Christine Sinsky, MD; Lacey Colligan, MD; Ling Li, PhD; Mirela Prgomet, PhD; Sam Reynolds, MBA; Lindsey Goeders, MBA; Johanna Westbrook, PhD; Michael Tutty, PhD; George Blike, MD
Over the past decade, ambulatory care in the United States has been subject to dramatic pressures to cut costs, meet regulations, and transition to electronic health records. Many physicians express dissatisfaction with how they spend their patient care time, but data on the specific proportions of time devoted to various activities have been lacking. This study used direct observation and self-report diaries to document time spent on specific patient care–related activities by physicians in family medicine, internal medicine, cardiology, and orthopedics.
Ann Intern Med. 2016;165(11):753-760. doi:10.7326/M16-0961
Zhishun Liu, MD, PhD; Shiyan Yan, PhD; Jiani Wu, MD; Liyun He, MD, PhD; Ning Li, MD; Guirong Dong, MD; Jianqiao Fang, MD, PhD; Wenbin Fu, MD; Lixin Fu, MD, PhD; Jianhua Sun, MD, PhD; Linpeng Wang, MD; Shun Wang, MD; Jun Yang, MD; Hongxing Zhang, MD; Jianbin Zhang, MD, PhD; Jiping Zhao, MD; Wei Zhou, MD; Zhongyu Zhou, MD; Yanke Ai, PhD; Kehua Zhou, MD, DPT; Jia Liu, MD, PhD; Huanfang Xu, MD, PhD; Yuying Cai, MD, PhD; Baoyan Liu, MD
Chronic severe functional constipation is a common problem. Preliminary studies have suggested that acupuncture might be effective. This large randomized, controlled trial assessed acupuncture for treatment of this problem.
Ann Intern Med. 2016;165(11):761-769. doi:10.7326/M15-3118
Patricia Jabre, MD, PhD; Wulfran Bougouin, MD, MPH; Florence Dumas, MD, PhD; Pierre Carli, MD, PhD; Corinne Antoine, MD; Laurent Jacob, MD, PhD; Benjamin Dahan, MD; Frankie Beganton, MS; Jean-Philippe Empana, MD, PhD; Eloi Marijon, MD, PhD; Nicole Karam, MD, MPH; Alexandre Loupy, MD, PhD; Carmen Lefaucheur, MD, PhD; Daniel Jost, MD, PhD; Alain Cariou, MD, PhD; Frédéric Adnet, MD, PhD; Thomas D. Rea, MD, MPH; Xavier Jouven, MD, PhD
Clinical decision rules known as termination-of-resuscitation rules help to identify cases where further resuscitation of patients with out-of-hospital cardiac arrest (OHCA) is futile. In this retrospective assessment using OHCA data from 2 registries and 1 trial, the authors evaluated 3 objective criteria for identifying patients with OHCA and no chance of survival to enable prompt orientation toward organ donation.
Ann Intern Med. 2016;165(11):770-778. doi:10.7326/M16-0402
Holly C. Wilcox, PhD; Hadi Kharrazi, MHI, MD, PhD; Renee F. Wilson, MS; Rashelle J. Musci, PhD; Ryoko Susukida, PhD; Fardad Gharghabi, MD; Allen Zhang, BS; Lawrence Wissow, MD, MPH; Karen A. Robinson, PhD
This systematic review, which accompanies a National Institutes of Health Pathways to Prevention Workshop, describes multiple data systems that can be linked to data from prevention studies to advance youth suicide prevention research.
Ann Intern Med. 2016;165(11):779-785. doi:10.7326/M16-1281
Nancy R. Cook, ScD; Paul M Ridker, MD
This article provides an update of the findings since publication of the Adult Treatment Panel III recommendations, an overview of the strengths and weaknesses of validation efforts, and a discussion of possible reasons for any discrepancies.
Ann Intern Med. 2016;165(11):786-794. doi:10.7326/M16-1739
Howard Libman, MD; Alan O. Malabanan, MD; Gordon J. Strewler, MD; Eileen E. Reynolds, MD
This Grand Rounds summarizes a discussion between 2 experts about the benefits and risks, and challenges and controversies, of screening for vitamin D deficiency.
Ann Intern Med. 2016;165(11):800-807. doi:10.7326/M16-1993
Todd D. Little, PhD; Kathleen M. Roche, PhD; Sy-Miin Chow, PhD; Anna P. Schenck, PhD; Leslie-Ann Byam, MA
This National Institutes of Health Pathways to Prevention Workshop provides a roadmap for optimizing youth suicide prevention efforts and identifies strategies necessary to advance relevant research.
Ann Intern Med. 2016;165(11):795-799. doi:10.7326/M16-1568
Patricia Flatley Brennan, RN, PhD
This commentary from the new Director of the National Library of Medicine discusses the Library's commitment to accelerating discovery and achieving the promise of precision medicine.
Ann Intern Med. 2016;165(11):808-809. doi:10.7326/M16-1737
Susan L. Norris, MD, MPH, MSc; Lisa Bero, PhD
The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach is a widely used and well-accepted system for grading the quality of evidence and strength of recommendations in guidelines. This commentary discusses some of its limitations and proposes means for advancement.
Ann Intern Med. 2016;165(11):810-811. doi:10.7326/M16-1254
Helen W. Boucher, MD; Johan S. Bakken, MD, PhD; Barbara E. Murray, MD
The authors summarize key aspects of the problem of antimicrobial resistance and share their views about an appropriate response to this international threat to public health.
Ann Intern Med. 2016;165(11):812-813. doi:10.7326/M16-2079
David Grande, MD, MPA; Katrina Armstrong, MD, MSCE
This commentary speculates on explanations for physicians' low voting rates and encourages physicians to become more engaged in the U.S. electoral process.
Ann Intern Med. 2016;165(11):814-815. doi:10.7326/M16-2470
Stephen M. Shortell, PhD, MPH, MBA; Diane Rittenhouse, MD, MPH
The authors discuss what they believe to be the 5 core principles the next U.S. president should highlight to advance health care and improve the health of Americans.
Ann Intern Med. 2016;165(11):816-817. doi:10.7326/M16-2471
Susan Hingle, MD
Electronic health records occupy much of physicians' time and draw attention away from direct interactions with patients. The editorialist discusses the implications of Sinsky and colleagues' observations and calls for changes that will redirect physicians' focus from the computer screen to patients.
Ann Intern Med. 2016;165(11):818-819. doi:10.7326/M16-1757
Joanna L. Hart, MD, MS; Scott D. Halpern, MD, PhD
In this editorial, the authors discuss the evidence base for deciding when and where to terminate resuscitation efforts in patients with OHCA and highlight areas where further research is needed.
Ann Intern Med. 2016;165(11):820-821. doi:10.7326/M16-2056
Richard B. Weinberg, MD
Ann Intern Med. 2016;165(11):822-823. doi:10.7326/M16-0258
Alan D. Haber, MD
Ann Intern Med. 2016;165(11):824-825. doi:10.7326/M15-2840
Ann Intern Med. 2016;165(11):826-827. doi:10.7326/L16-0415
Ann Intern Med. 2016;165(11):826. doi:10.7326/L16-0416
Ann Intern Med. 2016;165(11):827-828. doi:10.7326/L16-0417
Ann Intern Med. 2016;165(11):827. doi:10.7326/L16-0418
Ann Intern Med. 2016;165(11):828-829. doi:10.7326/L16-0420
Ann Intern Med. 2016;165(11):829. doi:10.7326/L16-0419
Ann Intern Med. 2016;165(11):829-830. doi:10.7326/L16-0479
Ann Intern Med. 2016;165(11):830-831. doi:10.7326/L16-0480
Ann Intern Med. 2016;165(11):831-832. doi:10.7326/M16-0596
Ann Intern Med. 2016;165(11):832. doi:10.7326/L16-0549
Susan A. Glod, MD
Ann Intern Med. 2016;165(11):819. doi:10.7326/M16-1328
Steven L. Cohn, MD, FACP, SFHM
Ann Intern Med. 2016;165(11):ITC81-ITC96. doi:10.7326/AITC201612060
Darren B. Taichman, MD, PhD
Ann Intern Med. 2016;165(11):ED11. doi:10.7326/AFED201612060
William J. Doan, BA, MFA, PhD
Annals Graphic Medicine brings together original graphic narratives, comics, animation/video, and other creative forms by those who provide or receive health care. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.
Ann Intern Med. 2016;165(11):W14-W16. doi:10.7326/G16-0009
Ann Intern Med. 2016;165(11):I-42. doi:10.7326/P16-9022
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