There’s Still Time to Participate in Clinical Decisions: Management of Sciatica

Posted by • April 3rd, 2017

Time hasn’t run out to participate in our last Clinical Decisions article discussion, Management of Sciatica. You have through April 5th to vote and discuss on whether you would recommend Mr. Winston, a 50-year-old bus driver who has come to your office with a 4-week history of pain in his left leg and lower back, undergo lumbar disk surgery or receive nonsurgical therapy. Read the entire case to make sure you have enough information to make an informed decision, then vote for the option that you would recommend for Mr. Winston. Participate here!

Clinical Decisions are a great way to help you evaluate treatment options and gain insight from colleagues. The articles include a case vignette, plus clinically acceptable management options, each supported in a short commentary by a respected clinician. You are invited to vote for, and comment on, the options at NEJM.org, where a diverse range of thinking is presented. Browse previous Clinical Decisions articles here!

 

Posted by • March 31st, 2017

Two new articles that explore data sharing were published by NEJM this week. The first, a Sounding Board article titled Data Authorship as an Incentive to Data Sharing, explains how designating a “data author” in clinical trials could help solve the major issue of providing academic credit to investigators who gather data in these trials. The other, a Special Article titled Use of the National Heart, Lung, and Blood Institute Data Repository, offers insight into the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) of the National Heart Lung and Blood Institute’s (NHLBI). The BioLINCC handles the preparation, presentation and use of clinical data. Depending on the complexity of the study, data preparation can take anywhere from 85 to 350 hours, showing that it is a very intense and significant step in data sharing.

Speaking of data sharing… there’s still time! If you want to be able to participate in this unique opportunity to make meaningful contributions to our free web event on Sharing Clinical Trial Data, don’t forget to sign up now. Where else will you be given the opportunity to engage with leading experts in moderated Q&A sessions, share your perspective in online working groups, and help explore possible solutions for the responsible sharing of data? Sound interesting? Sign up here.

New Clinical Decision Article: Management of Sciatica

Posted by • March 27th, 2017

In this week’s Clinical Decision, a 50-year-old bus driver comes to you with a 4-week history of pain in his left leg and lower back. He describes a combination of severe sharp and dull pain that originated in his left buttock and radiated to the dorsolateral aspect of his left thigh, as well as vague aching over the lower lumbar spine. After the first visit, you prescribe 150 mg of pregabalin per day, which is gradually increased to 600 mg daily because the symptoms had not abated.

Ten weeks after the initial onset of his symptoms, he returns for an evaluation. The medication has provided minimal alleviation of his sciatic pain. You discuss options for the next steps in managing his sciatica, but he is uncertain about invasive procedures such as lumbar disk surgery even though he feels limited by his pain.

What steps should you take next? Read the opinions, share your comments, and vote now!

Clinical Decisions are a great way to help you evaluate treatment options and gain insight from colleagues. The articles include a case vignette, plus clinically acceptable management options, each supported in a short commentary by a respected clinician. You are invited to vote for, and comment on, the options at NEJM.org, where a diverse range of thinking is presented. Browse more Clinical Decisions articles here!

Registration Now Open for Free Web Event on Sharing Clinical Trial Data

Posted by • March 20th, 2017

On March 7th, the New England Journal of Medicine named three teams hailing from universities in Israel and the United States as the winners of the SPRINT Data Analysis Challenge, which encouraged participants to explore and examine the potential of sharing clinical trial data. Open to health care professionals, researchers and data scientists, NEJM asked individuals and groups to analyze the dataset underlying the SPRINT article, “A Randomized Trial of Intensive versus Standard Blood-Pressure Control,” and challenged them to identify a novel scientific or clinical finding.

Hear what was learned from the SPRINT Challenge directly from the SPRINT PIs, data analysts, patient participants, and the NHLBI repository and view the SPRINT Challenge winners present their findings at the NEJM Aligning Incentives for Sharing Clinical Trial Data summit and free live web event on April 3-4, 2017.

NEJM invites you to participate in this open conversation. Join our expert speakers in panel discussions featuring clinical trialists, data analysts, and patient participants, as well as government and funding agencies. These moderated Q&A sessions give you a chance to share your expertise on the subject.

Together, let’s examine the potential for data sharing to teach us things we did not know, to maximize the contribution of patients who put themselves at risk, and to make a positive impact on health outcomes. Make sure to sign up here before April 3rd!

What’s New: SPRINT Data Analysis Challenge Winners Announced

Posted by • March 15th, 2017

On March 7th, the New England Journal of Medicine named three teams hailing from universities in Israel and the United States as the winners of the SPRINT Data Analysis Challenge, which encouraged participants to explore and examine the potential of sharing clinical trial data. Open to health care professionals, researchers and data scientists, NEJM asked individuals and groups to analyze the dataset underlying the SPRINT article, “A Randomized Trial of Intensive versus Standard Blood-Pressure Control,” and challenged them to identify a novel scientific or clinical finding.

Overall, 200 individuals and teams qualified to participate in the Challenge with NEJM receiving 143 submissions of novel findings based on the SPRINT data set. These entries, representing countries from around the world, were judged based on the findings’ originality and novelty, the utility of those findings to clinical medicine, and the quality and clarity of the methods used.

The multidisciplinary panel of judges were comprised of expert representatives from the clinical trial community: researchers, patient advocates and data scientists (the full list of judges can be found here). The final results were also open to evaluation by the Challenge’s more than 16,000 followers for crowd voting, which contributed to 10 percent of the total scoring.

The winners of the SPRINT Data Analysis Challenge were:

These three winning SPRINT Challenge teams will present their findings at the NEJM Aligning Incentives for Sharing Clinical Trial Data summit and free live web event on April 3-4, 2017. With the Aligning Incentives summit, NEJM aims to initiate an open and balanced discussion among clinical trials’ three key constituencies — clinical trialists, data analysts and patient participants — as well as the government and funding agencies that support research.

Join the conversation and register to attend the free web event.  Watch the SPRINT Challenge winners’ presentations and hear what was learned from the SPRINT Challenge directly from the SPRINT PIs, data analysts, patient participants, and the NHLBI depository. Visit http://events.nejm.org to view the agenda and expert speaker line up.

 

New Clinical Problem-Solving: Histology Rings True

Posted by • March 7th, 2017

In this week’s Clinical Problem-Solving Case, a 58-year-old man with nonerosive rheumatoid arthritis who was being treated with etanercept and methotrexate presented to the emergency department with a 2-week history of fevers (temperatures up to 39°C) and drenching night sweats. In the previous week, yellowing of his eyes and dark urine had developed. He reported no dyspnea, abdominal pain or distention, nausea, vomiting, dysuria, easy bruising, headache, or myalgias. What should be done? A new Clinical Problem-Solving article explains.

In this Journal feature, information about a real patient is presented in stages to an expert clinician, who responds to the information, sharing his or her reasoning with the reader. Click to read more about this case, including expert author commentary, on NEJM Resident 360.

New Quick Take: Inhibiting Plasma Kallikrein for Hereditary Angioedema Prophylaxis

Posted by • February 28th, 2017

This week’s Quick Take video describes how patients with hereditary angioedema with C1 inhibitor deficiency may have recurrent, unpredictable swelling episodes that require immediate treatment. However, current options for these patients are limited by side effects. Is there a safe and effective therapy? Take less than three minutes and find out!

Quick Take videos are a great way to quickly become familiar with the key findings of select Original Articles. This collection of brief video summaries, updated weekly, offers a succinct, innovative way to understand important article findings that have an impact on medical practice and patient care. Look for a new video each week in the featured article, or browse the collection from the Articles & Multimedia tab on NEJM.org.

New Clinical Decisions: Thromboprophylaxis after Knee Arthroscopy

Posted by • February 13th, 2017

In this week’s Clinical Decision, a 60-year-old woman comes to your office to discuss her upcoming arthroscopic knee surgery. She recently received a diagnosis of a right lateral meniscus tear and is scheduled to undergo arthroscopic meniscectomy. She has heard that knee surgery increases the risk of blood clots, and she wants to know whether she should take an anticoagulant after her surgery to reduce the risk. She asks your advice on how she can prevent blood clots after her procedure. What do you recommend?

Clinical Decisions are a great way to help you evaluate treatment options and gain insight from colleagues. The articles include a case vignette, plus clinically acceptable management options, each supported in a short commentary by a respected clinician. You are invited to vote for, and comment on, the options at NEJM.org, where a diverse range of thinking is presented. Browse more Clinical Decisions articles here!

New Interactive Medical Case: Making the Connection

Posted by • January 30th, 2017

In the case, “Making the Connection,” a 41-year-old man with hyperlipidemia and a history of morbid obesity since childhood was referred to a surgeon for a weight-management consultation and consideration of bariatric surgery. The patient had tried dieting on his own and had also tried several commercial weight-loss programs with little long-term success. Can you accurately assess this patient?

Interactive Medical Cases are online simulations based on a real patient’s experience of illness. You follow interactive steps through an evolving patient’s history, diagnosis, and management, from presentation to outcome.

Browse the list of previous Interactive Medical Cases. Try one or all 44!

New Quick Take: Mass Intoxication with Synthetic Cannabinoids

Posted by • January 24th, 2017

11113This week’s Quick Take video describes how medical professionals and law enforcement agents identified the cause of a July 2016 drug-induced intoxication and subsequent hospitalization of an unusually high number of people in Brooklyn. Emergency room workers knew only that the patients had been exposed to some type of “herbal incense” before beginning to exhibit “zombielike” behavior. When a drug that is rarely seen or tested for causes such events, how do clinicians use their experience and resources to pinpoint exactly what it is? Take less than three minutes to see how it happened in Brooklyn.

Quick Take videos are a great way to quickly become familiar with the key findings of select Original Articles. This collection of brief video summaries, updated weekly, offers a succinct, innovative way to understand important article findings that have an impact on medical practice and patient care. Look for a new video each week in the featured article, or browse the collection from the Articles & Multimedia tab on NEJM.org.