Response to Letter to the Editor regarding “Online physician ratings fail to predict actual performance on measures of quality, value, and peer review”
We thank Dr Bardach for her critical review of our paper evaluating the relationship between online ratings and objective measures of physician quality, value, and peer review. Her principal argument is that quality and value of care are opaque to consumers and therefore not reflected in online ratings of physicians. Indeed, this is the very crux of our paper ’s message. Dr Bardach details the ways in which our chosen metrics for quality and value of care – Choosing Wisely measures, cost of care, length of stay, and peer review – are outside of the scope of the patient experience and therefore unlikely to be captured by online consumer ratings. How ever, their imperceptibility is not an idiosyncrasy of our metrics; rather, these metrics exemplify a broad range of widely accepted measures of quality and value of care. In fact, all measures of quality and value of care are difficult for patients to discern. For example, regarding quality of care , whether or not a physician hews to specialty guidelines – regardless of whether it was unnecessary care omitted or necessary care delivered – would not be expected to be discernable by a patient. Similarly, it is difficult for patients to know whether out-of-pocket costs for a given episode of care are reasonable without an established reference for what that episode usually costs. It is because these elements of care are not reliably captured in online ratings that we proposed in our article that they &l...
CONCLUSION: Prevalence of antibiotic use was high not only versus other hospitals in the region but globally including Africa, coupled with significant evidence of sub-optimal prescribing. Swift action is needed to improve future prescribing to reduce AMR. One or two areas should initially be targeted for quality improvement including development of local guidelines, documentation of antibiotic indications and/or stop/review dates. PMID: 33034234 [PubMed - as supplied by publisher]
Authors: Rombauts A, Abelenda-Alonso G, Cuervo G, Gudiol C, Carratalà J Abstract INTRODUCTION: Despite adequate antibiotic coverage, community-acquired pneumonia (CAP) remains a leading cause of hospitalization and mortality worldwide. It induces both a local pulmonary and a systemic inflammatory response, particularly significant in severe cases. The intensity of the dysregulated host response varies from patient to patient and has a negative impact on survival and other outcomes. AREAS COVERED: This comprehensive review summarizes the pathophysiological aspects of the inflammatory response in CAP, brie...
Authors: Hammerschlag MR, Sharma R Abstract INTRODUCTION: Azithromycin was recommended as the first-line therapeutic regimen for treatment of genital infections in men and women by the Centers for Disease Control in 1998. A series of studies of azithromycin for treatment of rectal chlamydial infection in men who have sex with men (MSM) found that azithromycin was significantly less effective than doxycycline. AREAS COVERED: Literature on treatment of rectal C. trachomatis from 2000 through May 2020 was searched using PubMed. Retrospective and observational studies were identified documenting the frequency and t...
Authors: Reissier S, Cattoir V Abstract INTRODUCTION: Streptogramins (pristinamycin and quinupristin-dalfopristin) can be interesting options for the treatment of infections due to Gram-positive cocci, especially multidrug-resistant isolates. AREAS COVERED: This review provides an updated overview on structural and activity characteristics, mechanisms of action and resistance, pharmacokinetic/pharmacodynamic and clinical use of streptogramins. EXPERT OPINION: The streptogramin antibiotics act by inhibition of the bacterial protein synthesis. They are composed of two chemically distinct compounds, namely typ...
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