Calvin Ke, MD; Eric Lau, PhD; Baiju R. Shah, MD, PhD; Thérèse A. Stukel, PhD; Ronald C. Ma, MBChB; Wing-Yee So, MD, MBChB; Alice P. Kong, MD; Elaine Chow, PhD, MBChB; Philip Clarke, PhD; William Goggins, ScD; Juliana C.N. Chan, MD; Andrea Luk, MD, MBChB
Type 2 diabetes (T2D) increases hospitalization risk. Young-onset T2D (defined as onset before age 40 years) is associated with excess morbidity and mortality, but its effect on hospitalizations is unknown. In this population-based cohort study, the authors examined 2 large cohorts of Chinese adults with T2D to determine the effects of age at onset and modifiable risk factors on hospitalization during the working lifespan.
Todd Cassese, MD; Melinda S. Sharkey, MD; Amber T. Pincavage, MD; Korry Schwanz, BA; Jeanne M. Farnan, MD, MHPE
The federal regulation regarding student documentation in the medical record was recently changed to allow the teaching physician to verify in the medical record any student documentation of evaluation and management services rather than redocumenting the work. This change will alter how students and teaching physicians interact. Unintended outcomes are possible, and this article describes some that should be avoided.
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.
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.
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.
Tina M. Kaufman, PhD, PA-C; Sergio Fazio, MD, PhD; Michael D. Shapiro, DO
Jan K. Carney, MD, MPH
Eli Y. Adashi, MD, MS
Chester B. Good, MD, MPH; Natasha Parekh, MD, MS; Kavita Fischer, MD; James Schuster, MD; Chronis Manolis, RPh; William Shrank, MD, MSHS
Kennon Heard, MD, PhD; Andrew A. Monte, MD, PhD; Christopher O. Hoyte, MD
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.
Neal J. Thomas, MD, MSc
Faith T. Fitzgerald, MD
Amy Haddad, PhD
Markos Kalligeros, MD; Eleftherios Mylonakis, MD, PhD, FIDSA
Anupam Goel, MD, FACP
Robert H. Fletcher, MD, MSc
Calvin Hirsch, MD
Michelle Welsford, MD, FACEP, CCPE, FRCPC
Kristen Sullivan, MD; Harriette G.C. Van Spall, MD, MPH, FRCPC
Stefanie Furlan, DO; Steven Borzak, MD
Anthony Donato, MD, MHPE; Eric Elgin, MD
Jonathan M. Kirschner, MD; Benton R. Hunter, MD
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.
Darren B. Taichman, MD, PhD
David H. Wesorick, MD; Vineet Chopra, MD, MSc
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.
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.
Lois Snyder Sulmasy, JD; Thomas A. Bledsoe, MD; for the ACP Ethics, Professionalism and Human Rights Committee
W. Alton Russell, MS; Susan L. Stramer, PhD; Michael P. Busch, MD, PhD; Brian Custer, PhD
Universal individual donation nucleic acid testing (ID-NAT) of donated blood for Zika virus began in U.S. states and territories in 2016. This microsimulation study estimated the effectiveness and cost-effectiveness of universal ID-NAT, universal mini-pool NAT, and alternative Zika virus screening policies in Puerto Rico and the 50 states. It found that screening was cost-effective only in the high mosquito season in Puerto Rico, and no evaluated screening policy was cost-effective in the 50 states.
E. Amy Janke, PhD; Caroline Richardson, MD; Kristin L. Schneider, PhD; on behalf of the Society of Behavioral Medicine
The 2017 hypertension guidelines from the American College of Cardiology and American Heart Association provide little guidance regarding specific lifestyle and behavioral approaches to prevent and manage hypertension. The goal of this essay is to increase physician awareness of the value and effectiveness of lifestyle interventions for managing hypertension as well as sources of practical, evidence-based information on how to implement these strategies in the clinical setting.
Katherine D. Ellingson, PhD; Matthew J. Kuehnert, MD
In their article, Russell and colleagues report the cost-effectiveness of blood screening policies for preventing transfusion-transmitted Zika virus infection. The editorialists discuss the findings and the need to balance risk for infection with costs of screening in light of the public's expectation of near-zero risk for transfusion-transmitted infection.
Dhruv S. Kazi, MD, MSc, MS; Joanne Penko, MS, MPH; Pamela G. Coxson, PhD; David Guzman, MSPH; Pengxiao C. Wei, BS, MPH; Kirsten Bibbins-Domingo, PhD, MD, MAS
The high price of prescription drugs in the United States has been a barrier to adoption of potentially life-saving therapies. To address this issue, the authors propose that cost-effectiveness analyses be performed in a timely manner so that this information can help influence drug pricing shortly after approval. They illustrate how this process might work by describing their recent experience with PCSK9 (proprotein convertase subtilisin/kexin 9) inhibitors, monoclonal antibodies that lower cholesterol levels in the blood.
Michael Fralick, MD, SM; Seoyoung C. Kim, MD, ScD, MSCE; Sebastian Schneeweiss, MD, ScD; Dae Kim, MD, ScD; Donald A. Redelmeier, MD, MSc; Elisabetta Patorno, MD, DrPH
Canagliflozin, a sodium–glucose cotransporter-2 inhibitor used for diabetes treatment, has been associated with decreased bone mineral density, potentially putting patients at increased risk for fracture. This analysis examined risk for nonvertebral fractures among new users of canagliflozin compared with a glucagon-like peptide-1 agonist.
Mark A. Hlatky, MD
Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors substantially reduce cholesterol levels, but the U.S. Food and Drug Administration–approved PCSK9 inhibitors, alirocumab and evolocumab, came to market priced at $14 000 per year—more than 100 times the cost of a generic statin. Kazi and colleagues performed a cost-effectiveness analysis of alirocumab in secondary prevention based on new trial results and updated pricing. The editorialist discusses the findings and what it takes for preventive therapies to be cost-effective.
William D. Leslie, MD, MSc; John T. Schousboe, MD, PhD
In this issue, Fralick and colleagues use real-world observational data to clarify discrepant findings from clinical trials on whether canagliflozin, a sodium–glucose cotransporter-2 inhibitor, increases risk for fracture. The editorialists discuss the findings and why they believe that real-world data are critical to pharmacovigilance.
Copyright © 2019 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use