Researchers at Northwestern University developed the ADvanced Acousto-Mechanic (ADAM) sensor, a soft, flexible wireless device that objectively measures itch by capturing the motion and sound of scratching. The device is the first sensor that can capture scratching related to finger, wrist, and elbow motion, and was shown to be more accurate than smartwatch-based approaches.
[Read aDermWorld interview with Brian Kim, MD, MTR, about his Cell article "Sensory neurons co-opt classical immune signaling pathways to mediate chronic itch."]
The device was tested in 11 patients (predominantly pediatric) with moderate-to-severe atopic dermatitis over 46 sleep-nights totaling 378.4 hours. Each study participant’s nocturnal activities were recorded with a night vision video camera. The data indicate an accuracy of 99% with 84.3% sensitivity and 99.3% specificity against visual observation.
According to an interview with one of the study’s authors, the device, which is part of the FDA’s Drug Discovery Tool program, will cost less than a FitBit and may receive FDA clearance later this year.
Learn more about how dermatologists have used gabapentin and pregabalin to manage chronic itch inDermWorld.
DermWorld Insights and Inquiries: Stevens-Johnson Syndrome-toxic epidermal necrolysis — The aftermath
The American Academy of Dermatology’s SkinSerious® campaign highlights how dermatologists treat serious diseases. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) top the list. Justifiably, all attention focuses on the immediate issues in an attempt to diminish the complications of a disorder with an approximate 30% mortality rate (although it has been suggested that averaging the mortality rates of TEN and SJS is not advised as SJS is mainly a mucocutaneous disorder with good prognosis versus TEN associated with systemic toxicity of multiple organs).
The complications of SJS-TEN are legion — multidisciplinary management of fluid and electrolyte abnormalities, pain, thermodysregulation, ocular, pulmonary, gastrointestinal, and renal dysregulation is mandatory. Survivors may contend with life-altering cicatricial sequelae. This commentary focuses on the cutaneous complications of patients who have survived the acute ravages of SJS-TEN. It must be emphasized that SJS-TEN is a systemic disease, and ongoing management is multidisciplinary. I encourage you to read the outstanding review of the clinical presentations, prevention, and treatment of the long-term complications of SJS-TEN by Lee et al. The authors thoroughly discuss the cutaneous, ocular, oral, dental, pulmonary, urogenital,
gynecological, gastrointestinal, hepatic, renal, psychiatric, and psychosocial sequelae. Keep reading!
Bringing diversity to Academy committees and task forces
Each year, the Academy encourages its members and residents to apply for open council, committee, and task force (CCTF) positions. This year is no different, but to align with its three-year strategy on diversity, equity, and inclusion, DermWorld Weekly is highlighting underrepresented (URM) minority CCTF members.
Dara Spearman, MD, member of the Academy’s Public Education Committee, emphasizes that URM members’ lived experiences put them in a unique position to share invaluable perspectives while Saakshi Khattri, MD, member of the Academy’s Drug Pricing and Transparency Task Force, touches on the role all members play in creating a culture of inclusivity, even if they don’t identify as an underrepresented minority. Read the interview with Drs. Spearman and Khattri.
Is abrocitinib effective for moderate-to-severe atopic dermatitis patients?
In a phase 3 clinical trial published inJAMA Dermatology, investigators found that significantly greater proportions of patients treated with abrocitinib (lower and higher dosing) achieved an Investigator Global Assessment (IGA) response of clear or almost clear with improvement of at least two grades and/or at least 75% improvement in Eczema Area and Severity Index (EASI) scores.
Nearly 400 patients 12 years or older with moderate-to-severe atopic dermatitis were randomly assigned to receive once daily oral abrocitinib in 200- or 100-mg doses or placebo for 12 weeks. At week 12, greater proportions of patients in the 200- and 100-mg abrocitinib groups versus the placebo group achieved IGA (38.1% and 28.4% vs. 9.1%) and EASI-75 (61.0% and 44.5% vs. 10.4%).
Serious adverse events were reported in two patients (1%) in the 200-mg group, five patients (3%) in the 100-mg group, and one patient (1%) in the placebo group.
Read about how the potential FDA approval of multiple JAK inhibitors could offer new treatment options for dermatology patients in this month’sDermWorld.
AMA survey shows more than 50% of physicians work outside private practice
According to a recent analysis of an American Medical Association (AMA) 2020 practice benchmark survey (conducted September to October 2020), the share of physicians in private practice has dropped below 50% — to 49.1% — for the first time since the AMA began this analysis in 2012. This marks a drop of five percentage points from 2018, when 54% of physicians worked in physician-owned practices, and a drop of 11 percentage points since 2012.
[From academic, concierge, and large groups to ACOs, joint ventures, and selling your practice, learn about all your practice options in the Practice Management Center.]
The ongoing shift toward larger practice size also appears to have accelerated between 2018 and 2020. The share of physicians in practices with at least 50 physicians increased from 14.7% in 2018 to 17.2% in 2020, the largest two-year change measured by the AMA survey since 2012.
Despite the trend toward larger practices, 53.7% of physicians still work in small practices of 10 or fewer physicians. This share has fallen continuously from 61.4% in 2012. The survey found that physicians aged 55 and older were significantly more likely to work in small practices than physicians under the age of 40.
Get a step-by-step guide for physicians retiring from practice inDermWorld.
CMS reweights MIPS cost category
The Centers for Medicaid and Medicare Services (CMS) announced that due to challenges caused by the ongoing COVID-19 pandemic, it will reweight the 2020 Merit-based Incentive Payment System (MIPS) cost category weight from 15% to 0% for all eligible clinicians. The 15% cost performance category weight will be redistributed to other performance categories.
Physicians do not need to take any action as a result of this decision because the cost performance category relies on administrative claims data. For additional information visit CMS’s Quality Payment Program website.
Get more information about MIPS reporting and all four MIPS categories in the Academy's Practice Management Resource Center.
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