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psnet.ahrq.gov/node/860049/psn-pdf
January 04, 2024 - Myasthenia Crisis after a Delayed Diagnosis in a
Medically Complex Patient.
January 4, 2024
Chaffin Z. Myasthenia Crisis after a Delayed Diagnosis in a Medically Complex Patient. PSNet [internet].
2024.
https://psnet.ahrq.gov/web-mm/myasthenia-crisis-after-delayed-diagnosis-medically-complex-patient
The Case
A 9…
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psnet.ahrq.gov/node/49815/psn-pdf
December 01, 2017 - Over-the-Counter Oversight
December 1, 2017
Janamanchi V, Modha K, Whinney C. Over-the-Counter Oversight. PSNet [internet]. 2017.
https://psnet.ahrq.gov/web-mm/over-counter-oversight
The Case
A 56-year-old man was evaluated in the burn clinic for a second-degree burn on his chest. Although
portions of his skin we…
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psnet.ahrq.gov/node/49472/psn-pdf
March 01, 2005 - Preventable Rash
March 1, 2005
McLean C. Preventable Rash. PSNet [internet]. 2005.
https://psnet.ahrq.gov/web-mm/preventable-rash
The Case
A 35-year-old man with HIV was being followed in an outpatient internal medicine clinic. At a routine visit,
screening laboratories were checked. The clinic never contacted th…
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psnet.ahrq.gov/node/33611/psn-pdf
July 01, 2005 - In Conversation with…Christopher P. Landrigan, MD
April 1, 2005
In Conversation with…Christopher P. Landrigan, MD. PSNet [internet]. 2005.
https://psnet.ahrq.gov/perspective/conversation-withchristopher-p-landrigan-md
Editor's Note: In October 2004, in what immediately became a landmark paper in patient safety, Dr.…
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psnet.ahrq.gov/node/50842/psn-pdf
January 29, 2020 - Patient Identification Errors: A Systems Challenge
January 29, 2020
Choudhury LS, Vu CT. Patient Identification Errors: A Systems Challenge. PSNet [internet]. 2020.
https://psnet.ahrq.gov/web-mm/patient-identification-errors-systems-challenge
The Cases
The following four events involving five patients all involved…
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psnet.ahrq.gov/node/33847/psn-pdf
August 01, 2017 - In Conversation With… Karl Bilimoria, MD, MS
August 1, 2017
In Conversation With… Karl Bilimoria, MD, MS. PSNet [internet]. 2017.
https://psnet.ahrq.gov/perspective/conversation-karl-bilimoria-md-ms-0
Editor's note: Dr. Bilimoria is the Director of the Surgical Outcomes and Quality Improvement Center of
Northwest…
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psnet.ahrq.gov/node/49776/psn-pdf
November 01, 2016 - Continuity Errors in Resident Clinic
November 1, 2016
Warm EJ. Continuity Errors in Resident Clinic. PSNet [internet]. 2016.
https://psnet.ahrq.gov/web-mm/continuity-errors-resident-clinic
The Case
A 32-year-old woman presented to internal medicine clinic for evaluation of headaches and difficulty
concentrating. …
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psnet.ahrq.gov/node/49459/psn-pdf
September 01, 2004 - Caution, Interrupted
September 1, 2004
Wears RL. Caution, Interrupted. PSNet [internet]. 2004.
https://psnet.ahrq.gov/web-mm/caution-interrupted
The Case
A 55-year-old man with acute myelogenous leukemia and several recent hospitalizations for fever and
neutropenia presented to the emergency department (ED) with …
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psnet.ahrq.gov/innovation/behavioral-health-vital-signs-initiative-increases-patient-education-and-disclosure
February 26, 2025 - “Behavioral Health Vital Signs” Initiative Increases Patient Education and Disclosure about Interpersonal Violence (IPV)
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June 30, 2021
Innovat…
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psnet.ahrq.gov/node/49646/psn-pdf
February 01, 2012 - Poorly Advanced Directives
February 1, 2012
Anderson WG. Poorly Advanced Directives. PSNet [internet]. 2012.
https://psnet.ahrq.gov/web-mm/poorly-advanced-directives
The Case
Cared for at home by his wife and family, an 82-year-old man with multiple chronic medical conditions
described his overall health as decli…
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psnet.ahrq.gov/sites/default/files/2020-08/too_many_cooks_spotlight_pdf.pdf
January 01, 2020 - Spotlight
Too Many Cooks in the Kitchen
Source and Credits
• This presentation is based on the August 2020 AHRQ WebM&M
Spotlight Case
o See the full article at https://psnet.ahrq.gov/webmm
o CME credit is available
o Commentary by: Richard P. Dutton, MD, MBA
o AHRQ WebM&M Editors in Chief: Patrick Romano, MD…
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psnet.ahrq.gov/node/49718/psn-pdf
January 01, 2015 - Too Much, Too Fast
September 1, 2014
Tuot D. Too Much, Too Fast. PSNet [internet]. 2014.
https://psnet.ahrq.gov/web-mm/too-much-too-fast
The Case
A 68-year-old man with amyotrophic lateral sclerosis (ALS) was admitted to the intensive care unit (ICU) for
fever, tachycardia, and increased respiratory secretions. H…
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/stem-cell-children-future_research.pdf
February 01, 2012 - The natural history of this disease death occurs
by approximately by 6 months of age.
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digital.ahrq.gov/sites/default/files/docs/page/CongressionalBudgetOffice.pdf
January 01, 2009 - of
vendors and products may slow down adoption in the
short run, but the winnowing process that occurs
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cds.ahrq.gov/sites/default/files/cds/artifact/18/2024_CDS_Connect_IG_Statin_CVD_Clinician_Facing.pdf
January 01, 2024 - When this occurs, the project team includes a Pilot Report with the artifact to
describe CDS integration … The frequency of dialysis varies between
patients but occurs approximately three times a week.21 The
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/tinnitus_research-protocol.pdf
February 22, 2012 - Tinnitus often
co-occurs with hearing loss, and the bothersome effects of tinnitus may be alleviated … Assessing Applicability
Applicability may be affected by differences between what occurs in research
-
www.uspreventiveservicestaskforce.org/uspstf/document/evidence-summary22/iron-deficiency-anemia-in-pregnant-women-screening-and-supplementation-september-2015
March 30, 2015 - Iron deficiency occurs when the level of stored iron becomes depleted. … Iron deficiency anemia occurs when iron levels are sufficiently depleted to produce anemia. 1 , 6 Serum
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/pneumonia-antibiotic-treatment_disposition-comments.pdf
November 24, 2014 - development in the EHC program, it is assigned
to a research team, and further development of the topic
occurs … defined at all, or “clinical
response” is measured early in the course of treatment so
death that occurs
-
digital.ahrq.gov/sites/default/files/docs/citation/r21hs023654-munson-final-report-2017.pdf
January 01, 2017 - informatics systems (Li et al. 2011) to analyze the data to help us understand
when and how collaboration occurs … We describe how sharing occurs between patients and providers on self-tracked data and how
sharing
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/continuous-outcomes-quantitative-synthesis_methods.pdf
March 01, 2011 - However, baseline imbalance often occurs for one
or more characteristics. … will be underestimated using option 1 and
overestimated using option 2.
19
When baseline imbalance occurs