Corinne A. Riddell, PhD; Sam Harper, PhD; Magdalena Cerdá, PhD; Jay S. Kaufman, PhD
In the United States, suicide and homicide rates are known to differ between black and white men, but little is known about whether these disparities vary by state. This study compares the rates of firearm and nonfirearm homicide and suicide in black and white non-Hispanic men by U.S. state and examines whether these deaths are associated with state prevalence of gun ownership.
Øyvind Holme, MD, PhD; Magnus Løberg, MD, PhD; Mette Kalager, MD, PhD; Michael Bretthauer, MD, PhD; Miguel A. Hernán, MD, DrPH; Eline Aas, PhD; Tor J. Eide, MD, PhD; Eva Skovlund, MSc, PhD; Jon Lekven, MD, PhD; Jörn Schneede, MD, PhD; Kjell Magne Tveit, MD, PhD; Morten Vatn, MD, PhD; Giske Ursin, MD, PhD; Geir Hoff, MD, PhD; for the NORCCAP Study Group
Four randomized trials found that sigmoidoscopy screening reduces colorectal cancer incidence and mortality. Some of these also indicated that the effect might be smaller in women than men, but the differences varied by study and type of outcome (incidence or mortality). This population-based, randomized trial in Norway had a longer follow-up and more events, and it reached a clear conclusion.
Aubrey C. Chan, MD, PhD; Christopher A. Burke, MD; Ellen M. Coffey, MD; David R. Hilden, MD, MPH; Diego L. Coira, MD; Jessy Warner-Cohen, PhD, MPH; Margaret Grady, MSN, APN-C; Philip R. Muskin, MD, MA; Gen Shinozaki, MD
Some hospitalized patients with comorbid, chronic medical and psychiatric illnesses may benefit from admission to an integrated unit that can provide care for both conditions. This commentary describes integrated medical–psychiatric inpatient care units implemented in 5 U.S. institutions, the facilitators of and barriers to this model, and the benefits in terms of patient outcomes and provider satisfaction.
Kirsten Bibbins-Domingo, PhD, MD, MAS; John Inadomi, MD
Holme and colleagues offer the latest evidence that adds to and challenges our understanding of the optimal screening approach for colorectal cancer (CRC). The study confirms the effectiveness of screening sigmoidoscopy to reduce CRC incidence and mortality among men but not among women. The editorialist discusses the findings and why more research is needed.
Christine M. Durand, MD; Mary G. Bowring, MPH; Alvin G. Thomas, MSPH; Lauren M. Kucirka, MD, PhD; Allan B. Massie, PhD; Andrew Cameron, MD, PhD; Niraj M. Desai, MD; Mark Sulkowski, MD; Dorry L. Segev, MD, PhD
The epidemic of drug overdose deaths in the United States has led to an increase in organ donors. In this prospective observational cohort study, the authors used data from the Scientific Registry of Transplant Recipients from 2000 to 2017 to characterize organ donors who died of overdose and to analyze outcomes among transplant recipients.
Renee Butkus, BA; Joshua Serchen, BA; Darilyn V. Moyer, MD; Sue S. Bornstein, MD; Susan Thompson Hingle, MD; for the Health and Public Policy Committee of the American College of Physicians
Although women have made substantial progress in medical school enrollment, residency training opportunities, and composition of the physician workforce, much remains to be done to improve equity and increase leadership opportunities for women in medicine. This American College of Physicians position paper provides recommendations to achieve gender equity in physician compensation and career advancement.
Hilary Daniel, BS; Sue S. Bornstein, MD; Gregory C. Kane, MD; for the Health and Public Policy Committee of the American College of Physicians
The social conditions in which a person lives can profoundly affect their ability to stay healthy, their ability to access care, and their risks for illness and premature death. In this position paper, the American College of Physicians evaluates social determinants of health and makes recommendations to address them.
David R. Taylor, MD, MHPE; Yoon Soo Park, PhD; Christopher A. Smith, MD; Jolanta Karpinski, MD, MEd; William Coke, MD; Ara Tekian, PhD, MHPE
Competency-based medical education has not advanced residency training as much as expected, and some medical educators now advocate reorienting competency-based approaches to focus on a resident's ability to do authentic clinical work. In this study, the authors used a modified Delphi process to develop descriptions of clinical work for which internal medicine residents must gain proficiency to deliver meaningful patient care.
Katrina Armstrong, MD, MSCE
The quest to eliminate uncertainty in clinical decision making has become central to biomedical research over the past 50 years, driving the emergence of evidence-based medicine, precision medicine, and most recently, biomedical artificial intelligence. This commentary discusses how, despite being a source of discomfort, the handling of uncertainty can also have an important positive effect on medical care.
Gianna Zuccotti, MD; Lipika Samal, MD, MPH; Francine L. Maloney, MPH; Angela Ai, BA; Adam Wright, PhD
The authors observe that their hospital performed approximately equal numbers of screening mammographies and Pap smears each year. Follow-up was appropriate for more than 99% of abnormal mammograms but only 91% of abnormal Pap smears. They examine the reasons for these differences and propose improvements for follow-up of abnormal results from other diagnostic tests.
Powel Kazanjian, MD, PhD
In 1919, three deadly outbreaks of botulism caused by consumption of canned olives packed in California captured national headlines. The author cites this epidemic as an example of a disease outbreak that was controlled when business interests became aligned with public health goals. The outbreaks also illustrate how the perception of victims affects public health responses and provide insight into how epidemics capture public attention.
Camille Nelson Kotton, MD
In this issue, Durand and colleagues review the use of overdose-death donor (ODD) organ transplants involving 138 565 deceased donors and 337 934 solid organ transplant recipients from 2000 to 2017. The editorialist discusses the findings and the opportunities for expanding organ availability that the use of ODD organs provides.
Molly Carnes, MD, MS
An American College of Physicians (ACP) position paper provides recommendations aimed at eliminating gender inequities in compensation and career advancement opportunities and providing a more inclusive environment to realize the full potential of all physicians. The editorialist discusses how gender stereotypes threaten the realization of ACP's goal and proposes strategies to combat their influence.
David U. Himmelstein, MD; Steffie Woolhandler, MD, MPH
The American College of Physicians position paper focuses on deteriorating social determinants of health. The editorialists note that the paper highlights many social determinants that underlie health inequities but omits others, such as mass incarceration and inequities in power.
Vincent Quagliarello, MD
Bonnie Salomon, MD
D.A. Frater, MD
Eric B. Larson, MD, MPH
Calvin Hirsch, MD
Benton R. Hunter, MD
Omar Damji, MSc, MD; Eddy Lang, MD
Nabeel M. Syed, MD, FRCPC; Wieslaw Oczkowski, MD, FRCPC
Douglas P. Kiel, MD, MPH
Ellis Lader, MD, FACC, FACP
Eleni Bekiari, MD, MSc, PhD; Thomas Karagiannis, MD, MSc; Apostolos Tsapas, MD, MSc, PhD
Matthew B. Stanbrook, MD, PhD
Darren B. Taichman, MD, PhD
Michael Koerner, MS; Eliza Fredette, MS; Trudy A. Watt, MArch; Peter Lloyd Jones, PhD
David H. Wesorick, MD; Vineet Chopra, MD, MSc
Anna M. Maw, MD, MS; Nilam J. Soni, MD, MSc
Over the past decade, hospitalists have begun to use point-of-care ultrasound (POCUS) to answer focused diagnostic questions at the bedside. As ultrasound machines have become more compact and affordable, access to this technology has increased. As this technology becomes more commonly used, many hospitalists are wondering if they should learn how to use it. Here, we present a few reasons why more hospitalists are picking up POCUS.
Megan Miner, MD
Building on the popular Annals feature “On Being a Doctor,” storytellers share stories about the experience of doctoring on video.
J. Kevin Dorsey, MD, PhD
Yasmina Arroyo-Jimenez, MD
Meghna Desai, MD
Adam M. Licurse, MD, MHS; Ateev Mehrotra, MD
The virtual and remote technologies that we call telehealth are changing the availability and cost of health care. Telehealth can often be provided at a lower cost than other types of care, but it may increase the total amount of care delivered. The effect on spending depends on how much telehealth substitutes for other types of care, and how much it adds to the overall volume of care. This article explains the various mechanisms by which telehealth can affect this spending equation.
Peter J. Pronovost, MD, PhD; Julie Miller, MD; David E. Newman-Toker, MD, PhD; Lisa Ishii, MD; Albert W. Wu, MD, MPH
The Merit-based Incentive Payment System provides for new ways to pay for care, including bundled payment programs, which pay a fixed amount for the total cost of care during a defined period surrounding a procedure. Quality measures were defined for these bundles to encourage appropriate care and discourage underuse of needed services. The authors detail the ways in which current measures fail to adequately measure the quality of health care and describe a framework for improving these measures.
Theodore T. Lee, BA; Aaron S. Kesselheim, MD, JD, MPH
In 2017, the U.S. Food and Drug Administration announced the Digital Health Software Precertification (Pre-Cert) Program, which is designed to expedite regulatory review of software classified as a medical device for companies that demonstrate quality and organizational excellence in software development. Many questions have been raised about Pre-Cert, and this article reviews current controversies and implications.
Catharine B. Stack, PhD; Trevor Butterworth, BA, MPhil, MS; Rebecca Goldin, PhD
Handling of missing data in clinical trials is often suboptimal. One solution could involve creating new mechanisms to deliver the information directly to the communities of scientists at the front lines. In our continued effort to explain analytic methods to clinical researchers in new ways, Annals joined forces with Sense About Science USA to communicate concepts of missing data through graphic design.
David P. Durham, PhD; Meagan C. Fitzpatrick, PhD; Martial L. Ndeffo-Mbah, PhD; Alyssa S. Parpia, MPH; Nelson L. Michael, MD, PhD; Alison P. Galvani, PhD
Prenatal Zika virus infection has devastating consequences, and many vaccine candidates are under active development. To determine how best to prioritize populations for receipt of Zika vaccines, the authors developed a compartmental model that incorporated estimates of mosquito and human transmission, population susceptibility, age-specific fertility, and vaccine efficacy.
Cynthia M. Boyd, MD, MPH; Bruce Leff, MD; Julia Bellantoni, BS; Navpreet Rana, DO; Jennifer L. Wolff, PhD; David L. Roth, PhD; Kim Carl, RN; Orla C. Sheehan, MD, PhD
The Centers for Medicare & Medicaid Services form 485 (CMS-485) is typically used for certification of plans of care for patients who receive Medicare skilled home health care (SHHC) services. In this article, the authors summarize results from a nationally representative survey that sought to determine how physicians interact with SHHC agencies and use the CMS-485 in care coordination for patients receiving SHHC services.
James J. Chamberlain, MD; Eric L. Johnson, MD; Sandra Leal, PharmD, MPH, CDE; Andrew S. Rhinehart, MD, CDE; Jay H. Shubrook, DO; Lacie Peterson, MS, RD, CDE
This synopsis of the 2018 American Diabetes Association Standards of Medical Care focuses on guidance relating to cardiovascular disease and risk management in nonpregnant adults with diabetes. Recommendations address diagnosis and treatment of cardiovascular risk factors (hypertension and dyslipidemia), aspirin use, screening for and treatment of coronary heart disease, and lifestyle interventions.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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