Margaret C. Fang, MD, MPH; Yuchiao Chang, PhD; Elaine M. Hylek, MD, MPH; Jonathan Rosand, MD; Steven M. Greenberg, MD, PhD; Alan S. Go, MD; Daniel E. Singer, MD
The risk for intracranial hemorrhage increases at age 85 years. In this study, international normalized ratios (INRs) less than 2.0 and INRs of 2.0 to 3.0 were associated with the same risk for intracranial hemorrhage. The risk increases with INRs of 3.5 or greater. Therefore, in elderly patients with atrial fibrillation, clinicians should maintain INRs in the 2.0 to 3.0 range.
Ann Intern Med. 2004;141(10):745-752. doi:10.7326/0003-4819-141-10-200411160-00005
John DeWitt, MD; Benedict Devereaux, MD; Melissa Chriswell, RN; Kathleen McGreevy, RN; Thomas Howard, MD; Thomas F. Imperiale, MD; Donato Ciaccia, MD; Kathleen A. Lane, MS; Dean Maglinte, MD; Kenyon Kopecky, MD; Julia LeBlanc, MD; Lee McHenry, MD; James Madura, MD; Alex Aisen, MD; Harvey Cramer, MD; Oscar Cummings, MD; Stuart Sherman, MD
Accurate preoperative detection and precise staging of pancreatic cancer may identify patients with surgically curable locoregional disease. Endoscopic ultrasonography is superior to multidetector computed tomography for detecting and staging tumors. The tests have equivalent accuracy for nodal staging and detecting nonmetastatic pancreatic cancer that is resectable.
Ann Intern Med. 2004;141(10):753-763. doi:10.7326/0003-4819-141-10-200411160-00006
Li Wei, MB, MSc; Thomas M. MacDonald, MD, FRCPE; Brian R. Walker, MD, FRCPE
In this population-based study, patients receiving dosages of glucocorticoids greater than the equivalent of 7.5 mg of prednisolone per day had substantially higher 1- to 5-year rates of all cardiovascular diseases, including myocardial infarction, heart failure, and cerebrovascular disease.
Ann Intern Med. 2004;141(10):764-770. doi:10.7326/0003-4819-141-10-200411160-00007
John W. Peabody, MD, PhD; Jeff Luck, MBA, PhD; Peter Glassman, MBBS, MSc; Sharad Jain, MD; Joyce Hansen, MD; Maureen Spell, MD; Martin Lee, PhD
This study shows that vignettes are a valid tool for measuring the quality of clinical practice. They are particularly useful for evaluating quality when practice-based assessment is difficult because of differences in case mix between physicians.
Ann Intern Med. 2004;141(10):771-780. doi:10.7326/0003-4819-141-10-200411160-00008
John P.A. Ioannidis, MD; Stephen J.W. Evans, MSc; Peter C. Gøtzsche, MD, DrMedSci; Robert T. O'Neill, PhD; Douglas G. Altman, DSc; Kenneth Schulz, PhD; David Moher, PhD; for the CONSORT Group*
The CONSORT (Consolidated Standards of Reporting Trials) statement is a guideline for writing reports of randomized, controlled trials. Starting with the standard CONSORT checklist, the authors add 10 new recommendations for how to report harms observed during clinical trials.
Ann Intern Med. 2004;141(10):781-788. doi:10.7326/0003-4819-141-10-200411160-00009
John B. West, MD, PhD
This review discusses the relationship of altitude to barometric pressure, effects of the hypoxia of high altitude, acclimatization to high altitude, improving working efficiency at high altitude, physiologic changes at extreme altitudes, and high-altitude diseases.
Ann Intern Med. 2004;141(10):789-800. doi:10.7326/0003-4819-141-10-200411160-00010
David B. Hellmann, MD
This Update incorporates articles on vasculitis, rheumatoid arthritis, the antiphospholipid antibody syndrome, systemic lupus erythematosus, and osteoarthritis.
Ann Intern Med. 2004;141(10):801-804. doi:10.7326/0003-4819-141-10-200411160-00012
Judith A. Long, MD; Virginia W. Chang, MD, PhD; Said A. Ibrahim, MD, MPH; David A. Asch, MD
Underrepresented minorities in the United States are likely to have worse health and receive less health care than the racial and ethnic majority. This Update focuses on studies that document disparities, explain disparities, and test strategies to reduce disparities.
Ann Intern Med. 2004;141(10):805-812. doi:10.7326/0003-4819-141-10-200411160-00013
John Norcini, PhD
The study by Peabody and colleagues builds on a large body of research on clinical vignettes and moves the field forward by showing that performance on clinical vignettes is similar to actual practice caring for matched cases. The value of this method depends on whether physicians will make the same management decisions for the problem posed in the vignette as they do in their daily practice.
Ann Intern Med. 2004;141(10):813-814. doi:10.7326/0003-4819-141-10-200411160-00014
Talmadge E. King Jr, MD; Margaret B. Wheeler, MD
The U.S. health care system remains largely separate and unequal. Mounting evidence shows that unequal health care based on race and ethnicity is pervasive and clinically significant. In this issue, Long and colleagues review the recent health and health care disparities literature and summarize selected articles that can help to direct our search for answers.
Ann Intern Med. 2004;141(10):815-817. doi:10.7326/0003-4819-141-10-200411160-00015
Fitzhugh Mullan, MD
Dad never complained in the least that I didn't go into psychiatry. Delighted as he was that I made it into medicine at all, he was supportive and endlessly interested in everything that I did. To him, the specialty didn't matter—public health, psychiatry, pediatrics—it was medicine that bonded us.
Ann Intern Med. 2004;141(10):818-819. doi:10.7326/0003-4819-141-10-200411160-00016
Ann Intern Med. 2004;141(10):820. doi:10.7326/0003-4819-141-10-200411160-00017
Ann Intern Med. 2004;141(10):820. doi:10.7326/0003-4819-141-10-200411160-00018
Ann Intern Med. 2004;141(10):820-821. doi:10.7326/0003-4819-141-10-200411160-00019
Ann Intern Med. 2004;141(10):821. doi:10.7326/0003-4819-141-10-200411160-00020
Ann Intern Med. 2004;141(10):821-822. doi:10.7326/0003-4819-141-10-200411160-00021
Ann Intern Med. 2004;141(10):822. doi:10.7326/0003-4819-141-10-200411160-00022
Ann Intern Med. 2004;141(10):822-823. doi:10.7326/0003-4819-141-10-200411160-00023
Ann Intern Med. 2004;141(10):823. doi:10.7326/0003-4819-141-10-200411160-00024
Jennifer Fisher Wilson
Ann Intern Med. 2004;141(10):825-828. doi:10.7326/0003-4819-141-10-200411160-00027
Jack Coulehan, MD
Ann Intern Med. 2004;141(10):800. doi:10.7326/0003-4819-141-10-200411160-00011
Ann Intern Med. 2004;141(10):I-38. doi:10.7326/0003-4819-141-10-200411160-00001
Ann Intern Med. 2004;141(10):I-46. doi:10.7326/0003-4819-141-10-200411160-00002
Ann Intern Med. 2004;141(10):I-58. doi:10.7326/0003-4819-141-10-200411160-00003
Ann Intern Med. 2004;141(10):I-67. doi:10.7326/0003-4819-141-10-200411160-00004
Ellen Schur, MD; Joann Elmore, MD, MPH
Ann Intern Med. 2004;141(10):824. doi:10.7326/0003-4819-141-10-200411160-00025
Ann Intern Med. 2004;141(10):824. doi:10.7326/0003-4819-141-10-200411160-00026
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