Wednesday | January 27, 2021

ASIPP® is pleased to announce the publication of the Comprehensive Evidence-Based Guidelines for Epidural Interventions in the Management of Chronic Spinal Pain. In preparation of the guidelines, an extensive literature review was performed. The 210-page guidelines contains 33 figures, 48 tables, 1,345 references and has 60 authors.

In addition to the review of multiple manuscripts in reference to utilization, expenditures, anatomical and pathophysiological considerations, pharmacological and harmful effects of drugs and procedures, for evidence synthesis, we have included 47 systematic reviews and 43 RCTs covering all epidural. 

Medical licensing authorities looking for "innovative ways to assess clinical skills"

The Step 2 Clinical Skills (CS) test of the United States Medical Licensing Examination (USMLE) has been discontinued, the two organizations that sponsor the exam announced Tuesday.

Following the postponement of Step 2 CS last May due to the COVID-19 pandemic, the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) stated that part of the test will now be discontinued permanently.

More than 500 rural hospitals in the U.S. were at immediate risk of closure before the COVID-19 pandemic because of financial losses and lack of reserves to maintain operations, according to a report from the Center for Healthcare Quality and Payment Reform.

Nearly every state had at least one rural hospital at immediate risk of closure before the pandemic. In 22 states, 25 percent or more of rural hospitals were at immediate risk, according to the report. 

But some find science-by-press-release troubling

Anti-inflammatory oral drug colchicine improved COVID-19 outcomes for patients with relatively mild cases, according to certain topline results from the COLCORONA trial announced in a brief press release.

Overall, the drug used for gout and rheumatic diseases reduced risk of death or hospitalizations by 21% versus placebo, which "approached statistical significance."

However, there was a significant effect among the 4,159 of 4,488 patients who had their diagnosis of COVID-19 confirmed by a positive PCR test...

A Centers for Disease Control and Prevention (CDC) official said Tuesday that restrictions requiring travelers to test negative for COVID-19 before flying domestically in the U.S. are being seriously considered.

Reuters reported that the head of the CDC's Division of Global Migration and Quarantine said on a call with reporters that the agency is "actively looking" at tightening restrictions amid new variants of the COVID-19 virus spreading in parts of the world and now being reported in the U.S.

There are "conversations that are ongoing and looking at what the types and locations of testing might be," said Marty Cetron, according to the news service. "We're actively looking at it."
Join the 2021 Annual Meeting in New Orleans,
June 24-26, for the first on-site, COVID-Compliant Meeting
The 23rd annual meeting will be educational (providing much need CME credits), exciting, and will offer the long-awaited ability to leave our homes and attend meetings in person in a safe and responsible manner.

We are working on making the program highly relevant for our changing healthcare system and environment. We will also bring you cutting-edge lectures on exciting new technology, world-renowned speakers, and much, much more. Registration is now open. Topics will include: COVID-19, economics, burnout, social media, metabolic health, regulatory issues, scientific advances in IPM, and much more! 

Mark your calendars, book your room and click here to register!

Methamphetamine overdose deaths surged in an eight-year period in the United States, according to a study that will published today in JAMA Psychiatry. The analysis revealed rapid rises across all racial and ethnic groups, but American Indians and Alaska Natives had the highest death rates overall. The research was conducted at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

Deaths involving methamphetamines more than quadrupled among non-Hispanic American Indians and Alaska Natives from 2011-2018 (from 4.5 to 20.9 per 100,000 people) overall, with sharp increases for both men (from 5.6 to 26.4 per 100,000 from 2011-2018) and women (from 3.6 to 15.6 per 100,000 from 2012-2018) in that group. The findings highlight the urgent need to develop culturally tailored, gender-specific prevention and treatment strategies for methamphetamine use disorder to meet the unique needs of those who are most vulnerable to the growing overdose crisis. Long-term decreased access to education, high rates of poverty and discrimination in the delivery of health services are among factors thought to contribute to health disparities for American Indians and Alaska Natives.


In this study, the effectiveness of platelet-rich plasma (PRP) combined with hyaluronic acid (HA) injections vs HA injections alone for the management of knee osteoarthritis was tested. For Systematic Reviews and Meta-Analyses guidelines, this study was performed according to the Preferred Reporting Items. Researchers identified eligible randomized-controlled trials and observational studies directly comparing combined HA-PRP injections to HA injections alone through a search of Pubmed, Scopus, and Cochrane Central databases from inception to May 2020. They performed a random-effects model meta-analysis and the I 2 statistic was applied to evaluate for heterogeneity. They included four studies including a total of 377 patients (PRP-HA:193, HA:184) with knee osteoarthritis (OA) ranging from I-IV Kellgren - Lawrence grading scale. The results of this study exhibited that symptomatic patients with knee osteoarthritis, who were injected with a combination of PRP and HA indicated greater improvement in pain and function compared to patients who received HA injections only, as assessed by 3-, 6-, and 12-month VAS scores, and 12-month Western Ontario and McMaster Universities Osteoarthritis Index physical function and stiffness scores. In the management of symptomatic patients with knee OA, this research gives encouraging data for the use of the combined PRP-HA injections.

After reading the 2021 Abstracts & Poster Presentations guidelines, please complete the form along with the presenter's CV by clicking here. Questions can be directed to Savannah Gold at 270-554-9412 x 4219 or sgold@asipp.org.

  • Selected manuscripts will be presented in electronic poster presentation.
  • Top 25 will be published in the Pain Physician journal. 
  • Top 10 will be selected for abstract presentation at meeting.
  • Top 3 will receive cash prizes.

A $50 submission fee is required, and will be collected at the end of this form.

Proposals will be accepted until April 14, 2021

Click here for Abstract and Poster Presentation Submission Guidelines

Scientists are reporting troubling signs that some recent mutations of the virus that causes COVID-19 may modestly curb the effectiveness of two current vaccines, although they stress that the shots still protect against the disease.

Researchers expressed concern Wednesday about the preliminary findings, in large part because they suggest that future mutations could undermine vaccines. The research tested coronaviruses from the United Kingdom, South Africa and Brazil, and was led by Rockefeller University in New York with scientists from the National Institutes of Health and elsewhere.

A different, more limited study out Wednesday gave encouraging news about one vaccine's protection against some of the mutations.


Newer communication methods may be feasible after low-risk, ambulatory surgeries, studies show

Two reports suggested value in trying newer communication methods to check in on patients recovering from surgery, the downside being that some health disparities may be worsened depending on the patients' preferred language and digital literacy.

In the first study, investigators showed that telemedicine was sufficient as a way to follow up with patients who were discharged after low-risk surgery, though their small trial had been halted by COVID-19.

Dr. Rosenblum interview Amy Baxter, MD, Clinical Associate Professor in Emergency Medicine at Augusta University, founder and CEO of PainCare Labs, creator of Buzzy, on her thermo-mechanical neuromodulatory pain relief platform.

Regular aspirin use has clear benefits in reducing colorectal cancer incidence among middle-aged adults, but also comes with some risk, such as gastrointestinal bleeding. And when should adults start taking regular aspirin and for how long?

There is substantial evidence that a daily aspirin can reduce risk of colorectal cancer in adults up to age 70. But until now there was little evidence about whether older adults should start taking aspirin.

A team of scientists set out to study this question. They were led by Andrew T. Chan MD, MPH, a gastroenterologist and chief of the Clinical and Translational Epidemiology Unit at Massachusetts General Hospital (MGH). Their report appears in JAMA Oncology.

In the midst of a pandemic, the biggest changes healthcare leaders reported in their medical practices last year revolved around staffing, cost and revenue, practice transformation, information technology, and operations, according to a December 2020 report from the Medical Group Management Association (MGMA).

The report was assembled from the results of weekly Stat polls by MGMA, which consists of 15,000 group practices representing more than 350,000 physicians. During the course of the year, more than 4800 practice leaders were surveyed, but the individual polls had far fewer respondents.


Since this malpractice insurance program officially launched in November 2018, ASIPP has sign up hundreds of providers with an average savings of 30%. This is a professional liability insurance that is tailored to our specialty and will stand up for us and defend our practices.

Norcal Mutual is 'A' Rated by AM best and is license in all 50 states. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary award-winning risk management CME activities, click here.
Since this malpractice insurance program officially launched in November 2018, ASIPP has sign up hundreds of providers with an average savings of 30%. This is a professional liability insurance that is tailored to our specialty and will stand up for us and defend our practices.

Norcal Mutual is 'A' Rated by AM best and is license in all 50 states. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary award-winning risk management CME activities, click here.

This year has arrived bringing radical changes to documentation and coding for your E/M services. This initiative was devised to ‘decrease provider burden’ and lessen the volume of visit notes engendered by the 1995/1997 guidelines. As providers have begun to implement the new rules, it has raised many questions and concerns among pain physicians. How do we change our templates to capture the necessary elements for medical decision making? Uh-oh- When I use the MDM criteria, is it a problem that all of my visits are coming out to the same level? If I choose to code based on time, can I just put a simple statement at the end of my record indicating how much total time I spent? 
 
The promise of less paperwork and higher payment for your visits sounds ideal, doesn’t it? Tune in to this webinar to understand possible E/M documentation and coding pitfalls you will definitely want to avoid. How should you decide whether to select your level of E/M on time or MDM? Receive practical advice on revising your templates based on a deeper understanding of the new rules. Investing your time to listen to this session, will pay dividends in compliance and accurate reimbursement.
Pain Medicine Case Reports (PMCR) and Editor-in-Chief Alaa Abd-Elsayed, MD, PhD would like to invite you to submit case reports and case series to PMCR journal. Your article will be published free of charge.

Open access journals are freely available online for immediate worldwide open access to the full text of published articles. There is no subscription fee for open access journals. Open access journals are no different from traditional subscription-based journals: they undergo the same peer-review and quality control as any other scholarly journal.

Interested in becoming a member of the PMCR Editorial Board?
Editorial board members are asked to review 2-6 manuscripts per year. Please submit your most up-to-date CV to sgold@asipp.org for consideration.

For more information or to submit your articles, click here.

ASIPP has formed a partnership with Henry Schein and PedsPal,
a national GPO that has a successful history of negotiating better prices on medical supplies and creating value added services for the independent physician. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today.

All sessions from the September 2020 meeting are available through June 2021 for a reduced fee. On-demand registration also provides access to all of the great resources available in the exhibit hall.

*Recorded sessions are not eligible for CME credits.

ASIPP is now offering our members the benefit of a unique revenue cycle management/billing service. We have received a tremendous amount of interest in the ASIPP billing and coding program. Click here to learn more about the negotiated rate for practices and more!