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August 1, 2019
News From Medscape
The following recommended articles on are freely available through the partnership between ABC and Medscape, no registration or login required.
'Big Three' Diseases Account for Most Diagnostic Error Harm
Misdiagnosis-related harms are concentrated in the "big three" areas of vascular events, infections, and cancers, new research suggests. The findings, from an analysis of nearly 12,000 malpractice claims, were presented at a Capitol Hill briefing sponsored by the Society to Improve Diagnosis in Medicine (SIDM), which funded the research through a grant from the Gordon and Betty Moore Foundation.
Is Cardiology Overly Enamored of New Unproven Therapies?
Sometimes helping people is easy: antibiotics for bacterial infection, pacemakers for heart block, and stents for acute myocardial infarction. But medical practice is rarely that black and white. Most of what we recommend in the name of helping people is of uncertain benefit. A novel study published in the open-access and transparently peer-reviewed journal eLife attempted to quantify how often our efforts to help people prove to be of no benefit. This look back at medical history deserves attention.
'No Cure, No Pay' Pilot for Expensive Cancer Drugs
In the Netherlands, a new project is underway: the "no cure, no pay" model, in which certain expensive cancer drugs will be paid for if they turn out to be effective after 16 weeks. Drug companies will not receive payment if these drugs do not work. The hope is that this model will allow expensive medicines to remain available in this way, and that doctors will be able to prescribe them to patients who have exhausted other therapeutic options, and who may stand to benefit from them.
Items of Interest
AAP Issues First Policy On Racism's Impact On Child Health and How to Address It
The American Academy of Pediatrics (AAP) issued a new policy statement to specifically address racism’s impact on child and adolescent health, consistent with the vision outlined in the AAP Blueprint for Children.
Walgreens Bolsters Digital Marketplace With New Chronic Disease Management Tools
Walgreens digital marketplace Find Care has been expanded with new tools from Propeller Health and Dexcom to help individuals manage respiratory and metabolic diseases. Walgreens customers can now sign up to receive Dexcom G6 CGM and Propeller’s inhaler sensor which tracks medication usage and can help warn users of high sensitivity events through the company’s associated mobile app. The new vertical was launched in the face of increasing competition from retailers like CVS Health, Walmart and Amazon.
CVS Health Expands Direct-to-Consumer Telehealth Service to 26 States
CVS Health announced that its MinuteClinic service is now available through the Teladoc Health telemedicine platform to residents in eight more states, bringing the total number of states capable of accessing the connected health service to 26 and the District of Columbia. The pharmacy chain unveiled the direct-to-consumer telehealth offering in August of 2018.
Abbott's Latest MitraClip Version Gains FDA Approval
Abbott received FDA approval for the fourth generation of its MitraClip device, called MitraClip G4, with new features that allow for greater customization of the minimally invasive mitral valve repair procedure - an expanded range of clip sizes, an alternative leaflet grasping technology, and integration with a pressure monitor for real-time assessment during implant.
Fitbits and Other Wearables May Not Accurately Track Heart Rates in People of Color
An estimated 40 million people in the United States have smartwatches or fitness trackers that can monitor their heartbeats. But some people of color may be at risk of getting inaccurate readings. Fitbits, Samsung watches, and several other brands rely on only green lights, which has a shorter wavelength and is more readily absorbed by melanin, a natural skin pigment that is more prevalent in people with darker skin.
Featured Articles by Members
ABC Members: We welcome your published research submissions and articles for inclusion in future issues of Clinical Updates and Insights. Email Rachel Williams at and please attach file or include links to the original published work and/or abstract.
Monophasic Action Potential Amplitude for Substrate Mapping
Co-authored by lead author Ikeotunye R Chinyere (with Mathew Hutchinson, Talal Moukabary, Jordan Lancaster, Steven Goldman, and Elizabeth Juneman)
While radiofrequency ablation has revolutionized the management of tachyarrhythmias, the rate of arrhythmia recurrence is a large drawback. Successful substrate identification is paramount to abolishing arrhythmia and bipolar voltage electrogram's narrow field of view can be further reduced for increased sensitivity. In this report, we perform cardiac mapping with monophasic action potential (MAP) amplitude. We hypothesize that MAP amplitude (MAPA) will provide more accurate infarct sizes than other mapping modalities via increased sensitivity to distinguish healthy myocardium from scar tissue.
Contemporary Pharmacologic Management of Heart Failure with Reduced Ejection Fraction: A Review
Co-authored by Anekwe Onwuanyi (with Obiora Egbuche, Bishoy Hanna, Ifeoma Onuorah, Emmanuela Uko, Yasir Taha and Jalal K Ghali)
Despite breakthrough discoveries and advances in pharmacologic management of Heart failure (HF), Heart failure with reduced ejection fraction (HFrEF) patients continue to pose a significant economic burden due to progressive disease characterized by recurrent hospitalizations and need for advanced therapy. Since the morbidity and mortality benefits of some of the pharmacologic therapies are dose-dependent, optimal medical therapy is required to impact the burden of disease, quality of life, prognosis, and to curb health care expenditure. In this review, we summarize landmark trials that have impacted the management of HF and we review contemporary pharmacologic management of patients with HFrEF. We also provide insight on general considerations in the management of HFrEF in specific populations.
Mortality From Heart Failure and Dementia in the United States: CDC WONDER 1999-2016
Co-authored by Kevin M Alexander, MD (with Jacqueline T Vuong, BA, Sophia A Jacob, BS, Avinainder Singh, MBBS, Ronglih Liao, PhD, Akshay S Desai, MD MPH and Sharmila Dorbala, MD MPH)
Heart failure and dementia are diseases of the elderly that result in billions of dollars in annual health care expenditure. With the aging of the United States population and increasing evidence of shared risk factors, there is a need to understand the conditions’ shared contributions to nationwide mortality. The objectives of this study were to estimate the burden of mortality from heart failure and dementia and characterize the demographics of affected individuals.
Plant-Based Diets for Cardiovascular Safety and Performance in Endurance Sports
Co-authored by Travis C. Batts (with Neal D. Barnard, David M. Goldman, James F. Loomis, Hana Kahleova, Susan M. Levin and Stephen Neabore)
Studies suggest that endurance athletes are at higher-than-average risk for atherosclerosis and myocardial damage. The ability of plant-based regimens to reduce risk and affect performance was reviewed. The purpose of this review was to explore the role of nutrition in providing cardioprotection, with a focus on plant-based diets previously shown to provide cardiac benefits.

We LOVE to LEARN how our ABC Members are making a difference! Please Share. Giving a keynote speech? Presenting at a Grand Round? Receiving an Award? Interviewed by the Press? Published in a journal? Presenter or Panelist at a Conference? Graduating? Email Rachel Williams at or please tag or DM us on Facebook, Twitter or Instagram with links/details, so we can spotlight your excellence in our newsletter!


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