François-Xavier Mahon, MD, PhD; Carla Boquimpani, MD; Dong-Wook Kim, MD, PhD; Noam Benyamini, MD; Nelma Cristina D. Clementino, MD; Vasily Shuvaev, MD; Sikander Ailawadhi, MD; Jeffrey Howard Lipton, MD, PhD; Anna G. Turkina, MD; Raquel De Paz, MD, PhD; Beatriz Moiraghi, MD; Franck E. Nicolini, MD, PhD; Jolanta Dengler, MD; Tomasz Sacha, MD, PhD; Naoto Takahashi, MD, PhD; Rafik Fellague-Chebra, MD, MSc; Sandip Acharya, MSc; Stephane Wong, PhD, MSc; Yu Jin, MSc; Timothy P. Hughes, MD
For patients with chronic myeloid leukemia who achieve sustained deep molecular response (DMR) after treatment with imatinib, treatment-free remission (TFR) is possible. A single-group, phase 2 clinical trial investigated TFR in patients who achieved sustained DMR only after switching from imatinib to nilotinib.
Ann Intern Med. 2018;168(7):461-470. doi:10.7326/M17-1094
Beverly E. Thorn, PhD; Joshua C. Eyer, PhD; Benjamin P. Van Dyke, MA; Calia A. Torres, MA; John W. Burns, PhD; Minjung Kim, PhD; Andrea K. Newman, MA; Lisa C. Campbell, PhD; Brian Anderson, PsyD; Phoebe R. Block, MA; Bentley J. Bobrow, MD; Regina Brooks; Toya T. Burton, DC, MPH; Jennifer S. Cheavens, PhD; Colette M. DeMonte, PsyD; William D. DeMonte, PsyD; Crystal S. Edwards; Minjeong Jeong, PhD; Mazheruddin M. Mulla, MA, MPH; Terence Penn, BS; Laura J. Smith, BA; Deborah H. Tucker, MBA
Guidelines encourage the use of nonpharmacologic therapies, such as cognitive behavioral therapy (CBT), for pain management. However, low-income patients with pain may have decreased access to CBT because of low health literacy or limited time and resources. This randomized controlled trial compared the efficacy of group-based, literacy-adapted CBT or an educational program versus usual care among socioeconomically disadvantaged patients with chronic pain symptoms.
Ann Intern Med. 2018;168(7):471-480. doi:10.7326/M17-0972
Charles J. Kahi, MD, MSc; Heiko Pohl, MD; Laura J. Myers, PhD; Dalia Mobarek, MD, MSc; Douglas J. Robertson, MD; Thomas F. Imperiale, MD
Inconsistent findings have led to uncertainty about whether colonoscopy is associated with decreased mortality from both left- and right-sided colorectal cancer (CRC). This study used data from the largest integrated health provider in the United States, the Veterans Health Administration, to assess whether colonoscopy was associated with reduced mortality from left- and right-sided CRC.
Ann Intern Med. 2018;168(7):481-488. doi:10.7326/M17-0723
Canqing Yu, PhD; Haijing Tang, PhD; Yu Guo, MSc; Zheng Bian, MSc; Ling Yang, PhD; Yiping Chen, DPhil; Aiyu Tang, MD; Xue Zhou, PhD; Xu Yang, PhD; Junshi Chen, MD; Zhengming Chen, DPhil; Jun Lv, PhD; Liming Li, MD, MPH; on behalf of the China Kadoorie Biobank Collaborative Group
Although some studies have suggested that the temperature at which tea is consumed may be a risk factor for esophageal cancer, previous analyses did not adequately adjust for patterns of smoking and alcohol use. This large population-based study simultaneously adjusted for tea temperature, smoking, and alcohol consumption to assess their associations with esophageal cancer.
Ann Intern Med. 2018;168(7):489-497. doi:10.7326/M17-2000
Anjala V. Tess, MD; Melissa L.P. Mattison, MD; Joshua R. Leo, MD, MPH; Eileen E. Reynolds, MD
A psychiatrist and a geriatrician debate whether a 79-year-old man at high risk for postoperative delirium should receive prophylactic antipsychotics with his next surgery. They review risk factors, appropriate evaluation, and potential benefits and harms of the various medications often used in this setting.
Ann Intern Med. 2018;168(7):498-505. doi:10.7326/M18-0388
Lisa Soleymani Lehmann, MD, PhD; Lois Snyder Sulmasy, JD; Sanjay Desai, MD; for the ACP Ethics, Professionalism and Human Rights Committee
Hidden curricula are lessons embedded in culture that are not explicitly intended. In the field of medicine, the hidden curriculum powerfully influences student and resident norms and values. This position paper from the American College of Physicians focuses on ethics, professionalism, and the hidden curriculum and identifies challenges, opportunities, and strategies for optimizing learning environments.
Ann Intern Med. 2018;168(7):506-508. doi:10.7326/M17-2058
Krisda H. Chaiyachati, MD, MPH, MSHP; Jay Bhatt, DO, MPH, MPA; Jane M. Zhu, MD, MPP
Evidence suggests that the current growth in value-based payment models may unintentionally worsen health care disparities by disadvantaging hospitals caring for socially at-risk populations. To address this tension, value-based payment models should adopt a disparities-sensitive frame shift to integrate measures of equity into hospitals' financial calculus, incentivizing hospitals to tackle the disparities challenge without losing sight of quality.
Ann Intern Med. 2018;168(7):509-510. doi:10.7326/M17-2590
Austin B. Frakt, PhD; Craig Garthwaite, PhD
Through mergers and acquisitions, health care organizations are making large bets about the future of the U.S. medical landscape and the types of organizations that can ultimately succeed in it. There's been a recent uptick in vertical integration, such as hospitals buying physician practices and insurers buying providers. This commentary discusses the recently announced merger of CVS and Aetna and whether it will benefit consumers.
Ann Intern Med. 2018;168(7):511-512. doi:10.7326/M17-3319
Kenneth G. Castro, MD; Dabney P. Evans, PhD, MPH; Carlos Del Rio, MD; James W. Curran, MD, MPH
Recently, it was reported that Centers for Disease Control and Prevention (CDC) staff were advised to avoid using the following 7 words in budget documents: “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based,” and “science-based.” This commentary discusses the implications of such censorship on the work and credibility of the CDC and other U.S. government health organizations.
Ann Intern Med. 2018;168(7):513-514. doi:10.7326/M17-3410
Miguel A. Hernán, MD, DrPH; Daniel Scharfstein, ScD
Intention-to-treat (ITT) analyses of randomized trials have been favored because they alleviate concerns about baseline confounding, but ITT analyses estimate the effect of being assigned to an intervention rather than that of actually receiving it. Regulators, pharmaceutical companies, and academics are advocating approaches to complement ITT analyses. This commentary presents specifications to consider for such approaches.
Ann Intern Med. 2018;168(7):515-516. doi:10.7326/M17-3354
Robert D. Kerns, PhD
The editorialist believes that Thorn and colleagues' study shows that an engaged health care organization and staff, small financial incentives for patient travel, and a patient-centered approach to service delivery can overcome at least some of the known barriers to psychological approaches to treating chronic pain.
Ann Intern Med. 2018;168(7):517-518. doi:10.7326/M18-0061
Farin Kamangar, MD, PhD; Neal D. Freedman, PhD, MPH
The editorialists discuss Yu and coworkers' findings in light of what is known about thermal irritation and cancer.
Ann Intern Med. 2018;168(7):519-520. doi:10.7326/M17-3370
Michael A. LaCombe, MD
In this editorial, a response to the American College of Physicians position paper on the hidden curriculum, the writer presents a fictional narrative that illustrates how teaching by example might work.
Ann Intern Med. 2018;168(7):521-522. doi:10.7326/M18-0336
Molly Imber, MD
Ann Intern Med. 2018;168(7):523. doi:10.7326/M17-2554
Ann Intern Med. 2018;168(7):525-526. doi:10.7326/L17-0705
Ann Intern Med. 2018;168(7):526-527. doi:10.7326/L17-0706
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Ann Intern Med. 2018;168(7):529-530. doi:10.7326/L18-0077
Ann Intern Med. 2018;168(7):530-532. doi:10.7326/L18-0076
Sylvia S. Villarreal, MEd, MPH
Ann Intern Med. 2018;168(7):497. doi:10.7326/M17-1909
Elizabeth Lahti, MD
Ann Intern Med. 2018;168(7):524. doi:10.7326/M17-2708
Mark Lebwohl, MD
Ann Intern Med. 2018;168(7):ITC49-ITC64. doi:10.7326/AITC201804030
Darren B. Taichman, MD, PhD
Ann Intern Med. 2018;168(7):ED7. doi:10.7326/AFED201804030
Michael S. Weinstein, MD
Building on the popular Annals feature “On Being a Doctor,” storytellers share stories about the experience of doctoring on video.
Ann Intern Med. 2018;168(7):SS1. doi:10.7326/W18-0001
Alison Bell, OTD, OTR/L
Ann Intern Med. 2018;168(7):SS1. doi:10.7326/W18-0002
Dana P. Perlman, MD
Ann Intern Med. 2018;168(7):SS1. doi:10.7326/W18-0003
Judd Hollander, MD
Ann Intern Med. 2018;168(7):SS1. doi:10.7326/W18-0004
Karen Alexander, MD
Ann Intern Med. 2018;168(7):SS1. doi:10.7326/W18-0005
Kimberly Carter, PharmD
Ann Intern Med. 2018;168(7):SS1. doi:10.7326/W18-0006
Caroline Shooner, MD
Take a minute's break and enjoy this month's brief look at a humorous side of medical practice.
Ann Intern Med. 2018;168(7):W18-W20. doi:10.7326/G17-0021
Ann Intern Med. 2018;168(7):I-18. doi:10.7326/P17-9054
Ann Intern Med. 2018;168(7):I-22. doi:10.7326/P18-0001
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