Asthma guideline ranks steroid rescue inhalers above albuterol alone
Nov 4, 2026
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read by AI voices · all episodesTHE SHORT READ
The American Thoracic Society on Nov. 3 strongly recommended steroid-containing rescue inhalers over short-acting beta-agonists alone for adolescents and adults with mild asthma, in a new guideline.
The same day, the Food and Drug Administration warned that holes can form in some ButterflyBVM bag-valve-mask resuscitators and told users to remove the worst-affected lots. A National Institutes of Health cohort found that half of adults with long COVID at one year improved meaningfully by three years, and a Columbia study of nearly 1 million portal replies found that Epic's AI drafts did not shorten clinicians' overall response times.
THE DETAILS
- FYIEvidence Nov 3, 2026An American Thoracic Society clinical practice guideline published online Nov. 3 in the American Journal of Respiratory and Critical Care Medicine made a strong recommendation for as-needed ICS-SABA or as-needed ICS-formoterol over SABA-only relievers for adolescents and adults at National Asthma Education and Prevention Program steps 1 and 2, and a conditional recommendation for those regimens over scheduled ICS plus as-needed SABA. At steps 3 to 5, the panel strongly recommended maintenance-and-reliever therapy (MART) with ICS-formoterol over scheduled ICS-LABA plus as-needed SABA, and conditionally recommended an ICS+SABA reliever over a SABA reliever for patients staying on scheduled ICS-LABA. The panel answered six PICO questions using systematic reviews and GRADE, and said it weighed the prevention of severe exacerbations and the risks of SABA-only treatment and systemic steroid exposure. The authors wrote that ICS-containing reliever therapy "remains underutilized."
- ActIncident Nov 3, 2026
FDA's Nov. 3 alert says to remove lots 000109 to 000117 and A100 lot 000114 after replacements arrive, and pretest other listed lots.
The Food and Drug Administration issued an early alert Nov. 3 on Compact Medical's single-use ButterflyBVM bag-valve-mask resuscitators, calling it a potentially high-risk device issue: a hole can develop in the bellows so that tidal volume leaks out, which can cause inadequate ventilation and hypoxia. The company is removing READY lots 000109 through 000117 and standard A100/A108 lot 000114, which had a higher defect rate, and correcting instructions for other READY, standard and PLUS lots, which users are told to put through the pre-use equipment check before every patient. The FDA said users should keep backup resuscitators on hand and check the back of the device for a hole if ventilation seems poor. As of Nov. 2 the company had reported no serious injuries or deaths; it first wrote to customers Sept. 26.Source: FDA early alert - FYIEvidence Nov 3, 2026Among 1,019 adults in the National Institutes of Health's RECOVER-Adult cohort who met the study's long COVID index threshold 12 months after their first SARS-CoV-2 infection, an estimated 36.2% no longer met it at two consecutive visits by 24 months and 50.1% by 36 months, researchers reported Nov. 3 in Annals of Internal Medicine. By 36 months, 56.4% had at least a 50% drop in the index score with good or better quality of life, and 26.9% reached a score of 0. Participants still affected at 18 or 24 months improved on a similar relative timeline. The prospective cohort spanned 83 sites in 33 states, Washington, D.C., and Puerto Rico; the authors said the findings point to both natural recovery and "the urgent need for placebo-controlled therapeutic intervention trials."Sources: Annals of Internal Medicine, PubMed record
- FYIEvidence Oct 30, 2026After Columbia University Irving Medical Center switched on Epic's In Basket Augmented Response Technology enterprisewide in December 2024, adoption was associated with an 8.6% rise in overall turnaround on patient portal messages among the 1,542 clinicians studied, researchers reported Oct. 30 in JAMA Network Open. Using a draft on a given message was associated with 29.5% faster turnaround, but use of the tool was not associated with less after-hours messaging overall. Draft use cut after-hours replies 3.67 percentage points for test-result questions received during the workday and raised them 4.52 points for messages that arrived after hours, findings the authors said were sensitive to how working hours were defined. The retrospective study covered first responses from March 2023 to May 2025 to 272,091 patients.Sources: JAMA Network Open, PubMed record
- FYIDeployment Nov 3, 2026Humana and athenahealth said Nov. 3 they are expanding electronic prior authorization nationwide to the more than 180,000 clinicians on athenahealth's network, Becker's Hospital Review reported. In September, more than 6,000 providers processed almost 35,000 electronic requests with Humana, and more than 70% were completed without practice staff supplying additional information, according to the companies. Humana connects with practices on athenaOne through athenaPayer. Federal requirements for payers to offer prior authorization application programming interfaces under the 2024 interoperability and prior authorization rule take effect in 2027.Source: Becker's Hospital Review
- FYIEvidence Nov 3, 2026Of 26,618 emergency department encounters for heart failure, pneumonia, cellulitis, urinary tract infection, COVID-19 or anemia at Kaiser Permanente Northern California from January 2024 to June 2025, 25.3% were routed to an ambulatory treatment center, the Advanced Care at Home program or an ED observation unit rather than an inpatient bed, researchers reported Nov. 3 in JAMA Network Open. Escalation to admission was 4.3% from ambulatory centers and 5.3% from home care, against 28.0% from observation units. Seven-day ED return rates were similar across venues, and 30-day mortality was lower outside the hospital (1.7% at home vs. 5.3% inpatient), in unadjusted figures from a retrospective cohort whose patients were selected for each setting. Median patient age was 77.Sources: JAMA Network Open, PubMed record
- FYIEvidence Nov 3, 2026In 5,379 patients with unprotected left main coronary artery disease treated at 46 hospitals in South Korea, India, Japan, Indonesia and Malaysia, 10-year all-cause mortality was 24.0% after PCI with drug-eluting stents and 22.9% after CABG (overlap-weighted hazard ratio 1.00, 95% CI 0.87 to 1.14), according to the IRIS-MAIN analysis published Nov. 3 in The Lancet and presented at TCT 2026. The registry used target trial emulation and propensity-score overlap weighting; median follow-up was 10 years. The authors wrote that the confidence interval does not exclude benefit or harm with either strategy, that the results cannot establish equivalence, and that Heart Team discussion may help patients weigh the trade-offs.