A 43-year-old woman is hospitalized for chemotherapy following a local recurrence of breast cancer. Because the tumor responded well to the previous chemotherapy regimen, the ordering physician copies and pastes previous recommendations from her electronic health record into the patient’s new orders. Subsequently, the patient develops drug-related toxicity that prolongs her hospital stay. An investigation into the cause shows that she has lost 8 kg (17.6 lb) since her last chemotherapy course, while her other information in recent notes is identical to the past. Which of the following is the most appropriate recommendation to reduce the recurrence of similar types of errors in the future?
AUsing copy and paste only for patient demographics
BAvoiding copy and paste in electronic health records
CPreventing identification of authors
DLimiting copy and paste to lengthy progress notes
EMaking copy and paste material readily identifiable
A longstanding patient of yours has been hospitalized for a week with pneumonia. You have taken care of her while she was in the hospital. At the end of her hospitalization, she tells you how grateful she is for your care and gives you a small gift basket with homemade food, which you accept. However, when you get home, you realize that the basket also contains a $250 gift certificate to an expensive restaurant. Which of the following is an appropriate response to this situation?
AReturn both the food and gift certificate because it is never acceptable to take gifts from patients
BReturn the gift certificate for cash, and donate the cash to the hospital's free clinic
CKeep the food, but return the gift certificate
DKeep both the food and gift certificate
EReport the gifts to your hospital ethics committee
A research team develops a new monoclonal antibody checkpoint inhibitor for advanced melanoma that has shown promise in animal studies as well as high efficacy and low toxicity in early phase human clinical trials. The research team would now like to compare this drug to existing standard of care immunotherapy for advanced melanoma. The research team decides to conduct a non-randomized study where the novel drug will be offered to patients who are deemed to be at risk for toxicity with the current standard of care immunotherapy, while patients without such risk factors will receive the standard treatment. Which of the following best describes the level of evidence that this study can offer?
ALevel 1
BLevel 3
CLevel 5
DLevel 4
ELevel 2
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