Abstract:
OBJECTIVES:Studies have shown that the overutilization of laboratory tests ("labs") for hospitalized patients is common and can cause adverse health outcomes. Our objective was to compare the ordering tendencies for routine complete blood counts (CBC) and chemistry panels by internal medicine residents and hospitalists. METHODS:This observational study included a survey of medicine residents and hospitalists and a retrospective analysis of labs ordering data. The retrospective data analysis comprised patients admitted to either the teaching service or nonteaching hospitalist service at a single hospital during 2014. The survey asked residents and hospitalists about their practices and preferences on labs ordering. The frequency and timing of one-time and daily CBC and basic chemistry panel ordering for teaching service and hospitalist patients were obtained from our data warehouse. The average number of CBCs per patient per day and chemistry panels per patient per day was calculated for both services and multivariate regression was performed to control for patient characteristics. RESULTS:Forty-four of 120 (37%) residents and 41 of 53 (77%) hospitalists responded to the survey. Forty-four (100%) residents reported ordering a daily CBC and chemistry panel rather than one-time labs at patient admission compared with 22 (54%) hospitalists (P < 0.001). For CBCs, teaching service patients averaged 1.72/day and hospitalist service patients averaged 1.43/day (P < 0.001). For basic chemistry panels, teaching service patients averaged 1.96/day and hospitalist service patients averaged 1.78/day (P < 0.001). Results were similar in multivariate regression models adjusting for patient characteristics. CONCLUSIONS:Residents' self-reported and actual use of CBCs and chemistry panels is significantly higher than that of hospitalists in the same hospital. Our results reveal an opportunity for greater supervision and improved instruction of cost-conscious ordering practices.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Ellenbogen MI,Ma M,Christensen NP,Lee J,O'Leary KJdoi
10.14423/SMJ.0000000000000592subject
Has Abstractpub_date
2017-01-01 00:00:00pages
25-30issue
1eissn
0038-4348issn
1541-8243pii
SMJ50317journal_volume
110pub_type
杂志文章abstract::Bile acid sequestrants (BAS) continue to command a position in the treatment of dyslipidemias 25 years after their introduction. Partial diversion of the enterohepatic circulation using BAS depletes the endogenous bile acid pool by approximately 40%, thus stimulating an increase in bile acid synthesis from cholesterol...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.smj.0000208120.73327.db
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVES:Peripheral vascular disease (PVD) is underdiagnosed in primary care due to the absence of established criteria to warrant diagnostic testing. Our goal was to establish a risk factor hierarchy to enable earlier diagnosis of PVD. METHODS:Data sets of 142 patients with abnormal ankle brachial indices (ABI) wer...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000141303.47034.46
更新日期:2004-10-01 00:00:00
abstract::A 66-year-old woman with a subacute onset of mild dementia and headaches was discovered to have multiple large, hyperdense lesions on cranial CT scan. Biopsy showed poorly differentiated adenocarcinoma with necrosis and dystrophic calcification, which represented an unusual initial manifestation of metastatic breast c...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198602000-00030
更新日期:1986-02-01 00:00:00
abstract::The accuracy of the noninvasive carotid system studies done in our laboratory during an 18-month period were reviewed. The usefulness of these procedures was found to be limited when used as a "blind" screen for extracranial vascular disease. The overall correlation with angiography was good, with few false-negatives ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198205000-00008
更新日期:1982-05-01 00:00:00
abstract::A case of acute febrile neutrophilic dermatosis (Sweet's syndrome) is described in a patient with chronic myelogenous leukemia, with a review of all published reports in the English literature. The disease is characterized by an acute febrile illness with painful plaques involving the extremities, face, and neck, and ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197811000-00010
更新日期:1978-11-01 00:00:00
abstract::This paper describes a transverse approach to the knee which gives unequalled access to the joint for extensive synovectomies, extensive surgical debridement, installation of total knee prostheses, or reduction of supracondylar fracture of the femur involving the articular surfaces. The temporary patellar tendon subst...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197605000-00023
更新日期:1976-05-01 00:00:00
abstract::The neuroleptic malignant syndrome (NMS) is a rare but potentially lethal disorder associated with the administration of neuroleptic agents. This syndrome may be underdiagnosed because it is poorly understood and often unrecognized. It affects all age groups and has a 20% mortality. Presenting features include extrapy...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198603000-00018
更新日期:1986-03-01 00:00:00
abstract::Four patients, all sisters, presented a long-standing history of pain in the gallbladder region and no calculi. All were first thoroughly investigated and then relieved of their symptoms by cholecystectomy. This prompted an investigation of their family over three generations, which revealed a surprisingly large numbe...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199302000-00008
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) was investigated at a tertiary care hospital, and relationship was made between the clinical and genetic definitions of community- and healthcare-associated MRSA. METHODS:Nonduplicate isolates of S. aureus were collected during 2004. Iso...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31815d3fce
更新日期:2008-01-01 00:00:00
abstract::Renal mechanisms for metabolic acidosis in selective hypoaldosteronism were investigated in a patient with marked renal insufficiency. Studies demonstrated a distal hydrogen ion secretory defect. Control of elevated serum potassium levels did not normalize urinary acid excretion, but systemic acidosis was improved. Mi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197811000-00023
更新日期:1978-11-01 00:00:00
abstract::In this study, 1,027 healthy men over age 40 were screened for prostate cancer with digital rectal examinations (DRE) and prostate-specific antigen (PSA) levels. Findings were abnormal in 189 (18%). PSA levels alone were abnormal (> 4.0 ng/mL) in 111 men (12%), 60 men (8%) had abnormal DRE and normal PSA, and 18 men h...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199407000-00009
更新日期:1994-07-01 00:00:00
abstract::Ruptured ovarian artery aneurysm is rare. Of the eight cases previously reported, seven were diagnosed postpartum. Our case of a ruptured right ovarian artery aneurysm was associated with massive retroperitoneal bleeding. The probable time of rupture could be traced to the second stage of labor. This case indicates th...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199309000-00023
更新日期:1993-09-01 00:00:00
abstract::Poisoning by antimony led to the death of a great individual in English literature. This case report gives as much of the history of the illness as can be found and tells a little about the individual. ...
journal_title:Southern medical journal
pub_type: 传,历史文章,杂志文章
doi:10.1097/00007611-198205000-00021
更新日期:1982-05-01 00:00:00
abstract::We examined present and anticipated future levels of career satisfaction among psychiatrists in the greater Houston area. We gathered data by means of an anonymous questionnaire. The strongest univariate correlations between background variables and current and anticipated future levels of career satisfaction were fou...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199505000-00003
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVES:To explore temporal trends and geographic variations in mortality from prescription opioids from 1999 to 2016. METHODS:Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death files were used to calculate age-adjusted rates and 95% confidence int...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001074
更新日期:2020-03-01 00:00:00
abstract::The incidence of fatal and nonfatal pulmonary embolism (PE) was evaluated in a series of 578 patients, to quantify the suspected higher risk in cancer patients of death from massive PE when compared with patients not having cancer. PE occurred in 13% and was fatal in 8% of noncancer patients. It occurred in 17% and wa...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198007000-00005
更新日期:1980-07-01 00:00:00
abstract::We have described a 47-year-old white woman who had spontaneous E coli K1 meningitis after acquiring an E coli K1 urinary tract infection with associated sepsis. The patient's symptoms consisted only of severe headache, fever, and malaise. She had no meningeal or focal neurologic signs, and the CSF did not contain whi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198309000-00044
更新日期:1983-09-01 00:00:00
abstract::Safety restraints have proven effective in the prevention of serious automobile injuries and deaths, but safety education has been ineffective in getting consumers to use restraints. We surveyed the personal and counseling practices of a group of pediatricians over a one-year period to determine whether prenatal and p...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198110000-00003
更新日期:1981-10-01 00:00:00
abstract::Solitary abscesses of the spleen may occur as a consequence of septicemia from various septic foci, particularly intra-abdominal sites. A variety of causative organisms, including the clostridia, have been isolated. We have described a patient with multiple myeloma who had a solitary splenic abscess due to Clostridium...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198710000-00029
更新日期:1987-10-01 00:00:00
abstract::We have recently developed a Data Bank for Digestive Disorders, with primary data derived from the performance of upper gastrointestinal endoscopy. By using this system to analyze the clinical characteristics of patients with atypical chest pain, we found information from the patient's history (reflux, dysphagia, abdo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198301000-00007
更新日期:1983-01-01 00:00:00
abstract::Unicompartmental replacement using the Marmor prosthesis was done in 40 knees (37 patients) with medial compartment gonarthrosis. Of the 27 available for follow-up, results were considered excellent in 18 cases and good in seven, while two cases were considered failures. Meticulous removal of osteophytes by intercondy...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197906000-00013
更新日期:1979-06-01 00:00:00
abstract::Between 1972 and 1985, 39 patients with superior vena cava syndrome were admitted to the Medical College of Georgia Hospitals. I have reviewed the hospital courses of these patients and compared clinical and laboratory findings with those reported in previous series. The syndrome was malignant in 34 patients (mean age...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198710000-00011
更新日期:1987-10-01 00:00:00
abstract::Streptococcus pneumoniae produced an erysipelas-like eruption in a patient with the nephrotic syndrome. The eruption and accompanying fever resolved upon treatment with aqueous penicillin. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197906000-00038
更新日期:1979-06-01 00:00:00
abstract::Several treatment regimens of trimethoprim-sulfamethoxazole (TMP-SMZ) were compared to the USPHS-recommended schedules for treatment of uncomplicated gonorrhea with ampicillin plus probenecid, tetracycline, or aqueous procaine penicillin G in both men and women. TMP-SMZ, six tablets as a single oral dose daily for 3 d...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197509000-00020
更新日期:1975-09-01 00:00:00
abstract::Through a cooperative study, 87 ocular injuries caused by class C fireworks have been recorded in the State of Arkansas over a four-year period. The most common injuries were corneal abrasion, lid laceration or burn, and hyphema. Rockets and firecrackers caused 80% of the injuries. In over half the cases there was mod...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1980-06-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to assess the cardiovascular health status of baby boomers with diabetes mellitus (DM) in comparison to the same-age population with DM 10 years previously. METHODS:The study was conducted in baby boomers with DM using data from the National Health and Nutrition Examination S...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000473
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:The data from temperate regions indicate increases in pediatric traumatic injuries during the spring and summer months with anticipated admission spikes on warm weather holidays; hospitals in southern subtropical regions should not anticipate the same trends. The objectives of this study were to identify hol...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000947
更新日期:2019-03-01 00:00:00
abstract::We present a case of renal cell carcinoma extending into the inferior vena cava and resulting in total occlusion. Perioperative transesophageal echocardiography allowed us to assess cardiac function, follow the extent of vascular involvement, and prevent embolization of tumor and air. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199402000-00027
更新日期:1994-02-01 00:00:00
abstract:: Acute pulmonary embolism (PE) is a common clinical condition with presentations that may vary from asymptomatic subsegmental emboli to massive vascular obstruction and shock with high risk of death. Identifying patients at highest risk for death is critical to select those who would benefit most from thrombolytic the...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e318268dbca
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:Age-related macular degeneration (AMD) is the leading cause of blindness in the United States. Although AMD shares multiple risk factors with coronary artery disease (CAD), the association between AMD and CAD has not been established. The objective of our study was to demonstrate an association between the d...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000329
更新日期:2015-08-01 00:00:00