Hospital Volume and Surgical Mortality in the United States

Author(s):  
Andrew Gonzalez ◽  
SreyRam Kuy

This landmark study examined whether high-volume hospitals have better outcomes for major cardiovascular and oncologic surgery. The study found that patients undergoing major surgery in high-volume hospitals have significantly lower risk-adjusted mortality compared to other hospitals. However, there is wide variation in the difference in mortality across procedures. The chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

Author(s):  
Laurie O. Mark ◽  
Jean Kwo

This chapter provides a summary of the landmark study “Comparison of 8 versus 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.” In adult patients with ventilator-associated pneumonia (VAP), is treatment with an 8-day course of antimicrobials as effective as a 15-day course? Starting with that question, the chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. In ICU patients who develop microbiologically proven VAP, an 8-day antimicrobial course is not inferior to a 15-day course with respect to all-cause mortality or recurrence of pulmonary infection. However, these findings may not apply to patients who are immunocompromised, and shorter or longer duration of antibiotics may sometimes be indicated.


Author(s):  
Amanda Sun ◽  
Vinod H. Srihari

This chapter provides a summary of a landmark study on schizophrenia and the impact of demographic factors and psychotropic medications on markers of risk for cardiac events. Is QTc prolongation associated with specific psychotropic medications, the dose, or other factors? What is the correlation between other QT or T-wave abnormalities and these factors? Starting with these questions, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


Author(s):  
Nikhil Gupta ◽  
Catherine Chiles

This chapter provides a summary of a landmark study in psychiatry in primary care to mediate the effect of depression on overall health status . In the treatment of patients with major depression and coronary artery disease, what is the short-term efficacy of a selective serotonin reuptake inhibitor (citalopram) and/or interpersonal therapy? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


Author(s):  
David Grunwald ◽  
Erica Robinson ◽  
Sarah Fineberg

This chapter provides a summary of a landmark study on borderline personality disorder. How does transference-focused psychotherapy, supportive therapy, and dialectical behavioral therapy compare in the treatment of borderline personality disorder? Starting with that question, the chapter describes the basics of this study, including funding sources, study location, who was studied, and how many patients participated in the study. The study design is described, as well as the study intervention, follow-up, endpoints, results, and finally a discussion of criticisms and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


Author(s):  
Daniel Barron ◽  
Robert Ostroff

This chapter provides a summary of a landmark study on major depressive disorder. Is paroxetine or cognitive therapy more effective in treating patients with moderate to severe major depressive disorder? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


Author(s):  
Robert Ross ◽  
Rajesh R. Tampi

This chapter provides a summary of a landmark study on short and longterm treatment of insomnia. Should older patients with insomnia be managed with cognitive behavioral therapy, benzodiazepines, or both? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The study shows that bensodiazepines and cognitive behavioral therapy are equally effective for shorterm treatment of insomnia in otherwise healthy elderly participants but cognitive behavioral therapy is far more effective for longterm treatment of insomnia.


Author(s):  
Stephanie Yarnell ◽  
Ellen Edens

Chapter 20—The Prevalence and Severity of Psychiatric Comorbidities provides a summary of a landmark study in epidemiology, the The National Comorbidity Survey Replication (NCS-R). This chapter study sought to answer some fundamental questions. How common are comorbid psychiatric conditions? What are the prevalence and severity rates for comorbid anxiety, mood, impulse control, and substance use disorders? Starting with these questions, this chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


Author(s):  
Stephanie Yarnell ◽  
Ellen Edens

This chapter provides a summary of a landmark study in epidemiology. The Global Burden of Disease Study was a ground breaking venture in answering the question regarding the prevalence of various diseases. By analyzing this database, the current study was sought to determine the burden of disease attributable to mental and substance use disorders. With this in mind, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


Author(s):  
Falisha Gilman ◽  
Zheala Qayyum

This chapter provides a summary of a landmark study in child and adolescent psychiatry. Is sertraline, cognitive behavioral treatment, or their combination more effective in the initial treatment of children and adolescents with clinically significant obsessive-compulsive disorder? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


Author(s):  
David Saunders ◽  
Andres Martin ◽  
Jerome H. Taylor

This chapter provides a summary of a landmark study evaluating the treatment of anxiety disorders in child and adolescent psychiatry. Is sertraline in combination with cognitive behavioral therapy more effective than monotherapy with either treatment alone in children with anxiety disorders? Also, how do these treatments compare with placebo therapy? Starting with these questions, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


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