This issue (in my mind at least) retains the number one spot it held in last year’s top ten list. And, like last year, the skeptics are still winning. As Bob Wachter has said in so many words on more than one occasion, we have a long way to go before we get this thing right. Here’s a roundup of some of this year’s buzz.
The Optimize study found no benefit associated with most heart failure core measures.
The four hour antibiotic rule was found to be associated with over diagnosis of pneumonia (and consequently overuse of antibiotics).
"Ditto" said another study in Chest.
Pain management “quality” initiatives were found to have unintended consequences.
Bob Wachter made a convincing argument that core quality measures may be distracting from more important matters.
A systematic review failed to validate rapid response teams.
Pneumococcal vaccination in adults was again shown to have modest effects at best.
A poll of an audience at a popular hospital medicine course revealed skepticism.