Internal medicine journal
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Internal medicine journal · Feb 2025
Post-colonoscopy colorectal cancer in the Western Australian population: analysis of patient, histopathological and molecular characteristics.
Post-colonoscopy colorectal cancer (PCCRC), defined as colorectal cancer (CRC) detected after a cancer-negative colonoscopy, represents a key quality indicator for CRC detection and prevention. While most PCCRC is attributed to missed lesions, few studies examine pathologic and molecular characteristics of PCCRC to assess for possible de novo cancer formation causing PCCRC. ⋯ A significant percentage of PCCRC occurred despite adequate prior colonoscopy. Missed sessile serrated lesions may contribute to many of these cases; however, further studies are required to examine possible de novo cancer as a cause of PCCRC that may involve unique biological pathways.
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Internal medicine journal · Feb 2025
'Charge what you think you're worth': a qualitative study exploring the gender pay gap in medicine and the role of price transparency.
The gender pay gap in medicine is entrenched and has a negative impact on economic growth, institutional reputation and financial success, recruitment, retention and job satisfaction of female specialists and patient care. It also discourages women from entering specialist fields of medicine. In the Australian unregulated market setting, female specialists are not simply getting paid less, they are choosing to set lower fees than their male counterparts. ⋯ The gender pay gap is pervasive. Greater transparency on fees and quality could be explored as a potential solution to reduce pay inequality.
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Internal medicine journal · Feb 2025
Is Australia ready for the rollout of amyloid-targeting therapies for Alzheimer's disease? Results from a national survey characterising current infrastructure capability, workforce and training needs of memory and cognition clinics.
New amyloid-targeting monoclonal antibody (mAb) therapies for Alzheimer's disease (AD) are currently under review by the Therapeutic Goods Administration for use in Australia. ⋯ Australia's health system preparedness for amyloid-targeting mAb therapies will require further investment in infrastructure, equity of access, clinician training and support. Long wait times already impact access to clinics, and with the forecast rise in MCI and dementia cases, services will need to be expanded, and appropriate Models of Care and clear and efficient inter-sector health pathways will be needed to prepare for the use of mAbs.
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Internal medicine journal · Feb 2025
Multicenter StudyPrevalence of heart failure pharmacotherapy utilisation, frailty and adverse drug events among hospitalised adults older than 75 years: a multicentre cross-sectional study.
Optimal heart failure (HF) pharmacotherapy (guideline-directed medical therapy and diuretics) in older people with frailty is uncertain due to limited evidence. ⋯ Frailty, HF-pharmacotherapy changes in hospital and ADEs were common among older inpatients with HF. The association of adverse outcomes according to frailty needs further investigation. Poor documentation of HF phenotype may be a barrier to medication optimisation in older inpatients.
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Internal medicine journal · Feb 2025
Measuring variations in healthcare data using run charts and statistical process control charts: a survey of general physicians attending the quality improvement workshop.
General physicians as system leaders play a significant role in quality improvement (QI) initiatives within respective health services. However, there are very few formal QI training programmes available for general physicians in Australia. This survey described the experiences of attendees at the 2024 Internal Medicine Society of Australia and New Zealand QI workshop, which delivered topics on understanding variations in healthcare data using QI tools such as run charts and statistical process control (Shewhart) charts.