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This week: surgical checklists, statin myalgia and breast cancer radiotherapy

Janice, Nathan, and Amol want you to:

1. Understand the effect of surgical safety checklist implementation on surgical complication rates.

2. Understand the use of n-of-1 trials in evaluating the association between statin use and myalgia.

3. Recognize that intraoperative radiotherapy for breast cancer may be a viable alternative to standard postoperative external beam radiation therapy in terms of local recurrence.

Continuing Medical Education

Internists can receive 0.5 hours of Continuing Medical Education credit for each podcast they listen to through the Canadian Society of Internal Medicine (MOC Category 1) and the American Medical Association (PRA Category 1). To receive CME credit for listening to this podcast, please click here to fill out our Evaluation and Impact Assessment Form.

The papers

David Urbach et al. Introduction of surgical safety checklists in Ontario, Canada. N Engl J Med. 2014;  370:1029-1038. (PubMed)

Tisha Joy et al. N-of-1 (Single-Patient) Trials for Statin-Related Myalgia. Ann Intern Med. 2014;160(5):301-310.

Jayant Vaidya et al. Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer: 5-year results for local control and overall survival from the TARGIT-A randomised trial. Lancet. 2013; 383:603-613.  (PubMed)

Good stuff

Janice – When checklists work and when they don’t, Atul Gawande, The Incidental Economist, March 15, 2014.

Nathan – Weed 2, a documentary by CNN’s Dr. Sanjay Gupta.

Amol – Malcolm Gladwell: Tell People What It’s Really Like To Be A Doctor, Robert Pearl, Forbes, March 13, 2014.

Other Links Discussed this Week

Judith Finegold et al. What proportion of symptomatic side effects in patients taking statins are genuinely caused by the drug? Systematic review of randomized placebo-controlled trials to aid individual patient choice, Eur J Prev Cardiol, 2014 Apr;21(4):464-74.

Elizabeth Lillie et al. The n-of-1 clinical trial: the ultimate strategy for individualizing medicine? Per Med. 2011 March ; 8(2): 161–173. (PubMed)

Question of the Week

Is it the surgical checklist or safety culture that matters to reduce surgical complication rates?