Anthony Delitto, PT, PhD; Sara R. Piva, PT, PhD; Charity G. Moore, PhD, MSPH; Julie M. Fritz, PT, PhD; Stephen R. Wisniewski, PhD; Deborah A. Josbeno, PT, PhD; Mark Fye, MD; William C. Welch, MD
Evidence on nonsurgical alternatives to surgical decompression for patients with symptomatic lumbar spinal stenosis (LSS) is limited. This randomized, controlled trial randomly assigned patients with LSS, who were candidates for and had consented to surgery, to physical therapy for 6 weeks or surgical decompression. The physical therapy and surgery groups achieved similar symptom relief and improvements in physical functioning at 2-year follow-up. However, half of patients in the physical therapy group crossed over to receive surgery.
Ann Intern Med. 2015;162(7):465-473. doi:10.7326/M14-1420
Tessa S.S. Genders, MD, PhD; Steffen E. Petersen, MD, DPhil, MPH; Francesca Pugliese, MD, PhD; Amardeep G. Dastidar, MBBS; Kirsten E. Fleischmann, MD, MPH; Koen Nieman, MD, PhD; M.G. Myriam Hunink, MD, PhD
The optimal imaging strategy for patients with stable chest pain is uncertain. This cost-effectiveness analysis evaluated the comparative effectiveness and costs of coronary computed tomography (CT) angiography and cardiac stress imaging (cardiac stress magnetic resonance imaging, stress single-photon emission CT, and stress echocardiography) from the perspective of the United States, the United Kingdom, and the Netherlands. Their results suggest that coronary CT angiography is a costeffective triage test for 60-year-old patients who have stable, nonacute chest pain and a low to intermediate probability of coronary artery disease.
Ann Intern Med. 2015;162(7):474-484. doi:10.7326/M14-0027
Paul F. Pinsky, PhD; David S. Gierada, MD; William Black, MD; Reginald Munden, MD; Hrudaya Nath, MD; Denise Aberle, MD; Ella Kazerooni, MD
The definitions used to classify low-dose computed tomography findings may markedly influence the benefits and harms of lung cancer screening. This analysis of data from a large screening trial found that using the recently proposed Lung-RADS approach to classifying low-dose computed tomography findings substantially decreases the false-positive result rate but with a concomitant decrease in sensitivity. Adopting the Lung-RADS classification system may improve the results of lung cancer screening programs.
Ann Intern Med. 2015;162(7):485-491. doi:10.7326/M14-2086
Ali Rowhani-Rahbar, MD, MPH, PhD; Douglas Zatzick, MD; Jin Wang, PhD; Brianna M. Mills, MA; Joseph A. Simonetti, MD, MPH; Mary D. Fan, MPhil, JD; Frederick P. Rivara, MD, MPH
Information on the risk for subsequent violent victimization or crime perpetration after a firearm-related hospitalization (FRH) is lacking. Such information would help to inform the need for future interventions among this group of patients. The authors conducted a statewide epidemiologic investigation to determine the absolute rate of subsequent violent injury, death, or crime perpetration after discharge among patients with an FRH. Their findings suggest that FRHs are associated with a heightened risk for subsequent violent victimization or crime perpetration.
Ann Intern Med. 2015;162(7):492-500. doi:10.7326/M14-2362
Kimberly A. Gudzune, MD, MPH; Ruchi S. Doshi, BA; Ambereen K. Mehta, MD, MPH; Zoobia W. Chaudhry, MD; David K. Jacobs, BA; Rachit M. Vakil, BS; Clare J. Lee, MD; Sara N. Bleich, PhD; Jeanne M. Clark, MD, MPH
Commercial and proprietary weight-loss programs are popular options for obesity treatment, but their efficacy is unclear. This systematic review examined the benefits, adherence, and harms of commercial or proprietary weight-loss programs compared with control/education or behavioral counseling among overweight and obese persons. Reviewers found consistent evidence supporting the long-term efficacy of Weight Watchers and Jenny Craig. Other popular programs show promising shortterm weight-loss results, but additional studies evaluating long-term outcomes are needed.
Ann Intern Med. 2015;162(7):501-512. doi:10.7326/M14-2238
Steven E. Weinberger, MD; David B. Hoyt, MD; Hal C. Lawrence III, MD; Saul Levin, MD, MPA; Douglas E. Henley, MD; Errol R. Alden, MD; Dean Wilkerson, JD, MBA; Georges C. Benjamin, MD; William C. Hubbard, JD
Many physicians strongly believe that firearm-related injury and death is a major public health problem. The executive staff leadership of 7 medical professional societies, the American Public Health Association, and the American Bar Association renew their organizations' calls for policies to reduce firearm-related injuries and deaths in the United States and reiterate their commitment to being a part of the solution in mitigating such events. The policies that are advocated could reduce firearmrelated injury and death without violating the Second Amendment.
Ann Intern Med. 2015;162(7):513-516. doi:10.7326/M15-0337
Deborah Cotton, MD, MPH, Deputy Editor
The public health issue of firearm-related injury and death is the topic of this issue's discussion from the Annals archives.
Ann Intern Med. 2015;162(7):517. doi:10.7326/M15-0179
Jeffrey N. Katz, MD, MSc
In this issue, Delitto and colleagues examined surgical versus nonsurgical treatment options for lumbar spinal stenosis. The editorialist discusses the strengths of the trial, notes similar studies that support a standardized physical therapy regimen before surgery, and emphasizes that patient preferences should weigh heavily in the decision to have surgery.
Ann Intern Med. 2015;162(7):518-519. doi:10.7326/M15-0360
Darren B. Taichman, MD, PhD, Executive Deputy Editor; Christine Laine, MD, MPH, Editor in Chief; on behalf of the Annals editors
Health care professionals have been relatively silent on firearm-related harms compared with other public health crises. With the emergence of new research, the development of a national research agenda, and a united call for action from many physician professional organizations, the editors call on health care professionals to join in speaking up and demanding the resources and freedom to learn how to fix the public health crisis of firearm-related harms.
Ann Intern Med. 2015;162(7):520-521. doi:10.7326/M15-0428
Christina C. Wee, MD, MPH
In this issue, Gudzune and colleagues review evidence on the efficacy of commercial programs that focus on nutrition and incorporate behavioral counseling or social support as components. The editorialist discusses the study and stresses the importance of evaluating whether partnering physician counseling with these programs improves effectiveness.
Ann Intern Med. 2015;162(7):522-523. doi:10.7326/M15-0429
John H. Davidson, MD
He lived 100 miles away but had come to the clinic over the past 5 years for various medical concerns. I was the 11th physician to see him in this short span. Not a good sign.
Ann Intern Med. 2015;162(7):524-525. doi:10.7326/M14-2101
Ann Intern Med. 2015;162(7):526. doi:10.7326/L15-5072
Ann Intern Med. 2015;162(7):526-527. doi:10.7326/L15-5072-2
Ann Intern Med. 2015;162(7):527. doi:10.7326/L15-5073
Ann Intern Med. 2015;162(7):527-528. doi:10.7326/L15-5073-2
Ann Intern Med. 2015;162(7):528. doi:10.7326/L15-5074
Ann Intern Med. 2015;162(7):528-529. doi:10.7326/L15-5074-2
Ann Intern Med. 2015;162(7):529. doi:10.7326/L15-5074-3
Ann Intern Med. 2015;162(7):529-530. doi:10.7326/L15-5075
Ann Intern Med. 2015;162(7):530-531. doi:10.7326/L15-5075-2
Ann Intern Med. 2015;162(7):531. doi:10.7326/L15-5076
Ann Intern Med. 2015;162(7):531-532. doi:10.7326/L15-5076-2
Ann Intern Med. 2015;162(7):532. doi:10.7326/L15-5076-3
Ann Intern Med. 2015;162(7):532. doi:10.7326/L15-5077
Richard Bronson, MD
Ann Intern Med. 2015;162(7):525. doi:10.7326/M15-0112
Brijen J. Shah, MD; Nisha Rughwani, MD; Suzanne Rose, MD, MSEd
Ann Intern Med. 2015;162(7):ITC1. doi:10.7326/AITC201504070
Michael J. Green, MD, MS; Ray Rieck
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. 2015;162(7):W74-W79. doi:10.7326/G14-0009
Ann Intern Med. 2015;162(7):I-32. doi:10.7326/P15-9009
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