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.
Hospitalists should know whether their laboratory uses one of the D-dimer assays that have been studied in the context of AADD interpretation (these assays are listed in a table in the article).
The authors recommend that all D-dimer vendors perform the necessary validation for their individual assays to support wider use of age adjustment in clinical practice.
Although pay-for-performance programs are becoming increasingly common, there is still little evidence that they improve patient health outcomes.
An editorial notes that 2017 will see the roll-out of the largest pay-for-performance initiative in history, affecting more than 500 000 clinicians. Because hospital medicine currently has only a few established Centers for Medicare & Medicaid Services–approved quality measures, the details of pay-for-performance programs for these practitioners will continue to evolve over time.
Although there is strong evidence that reducing BP to less than 150/90 mm Hg is beneficial, tighter control may benefit only selected patients.
The new American College of Physicians/American Academy of Family Physicians guideline, which is based on these findings, suggests that a BP target of 140/85 mm Hg and higher be reserved for patients with a history of stroke or transient ischemic attack and those at high risk for cardiovascular events.
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Wesorick DH, Chopra V. Annals for Hospitalists - 21 March 2017. Ann Intern Med. ;166:HO1. doi: 10.7326/AFHO201703210
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Published: Ann Intern Med. 2017;166(6):HO1.
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