Michael D. George, MD, MSCE; Joshua F. Baker, MD, MSCE; Kevin Winthrop, MD, MPH; Evo Alemao, RPh, PhD; Lang Chen, PhD; Sean Connolly, PhD; Jesse Y. Hsu, PhD; Teresa A. Simon, MPH; Qufei Wu, MS; Fenglong Xie, MS; Shuo Yang, MS; Jeffrey R. Curtis, MD, MS, MPH
Patients, particularly those with rheumatoid arthritis (RA), are at increased risk for infection after major surgery. In this analysis, the authors examined risk for infection across different biologic medications and with exposure to glucocorticoids in a large sample of patients with RA who underwent a primary or revision total knee or hip arthroplasty.
Ann Intern Med. 2019;170(12):825-836. doi:10.7326/M18-2217
Supplemental Content
Jennifer L. Wolff, PhD; Lauren H. Nicholas, PhD; Amber Willink, PhD; John Mulcahy, MSPH; Karen Davis, PhD; Judith D. Kasper, PhD
This observational study, based on the 2015 NHATS (National Health and Aging Trends Study) and linked Medicare claims, quantified differences in health care spending associated with adequate support for daily activities among community-living older adults with disability.
Ann Intern Med. 2019;170(12):837-844. doi:10.7326/M18-2467
M. Hong Nguyen, MD; Cornelius J. Clancy, MD; A. William Pasculle, ScD; Peter G. Pappas, MD; George Alangaden, MD; George A. Pankey, MD; Bryan H. Schmitt, DO; Altaf Rasool, MD; Melvin P. Weinstein, MD; Raymond Widen, MD†; Diana R. Hernandez, PhD; Donna M. Wolk, PhD; Thomas J. Walsh, MD; John R. Perfect, MD; Mollie N. Wilson, MS; Eleftherios Mylonakis, MD
The T2Bacteria Panel is a direct-from-blood, nonculture test that detects 5 common bacterial pathogens. This multicenter study examines the performance of the test in diagnosing suspected bloodstream infections in hospitalized adults.
Ann Intern Med. 2019;170(12):845-852. doi:10.7326/M18-2772
Jordana B. Cohen, MD, MSCE; Michael J. Lotito; Usha K. Trivedi, BS; Matthew G. Denker, MD, MSCE; Debbie L. Cohen, MD; Raymond R. Townsend, MD
This systematic review and meta-analysis examines cardiovascular and mortality risks associated with untreated white coat hypertension and treated white coat effect.
Ann Intern Med. 2019;170(12):853-862. doi:10.7326/M19-0223
CME Supplemental Content
Amir Qaseem, MD, PhD, MHA; Devan Kansagara, MD, MCR; Jennifer S. Lin, MD, MCR; Reem A. Mustafa, MD, MPH, PhD; Timothy J. Wilt, MD, MPH; for the Clinical Guidelines Committee of the American College of Physicians
The American College of Physicians (ACP) Clinical Guidelines Committee, in collaboration with staff from the Clinical Policy department, develops clinical guidelines and guidance statements and continues to refine and enhance its methodology. This article presents an update of the methods used to develop ACP's clinical guidelines and guidance statements.
Ann Intern Med. 2019;170(12):863-870. doi:10.7326/M18-3290
Philip J. Candilis, MD; Daniel T. Kim, MA, MPH; Lois Snyder Sulmasy, JD; for the ACP Ethics, Professionalism and Human Rights Committee
This ACP position paper, which is informed by an environmental scan of the literature, provides advice to clinicians and health care institutions on how to respond to physicians who may be impaired.
Ann Intern Med. 2019;170(12):871-879. doi:10.7326/M18-3605
Keith D. Hentel, MD, MS; Andrew Menard, JD; John Mongan, MD; Jeremy C. Durack, MD; Pamela T. Johnson, MD; Ali S. Raja, MD, MBA, MPH; Ramin Khorasani, MD, MPH
Beginning 1 January 2020, providers ordering advanced imaging examinations (magnetic resonance imaging, computed tomography, and nuclear medicine studies) in outpatient and emergency department settings must use certified clinical decision support systems that meet approved appropriate use criteria as a prerequisite for payment for all patients covered by Medicare. This article explains the new regulations and program requirements.
Ann Intern Med. 2019;170(12):880-885. doi:10.7326/M19-0287
Bheeshma Ravi, MD, PhD; Gillian Hawker, MD, MSc
George and colleagues reported a cohort study that used administrative claims data to compare infection risk across biologic therapies in the setting of primary or revision hip or knee joint replacement surgery in adults with RA. The editorialists discuss the findings but note that this study does not resolve the question of whether withholding biologic therapies in the perioperative period reduces overall risk for infection complications.
Ann Intern Med. 2019;170(12):886-887. doi:10.7326/M19-1088
David A. Weinrib, MD; Gerald A. Capraro, PhD, D(ABMM)
Nguyen and colleagues reported on the performance of the T2Bacteria Panel, which combines polymerase chain reaction amplification and T2 magnetic resonance to identify 5 important pathogens: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. The editorialists discuss the findings and the additional evidence that is needed to evaluate the clinical usefulness of the assay.
Ann Intern Med. 2019;170(12):888-889. doi:10.7326/M19-0971
Daichi Shimbo, MD; Paul Muntner, PhD
Cohen and colleagues' systematic review and meta-analysis examined the associations between white coat hypertension and cardiovascular events and mortality. The editorialist discusses the findings, which provide contemporary data supporting U.S. and European guidelines that recommend out-of-office blood pressure monitoring.
Ann Intern Med. 2019;170(12):890-892. doi:10.7326/M19-1134
Jeffrey H. Samet, MD, MA, MPH; Jane Liebschutz, MD, MPH
In its position paper, ACP provided recommendations on identifying, managing, and treating impaired physicians. The editorialists commend ACP for addressing this difficult issue and setting forth principles to help guide everyone involved in identifying and managing physician impairment.
Ann Intern Med. 2019;170(12):893-894. doi:10.7326/M19-1192
Chloe Y. Li, BA
On one especially humid afternoon, we learned the head and neck examination. Then, my classmates and I learned I had a tumor.
Ann Intern Med. 2019;170(12):895-896. doi:10.7326/M19-0032
Audio
Colleen R. Kelly, MD
We had witnessed a power we could not understand or explain, but it was real. I felt deep stirrings of faith that I hadn't experienced since childhood.
Ann Intern Med. 2019;170(12):897-898. doi:10.7326/M19-0236
Dean Gianakos, MD
I asked myself, “How could I be so wrong about this? Am I possibly ending her life prematurely?”
Ann Intern Med. 2019;170(12):899. doi:10.7326/M18-2754
Ann Intern Med. 2019;170(12):901-904. doi:10.7326/L18-0589
Ann Intern Med. 2019;170(12):904-905. doi:10.7326/L18-0623
Ann Intern Med. 2019;170(12):905-906. doi:10.7326/L18-0593
Ann Intern Med. 2019;170(12):906-907. doi:10.7326/L19-0150
Ann Intern Med. 2019;170(12):907. doi:10.7326/L19-0153
Ann Intern Med. 2019;170(12):907-908. doi:10.7326/L19-0154
Ann Intern Med. 2019;170(12):908-909. doi:10.7326/L19-0155
Ann Intern Med. 2019;170(12):909. doi:10.7326/L19-0156
Ann Intern Med. 2019;170(12):909-910. doi:10.7326/L19-0157
Ann Intern Med. 2019;170(12):910. doi:10.7326/L19-0159
Ann Intern Med. 2019;170(12):910-911. doi:10.7326/L19-0160
Ann Intern Med. 2019;170(12):911. doi:10.7326/L19-0161
Ann Intern Med. 2019;170(12):911-912. doi:10.7326/L19-0162
Ann Intern Med. 2019;170(12):912. doi:10.7326/L19-0314
Lynette Lamp, MD
Ann Intern Med. 2019;170(12):900. doi:10.7326/M19-0238
Eric R. Bates, MD
Ann Intern Med. 2019;170(12):JC62. doi:10.7326/ACPJ201906180-062
Jonathan M. Kirschner, MD; Benton R. Hunter, MD
Ann Intern Med. 2019;170(12):JC63. doi:10.7326/ACPJ201906180-063
Ang Li, MD, MS; David A. Garcia, MD
Ann Intern Med. 2019;170(12):JC64. doi:10.7326/ACPJ201906180-064
Justin Lee, BScPhm, MD; Anne Holbrook, MD, PharmD
Ann Intern Med. 2019;170(12):JC65. doi:10.7326/ACPJ201906180-065
Michael J. Jacka, MD, MSc, MBA
Ann Intern Med. 2019;170(12):JC66. doi:10.7326/ACPJ201906180-066
Andrea Cervi, MD; James Douketis, MD
Ann Intern Med. 2019;170(12):JC67. doi:10.7326/ACPJ201906180-067
Jeffery Gray, MD; Patrick O’Malley, MD, MPH, FACP
Ann Intern Med. 2019;170(12):JC68. doi:10.7326/ACPJ201906180-068
Panagiotis I. Georgianos, MD, PhD; Rajiv Agarwal, MD, MBBS
Ann Intern Med. 2019;170(12):JC69. doi:10.7326/ACPJ201906180-069
John C. O’Horo, MD, MPH, FACP; Aaron J. Tande, MD
Ann Intern Med. 2019;170(12):JC70. doi:10.7326/ACPJ201906180-070
Clive Kearon, MB, FRCPC, PhD
Ann Intern Med. 2019;170(12):JC71. doi:10.7326/ACPJ201906180-071
Geno J. Merli, MD; Howard H. Weitz, MD
Annals Consult Guys brings a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.
Ann Intern Med. 2019;170(12):CG1. doi:10.7326/W18-0045
Video CME Supplemental Content
Darren B. Taichman, MD, PhD
Ann Intern Med. 2019;170(12):ED12. doi:10.7326/AWED201906180
David H. Wesorick, MD; Vineet Chopra, MD, MSc
Ann Intern Med. 2019;170(12):HO1. doi:10.7326/AWHO201906180
Lillian Min, MD, MSHS; Lona Mody, MD, MSc
To help hospitalists routinely and efficiently assess functional and cognitive decline brought on by acute illness in older patients, we suggest hospitalists use 4 GEMS (Geriatric Evaluation and Management Strategies) when admitting older patients to the hospital.
Ann Intern Med. 2019;170(12):HO2-HO3. doi:10.7326/M19-1372
Robert M. Centor, MD; Michael J. Blaha, MD, MPH
In this episode of Annals On Call, Dr. Centor discusses the use of coronary artery calcium testing in decision making about cardiovascular prevention with Dr. Michael Blaha.
Ann Intern Med. 2019;170(12):OC1. doi:10.7326/A19-0007
CME Audio
Michael Natter, MD
Progress Notes explores the everyday emotional, clinical, humorous, and ethical challenges of the medical residency training process. It appears monthly in Annals Graphic Medicine at Annals.org.
Ann Intern Med. 2019;170(12):W123-W124. doi:10.7326/G19-0023
Naveed Shah
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. 2019;170(12):W125-W126. doi:10.7326/G18-0029