Amol, general internal medicine resident at the University of Toronto, and Reena, staff physician in internal medicine at St. Michael’s hospital, discuss 2 recent papers:
Opioid prescription is an increasing public health crisis. A retrospective cohort study found that patients who experience non-fatal opioid overdose almost always get re-prescribed opioids at large doses a month later. Reena asks, is this due to fragmented care, or providers lacking knowledge in how to better manage chronic pain?
A battle of high sensitivity troponin assay vs. serial troponin measurements. A prospective cohort study found that a single high sensitivity troponin measurement can be used with very good negative predictive value in patients with suspected acute coronary syndrome. Whether high sensitivity troponin assays lead to increased false positive results and unnecessary testing remains to be seen.
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1. Patient story on opiod: http://facesofhealthcare.ca/brian-p/#brian-p-1
2. Opiod prescription: http://annals.org/article.aspx?articleid=2479117
3. High sensitivity troponin: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00391-8/abstract
Music Credits (Creative Commons)
In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart
Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music
All tracks have been modified for the purposes of this podcast.