Journal of general internal medicine
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Monoclonal antibody drugs are widely used, highly marketed, expensive compounds. Relationships between these drug manufacturers and physicians may increase the potential for bias in relevant studies. ⋯ Substantial inconsistencies were found between self-reported disclosures and the Open Payments Database among physicians receiving high compensation for MAbDs. A policy of full disclosure for all publications should be adopted.
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The pharmaceutical industry promotes prescribing through the cultivation of key opinion leaders. Advanced practice nurses (APNs) are a growing and influential group of prescribers across generalist and specialty practice. Public reporting of industry payments to APNs allows for exploration of their influence within practice settings. ⋯ Top APN payment recipients attracted high-value payments in practice settings and specialities associated with high-cost drug development; however, there may be little oversight of APNs' industry relationships. Policy development related to industry relationships must be inclusive of and responsive to the activities of interprofessional providers.
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Recognition of clinically deteriorating hospitalized patients with activation of rapid response (RR) systems can prevent patient harm. Patients with limited English proficiency (LEP), however, experience less benefit from RR systems than do their English-speaking counterparts. ⋯ In this pilot study, prioritized tracking, utilization of EWS-triggered evaluations, and interpreter integration into the RR system for LEP patients were feasible to implement and showed promise for reducing post-RR system activation mortality.
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Disparities in life-saving interventions for low-income patients with cirrhosis necessitate innovative models of care. ⋯ Patients with refractory ascites in large safety net hospitals may benefit from an outpatient procedure clinic instead of ED care.
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Machine translation (MT) apps are used informally by healthcare professionals in many settings, especially where interpreters are not readily available. As MT becomes more accurate and accessible, it may be tempting to use MT more widely. Institutions and healthcare professionals need guidance on when and how these applications might be used safely and how to manage potential risks to communication. ⋯ While professional interpreters remain the gold standard for overcoming language barriers, voice-to-voice MT may be acceptable in some clinical situations. Healthcare institutions and professionals must be attentive to potential sources of MT errors and ensure the conditions necessary for safe and effective communication. More research in natural settings is needed to inform guidelines and training on using MT in clinical communication.