Nareg H. Roubinian, MD, MPHTM; Edward L. Murphy, MD, MPH; Dustin G. Mark, MD; Darrell J. Triulzi, MD; Jeffrey L. Carson, MD; Catherine Lee, PhD; Patricia Kipnis, PhD; Steven Kleinman, MD; Vincent X. Liu, MD; Gabriel J. Escobar, MD
Randomized clinical trials have shown similar outcomes with less frequent transfusions in hospitalized patients with moderate anemia. Longer-term clinical outcomes associated with a restrictive approach to transfusion have not been well described. This analysis of data from Kaiser Permanente Northern California describes the prevalence of moderate anemia among patients discharged from the hospital as well as 6-month outcomes in these patients.
Ann Intern Med. 2019;170(2):81-89. doi:10.7326/M17-3253
Sean M. Murphy, PhD; Kathryn E. McCollister, PhD, MA; Jared A. Leff, MS; Xuan Yang, MPH, MHS; Philip J. Jeng, MS; Joshua D. Lee, MD, MSc; Edward V. Nunes, MD; Patricia Novo, MPA, MPH; John Rotrosen, MD; Bruce R. Schackman, PhD, MBA
The U.S. Food and Drug Administration approved 3 medications for first-line treatment of opioid use disorder: methadone, buprenorphine, and naltrexone. Buprenorphine is usually combined with naloxone to prevent misuse and is administered orally once daily; naltrexone is frequently administered as an injection once a month. This study analyzes how the differences in measures of effectiveness and cost between buprenorphine–naloxone and extended-release naltrexone interact to determine whether either medication provides better value.
Ann Intern Med. 2019;170(2):90-98. doi:10.7326/M18-0227
Antoine Meyer, MD; Jérémie Rudant, MD, PhD; Jérôme Drouin; Alain Weill, MD; Franck Carbonnel, MD, PhD; Joël Coste, MD, PhD
CT-P13 is a biosimilar of the reference product infliximab and is an approved treatment for ankylosing spondylitis and rheumatoid arthritis. Regulatory agencies extended the approval of CT-P13 to other inflammatory conditions, including Crohn disease. This analysis of French nationwide health administrative data compares outcomes among patients with Crohn disease treated with CT-P13 or infliximab.
Ann Intern Med. 2019;170(2):99-107. doi:10.7326/M18-1512
John P.A. Ioannidis, MD, DSc; Yuan Jin Tan, BS; Manuel R. Blum, MD
E-values—a type of sensitivity analysis—are measures that may be used to assess how robust an association reported in an observational study is to potential unmeasured confounding. In this article, the authors posit several limitations of E-values and discuss how these measures may be misinterpreted.
Ann Intern Med. 2019;170(2):108-111. doi:10.7326/M18-2159
Steven D. Pizer, PhD; Austin B. Frakt, PhD; Kyle Sheetz, MD, MS; Carolyn Clancy, MD
The recently established Center for Innovation for Care and Payment will give the U.S. Department of Veterans Affairs (VA) the ability to test novel payment and service delivery models; will facilitate the VA's shift toward value-based coverage strategies, with a greater emphasis on population health; and will empower the VA to collaborate with other payers to drive improvements in quality, costs, and efficiency. The authors discuss these opportunities as well as the risks for unintended consequences.
Ann Intern Med. 2019;170(2):112-113. doi:10.7326/M18-2225
Lawrence P. Casalino, MD, PhD; Rayhan Saiani, MD; Sami Bhidya, MS; Dhruv Khullar, MD, MPP; Eloise O'Donnell, MPH
Private equity firms have been buying physician practices at increasing rates during the past few years with little scrutiny from outsiders. This article briefly examines this phenomenon.
Ann Intern Med. 2019;170(2):114-115. doi:10.7326/M18-2363
Leonard L. Berry, PhD, MBA
The author of this commentary discusses service guarantees and how they could be used in the field of health care to strengthen an organization's culture of service excellence and elevate individual and team accountability to perform the service well and create trust-based relationships with patients. A real-world example of such a guarantee is presented.
Ann Intern Med. 2019;170(2):116-117. doi:10.7326/M18-2412
Kevin F. Boehnke, PhD; Daniel J. Clauw, MD
This commentary was 1 of 6 selected for publication from 100 submissions that responded to a call for readers' perspectives on prescribing or recommending marijuana.
Ann Intern Med. 2019;170(2):118. doi:10.7326/M18-2972
Tina M. Kaufman, PhD, PA-C; Sergio Fazio, MD, PhD; Michael D. Shapiro, DO
Ann Intern Med. 2019;170(2):119-120. doi:10.7326/M18-3009
Jan K. Carney, MD, MPH
Ann Intern Med. 2019;170(2):121. doi:10.7326/M18-3167
Eli Y. Adashi, MD, MS
Ann Intern Med. 2019;170(2):122. doi:10.7326/M18-3175
Chester B. Good, MD, MPH; Natasha Parekh, MD, MS; Kavita Fischer, MD; James Schuster, MD; Chronis Manolis, RPh; William Shrank, MD, MSHS
Ann Intern Med. 2019;170(2):123. doi:10.7326/M18-3237
Kennon Heard, MD, PhD; Andrew A. Monte, MD, PhD; Christopher O. Hoyte, MD
Ann Intern Med. 2019;170(2):124. doi:10.7326/M18-3280
Aryeh Shander, MD; Lawrence Tim Goodnough, MD
Roubinian and colleagues reported that parallel to a decrease in red blood cell transfusions, the prevalence of anemia at hospital discharge and at 6 months increased from 2010 to 2014 without a corresponding increase in 6-month mortality, rehospitalization, or transfusion. The editorialists look forward to future studies that evaluate the management of anemia during the postdischarge period.
Ann Intern Med. 2019;170(2):125-126. doi:10.7326/M18-3145
Joshua A. Barocas, MD; Richard Saitz, MD, MPH
Murphy and colleagues reported a cost-effectiveness analysis of sublingual buprenorphine with naloxone versus extended-release naltrexone to treat opioid use disorder. The editorialists believe the analysis is an eloquent demonstration of how cost-effectiveness analysis forces us to be explicit about the factors that influence our decisions.
Ann Intern Med. 2019;170(2):127-128. doi:10.7326/M18-3293
Ole Haagen Nielsen, MD, DMSc; Mark Andrew Ainsworth, MD, PhD, DMSc
Meyer and colleagues reported a large and well-conducted cohort study that demonstrates that the effectiveness of the biosimilar CT-P13 is equivalent to that of infliximab in infliximab-naive patients with Crohn disease. The editorialists discuss the results and the assurance they provide about the effectiveness and safety of biosimilars.
Ann Intern Med. 2019;170(2):129-130. doi:10.7326/M18-3060
Tyler J. VanderWeele, PhD; Maya B. Mathur, PhD; Peng Ding, PhD
In their article, Ioannidis and colleagues raise several important issues concerning the potential misuse and misinterpretation of the E-value, a metric related to the robustness of associations to potential unmeasured or residual confounding. The editorialists discuss the usefulness of the E-value in practice in response to practical objections sometimes raised to other sensitivity analysis techniques that they are too complicated to describe in papers, are too difficult to present, take up too much space, and are difficult to understand.
Ann Intern Med. 2019;170(2):131-132. doi:10.7326/M18-3112
J.S. Blumenthal-Barby, PhD, MA; Bernard Lo, MD
The American College of Physicians' ethics manual, published as a supplement to this issue, provides helpful guidance on many difficult ethical issues that internists face. The editorialists use a clinical vignette to illustrate several areas where the guidance could be improved.
Ann Intern Med. 2019;170(2):133-134. doi:10.7326/M18-3120
Neal J. Thomas, MD, MSc
Ann Intern Med. 2019;170(2):135. doi:10.7326/M18-2032
Faith T. Fitzgerald, MD
Ann Intern Med. 2019;170(2):136. doi:10.7326/M18-2331
Ann Intern Med. 2019;170(2):142-143. doi:10.7326/L18-0563
Ann Intern Med. 2019;170(2):143. doi:10.7326/L18-0564
Ann Intern Med. 2019;170(2):142. doi:10.7326/L18-0614
Ann Intern Med. 2019;170(2):143. doi:10.7326/L18-0561
Ann Intern Med. 2019;170(2):143-144. doi:10.7326/L18-0562
Ann Intern Med. 2019;170(2):138. doi:10.7326/L18-0647
Ann Intern Med. 2019;170(2):138. doi:10.7326/L18-0648
Ann Intern Med. 2019;170(2):138. doi:10.7326/L18-0673
Amy Haddad, PhD
Ann Intern Med. 2019;170(2):137. doi:10.7326/M18-1880
Robert H. Fletcher, MD, MSc
Ann Intern Med. 2019;170(2):JC2. doi:10.7326/ACPJC-2019-170-2-002
Calvin Hirsch, MD
Ann Intern Med. 2019;170(2):JC3. doi:10.7326/ACPJC-2019-170-2-003
Michelle Welsford, MD, FACEP, CCPE, FRCPC
Ann Intern Med. 2019;170(2):JC4. doi:10.7326/ACPJC-2019-170-2-004
Kristen Sullivan, MD; Harriette G.C. Van Spall, MD, MPH, FRCPC
Ann Intern Med. 2019;170(2):JC5. doi:10.7326/ACPJC-2019-170-2-005
Stefanie Furlan, DO; Steven Borzak, MD
Ann Intern Med. 2019;170(2):JC6. doi:10.7326/ACPJC-2019-170-2-006
Anthony Donato, MD, MHPE; Eric Elgin, MD
Ann Intern Med. 2019;170(2):JC7. doi:10.7326/ACPJC-2019-170-2-007
Ann Intern Med. 2019;170(2):JC8. doi:10.7326/ACPJC-2019-170-2-008
Jonathan M. Kirschner, MD; Benton R. Hunter, MD
Ann Intern Med. 2019;170(2):JC9. doi:10.7326/ACPJC-2019-170-2-009
Markos Kalligeros, MD; Eleftherios Mylonakis, MD, PhD, FIDSA
Ann Intern Med. 2019;170(2):JC10. doi:10.7326/ACPJC-2019-170-2-010
Anupam Goel, MD, FACP
Ann Intern Med. 2019;170(2):JC11. doi:10.7326/ACPJC-2019-170-2-011
Geno J. Merli, MD; Howard H. Weitz, MD
Annals Consult Guys brings a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.
Ann Intern Med. 2019;170(2):CG1. doi:10.7326/W18-0028
Darren B. Taichman, MD, PhD
Ann Intern Med. 2019;170(2):ED2. doi:10.7326/AFED201901150
David H. Wesorick, MD; Vineet Chopra, MD, MSc
Ann Intern Med. 2019;170(2):HO1. doi:10.7326/AFHO201901150
Molly J. Horstman, MD; Eduardo Salas, PhD
Caregivers often lack the training necessary to adequately care for family members after hospitalization. Hospital medicine should use the CARE Act mandate as motivation to launch effective caregiver engagement and training programs. Although innovative technologies will be needed to provide universal caregiver training, improvement can start today by focusing on existing systems.
Ann Intern Med. 2019;170(2):HO2-HO3. doi:10.7326/M18-3614
Robert M. Centor, MD; Angelo L. Gaffo, MD, MSPH
In this episode of Annals On Call, Dr. Centor discusses the pathophysiology of gout and the prevention and treatment of gout attacks with Dr. Angelo Gaffo, Rheumatology Section Chief at University of Alabama at Birmingham.
Ann Intern Med. 2019;170(2):OC1. doi:10.7326/A18-0012
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