Chintan V. Dave, PharmD; Aaron S. Kesselheim, MD, JD, MPH; Erin R. Fox, PharmD; Peihua Qiu, PhD; Abraham Hartzema, PharmD, MSPH, PhD
Substantial price increases for specific generic drugs have recently received national attention. Some reasons for these price increases include shortages in the manufacturing supply chain and reductions in the number of generic drug manufacturers. This study used prescription claims data from commercial health plans to examine the relationship between market competition levels and changes in generic drug prices between 2008 and 2013.
Ann Intern Med. 2017;167(3):145-151. doi:10.7326/M16-1432
Gene K. Ma, MD; Colleen M. Brensinger, MS; Qufei Wu, MS; James D. Lewis, MD, MSCE
Clostridium difficile infection (CDI) differs from most other infections in that it often recurs after treatment. This retrospective cohort study analyzed data on nearly 39 million commercially insured patients to evaluate whether incidence of multiply recurrent CDI (mrCDI) is increasing, determine whether any such increase is proportional to the increase in CDI, and identify risk factors for mrCDI among patients with an episode of CDI.
Ann Intern Med. 2017;167(3):152-158. doi:10.7326/M16-2733
Jason L. Vassy, MD, MPH, SM; Kurt D. Christensen, PhD, MPH; Erica F. Schonman, MPH; Carrie L. Blout, MS, CGC; Jill O. Robinson, MA; Joel B. Krier, MD; Pamela M. Diamond, PhD; Matthew Lebo, PhD; Kalotina Machini, PhD; Danielle R. Azzariti, MS, CGC; Dmitry Dukhovny, MD, MPH; David W. Bates, MD, MSc; Calum A. MacRae, MD, PhD; Michael F. Murray, MD; Heidi L. Rehm, PhD; Amy L. McGuire, JD, PhD; Robert C. Green, MD, MPH,; for the MedSeq Project
The clinical value of whole-genome sequencing (WGS) in asymptomatic adults is uncertain. This pilot trial describes the effects on care of adding WGS to standardized family history assessment in primary care and observed that it revealed new molecular findings of uncertain clinical utility and prompted clinical actions of unclear value.
Ann Intern Med. 2017;167(3):159-169. doi:10.7326/M17-0188
Derek K. Chu, MD, PhD; Christopher M. Hillis, MD, MSc; Darryl P. Leong, MBBS(Hons), MPH, MBiostat, PhD; Sonia S. Anand, MD, PhD; Deborah M. Siegal, MD, MSc
This systematic review examines current evidence about the benefits and risks of antiplatelet therapy for adults with essential thrombocythemia, a disorder associated with high risk for both thrombosis and hemorrhage.
Ann Intern Med. 2017;167(3):170-180. doi:10.7326/M17-0284
Joseph W. Frank, MD, MPH; Travis I. Lovejoy, PhD, MPH; William C. Becker, MD; Benjamin J. Morasco, PhD; Christopher J. Koenig, PhD; Lilian Hoffecker, PhD, MLS; Hannah R. Dischinger, BS; Steven K. Dobscha, MD; Erin E. Krebs, MD, MPH
This systematic review of 67 studies examines the effectiveness of 8 strategies to reduce or discontinue long-term opioid therapy in adults with chronic pain.
Ann Intern Med. 2017;167(3):181-191. doi:10.7326/M17-0598
Risa B. Burns, MD, MPH; Gerald W. Smetana, MD; Roscoe Brady, MD, PhD
This Grand Rounds summarizes a discussion between 2 experts on how they would treat a 64-year-old man with depression who is reluctant to begin medication.
Ann Intern Med. 2017;167(3):192-199. doi:10.7326/M17-0966
Jean P. Hall, PhD
High-risk pools are included as a state option in the American Health Care Act recently passed by the U.S. House of Representatives. This commentary discusses what we know about the past performance of high-risk pools and why reinstituting them would be a huge step backward for U.S. health care policy.
Ann Intern Med. 2017;167(3):200-201. doi:10.7326/M17-1196
Sameer D. Saini, MD, MS; Akbar K. Waljee, MD, MSc
Ma and colleagues report a retrospective cohort study to address gaps in our knowledge about mrCDI. The editorialists discuss the study's findings and limitations and why a better understanding of the epidemiology of mrCDI is a critical first step toward developing a sound strategy to address this growing problem.
Ann Intern Med. 2017;167(3):202-203. doi:10.7326/M17-1565
Teri A. Manolio, MD, PhD
Vassy and colleagues found that adding WGS to standardized family history assessment revealed new molecular findings of uncertain clinical utility. The editorialist discusses the findings and asks whether WGS will truly improve patient outcomes.
Ann Intern Med. 2017;167(3):204-205. doi:10.7326/M17-1518
Joel S. Bennett, MD
Chu and colleagues' systematic review examined the benefits and risks of treating patients with essential thrombocythemia with antiplatelet agents. The editorialist discusses the uncertainty the review uncovers and the need for high-quality trials to definitively address this important clinical question.
Ann Intern Med. 2017;167(3):206-207. doi:10.7326/M17-1378
Deborah Dowell, MD, MPH; Tamara M. Haegerich, PhD
The editorialists discuss Frank and colleagues' findings and how they show that it is possible to reduce opioid use and associated risks while reducing pain and improving function and quality of life.
Ann Intern Med. 2017;167(3):208-209. doi:10.7326/M17-1402
Brian J. Hemens, BScPhm, MSc, RPh; Alfonso Iorio, MD, PhD
Shekelle and colleagues describe important refinements to machine-learning software designed to reduce the need for human activity to identify relevant studies for a systematic review update. The editorialists discuss the findings and call on reviewers to evaluate these efficiency-boosting methods and reevaluate their approach to updating reviews.
Ann Intern Med. 2017;167(3):210-211. doi:10.7326/M17-1295
Raphael Karkowsky, MD
Ann Intern Med. 2017;167(3):212. doi:10.7326/M17-1147
Ann Intern Med. 2017;167(3):213-215. doi:10.7326/L17-0124
Ann Intern Med. 2017;167(3):215-216. doi:10.7326/L17-0102
Ann Intern Med. 2017;167(3):216-218. doi:10.7326/L16-0588
Ann Intern Med. 2017;167(3):218-219. doi:10.7326/L17-0253
Ann Intern Med. 2017;167(3):218. doi:10.7326/L17-0254
Ann Intern Med. 2017;167(3):219. doi:10.7326/L17-0255
Ann Intern Med. 2017;167(3):219-220. doi:10.7326/L17-0256
Ann Intern Med. 2017;167(3):220. doi:10.7326/L17-0257
Kristine E. Ensrud, MD, MPH; Carolyn J. Crandall, MD, MS
Ann Intern Med. 2017;167(3):ITC17-ITC32. doi:10.7326/AITC201708010
Darren B. Taichman, MD, PhD
Ann Intern Med. 2017;167(3):ED3. doi:10.7326/AFED201708010
Kartik A. Valluri, MD
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. 2017;167(3):W35. doi:10.7326/G17-0003
Ann Intern Med. 2017;167(3):I-20. doi:10.7326/P17-9040
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