Skip Navigation
Menu
Updates |1 May 2012

Update in General Internal Medicine: Evidence Published in 2011

Robert C. Brooks, MD, PhD; Peggy B. Hasley, MD, MHSc; Harish Jasti, MD; David Macpherson, MD, MPH

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From the University of Pittsburgh School of Medicine, Veterans Affairs Pittsburgh Healthcare System, and the 4th Veterans Integrated Service Network, Pittsburgh, Pennsylvania.

    Acknowledgment: The authors thank Christine Brush for her exceptional organizational work in preparing this Update and the members of the Division of General Internal Medicine Journal Club at the University of Pittsburgh for their input about the appropriateness of journal articles to include in the Update.

    Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0186.

    Requests for Single Reprints: David Macpherson, MD, MPH, 323 North Shore Drive, Suite 400, Pittsburgh, PA 15212; e-mail, mailto:David.Macpherson@va.gov.

    Current Author Addresses: Dr. Brooks: Pittsburgh VA Healthcare System, University Drive C, 130-U, Pittsburgh, PA 15240.

    Dr. Hasley: University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213.

    Dr. Jasti: University of Pittsburgh, 200 Lothrop Street, MUH 9W33, Pittsburgh, PA 15213.

    Dr. Macpherson: University of Pittsburgh, 323 North Shore Drive, Suite 400, Pittsburgh, PA 15212.

    Author Contributions: Conception and design: P.B. Hasley, H. Jasti, D. Macpherson.

    Analysis and interpretation of the data: R.C. Brooks, P.B. Hasley, H. Jasti, D. Macpherson.

    Drafting of the article: R.C. Brooks, P.B. Hasley, H. Jasti, D. Macpherson.

    Critical revision of the article for important intellectual content: R.C. Brooks, P.B. Hasley, H. Jasti, D. Macpherson.

    Final approval of the article: R.C. Brooks, P.B. Hasley, H. Jasti, D. Macpherson.

    Administrative, technical, or logistic support: D. Macpherson.

    Collection and assembly of data: R.C. Brooks, P.B. Hasley, H. Jasti, D. Macpherson.

×
FULL TEXT
In 2011, investigators published several important studies that require general internists to consider practice change. Although the publications summarized here cover a broad spectrum of issues that general internists commonly face, they reflect 1 broad theme: Current practice behaviors should offer value in terms of improving meaningful clinical outcomes. The lack of evidence for improved cardiovascular outcomes with combinations of lipid-lowering agents compared with a high-dose statin regimen (1) and the lack of evidence for improved mortality with heparin prophylaxis in hospitalized medical patients, with inpatient treatment of low-risk pulmonary embolism (PE) or with prostate and ovarian cancer screening, highlight these areas for practice change. The use of a small number of clinic blood pressure (BP) measurements to make diagnosis and treatment decisions increases the risk for overtreating patients for hypertension. Appropriate use of innovation in oral anticoagulation and computed tomography (CT)–based lung cancer screening will require careful consideration of cost-effectiveness. This theme is consistent with the view of primary care physicians who opined on a recent national survey that they, their colleagues, and specialists are delivering too much health care (2). We hope that the alignment of opinion and publication findings reinforces change toward a greater consideration of value when general internists recommend care to their patients.
FULL TEXT
PDF
Not Available
Citations
Citation

Brooks RC, Hasley PB, Jasti H, Macpherson D. Update in General Internal Medicine: Evidence Published in 2011. Ann Intern Med. ;156:649–653. doi: 10.7326/0003-4819-156-9-201205010-00410

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 2012;156(9):649-653.

DOI: 10.7326/0003-4819-156-9-201205010-00410

0 Citations

Related Articles
Oral Vitamin K Versus Placebo to Correct Excessive Anticoagulation in Patients Receiving Warfarin: A Randomized Trial
Annals of Internal Medicine; 150 (5): 293-300
Update in Hematology and Oncology
Annals of Internal Medicine; 152 (10): 655-662
Update in Hematology and Medical Oncology: Evidence Published in 2011
Annals of Internal Medicine; 157 (4): 276-283
Deciding about Screening
Annals of Internal Medicine; 118 (11): 901-902
View MoreView Less

Journal Club
Review: Heparin and mechanical compression are similar in reducing postsurgical VTE risk, but heparin increases bleeding
Annals of Internal Medicine; 153 (2): JC1-7
Adding niacin plus laropiprant to statins did not reduce vascular events and increased serious adverse events
Annals of Internal Medicine; 161 (10): JC8
Warfarin continuation was better than heparin bridging during pacemaker or ICD surgery
Annals of Internal Medicine; 159 (4): JC7
After PCI with stents for AF, adding rivaroxaban vs warfarin to antiplatelet drugs reduced bleeding
Annals of Internal Medicine; 166 (6): JC29
View MoreView Less

Related Point of Care
Acute Gastrointestinal Bleeding
Annals of Internal Medicine; 159 (3): ITC2-1
Prostate Cancer
Annals of Internal Medicine; 163 (11): ITC1
View MoreView Less

Related Topics
Cardiology
Coronary Risk Factors
Hematology/Oncology
Hypertension
Nephrology

Cardiology, Coronary Risk Factors, Hematology/Oncology, Hypertension, Nephrology.

PubMed Articles
Contraception.
Ann Intern Med 2019;170(3):ITC18-ITC32.
Recent incidence and surgery trends for prostate cancer: Towards an attenuation of overdiagnosis and overtreatment?
PLoS One 2019;14(2):e0210434.
View More

Results provided by: PubMed

CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×