Data Stream
Do Shorter Shifts Give Patients
the Short Shrift?
Patients Are Choosing Wisely, Too
Scheduling shorter shifts for medical residents doesn’t seem to
improve doctors’ fatigue levels or patient care, according to a study
of 47 residents in two university-affiliated ICUs who were randomly
assigned to three different shift lengths. In terms of adverse events
per 1,000 patient-days:
“Demanding patients” are not to blame for high medical costs associated
with unnecessary tests and treatments, according to a survey of 60 doctors’
interactions with more than 3,600 cancer patients.
Patients asked for a
particular treatment in only
8.7% of interactions.
Of those, doctors considered
only 11.4% to be inappropriate
or unnecessary care.
RESIDENTS ASSIGNED TO
24-hour
shifts
16-hour
shifts
12-hour
shifts
Overall, most clinicians don’t comply with patients’ requests for unnecessary or
inappropriate treatments – and most patients don’t ask them to.
Source: Gogineni K, Shuman KL, Chinn D, et al. JAMA Oncol. 2015 February 12. [Epub ahead of print]
Smoke ‘Em if You Got ‘Em?
Interestingly, 7 out of the 8 “preventable” adverse events happened
during the shortest shift. One reason for these findings suggested by
the authors: a doctor who stays longer with a patient might be more
tuned in to that patient’s needs.
Source: Parshuram CS, Amaram ACKB, Ferguson ND, et al. CMAJ. 2015 February 9. [Epub
ahead of print]
Great Strides in Survivorship
The NCI estimates that, as of January 2014, there are 14.5 million cancer
survivors in the United States – over 4% of the general population,
and a record high in cancer survivorship. Over the next decade, the NCI
projects:
almost
19 MILLION
cancer survivors in the U.S. (an increase of
more than 4 million survivors in 10 years)
the number of people who have lived
5+ years after their cancer diagnosis
will increase approximately 37% - to
37%
11.9 MILLION
PEOPLE
According to a pooled
analysis of nine casecontrol studies, former
smokers had only a 3%
greater risk of developing multiple myeloma
compared with neversmokers, suggesting
that cigarette smoking
is not a risk factor for
multiple myeloma.
3
%
Quitting smoking
earlier in life, however,
lowered risk by
40 percent.
40
%
Source: Andreotti G, Birmann BM, Cozen W, et al. Cancer Epidemiol Biomarkers Prev. 2014 December 23.
[Epub ahead of print]
Source: National Cancer Institute’s Office of Cancer Survivorship
16
ASH Clinical News
March 2015