David H. Wesorick, MD; Vineet Chopra, MD, MSc
Disclosures: Dr. Chopra reports grants from the Agency for Healthcare Research and Quality. Dr. Wesorick has disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1400.
In this real-world setting, dabigatran was as equally effective in preventing stroke as warfarin and was associated with fewer intracranial bleeding episodes.
Dabigatran was associated with higher rates of MI than warfarin. However, the authors questioned the validity of this finding, given a lack of statistical significance in sensitivity analyses.
Subgroup analysis did show higher rates of MI in patients treated with dabigatran who were men and were older than 75 years and showed higher rates of gastrointestinal bleeding in patients treated with dabigatran who also had renal dysfunction and were older than 75 years.
Hospitals can use the electronic health record to search for triggers associated with harmful errors, allowing targeted record reviews. This type of triggered review can detect more than 90% of harm in hospitalized patients.
Hospitals can automate reporting of certain lab values to identify important conditions (e.g., reports of blood cultures results may be used to identify catheter-associated bloodstream infection).
Although evidence is limited, electronic patient portals may be useful in increasing satisfaction and engagement of hospitalized patients.
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Wesorick DH, Chopra V. Annals for Hospitalists - 19 December 2017. Ann Intern Med. ;167:HO1. doi: 10.7326/AFHO201712190
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Published: Ann Intern Med. 2017;167(12):HO1.
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