Fire Away! Choosing the Right NOAC & How Physician Training Affects Patient Outcomes


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This week on The Rounds Table we are trying something different as our first new episode of 2018: just the salient points from FOUR articles instead of two! Same time spent listening, twice the take-away! Mike and Kieran break it down for listeners.

Novel oral anticoagulants (NOACs) are everywhere, and they can put patients at increased risk of bleeding. Mike covers a retrospective cohort study examining the risk of major bleeding among patients with non-valvular atrial fibrillation treated with non-vitamin K oral anticoagulants in combination with twelve medications that share metabolic pathways.

Next, Mike keeps listeners in the NOAC headspace and leads the discussion on a systematic review and meta-analysis examining the comparative efficacy, safety, and cost effectiveness of NOACs for prevention of stroke in patients with atrial fibrillation.

Kieran next takes the lead and guides listeners through a retrospective cohort study investigating whether the type of generalist physician caring for a hospitalized patient – the patient’s primary care physician, a hospitalist, or another covering outpatient generalist – affects patient outcomes in and out of the hospital.

Kieran then takes listeners through a retrospective cohort study investigating whether there are systematic differences in the quality of inpatient care provided by locum tenens versus non-locum tenens internal medicine physicians.

Finally, a special Good Stuff segment. Have you heard of the Perioperative Surgical Home? Kieran interviews Dr. Zeev Kain, who breaks it down for listeners.

What do you think of the Rapid Fire format? Let us know on Twitter @roundstable. Tweet at Kieran directly @kieranlquinn, Mike @FralickMike, and Zeev @ThePeoplesDr.

The Papers

1. NOACs & Concurrent Meds: https://jamanetwork.com/journals/jama/article-abstract/2656168?redirect=true

2. NOACs & Stroke Prevention: http://www.bmj.com/content/359/bmj.j5058

3. Continuity of Care: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2663254?redirect=true

4. Locums: https://jamanetwork.com/journals/jama/article-abstract/2665001?redirect=true

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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