Meredith Vanstone, PhD; Thanh H. Neville, MD, MSHS; France J. Clarke, RRT; Marilyn Swinton, MSc; Marina Sadik, MA; Alyson Takaoka, MSc; Orla Smith, RN, PhD; Andrew J. Baker, MD; Allana LeBlanc, RN, MScN; Denise Foster, RN; Vinay Dhingra, MD; Peter Phung, MD, MBA; Xueqing (Sherry) Xu, RN, MSN, CCRN; Yuhan Kao, RN, MSN; Diane Heels-Ansdell, MSc; Benjamin Tam, MD, MSc; Feli Toledo, MDiv; Anne Boyle, MD; Deborah J. Cook, MD, MSc
The 3 Wishes Project was pioneered in an academic medical center's intensive care unit to promote compassionate end-of-life care by eliciting and fulfilling the wishes of dying patients or their families. This study evaluates the implementation and value of this project in various intensive care units and medical centers.
Ann Intern Med. 2020;172(1):1-11. doi:10.7326/M19-2438
John A. Dodson, MD, MPH; Alexandra M. Hajduk, PhD, MPH; Mary Geda, RN, MSN; Harlan M. Krumholz, MD; Terrence E. Murphy, PhD; Sui Tsang, MS; Mary E. Tinetti, MD; Michael G. Nanna, MD; Richard McNamara, MD; Thomas M. Gill, MD; Sarwat I. Chaudhry, MD
Older adults have increased risk for death after acute myocardial infarction (AMI). This article describes the development and initial validation of a risk prediction model that incorporates information on functional impairments and its utility in predicting 6-month mortality among older adults who were hospitalized with AMI and discharged alive.
Ann Intern Med. 2020;172(1):12-21. doi:10.7326/M19-0974
Jean-François Laprise, PhD; Harrell W. Chesson, PhD; Lauri E. Markowitz, MD; Mélanie Drolet, PhD; Dave Martin, PhD; Élodie Bénard, MSc; Marc Brisson, PhD
In the United States, the vaccine against human papillomavirus is usually administered to girls and boys beginning just before the start of adolescence. Studies have shown that the vaccine prevents cancer and saves money when it is given this way. The U.S. Food and Drug Administration recently approved the vaccine for use in women and men up to age 45, and this article estimates the cost-effectiveness of the vaccine in these adults.
Ann Intern Med. 2020;172(1):22-29. doi:10.7326/M19-1182
David M. Kent, MD, MS; Jessica K. Paulus, ScD; David van Klaveren, PhD; Ralph D'Agostino, PhD; Steve Goodman, MD, MHS, PhD; Rodney Hayward, MD; John P.A. Ioannidis, MD, DSc; Bray Patrick-Lake, MFS; Sally Morton, PhD; Michael Pencina, PhD; Gowri Raman, MBBS, MS; Joseph S. Ross, MD, MHS; Harry P. Selker, MD, MSPH; Ravi Varadhan, PhD; Andrew Vickers, PhD; John B. Wong, MD; Ewout W. Steyerberg, PhD
Subgroup analyses contrasting effects in groups of patients defined as “1 variable at a time” are typically used to examine heterogeneity of treatment effects in randomized trials. This guidance—the PATH (Predictive Approaches to Treatment effect Heterogeneity) Statement—presents alternative modeling approaches that account for multiple variables simultaneously to better identify individualized treatment effects.
Ann Intern Med. 2020;172(1):35-45. doi:10.7326/M18-3667
David M. Kent, MD, MS; David van Klaveren, PhD; Jessica K. Paulus, ScD; Ralph D'Agostino, PhD; Steve Goodman, MD, MHS, PhD; Rodney Hayward, MD; John P.A. Ioannidis, MD, DSc; Bray Patrick-Lake, MFS; Sally Morton, PhD; Michael Pencina, PhD; Gowri Raman, MBBS, MS; Joseph S. Ross, MD, MHS; Harry P. Selker, MD, MSPH; Ravi Varadhan, PhD; Andrew Vickers, PhD; John B. Wong, MD; Ewout W. Steyerberg, PhD
The PATH Statement presents modeling approaches that facilitate prediction of individualized treatment effects. This explanation and elaboration document, available at Annals.org, details the PATH recommendations, underpinning concepts, and implications.
Ann Intern Med. 2020;172(1):W1-W25. doi:10.7326/M18-3668
Holger J. Schünemann, MD, PhD, MSc; Donata Lerda, PhD; Cecily Quinn, MD; Markus Follmann, MD, MPH, MSc; Pablo Alonso-Coello, MD, PhD; Paolo Giorgi Rossi, PhD; Annette Lebeau, MD; Lennarth Nyström, PhD; Mireille Broeders, PhD; Lydia Ioannidou-Mouzaka, MD; Stephen W. Duffy, BSc, MSc, CStat; Bettina Borisch, MD; Patricia Fitzpatrick, MD; Solveig Hofvind, PhD; Xavier Castells, MD, PhD; Livia Giordano, MD; Carlos Canelo-Aybar, MD, MSc; Sue Warman, MEd; Robert Mansel, MD; Francesco Sardanelli, MD; Elena Parmelli, PhD; Axel Gräwingholt, MD; Zuleika Saz-Parkinson, PhD; for the European Commission Initiative on Breast Cancer (ECIBC) Contributor Group
This synopsis of the European Breast Guidelines discusses 15 key recommendations related to organized programs for breast cancer screening in women aged 40 to 75 years at average risk. Recommendations address the method and frequency of screening; the addition of hand-held ultrasonography, automated breast ultrasonography, or magnetic resonance imaging compared with mammography screening alone; and tests for women who are recalled for suspicious lesions or who have high breast density.
Ann Intern Med. 2020;172(1):46-56. doi:10.7326/M19-2125
Randol W. Hooper II, MBBS, MS; Jamie L. Garfield, MD
In the context of the emergence of vaping-associated pulmonary injury (VAPI), this commentary discusses what we know about the health effects of vaping and, more important, what we need to learn. Research on the respiratory toxicity of vaporized e-cigarette compounds and cannabis extracts, population studies on consumption patterns, and increased physician attention are urgently needed to mitigate the effects of VAPI.
Ann Intern Med. 2020;172(1):57-58. doi:10.7326/M19-2908
Fei Wang, PhD; Rainu Kaushal, MD, MPH; Dhruv Khullar, MD, MPP
Health care applications of artificial intelligence (AI) have recently emerged. Artificial intelligence approaches, such as deep learning, rely on vast amounts of data and complex model structures with millions of parameters, making them difficult to understand. Thus, these models are often called “black boxes.” Should physicians and other stakeholders demand greater insight into how AI algorithms work?
Ann Intern Med. 2020;172(1):59-60. doi:10.7326/M19-2548
Vineet Chopra, MD, MSc; Lynn Janssen, MS, CIC, CPHQ; Kristina Bryant, MD; Loretta Fauerbach, MS, CIC; Thomas R. Talbot III, MD, MPH; Hillary M. Babcock, MD, MPH
With an influx of new infection control products, the Centers for Disease Control and Prevention asked the Healthcare Infection Control Practices Advisory Committee to develop a process to inform committees considering product-related recommendations. This article describes the development of that process and a tool that may be used when guidelines or recommendations for such products are being developed.
Ann Intern Med. 2020;172(1):30-34. doi:10.7326/M19-2172
Dhruv S. Kazi, MD, MSc, MS; Kirsten Bibbins-Domingo, PhD, MD, MAS
In this issue, Dodson and colleagues report the development of a prediction model for all-cause mortality 6 months after myocardial infarction among older adults that incorporates measures of functional impairment. The editorialists discuss the models; the increasing use of prediction models to identify patients at the highest risk; and the need to develop, test, and deploy interventions to help address their needs.
Ann Intern Med. 2020;172(1):61-62. doi:10.7326/M19-3662
A. Russell Localio, PhD; Cynthia D. Mulrow, MD, MSc; Michael E. Griswold, PhD
Kent and colleagues describe 2 alternatives to subgroup analyses to help personalize clinical trial results: “risk modeling” and “effect modeling.” The editorialists commend the authors for moving beyond subgroup analyses and look forward to methodological enhancements that address the substantial complexities of identifying and evaluating treatment effect heterogeneity.
Ann Intern Med. 2020;172(1):63-64. doi:10.7326/M19-3010
Joann G. Elmore, MD, MPH; Christoph I. Lee, MD, MS
This issue includes a summary of the European Breast Guidelines, developed by an international multidisciplinary panel and based on a high-quality evidence review of breast cancer screening in the context of European organized screening programs. The editorialists discuss the recommendations and their implications for women and clinicians in the United States.
Ann Intern Med. 2020;172(1):65-66. doi:10.7326/M19-3104
Lauren F. Collins, MD
We must do better. These men deserve better.
Ann Intern Med. 2020;172(1):67-68. doi:10.7326/M19-1996
Jenny C. Dohlman, MD
Was it the weight of the shackles that prevented him from wiping the tear away, or was it something else?
Ann Intern Med. 2020;172(1):69. doi:10.7326/M19-2173
Ann Intern Med. 2020;172(1):70-72. doi:10.7326/M19-0476
Ann Intern Med. 2020;172(1):72. doi:10.7326/L19-0620
Ann Intern Med. 2020;172(1):72-73. doi:10.7326/L19-0621
Ann Intern Med. 2020;172(1):73-74. doi:10.7326/L19-0714
Ann Intern Med. 2020;172(1):74. doi:10.7326/L19-0715
Ann Intern Med. 2020;172(1):75. doi:10.7326/L19-0716
Ann Intern Med. 2020;172(1):75-76. doi:10.7326/L19-0721
Joshua Elliott Rubin, MD; Sheila E. Crowe, MD
Ann Intern Med. 2020;172(1):ITC1-ITC16. doi:10.7326/AITC202001070
Darren B. Taichman, MD, PhD
Ann Intern Med. 2020;172(1):ED1. doi:10.7326/AWED202001070
Robert M. Centor, MD; Chad Burski, MD
In this episode of Annals On Call, Dr. Centor discusses the approach to patients with upper gastrointestinal bleeding with Dr. Chad Burski.
Ann Intern Med. 2020;172(1):OC1. doi:10.7326/A19-0021
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. 2020;172(1):W26-W27. doi:10.7326/G19-0075
Annie Zhu, BHSc; Arnav Agarwal, 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. 2020;172(1):W28. doi:10.7326/G19-0063
Charlotte A. Wu, MD; Kimberly R. Myers, MA, PhD; Zoe S. Schein, MA; Molly Osborne, MD, PhD
Ann Intern Med. 2020;172(1):W29-W35. doi:10.7326/G19-0004
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