Literature Review



Sunday newsletters

11/17/24 at 03:00 AM

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

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Today's Encouragement

11/16/24 at 03:55 AM

Every man has his secret sorrows which the world knows not; and often times we call a man cold when he is only sad. ~Henry Wadsworth Longfellow

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Large language model influence on diagnostic reasoning - A randomized clinical trial

11/16/24 at 03:40 AM

Large language model influence on diagnostic reasoning-A randomized clinical trialJAMA Network Open; Ethan Goh, MBBS, MS; Robert Gallo, MD; Jason Hom, MD; Eric Strong, MD; Yingjie Weng, MHS; Hannah Kerman, MD; Joséphine A. Cool, MD; Zahir Kanjee, MD, MPH; Andrew S. Parsons, MD, MPH; Neera Ahuja, MD; Eric Horvitz, MD, PhD; Daniel Yang, MD; Arnold Milstein, MD; Andrew P. J. Olson, MD; Adam Rodman, MD, MPH; Jonathan H. Chen, MD, PhD; 10/24Large language models (LLMs) have shown promise in their performance on both multiple-choice and open-ended medical reasoning examinations, but it remains unknown whether the use of such tools improves physician diagnostic reasoning. In this trial, the availability of an LLM to physicians as a diagnostic aid did not significantly improve clinical reasoning compared with conventional resources. The LLM alone demonstrated higher performance than both physician groups, indicating the need for technology and workforce development to realize the potential of physician-artificial intelligence collaboration in clinical practice.

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Comorbid depression in patients with head and neck cancer compared with other cancers

11/16/24 at 03:35 AM

Comorbid depression in patients with head and neck cancer compared with other cancersJAMA Otolaryngology-Head Neck Surgery; Marina C. Martinez,; Andrey Finegersh, MD, PhD; Fred M. Baik, MD; F. Chris Holsinger, MD; Heather M. Starmer, PhD, CCC-SLP, BCS-S; Lisa A. Orloff, MD; John B. Sunwoo, MD; Davud Sirjani, MD; Vasu Divi, MD; Michelle M. Chen, MD, MHS; 10/24This cohort study found that patients with HNC were twice as likely to screen positive for depression on a validated survey than those with other cancers, despite having similar rates of self-reported depression and depression medication use. These findings suggest that self-reporting of depression may result in underreporting and undertreatment in this population and, thus, a need for further work in developing interventions to improve identification of and optimize treatment for patients with HNC and comorbid depression.

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Knowledge of palliative care in men and women diagnosed with metastatic breast cancer

11/16/24 at 03:30 AM

Knowledge of palliative care in men and women diagnosed with metastatic breast cancerAmerican Journal of Hospice and Palliative Medicine; Evelyn Robles-Rodriguez, DNP, APN, AOCN; Ashley Weinmann, MSN, APN-C; Generosa Grana, MD, FACP; Teralyn Carter, MD; Bonnie Jerome-D’Emilia, PhD, MPH, RN; 10/24This sample of men and women diagnosed with metastatic breast cancer and being treated in a Cancer Center had limited knowledge and exposure to Palliative Care services across race and ethnicity. While no specific disparity was noted, the utilization of PC [palliative care] was low. Whether a function of a lack of referrals or patient preference, an effort should be made to increase PC referrals for all patients diagnosed with cancer.

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Cancer caregiver anxiety over time: The influence of palliative care

11/16/24 at 03:25 AM

Cancer caregiver anxiety over time: The influence of palliative careJournal of Palliative Care; Laura A Siminoff, PhD; Maureen Wilson-Genderson, PhD; Marcin Chwistek, MD, FAAHPM; Maria D Thomson; 10/24Our analysis detected 3 distinct cancer caregiver groups reporting low, elevated, and very high levels of anxiety. Caregivers with elevated or high anxiety also demonstrated increasing anxiety overtime; however increases were attenuated with patient receipt of palliative care. For cancer caregivers with elevated and high levels of anxiety, palliative care buffers further deterioration of their mental health. Caregivers with the lowest level of anxiety were more likely to be Black, report fewer symptoms of depression or caregiver burden and higher self-rated physical health. Caregivers who were younger reported higher anxiety.

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Prevalence of unrecognized cognitive impairment in federally qualified health centers

11/16/24 at 03:20 AM

Prevalence of unrecognized cognitive impairment in federally qualified health centersJAMA Network Open; Ambar Kulshreshtha, MD, PhD; Erik S. Parker, PhD; Nicole R. Fowler, PhD; Diana Summanwar, MD; Zina Ben Miled, PhD; Arthur H. Owora, PhD; James E. Galvin, MD; Malaz A. Boustani, MD, MPH; 10/24This cross-sectional study found that unrecognized cognitive impairment is ubiquitous among older adults from underrepresented, minoritized racial and ethnic groups and those who are socially vulnerable receiving primary care from FQHCs [federally qualified health centers]. To overcome the disparity in early detection of cognitive impairment, timely, equitable, scalable, and sustainable detection approaches need to be developed.

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Alzheimer Disease—What’s in a name?

11/16/24 at 03:15 AM

Alzheimer Disease—What’s in a name?JAMA Neurology; Ronald C. Petersen, PhD, MD; Elizabeth Mormino, PhD; Julie A. Schneider, MD, MS; 11/24Back in 2018, the National Institute on Aging (NIA)–AA [Alzheimer Association] group proposed a biological definition of AD [Alzheimer Disease] stating that if a person had the biomarker evidence of brain amyloid (A) and tau (T), the pathologic hallmarks of the disease, the patient had AD irrespective of the person’s clinical state. In their recent 2024 revision, they maintain a biological definition but have extended it to incorporate more recent biomarkers for AD; ... positivity on core 1 biomarkers that indicate the crossing of a specific amyloid threshold on amyloid positron emission tomography (PET), cerebrospinal fluid, and foreseeably, plasma biomarkers. A major question pertains to the requirement for tau in the definition [as] the AA group argues that the vast majority of individuals who have amyloid-positive PET scans have some tau pathology. Furthermore, the AA group proposes a clinical staging scheme that provides a framework to define the frequent mismatch between AD biomarker positivity (and underlying neuropathology) and the clinical expression of the disease, often an indicator of mixed pathologies or resilience. Importantly, although the AA group does base the AD diagnosis on biomarker positivity, they do not currently advise testing in asymptomatic persons in a clinical setting.

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Challenges in health care for persons with multiple chronic conditions—where to go and how to get there?

11/16/24 at 03:10 AM

Challenges in health care for persons with multiple chronic conditions—where to go and how to get there?JAMA Open Network; Gregory M. Ouellet, MD, MHS; Jennifer A. Ouellet, MD, MHPE; Mary E. Tinetti, MD; 10/24Approximately 75% of older adults, and more than one-third of all adults receiving health care, have MCC [multiple chronic conditions]. As has been well reported, siloed, disease-based health care for persons with MCC may be burdensome, fragmented, of uncertain benefit and potential harm, and not aligned with individuals’ health priorities (ie, what matters most to them about their health and health care). The result of all this is the imposition of unwanted and unhelpful care, neglect of potentially helpful interventions that do not fall under the narrow confines of disease-based care, and inattention to what matters to each person. Finally, quality and payment metrics focused on what matters to the individual will both encourage, and result from, a push to whole-person care.

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End-of-Life health care service use and cost among Medicare decedents with neurodegenerative diseases

11/16/24 at 03:05 AM

End-of-Life health care service use and cost among Medicare decedents with neurodegenerative diseasesNeurology; by Whitley W Aamodt, Chuxuan Sun, Nabila Dahodwala, Holly Elser, Andrea L C Schneider, John T Farrar, Norma B Coe, Allison W Willis; 11/24We conducted a retrospective study of Medicare Part A and B beneficiaries with Alzheimer disease (AD), Parkinson disease (PD), or amyotrophic lateral sclerosis (ALS) who died in 2018. Decedents diagnosed with malignant brain tumors or pancreatic cancer served as non-neurodegenerative comparators... Persons with neurodegenerative diseases in the United States are more likely to visit the ED and less likely to use inpatient and hospice services at EoL than persons with brain or pancreatic cancer. These group differences may stem from prognostic uncertainty and reflect inadequate EoL care practices, requiring further investigation to ensure more timely palliative care and hospice referrals.

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[UK] Multiple points of system failure underpin continuous subcutaneous infusion safety incidents in palliative care: A mixed methods analysis

11/16/24 at 03:05 AM

[UK] Multiple points of system failure underpin continuous subcutaneous infusion safety incidents in palliative care: A mixed methods analysisPalliative Medicine; Amy Brown, Sarah Yardley, Ben Bowers, Sally-Anne Francis, Lucy Bemand-Qureshi, Stuart Hellard, Antony Chuter, Andrew Carson-Stevens; 10/24 About 25% of palliative medication incidents involve continuous subcutaneous infusions. Complex structural and human factor issues make these risk-prone interventions. Primary incidents (most proximal to patient outcomes) leading to inappropriate medication use (including not using medication when it was needed) were underpinned by breakdowns in three major medication processes: monitoring and supply ... administration ... and prescribing ... Recurring contributory factors included discontinuity of care within and between settings, inadequate time, inadequate staffing and unfamiliarity with protocols. Psychological harms for patients and families were identified. System infrastructure is needed to enable timely supply of medication and equipment, effective coordinated use of continuous subcutaneous infusions, communication and continuity of care.

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Solo but not alone: An examination of social and help networks among community-dwelling older adults without close family

11/16/24 at 03:00 AM

Solo but not alone: An examination of social and help networks among community-dwelling older adults without close familyJournal of Applied Gerontology (J Appl Gerontol); by Jane Lowers, Duzhi Zhao, Evan Bollens-Lund, Dio Kavalieratos, Katherine A Ornstein; 11/31/2022... Nearly one in four adults is at high risk for aging without a spouse or children ... Previous descriptions of adults aging solo have focused on social isolation (Chamberlain et al., 2018; Roofeh et al., 2020), yet diverse, non-kin social networks can provide robust emotional and instrumental (task-oriented) support and such networks are becoming more common over time (Suanet & Antonucci, 2016; Verdery et al., 2019), although the type and intensity of support may vary by the type of relationship (e.g., kin vs non-kin) and factors including frequency of interaction (Wellman 1990). ... Therefore, as a first step, we sought to define the population of adults aging solo and compare its social networks and sources of help to adults with close family nearby. Editor's note: Though this article is from 2022, we are posting it due to our post on 11/13/24, Older Americans living alone often rely on neighbors or others willing to help, and our readers' frequent "most read" articles about seniors' challenges with isolation, depression, and caregiving challenges. 

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Use of hospice and end-of-life care quality among medical centers with high versus lower specialist palliative care reach among people with heart failure: An observational study

11/16/24 at 03:00 AM

Use of hospice and end-of-life care quality among medical centers with high versus lower specialist palliative care reach among people with heart failure: An observational studyJournal of Palliative Medicine; by Shelli L Feder, Ling Han, Yan Zhan, Erica A Abel, Kathleen M Akgün, Terri Fried, Mary Ersek, Nancy S Redeker; 11/24Rates of specialist palliative care (SPC) vary among Veterans Affairs Medical Centers (VAMCs) for people with advanced heart failure (aHF). We evaluated the associations between facility rates of SPC reach and the quality of end of life (EOL) care received among this population. Families of patients with aHF who die in VAMCs with higher SPC reach report better EOL care quality regardless of whether or not they receive SPC. Research is needed to investigate factors beyond receiving SPC associated with these EOL outcomes.

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[Canada] Timing of palliative care, end-of-life quality indicators, and health resource utilization

11/16/24 at 03:00 AM

Timing of palliative care, end-of-life quality indicators, and health resource utilizationJAMA Network Open; Sarah J. Mah, MD, MSc; Daniel M. Carter Ramirez, MD, PhD; Kara Schnarr, MD, PhD; Lua R. Eiriksson, MD, MPH; Anastasia Gayowsky, MSc; Hsien Seow, PhD; 10/24In this cohort study of 8,297 individuals with ovarian cancer decedents, initiating palliative care earlier than 3 months before death was associated with lower rates of death in the hospital, late chemotherapy, intensive care unit admission, and aggressive care at the end-of-life. Implementation strategies for early palliative care initiation are needed to optimize care quality and health resource utilization at the end of life.

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Saturday newsletters

11/16/24 at 03:00 AM

Saturday newsletters focus on headlines and research - enjoy!

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Unity Hospice to open East Side Resale Shoppe on November 18th

11/15/24 at 03:15 AM

Unity Hospice to open East Side Resale Shoppe on November 18th The Chamber, Manitowoc County, De Pere, WI; Press Release; 11/13/24 Unity, Northeast Wisconsin’s pioneering nonprofit healthcare provider, is excited to announce the expansion into a second Resale Shoppe location at 1302 S. Broadway in De Pere. This east side location, scheduled to open 10:00 am Monday, November 18, 2024, will provide a meaningful place for the community to donate or purchase cherished household goods and clothing. This new location will allow even greater convenience for customers and donors located on the east side of De Pere. 

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It's not just pumpkin spice time--it's time for the family conversation!

11/15/24 at 03:00 AM

It's not just pumpkin spice time--it's time for the family conversation! Dunlap Bennet & Ludwig; by George Reilly; 11/13/24 “Quality family time” is a phrase often heard in the period from Thanksgiving to New Year’s, sometimes even with air quotes, to describe what many people believe to be a necessary, but not necessarily enjoyable, time of family togetherness. ... Whatever your perspective on this “quality family time,” chances are that for most of you, it was/will be a missed opportunity to discuss very important matters with your loved ones—namely what happens in the event of disability or death; who takes care of what; a parent’s (or grandparents, or your own) wishes on the end of life medical care and funeral/burial/cremation choices; your wishes on guardians for minor children; and other critical, but admittedly sensitive and gloomy topics. ...  Consider these statistics from surveys conducted by the Conversation Project: ... 92% of Americans say it’s important to discuss their wishes for end-of-life care, but only 32% have had such a conversation! [Click on the title's link to continue reading.]

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Executive Personnel Changes - 11/15/24

11/15/24 at 03:00 AM

Executive Personnel Changes - 11/15/24

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Today's Encouragement: What we see depends mainly on ...

11/15/24 at 03:00 AM

What we see depends mainly on what we look for. ~ John Lubbock

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CMS to surveyors: Keep eyes open for hospice fraud

11/15/24 at 03:00 AM

CMS to surveyors: Keep eyes open for hospice fraud Hospice News; by Jim Parker; 11/14/24 The U.S. Centers for Medicare & Medicaid Services (CMS) has issued a memo to accreditation bodies and state agencies advising surveyors to watch out for potential hospice fraud. The memo directs surveyors to refer issues to CMS if they suspect fraudulent activity. These actions were spurred by a rash of fraudulent hospices that have emerged primarily in California, Texas, Nevada and Arizona. “While the primary purpose of [state agencies and accreditation organization] surveys is to determine compliance with the Medicare Hospice CoPs, there are several elements of the survey process that can uncover concerns that would necessitate a referral to CMS for potential fraud,” CMS indicated in the memo. 

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The future of AI in hospice care

11/15/24 at 03:00 AM

The future of AI in hospice care Hospice News; by Elizabeth Ecker; 11/13/24 As a high-touch, highly human care delivery type, hospice care may seem in a sense removed from the fast-paced, high-tech world of artificial intelligence. Yet in many ways AI is giving rise to exactly what hospice professionals set out to do in the first place: provide patient care. It also supports hospice professionals and patients in several other important ways, from reducing hospitalizations to providing scheduling efficiencies for staff and providing significant time savings. It can even be a key to providing the right care at the right time, and improved accuracy of patient data. ... It also supports hospice professionals and patients in several other important ways, from reducing hospitalizations to providing scheduling efficiencies for staff and providing significant time savings. It can even be a key to providing the right care at the right time, and improved accuracy of patient data.

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Annual Golf Marathon raises $120K to benefit Hope Hospice

11/15/24 at 03:00 AM

Annual Golf Marathon raises $120K to benefit Hope Hospice The Independent, Livermore, CA; 11/14/24 Hope Hospice, a nonprofit that provides support services for patients with terminal illnesses and their caregivers, reported raising almost $120,000 during the 10th annual Hope 100 Golf Marathon last month at Castlewood Country Club in Pleasanton. Event organizers said 28 golfers took on the challenge of playing 100 holes in one day on the club’s Valley Course, while another 20 participated in an inaugural skills competition that included putting, trick shots and long drives. “The Hope Hospice team is deeply grateful to all the players, sponsors and donors who made this event a success,” said Jennifer Hansen, Hope Hospice senior vice president. 

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Death is a natural part of life, but our society struggles to support those who are grieving.

11/15/24 at 03:00 AM

Death is a natural part of life, but our society struggles to support those who are grieving. Iowa Public Radio (IPR); host Charity Nebbe; 11/14/24 After a profound loss, the instinct is often to try and ease the pain for those who are grieving, but grief counselor Lynette Jordan says the pain of grief needs to be felt. This hour, host Charity Nebbe speaks with Jordan as well as mother and son Brianna and Grayson Wills about how they developed an open dialogue of grief in the seven years since the death of Grayson's twin brother, Calder. She also speaks with CL Lepley, who through experiencing many difficult losses since age five has become an expert in supporting those who are grieving. Guests:

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HomeCare & Hospice receives Renodin Grant

11/15/24 at 03:00 AM

HomeCare & Hospice receives Renodin Grant Olean Times Herald, Allegany, NY; 11/14/24 HomeCare & Hospice announces it has received a generous grant from the Dr. Lyle F. Renodin Foundation to support its comfort care basket initiative for hospice patients. This funding will enable HomeCare & Hospice to provide comfort care baskets filled with thoughtfully selected items that promote relaxation, comfort and dignity for those facing end-of-life care. Each basket is designed to offer a bit of respite, bringing a sense of warmth and care to patients during a vulnerable time. The Dr. Lyle F. Renodin Foundation, affiliated with the Franciscan Sisters of Allegany, is committed to supporting projects that uplift individuals experiencing poverty, homelessness, food insecurity and other vulnerabilities. “We are deeply grateful to the Dr. Lyle F. Renodin Foundation for their support,” said Melissa Sullivan, CEO of HomeCare & Hospice. “This grant will allow us to provide meaningful and comforting items to our hospice patients, helping to ease their journey and providing support that reflects the compassion and respect at the heart of our mission.”

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[United Kingdom] After tragedy, NJ doctor finds renewed purpose working—and living—at a hospice

11/15/24 at 03:00 AM

[United Kingdom] After tragedy, NJ doctor finds renewed purpose working — and living — at a hospice My Central Jersey - NorthJersey.com; by Scott Fallon; 11/14/24 Even though she was on hospice care for terminal cancer at a New York hospital, Sandy Cattani’s last days were marred with pain and suffering. At one point, she began flailing so much in her hospital bed that her husband, Dr. Charles Vialotti, and other family members had to help hold her arms and legs down. This is not how any patient should die, Vialotti thought. He ought to know, having helped pioneer hospice care at three New Jersey hospitals. About a year after Sandy's death, Vialotti took the unusual step of moving into the Villa Marie Claire hospice in Saddle River, where he has spent 14 years attending to the terminally ill.

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