequent development of HTN, DM, and CAD. These findings have profound implications for the primary care of injured service members in both the DoD/VA health systems and may be applicable to civilian trauma patients as well. Further exploration of pathophysiologic, health behavior, and mental health changes after trauma is warranted to guide future intervention strategies.