Darren B. Taichman, MD, PhD
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From the Editors of Annals of Internal Medicine and Education Guest Editor, Gretchen Diemer, MD, FACP, Associate Dean of Graduate Medical Education and Affiliations, Thomas Jefferson University.
Start a teaching session with a multiple-choice question. We've provided one below!
Ask your learners what CPIs are. How do they work as antitumor agents? For what types of cancer have they been shown to be successful? Invite an oncologist to join your discussion.
Why have patients with autoimmune disease been excluded from clinical trials of CPIs? Why might the mechanism of action of CPIs lead to autoimmune adverse events?
Review the results of this study. What are the limitations of the available data? Use the authors' discussion and the accompanying editorial to help answer this question.
How are the observational reports identified in this review helpful for clinical practice and further research, despite their weaknesses?
Ask your learners how they decide which patients should use statins for primary prevention of cardiovascular disease.
What do the guidelines recommend? Which ones do your learners know about?
Review Table 1, which summarizes the approaches taken by each of the 5 major guidelines. What are the key differences?
Ask your learners why following each of the guidelines results in a different number of patients recommended for statin use in the population modeled here and why the number of cardiovascular events differs.
Why do guideline groups issue different recommendations despite using largely the same evidence? Use the accompanying editorial to help frame your discussion.
What approach do your learners intend to follow? Why? What are the risks and benefits of their planned approaches?
Ask your learners what strategies are used in their practices to help patients reach blood pressure treatment goals.
Review the list of implementation strategies in Table 1. Which ones are used at your center? Before reviewing this study's results, ask your learners how well they think each of the listed strategies performs.
Review the results. Are your learners surprised?
Why do your learners think certain strategies work better than others?
If team-based approaches to blood pressure control are used at your institution's outpatient practices, who is involved? Who monitors performance in your practice? How is performance assessed? Invite a quality improvement officer to join your discussion.
Why do your learners think that involvement of nonphysician team members was found to be useful? What are the potential benefits, as well as barriers to their involvement? Use the accompanying editorial to help frame your discussion.
Log on and answer the accompanying questions to earn CME/MOC credit for yourself!
Ask your learners why establishing a pretest clinical probability of either DVT or PE is important. How does the pretest probability affect the choice of test and the interpretation of results?
How do your learners assess pretest probability? Do they do so in a systematic manner?
What is the PERC tool, and when is it useful?
Review the algorithms for evaluation of potential DVT and PE. Are these the approaches followed by your learners? Why or why not?
What imaging tests should be used for suspected DVT or PE in a pregnant patient? Does a V/Q or CT angiographic study expose the patient or fetus to more radiation?
Taichman DB. Annals for Educators - 16 January 2018. Ann Intern Med. 2018;168:ED2. doi: https://doi.org/10.7326/AFED201801160
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Published: Ann Intern Med. 2018;168(2):ED2.
Cardiology, Coronary Risk Factors, Dyslipidemia, Emergency Medicine, Hematology/Oncology.
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