Some interesting hospitalist news briefs

The latest issue of Today’s Hospitalist contains a number of interesting news briefs, mainly summarizing and commenting on recent medical journal articles. Among them:

• A NEJM article by a sleep specialist calls for mandatory disclosure when sleep-deprived surgeons are scheduled to perform elective surgeries, and suggest hospitals take steps to prevent them from working. The American College of Surgeons prefers having surgeons trained to recognize when they’re too tired to work.
• An Archives of Internal Medicine study reveals that most recommendations contained in guidelines issued by the Infectious Diseases Society of America are based on expert opinion. Only 14 percent were derived from randomized clinical trials. They do mention that it’s hard to do randomized trials for infectious diseases, since many appear infrequently. Still, the authors urge physicians to be careful when they rely purely on guidelines.
• An Annals of Pharmacotherapy article showed most patients transferred between inpatient units have one or more medication discrepancies, often because a medicine is omitted. Reconciliation error rates don’t seem to be affected by whether the order entry system is paper-based or electronic. The study was conducted in Canada.
• A JAMA article revealed that more than 20 percent of patients receiving implantable cardioverter-defibrillators (ICDs) don’t meet the evidence-based guidelines for their use. Thoracic surgeons stood out for their high rate (36%) of patients not meeting guidelines.