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You don’t need X-Rays in a child with bronchiolitis, croup, asthma, or first time wheezing

PEMBlog

As many as 40% of these children will receive a chest x-ray (CXR) during their ED visit despite clinical guidelines advising most of these tests are low value. Understanding root causes of CXR use in the ED clinical setting is key to mitigating overuse of this test.

Asthma 52
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GeriPal 300th Episode: Ask Me Anything Hot Ones Style

GeriPal

Not the most common circumstances that people with serious illness face where attention and understanding of what my goals and values are. But when we have people in rural areas of California, so we don’t know our clinical site, we go from San Francisco all the way to the Northern California border, super rural areas.

IT 126
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POLST Evidence and Update: Kelly Vranas, Abby Dotson, Karl Steinberg, and Scott Halpern

GeriPal

And we have Scott Halpern, who is Professor of Medical Ethics and Health Policy and Director of the Palliative and Advanced Illness Research Center or Payer Center at the University of Pennsylvania. And we were able, because of the way OHSU has the registry and POLST link had just been integrated into our electronic medical records.

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PC Trials at State of Science: Tom LeBlanc, Kate Courtright, & Corita Grudzen

GeriPal

Ten years ago we would have been hard pressed to find 3 clinical trial abstracts submitted to the annual meeting, much less high quality randomized trials with robust measures, sample sizes, and analytics plans. Kate: So it was an embedded alert in the electronic health record and they just clicked those two answers very quickly.

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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand

GeriPal

In case you miss the introductions at the start of the podcast, Bernie and Laurie are married, and offer wonderful reminiscence of their clinical practice over the last several decades. They were seriously ill and had a chance to get to know. Now as I understand it, you and Dr. Widera talked in clinic about this and that.

Families 112
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Pragmatic Trial of ACP: Jennifer Wolff, Sydney Dy, Danny Scerpella, and Jasmine Santoyo-Olsson

GeriPal

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. Alex 02:44 Still suffering from some illness from there, which is why I was sick and not in the office with Eric today. We did it by the clinic level. Is that right?

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Jumpstarting Goals of Care Convos: Erin Kross, Bob Lee, and Ruth Engelberg

GeriPal

Today we discuss a new paper in JAMA that tests a stripped down version of the clinician only facing intervention in a pragmatic randomized trial for older adults with serious illness and those 80+. Eric and I also reflect on the podcast Randy generously did with us on his experience living with and studying serious illness.