Harry Hemingway, MBBChir; Ruoling Chen, MD; Cornelia Junghans, PhD; Adam Timmis, MBBChir; Sandra Eldridge, PhD; Nick Black, MD; Paul Shekelle, MD; Gene Feder, MD
Can patient-specific appropriateness criteria developed by experts identify which patients with suspected angina should undergo coronary angiography? In Hemingway and colleagues' study, expert panels scored hundreds of patient-specific scenarios as inappropriate, uncertain, or appropriate indications for coronary angiography. Researchers matched these appropriateness indications to 9356 clinic patients with recent-onset chest pain. Many patients judged as appropriate candidates did not undergo angiography and more had subsequent coronary events than did patients who “appropriately” had angiography.
Ann Intern Med. 2008;149(4):221-231. doi:10.7326/0003-4819-149-4-200808190-00003
Mark Loeb, MD, MSc; Steven Hanna, PhD; Lindsay Nicolle, MD; John Eyles, PhD; Susan Elliott, PhD; Michel Rathbone, MD; Michael Drebot, PhD; Binod Neupane, MSc; Margaret Fearon, MD; James Mahony, PhD
In this longitudinal study, Loeb and associates examined the patterns of physical and mental function after infection with West Nile virus and determined factors associated with recovery. Among 156 patients with West Nile virus infection in 4 Canadian provinces, physical and cognitive function, as well as mood and fatigue, seemed to return to population norms within about 1 year.
Ann Intern Med. 2008;149(4):232-241. doi:10.7326/0003-4819-149-4-200808190-00004
Jane A. Cauley, DrPH; Andrea Z. LaCroix, PhD; LieLing Wu, MS; Mara Horwitz, MD; Michelle E. Danielson, PhD; Doug C. Bauer, MD; Jennifer S. Lee, MD; Rebecca D. Jackson, MD; John A. Robbins, MD; Chunyuan Wu, MS; Frank Z. Stanczyk, PhD; Meryl S. LeBoff, MD; Jean Wactawski-Wende, PhD; Gloria Sarto, MD; Judith Ockene, PhD; Steven R. Cummings, MD
Vitamin D supplementation may help prevent fractures, but it is not clear whether blood vitamin D concentrations predict fracture risk. In Cauley and colleagues' case–control study, women with lower serum 25-hydroxyvitamin D concentrations had a higher hip fracture risk. The association was independent of frailty, body mass index, physical function, and falls.
Ann Intern Med. 2008;149(4):242-250. doi:10.7326/0003-4819-149-4-200808190-00005
Kevin P. Hill, MD, MHS; Joseph S. Ross, MD, MHS; David S. Egilman, MD, MPH; Harlan M. Krumholz, MD, SM
The public has lacked strong documentary evidence of a long-suspected practice: drug company sponsorship of randomized trials to promote a new drug by getting physicians accustomed to using it while following the trial protocol (seeding trials). Hill and coworkers obtained court-ordered documents that showed that Merck & Co.'s marketing division conducted the ADVANTAGE (Assessment of Differences between Vioxx and Naproxen To Ascertain Gastrointestinal Tolerability and Effectiveness) randomized trial to promote the use of Vioxx (rofecoxib)—the drug prescribed to the trial participants. The company did not tell institutional review boards, physicians, or patients the true purpose of the trial.
Ann Intern Med. 2008;149(4):251-258. doi:10.7326/0003-4819-149-4-200808190-00006
Susan B. LeGrand, MD; Dona Leskuski, DO; Ivan Zama, MD
First-line therapy with saline and furosemide continues to be the standard of care for acute management of hypercalcemia. LeGrand and colleagues sought evidence on this practice and found none that supported the common practice of using furosemide for hypercalcemia of any cause.
Ann Intern Med. 2008;149(4):259-263. doi:10.7326/0003-4819-149-4-200808190-00007
Yael Schenker, MD; Bernard Lo, MD; Katharine M. Ettinger, JD; Alicia Fernandez, MD
Physicians often find themselves caring for patients with limited English proficiency in settings with limited language services. Schenker and associates describe 4 factors that should inform the decision to call an interpreter (the clinical situation, degree of language gap, available interpretive resources, and patient preference), discuss who may be an appropriate interpreter, and offer coping strategies for when a professional interpreter is not available.
Ann Intern Med. 2008;149(4):264-269. doi:10.7326/0003-4819-149-4-200808190-00008
Pradyumna D. Phatak, MD; Herbert L. Bonkovsky, MD; Kris V. Kowdley, MD
Hereditary hemochromatosis, an inherited disease characterized by excessive absorption of dietary iron, may lead to progressive tissue iron accumulation, organ damage, and premature death. Some evidence-based guideline groups have recommended against screening asymptomatic individuals for hereditary hemochromatosis. Phatak and colleagues discuss hereditary hemochromatosis as a cause of preventable organ dysfunction and propose targeted case finding for Caucasian men of Northern European ancestry.
Ann Intern Med. 2008;149(4):270-272. doi:10.7326/0003-4819-149-4-200808190-00009
David A. Grimes, MD
Popular in medicine from about 1925 to 1975, a nomogram is a graphical means for solving an equation by placing a straightedge across several scales. Today, most reported nomograms are inconsistent with established definitions and clinical use. Grimes discusses nomograms, reviews their history as crude calculators, documents the current epidemic, gives examples of good and bad medical nomograms, and recommends a better approach to contemporary medical calculations.
Ann Intern Med. 2008;149(4):273-275. doi:10.7326/0003-4819-149-4-200808190-00010
David P. Faxon, MD
In this issue, Hemingway and associates assessed the reliability and validity of patient-specific appropriateness criteria for coronary angiography in patients with suspected stable angina pectoris. The study provides valuable new insights into the validity and potential application of appropriateness ratings.
Ann Intern Med. 2008;149(4):276-278. doi:10.7326/0003-4819-149-4-200808190-00011
Harold C. Sox, MD, Editor; Drummond Rennie, MD
A seeding trial is marketing in the guise of science. In 2003, Annals published a seeding trial sponsored by Merck & Co. No one told Annals the true purpose of the trial until the Editor received a letter from a consultant who was involved in the civil suits against Merck and had access to publicly accessible trial documents that disclosed the trial's true intent. These documents are the focus of Hill and colleagues' article in this issue about seeding trials.
Ann Intern Med. 2008;149(4):279-280. doi:10.7326/0003-4819-149-4-200808190-00012
Kimberly D. Manning, MD
My colleague-speaker-friend recently announced that he was leaving our division for an in-town private practice job. He would be the third person that month to make such an announcement. I knew he wasn't dying, but it was a death of sorts. In my heart, I knew it was the death of another clinician-educator.
Ann Intern Med. 2008;149(4):281-282. doi:10.7326/0003-4819-149-4-200808190-00013
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Ann Intern Med. 2008;149(4):I-34. doi:10.7326/0003-4819-149-4-200808190-00001
Ann Intern Med. 2008;149(4):I-42. doi:10.7326/0003-4819-149-4-200808190-00002
Nancy Berkman, PhD
Ann Intern Med. 2008;149(4):288. doi:10.7326/0003-4819-149-4-200808190-00020
Dan A. Henry, MD
Ann Intern Med. 2008;149(4):288. doi:10.7326/0003-4819-149-4-200808190-00021
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