Christopher E. Cox, MD; Douglas B. White, MD; Catherine L. Hough, MD; Derek M. Jones, MDiv; Jeremy M. Kahn, MD; Maren K. Olsen, PhD; Carmen L. Lewis, MD; Laura C. Hanson, MD; Shannon S. Carson, MD
Patients requiring prolonged mechanical ventilation face high morbidity and mortality and frequently lack decisional capacity. Decision aids might help align understanding of patient prognosis between surrogate decision makers and clinicians to better inform discussions regarding plans of care. This randomized trial assessed whether a decision aid improved agreement on patient prognosis between surrogates and clinicians.
Ann Intern Med. 2019;170(5):285-297. doi:10.7326/M18-2335
Jiapeng Lu, MD, PhD; Yuan Lu, ScD; Hao Yang, BSc; Wuhan Bilige, MB; Yetong Li, BSc; Wade Schulz, MD, PhD; Frederick A. Masoudi, MD, PhD; Harlan M. Krumholz, MD, PhD
Although cardiovascular disease (CVD) accounts for 40% of deaths in China, information on the risks for CVD and how to manage it is lacking. This study of more than 1 million Chinese persons assessed the prevalence and treatment of those at high risk for CVD.
Ann Intern Med. 2019;170(5):298-308. doi:10.7326/M18-1932
Robert E. Brutcher, PharmD, PhD; Connie Kurihara, RN; Mark C. Bicket, MD; Parvaneh Moussavian-Yousefi, PharmD; David E. Reece, MD; Lisa M. Solomon, BS; Scott R. Griffith, MD; David E. Jamison, MD; Steven P. Cohen, MD
The use of compounded topical pain creams has increased dramatically, yet their effectiveness has not been well evaluated. This trial assessed the effectiveness of compounded creams versus placebo for treating localized chronic pain.
Ann Intern Med. 2019;170(5):309-318. doi:10.7326/M18-2736
Thomas F. Imperiale, MD; Rachel N. Gruber, MS; Timothy E. Stump, MA; Thomas W. Emmett, MD; Patrick O. Monahan, PhD
This systematic review of 31 studies updates information about the performance characteristics of fecal immunochemical tests (FITs) for colorectal cancer (CRC) and advanced adenomas in average-risk persons having screening colonoscopy.
Ann Intern Med. 2019;170(5):319-329. doi:10.7326/M18-2390
K.M. Venkat Narayan, MD; Shivani A. Patel, PhD; Solveig A. Cunningham, PhD; James Curran, MD
This commentary describes the recent reversal of health gains in the United States due to increases in midlife mortality rates among many groups. The authors' solution is to equally emphasize research and allocate resources on biological, socioeconomic, and political determinants of health.
Ann Intern Med. 2019;170(5):330-331. doi:10.7326/M18-3653
Deborah Mascalzoni, PhD; Heidi Beate Bentzen, LLM; Isabelle Budin-Ljøsne, PhD; Lee Andrew Bygrave, LLD; Jessica Bell, PhD; Edward S. Dove, PhD; Christian Fuchsberger, PhD; Kristian Hveem, MD, PhD; Michaela Th. Mayrhofer, PhD; Viviana Meraviglia, PhD; David R. O'Brien, JD; Cristian Pattaro, PhD; Peter P. Pramstaller, MD; Vojin Rakić, PhD; Alessandra Rossini, PhD; Mahsa Shabani, PhD; Dan Jerker B. Svantesson, PhD; Marta Tomasi, PhD; Lars Ursin, PhD; Matthias Wjst, MD; Jane Kaye, DPhil
New efforts and requirements to deposit data in research repositories are necessary to protect privacy interests and comply with the European Union's General Data Protection Regulation. The authors discuss some of the conflicts involved and why they must be reconciled to support ethical and lawful data sharing.
Ann Intern Med. 2019;170(5):332-334. doi:10.7326/M18-2854
Heidi Beate Bentzen, LLM; Njål Høstmælingen, LLM
The health care community is concerned that the European Union's General Data Protection Regulation may impede the flow of information needed to facilitate research and improve care. The authors address these concerns and contend that the regulation specifically aims to facilitate the free movement of data within the European Union rather than restrict or prohibit it.
Ann Intern Med. 2019;170(5):335-337. doi:10.7326/M18-2782
Aaron M. Tannenbaum, MD; Scott D. Halpern, MD, PhD
Cox and colleagues examined whether a surrogate decision aid improves clinician–surrogate concordance on estimates of 1-year survival or any of several patient and surrogate outcomes for patients receiving prolonged mechanical ventilation. They found no such benefit. The editorialists posit that interventions that merely enhance knowledge and induce deliberation may never promote better surrogate decision making.
Ann Intern Med. 2019;170(5):338-339. doi:10.7326/M18-3691
Paul K. Whelton, MB, MD, MSc; Lisandro D. Colantonio, MD, PhD
Lu and colleagues estimated the prevalence of high CVD risk in a cohort of almost 1.7 million Chinese adults aged 35 to 75 years with no history of a CVD event. The editorialists see these findings as an important call to action for highly populated middle- and low-income countries in which worsening of the CVD risk factor profile is outpacing the current health sector response.
Ann Intern Med. 2019;170(5):340-341. doi:10.7326/M18-3301
James Allison, MD
Imperiale and colleagues' systematic review included 31 studies involving 120 255 patients and concluded that single-application FITs have moderate to high sensitivity and specificity for CRC, depending on the positivity threshold. The editorialist discusses why these findings, combined with other evidence, should help to reassure physicians and patients about the performance of FITs for CRC detection.
Ann Intern Med. 2019;170(5):342-343. doi:10.7326/M19-0301
Marcus D. Ruopp, MD
Instead of the doctor, I was part of the family—on the other side of the looking glass, without any information other than what was provided to me.
Ann Intern Med. 2019;170(5):344-345. doi:10.7326/M18-3413
Avital Y. O'Glasser, MD
How can we know what a small window of time potentially holds for a patient unless we ask?
Ann Intern Med. 2019;170(5):346-347. doi:10.7326/M18-2837
Ann Intern Med. 2019;170(5):351-352. doi:10.7326/L18-0359
Ann Intern Med. 2019;170(5):352-354. doi:10.7326/M18-2415
Ann Intern Med. 2019;170(5):354-356. doi:10.7326/M18-2246
Ann Intern Med. 2019;170(5):356. doi:10.7326/L18-0637
Ann Intern Med. 2019;170(5):356. doi:10.7326/L19-0048
Jack Coulehan, MD
Ann Intern Med. 2019;170(5):348. doi:10.7326/M18-2713
Ann Intern Med. 2019;170(5):348. doi:10.7326/M19-0312
Ann Intern Med. 2019;170(5):349. doi:10.7326/M19-0311
John C. Mannone, MS
Ann Intern Med. 2019;170(5):350. doi:10.7326/M18-3306
Adam Gilden Tsai, MD, MSCE; Daniel H. Bessesen, MD
Ann Intern Med. 2019;170(5):ITC33-ITC48. doi:10.7326/AITC201903050
Darren B. Taichman, MD, PhD
Ann Intern Med. 2019;170(5):ED5. doi:10.7326/AWED201903050
Robert M. Centor, MD; Meagan Gray, MD
In this episode of Annals On Call, Dr. Centor discusses nonalcoholic fatty Liver disease with Dr. Meagan Gray, Assistant Professor of Medicine, University of Alabama.
Ann Intern Med. 2019;170(5):OC1. doi:10.7326/A18-0015
Grace E. Farris, MD
Dr. Mom explores the challenges and ups and downs of juggling life as a hospitalist and mother. The feature appears monthly in Annals Graphic Medicine at Annals.org.
Ann Intern Med. 2019;170(5):W80-W81. doi:10.7326/G18-0043
Ann Intern Med. 2019;170(5):I-20. doi:10.7326/P18-0023
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