50 Studies Every Hospitalist Should Know describes 50 sentinel studies from past medical literature that underpin the common practices in hospital medicine. The authors offer a summary of the studies, highlighting their strengths and limitations while contextualizing them in more recent studies, bringing key literature to the forefront and giving hospitalists a deeper understanding of why we do what we do.
Hospital medicine is rapidly growing, driven by the increasing complexity of acutely ill patients and efficiency considerations. The field has expanded significantly, with over 60,000 hospitalists in the United States, including physicians, nurse practitioners, and physician assistants. These professionals face endless diagnostic dilemmas and management options for ever more complex patients, as well as administrative pressure to improve care quality while controlling costs. Pay-for-performance incentives and medicolegal requirements further emphasize the need for current evidence-based management.
Specialty societies provide evidence-based guidelines for clinical care. However, managing individual patients on a general medicine service often requires detailed knowledge of key studies to determine if guidelines or meta-analyses are applicable. Understanding study populations and treatment effect sizes is crucial for making personalized management decisions and guiding patients and caregivers.
50 Studies Every Hospitalist Should Know introduces readers to pivotal articles that impact daily clinical practice and inform management recommendations. The book highlights essential details of each study, helping readers assess strengths and limitations not evident in guidelines and reviews. This knowledge aids providers in selecting therapeutic strategies and advising patients and families. The selected studies are high-yield and relevant to hospitalists' everyday decisions. The book is also a valuable teaching tool for trainees, illustrating evidence-based medicine and its application to patient cases.
SECTION 1: NEUROLOGY & PSYCHIATRY
Chapter 1 Detecting delirium: The CAM
study Benjamin P. Geisler, MD, MPH
Chapter 2 Delirium prevention in older
hospitalized patients: The Elder Life Program Trial Mobola Campbell, MD, MPH,
MEd
Chapter 3 Patent foramen ovale closure for cryptogenic stroke: The REDUCE
Trial Hugo Torres, MD, MPH
Chapter 4 Thrombolysis timing in acute ischemic
stroke: The ECASS III Trial Jillian M. Berkman, MD and Mark Etherton, MD, PhD
Chapter 5 Symptom-triggered vs fixed-schedule benzodiazepines for alcohol
withdrawal Rahul B. Ganatra, MD, MPH
Chapter 6 Education and naloxone
distribution to prevent opioid overdoses Victoria D. Powell, MD and Pooja
Lagisetty, MD SECTION 2: CARDIOLOGY
Chapter 7 Peri-operative risk for
myocardial infarction or cardiac arrest Jeffrey L. Greenwald, MD
Chapter 8
Perioperative beta blockers for non-cardiac surgery Jeffrey L. Greenwald, MD
Chapter 9 Heparin vs. enoxaparin for unstable coronary artery disease: The
ESSENCE trial Bradford A. Hilson, MD
Chapter 10 Early invasive management for
non-ST segment elevation acute coronary syndrome: The TACTICS-TIMI-18 Trial
Cian P. McCarthy, MB, BCH, BAO, SM
Chapter 11 Dual antiplatelet therapy for
non-ST segment elevation acute coronary syndromes: The Cure Trial Cian P.
McCarthy, MB, BCH, BAO, SM
Chapter 12 Intensive vs moderate-intensity statins
after acute coronary syndromes: The PROVE IT-TIMI 22 Trial Nilay K. Patel, MD
Chapter 13 Loop diuretics for decompensated heart failure: The DOSE Study
Debbie Lin Teodorescu, MD, MEng, AM and Hugo Torres, MD, MPH
Chapter 14
Angiotensin receptor-neprilysin inhibition in heart failure: The PARADIGM-HF
Trial Peyton Hanson, MD and Kathleen M. Finn MD, MPhil
Chapter 15 Estimating
risk of stroke in atrial fibrillation: The CHADS2 Trial Yichi Zhang MD, MBA,
Christopher S. Schenck, MD, and David M. Dudzinski, MD
Chapter 16 Apixaban
vs. warfarin for atrial fibrillation: The ARISTOTLE trial Priyank Jain, MBBS
SECTION 3: PULMONOLOGY & CRITICAL CARE
Chapter 17 Procalcitonin-guided
antibiotic use in lower respiratory tract infection Claudia Gregoriano, PhD
and Philipp Schuetz, MD, MPH
Chapter 18 Early discontinuation of antibiotics
for community-acquired pneumonia Kathy May Tran, MD
Chapter 19
Glucocorticoids in exacerbations of chronic obstructive pulmonary disease:
The REDUCE Trial Mobola Campbell, MD, MPH, MEd and Jeffrey L. Greenwald, MD
Chapter 20 Noninvasive ventilation for exacerbations of chronic obstructive
pulmonary disease Raymond C. Parrish II, MD
Chapter 21 Clinical criteria and
D-dimer to exclude pulmonary embolism: The Wells Criteria Jeffrey L.
Greenwald, MD
Chapter 22 Point-of-care ultrasound in acute respiratory
failure: The BLUE Protocol Thomas F. Heyne, MD, MSt and Kathy May Tran, MD
Chapter 23 Low tidal volume ventilation in acute respiratory distress
syndrome: The ARMA Trial Raymond C. Parrish II, MD
Chapter 24 Fluid
management in acute respiratory distress syndrome: The FACTT Trial Dominik J.
Hoechter, MD
Chapter 25 Dopamine vs. norepinephrine for shock: The SOAP II
Trial Benjamin P. Geisler, MD, MPH
Chapter 26 Protocol-based care for septic
shock: The ProCESS Trial Benjamin P. Geisler, MD, MPH
Chapter 27 Targeted
temperature management after cardiac arrest: The TTM Trial Christy N. Taylor,
MD, MPH and Jonathan Ludmir, MD SECTION 4: GASTROENTEROLOGY
Chapter 28 Fecal
transplant for recurrent Clostridiodes difficile infection Farrin A. Manian,
MD, MPH
Chapter 29 Antibiotic prophylaxis in cirrhosis and upper
gastrointestinal bleeding Farrin A. Manian, MD, MPH
Chapter 30 Endoscopic
variceal ligation and nadolol to prevent variceal rebleeding Rahul B.
Ganatra, M.D., MPH
Chapter 31 Albumin for spontaneous bacterial peritonitis
in cirrhosis Bradford A. Hilson, MD SECTION 5: HEMATOLOGY & ONCOLOGY
Chapter
32 Risk for venous thromboembolism in hospitalized patients: The Padua
Prediction Score Rahul B. Ganatra, MD, MPH
Chapter 33 Low-molecular weight
vs. unfractionated heparin for pulmonary embolism William C. Hillmann, MD, MS
Chapter 34 Low-molecular weight heparin vs. oral vitamin K antagonist for
cancer-associated venous thromboembolism: The CLOT Trial Marko Velimirovic,
MD, MMSc and Hugo Torres, MD, MPH
Chapter 35 Perioperative anticoagulation
for atrial fibrillation: The BRIDGE Trial Priyank Jain, MBBS
Chapter 36
Bleeding risk from anticoagulation in atrial fibrillation: HAS-BLED Jeffrey
L. Greenwald, MD
Chapter 37 Transfusion thresholds in critically ill
patients: The TRICC Trial Jeffrey L. Greenwald, MD
Chapter 38 4 T's Score to
exclude heparin-induced thrombocytopenia Jeffrey L. Greenwald, MD
Chapter 39
Early palliative care for metastatic cancer Mobola Campbell, MD, MPH, MEd and
Kathy May Tran, MD SECTION 6: FLUIDS, NUTRITION, & METABOLISM
Chapter 40
Timing of parenteral nutrition in critically ill patients: The EPaNIC Study
Mobola Campbell, MD, MPH, MEd and Katharine E. Black, M.D.
Chapter 41 Early
nasoenteric tube feeding in acute pancreatitis: The PYTHON Trial Margaret M.
Chapman, MD
Chapter 42 Glucose control in critically ill patients: The
NICE-SUGAR Trial Hugo Torres, MD, MPH
Chapter 43 Zoledronic acid after hip
fracture: The HORIZON-RFT Trial Hugo Torres, MD, MPH and Kathy May Tran, MD
SECTION 7: HOSPITAL SYSTEMS & OPERATIONS
Chapter 44 Unconscious bias in
referrals for cardiac catheterization William J. Tate, MD and Sherri-Ann M.
Burnett-Bowie, MD, MPH
Chapter 45 Replacing indwelling urinary catheters for
urinary tract infection Hugo Torres, MD, MPH
Chapter 46 Financial impact of
healthcare-associated infections Marc Philip T. Pimentel, MD, MPH
Chapter 47
Pharmacist-guided medication reconciliation to reduce readmissions Hugo
Torres, MD, MPH
Chapter 48 Patient-targeted discharge education to prevent
heart failure readmissions Aditya Achanta, MD and Jason H. Wasfy, MD, MPhil
Chapter 49 Identifying preventable 30-day hospital readmissions Hugo Torres,
MD, MPH and Jeffrey L. Greenwald, MD
Chapter 50 Effect of hospitalist care on
medical utilization Anand Kartha, MD, MS
Benjamin P. Geisler is a hospitalist at Massachusetts General Hospital and an Instructor in Medicine at Harvard Medical School. Throughout his career, he has worked in various roles on health-economic evaluations, systematic reviews and with real world evidence such as population-based health registries. Dr. Geisler has also worked on quality and safety topics, as well as in a research group that focuses on machine learning and artificial intelligence. Dr. Geisler's career interest is the interface between new health technologies, their evidence base, and value.
Jeffrey L. Greenwald is an academic hospitalist at Massachusetts General Hospital whose career has taken him into the fields of HIV testing, care transitions, quality improvement and patient safety, medical education, and, for the last several years, primary palliative care education and implementation. He is an active clinician and teacher and an Associate Professor at Harvard Medical School.
Kathy May Tran is an academic hospitalist at the Massachusetts General Hospital, teacher at Harvard Medical School, and Associate Editor of the Case Records of the New England Journal of Medicine. In addition to her identities as an active clinician, medical educator, and writer and editor, Dr. Tran is an advocate for workforce well-being, patient experience, and the arts and humanities in medicine.
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