Abstract:
BACKGROUND:Obtaining blood cultures (BCs) for patients hospitalized with community-acquired-pneumonia (CAP) has been recommended by experts and used as a measure of quality of care. However, BCs are infrequently positive in these patients and their effect on clinical management has been questioned. PURPOSE:We performed a systematic review of the literature to determine the impact of BCs on clinical management in CAP requiring hospitalization and thus its appropriateness as a quality measure. DATA SOURCES:We searched MEDLINE, MEDLINE In-Process, and the Cochrane databases for English-language studies that reported the effect of BCs on management of adults hospitalized with CAP. We also searched the reference lists of included studies and background articles and asked experts to review our list for completeness. STUDY SELECTION:Studies were chosen if they included adults admitted to the hospital with CAP, BCs were obtained at admission, and BC-directed management changes were reported. DATA EXTRACTION:We abstracted study design, BC positivity, and frequency of BC-directed management changes. DATA SYNTHESIS:Fifteen studies, all with observational cohort design, were identified and reviewed. Two included only patients with BCs positive for pneumococcus, yielding 13 studies for the primary analysis. BCs were true-positive in 0% to 14% of cases. They led to antibiotic narrowing in 0% to 3% of patients and to antibiotic broadening ultimately associated with a resistant organism in 0% to 1% of patients. CONCLUSIONS:BCs have very limited utility in immunocompetent patients hospitalized with CAP. Pneumonia quality measures that include BCs should be reassessed.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Afshar N,Tabas J,Afshar K,Silbergleit Rdoi
10.1002/jhm.382subject
Has Abstractpub_date
2009-02-01 00:00:00pages
112-23issue
2eissn
1553-5592issn
1553-5606journal_volume
4pub_type
杂志文章,评审abstract::Physicians are notorious for poor hand hygiene (HH) compliance. We wondered if lower performance by physicians compared with other health professionals might reflect differences in the Hawthorne effect. We introduced covert HH observers to see if performance differences between physicians and nurses decreased and to g...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The affordability of prescription medications continues to be a major public health issue in the United States. Estimates of cost-related medication underuse come largely from surveys of ambulatory patients. Hospitalized patients may be vulnerable to cost-related underuse and its consequences, but have been ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.948
更新日期:2012-02-01 00:00:00
abstract::Physical examination (PE) is a core clinical competency, and the internal medicine clerkship is a premiere venue for students to develop PE skills. However, clinical rotations often lack opportunities for real-time instruction. We sought to measure the frequency, content, and factors affecting PE instruction during th...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2018-06-01 00:00:00
abstract::Nephrogenic systemic fibrosis (NSF) has now been linked to gadolinium-based contrast (GBC) exposure in those with compromised kidney function, particularly those with end-stage renal disease (ESRD). When ESRD is present, symptoms can be quite devastating for the patient including severe pain and immobility and even de...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.493
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Gender earnings disparities among physicians exist even after considering differences in specialty, part-time status, and practice type. Little is known about the role of job satisfaction priorities on earnings differences. OBJECTIVE:To examine gender differences in work characteristics and job satisfaction...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Patient whiteboards can serve as a communication tool between hospital providers and as a mechanism to engage patients in their care, but little is known about their current use or best practices. METHODS:We surveyed bedside nurses, internal medicine housestaff, and hospitalists from the medical service at ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Little is known about the state of research in academic hospital medicine (HM) despite the substantial growth of this specialty. METHODS:We used the Society of Hospital Medicine (SHM) membership database to identify research programs and their leadership. In addition, the members of the SHM Research Committ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2019-04-01 00:00:00
abstract::Depressive symptoms during a medical hospitalization may be an overlooked prognostic factor for adverse events postdischarge. Our aim was to evaluate whether depressive symptoms predict 30-day readmission or death after medical hospitalization. We conducted a systematic review of studies that compared postdischarge ou...
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pub_type: 杂志文章,meta分析,评审
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更新日期:2016-05-01 00:00:00
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更新日期:2019-05-01 00:00:00
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journal_title:Journal of hospital medicine
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更新日期:2014-09-01 00:00:00
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更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Despite safe and cost-effective venous thromboembolism (VTE) prevention measures, VTE prophylaxis rates are often suboptimal. Healthcare reform efforts emphasize transparency through programs to report performance and payment incentives through pay-for-performance programs. OBJECTIVE:To sequentially examine...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Access to hand-carried ultrasound technology for noncardiologists has increased significantly, yet development and evaluation of training programs are limited. OBJECTIVE:We studied a focused program to teach hospitalists image acquisition of inferior vena cava (IVC) diameter and IVC collapsibility index wit...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2013-12-01 00:00:00
abstract:BACKGROUND: OBJECTIVE: DESIGN, SETTING, PATIENTS: INTERVENTION: MEASUREMENTS: CONCLUSIONS: ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2019-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in childhood. Few studies have addressed the association of antimicrobial treatment and outcomes. OBJECTIVE:To determine whether macrolide therapy is associated with improved outcomes among children hospitalized with M. pneumoniae pneum...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
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更新日期:2012-04-01 00:00:00
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journal_title:Journal of hospital medicine
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更新日期:2014-05-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Patients with suspected thiamine deficiency should receive treatment with parenteral thiamine to achieve the high serum thiamine levels necessary to reverse the effects of deficiency and to circumvent problems with absorption common in the medically ill. OBJECTIVE:To quantify rates of parenteral administrat...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
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更新日期:2015-04-01 00:00:00
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更新日期:2011-01-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2014-08-01 00:00:00
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journal_title:Journal of hospital medicine
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更新日期:2010-01-01 00:00:00
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更新日期:2017-05-01 00:00:00
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journal_title:Journal of hospital medicine
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更新日期:2007-07-01 00:00:00
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更新日期:2017-07-01 00:00:00
abstract:WHAT'S NEW:This is the first study of a pediatric hospitalist preoperative clinic. Pediatric hospitalists frequently make significant recommendations for patients with neuromuscular scoliosis prior to spinal surgery, especially those with medical complexity. Certain clinical criteria are statistically significantly ass...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2013-12-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2016-06-01 00:00:00
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pub_type: 杂志文章
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