SECOND LOOK

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CMS final rule for 2008 continues PQRI
The U.S. Centers for Medicare and Medicaid Services (CMS) retained the Physician Quality Reporting Initiative (PQRI) for 2008 by including the 2007 measures and adding new measures that had been adopted or endorsed by a consensus organization. According to CMS, the AQA Alliance (formally the Ambulatory Care Quality Alliance) and the National Quality Forum meet the criteria for a consensus organization; new measures, therefore, are expected to be added for back pain. Additionally, CMS (working through Quality Insights of Pennsylvania) developed structural measures for the use of e-prescribing and the use of electronic health records. For an analysis of the 2008 PQRI, visit the
AAOS Government relations Web site

Improved outcomes with zoledronic acid after hip fracture
A
recent study published in the New England Journal of Medicine finds that an annual infusion of zoledronic acid after repair of a low-trauma hip fracture may be associated with improved survival and a reduction in the rate of new fractures. Researchers conducted a randomized, double-blind, placebo-controlled trial of 1,065 patients who were assigned to receive a 5 mg yearly dose of intravenous zoledronic acid, and 1,062 patients who were given placebo. With a median follow-up of 1.9 years, the rate of any new clinical fracture was 8.6 percent in the zoledronic acid group, and 13.9 percent in the placebo group—a 35 percent risk reduction for those in the experimental group. Additionally, 101 of 1,054 patients in the zoledronic acid group (9.6 percent) died, compared to 141 of 1,057 patients (13.3 percent) in the placebo group—a reduction of 28 percent in deaths from any cause in the zoledronic acid group

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