Calling Home: Accuracy of The Surprise Question, Medical Assistance in Dying, and SGLT2 Inhibitors & DKA
This week on The Rounds Table we are focusing on papers that highlight talent at home – here in Toronto! Kieran hosts Dr. James Downar and Dr. Mike Fralick to discuss their recent publications, and Emily and Sheliza bring listeners the final special segment of the year.
The surprise question – Would I be surprised if this patient died within the next 12 months? – is used as an intuitive means for physicians to try to identify patients they think might benefit from a palliative approach. James takes listeners through his recent meta-analysis examining the accuracy of the surprise question in practice for predicting mortality.
Next, the final special segment of the year! Medical Assistance in Dying (MAiD) has received considerable attention in the past year as recent legislation in Canada surrounding it has changed. Emily and Sheliza bring listeners up to speed with an overview of the changes, a framework for implementation developed at the University Health Network in Toronto, and practical considerations for clinicians.
Finally, a patient – on a new diabetes medication – comes into the Emergency Department and their bloodwork suggests diabetic ketoacidosis (DKA). Sound familiar? Mike takes listeners through his recent study examining the risk of DKA after initiation of an SGLT2 inhibitor compared to a DPP4 inhibitor.
1. The Surprise Question: http://www.cmaj.ca/content/189/13/E484.abstract
2. SGLT2 inhibitors & DKA: http://www.nejm.org/doi/full/10.1056/NEJMc1701990#t=article
Medical Assistance in Dying (MAiD) Special Segment
1. NEJM article from UHN: http://www.nejm.org/doi/pdf/10.1056/NEJMms1700606
2. Practical Considerations: http://ocfp.on.ca/tools/clinical-tools-and-resources/clinical-tools-and-resources-for-primary-care/clinical-tools-and-resources-for-primary-care/2016/11/18/maid-resource-guide—centre-for-effective-practice
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