Background: Low-value care in the form of overuse of inpatient diagnostic testing is an important driver of high healthcare costs. Financial incentives are known to impact physician behavior and may be a driver of inpatient diagnostic overuse. However, the association between hospital payer mix (which likely impacts the financial incentives for ordering diagnostic tests) and [...]

Background: Helicobacter pylori (HP) infection is one of the most prevalent chronic bacterial infections, infecting more than half of the global population. The sensitivity of HP diagnostic tests decreases with the use of antibiotics and/or antisecretory drugs. Given the increasing rates of macrolide resistance worldwide, comprehensive testing for HP eradication is imperative. In this quality [...]

Background: Hip fracture is a common reason for urgent inpatient surgery. In the last few years, several professional societies have identified preoperative echocardiography and stress testing for non-cardiac surgeries as low-value diagnostics. Delaying hip fracture surgery beyond 48 hours leads to worse outcomes. We sought to describe the prevalence of preoperative cardiac testing for inpatient [...]

Background: Wilson Disease (WD) is a known cause of liver test abnormalities. Guidelines have been established to help clinicians avoid routine testing. According to the American Association for the Study of Liver Diseases (AASLD) Guideline, screening for WD—with serum ceruloplasmin, 24-hour urinary copper excretion, and slit-lamp examination for Kayser-Fleischer rings—is warranted in any patient with [...]

Case Presentation: A 34-year-old male with history of methamphetamine use presented with a one-week history of neck, shoulder, and wrist pain, intermittent radiculopathy, fevers, chills, myalgias, and arthralgias, and a one-day history of confusion. He denied rash, urinary symptoms, diarrheal illness, IV drug use, recent travel, and new sexual contacts. On admission, he was afebrile, [...]

Case Presentation: A 76-year-old male with history of hypertension and recent travel to India presented to our health system with a history of sub acutely progressive dyspnea, low grade fevers, night sweats and chronic cough. Two months prior to this presentation, he was treated for community acquired pneumonia at an outside facility. About one month [...]