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.
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.
Albert W. Wu, MD, MPH; Victor J. Dzau, MD
Lessons learned from patient safety initiatives may be applied to reducing clinician burnout and alleviating the current crisis. Research on burnout has focused primarily on hospitals and trainees. Relatively little is known about the status of clinicians in ambulatory practice and the factors contributing to burnout in that setting. Research is needed on the most effective tools to identify burnout, as well as incentives to motivate change. Here, the authors identify 4 key lessons learned from successes in research, implementation, and policy.
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.
Stefan Tigges, 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.
Barbara J. Turner, MD, MSEd; Andrea Rochat, MFA; Sarah Lill, MAM; Raudel Bobadilla, BS; Ludivina Hernandez; Aro Choi, MS; Juan A. Guerrero, MD
The advent of highly effective direct-acting antiviral therapy for hepatitis C virus (HCV) infection has led to the call for elimination of hepatitis C in the near future. HCV disproportionately affects disadvantaged communities where the prevalence of infection is high and yet care delivery can be particularly challenging. The current study is a mixed-methods retrospective analysis describing the design and real-world implementation of a multicomponent intervention for HCV screening and care in safety-net primary care practices.
Andrew Conner, BS; Deborah Azrael, PhD; Matthew Miller, MD, MPH, ScD
The suicide case-fatality rate (CFR)—the proportion of suicidal acts that are fatal—depends on the distribution of methods used in suicidal acts and the probability of death given a particular method. In this cross-sectional study, the authors use data from 3 large databases for 2007 to 2014 to evaluate rates of suicide deaths and nonfatal suicide attempts, overall and method-specific CFRs, and distributions of methods used among persons aged 5 years or older.
Risa B. Burns, MD, MPH; Peter Zimetbaum, MD; Steven A. Lubitz, MD, MPH; Gerald W. Smetana, MD
Two cardiologists discuss the U.S. Preventive Services Task Force guidelines on atrial fibrillation and whether they would recommend anticoagulation for a specific patient with screen-detected atrial fibrillation.
Elizabeth Adler, MD
Darren B. Taichman, MD, PhD
Sanjay R. Patel, MD, MS
Robert M. Centor, MD; Fernando Ovalle, MD
In this episode of Annals On Call, Dr. Centor discusses the use of technology to improve diabetes management with Dr. Fernando Ovalle of the University of Alabama at Birmingham.
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.
Sehoon Park, MD; Soojin Lee, MD; Yaerim Kim, MD, PhD; Yeonhee Lee, MD; Min Woo Kang, MD; Kyungdo Han, PhD; Seung Seok Han, MD, PhD; Hajeong Lee, MD, PhD; Jung Pyo Lee, MD, PhD; Kwon Wook Joo, MD, PhD; Chun Soo Lim, MD, PhD; Yon Su Kim, MD, PhD; Dong Ki Kim, MD, PhD
Metabolic syndrome has become a growing public health problem worldwide. Much effort has been devoted to the prevention and treatment of this syndrome, because affected persons have increased risk for cardiovascular disease. The objective of this population-based retrospective cohort study was to evaluate the risk for major adverse cardiovascular events among persons who develop or recover from metabolic syndrome.
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.
Melissa B. Weimer, DO, MCR; Jeanette M. Tetrault, MD; David A. Fiellin, MD
There are ongoing efforts to lift training requirements for providers to prescribe buprenorphine for the treatment of opioid use disorder. These authors argue that such efforts, while well-meaning, are short-sighted, and that more rather than less training is needed.
Joann G. Elmore, MD, MPH; Christoph I. Lee, MD, MS
Annals has published 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.
Alex Koziarz, MSc; Niv Sne, MD; Fraser Kegel, BSc; Siddharth Nath, BSc; Jetan H. Badhiwala, MD; Farshad Nassiri, MD; Alireza Mansouri, MD; Kaiyun Yang, MD; Qi Zhou, PhD; Timothy Rice, MD; Samir Faidi, MD; Edward Passos, MD; Andrew Healey, MD; Laura Banfield, MLIS; Mark Mensour, MD; Andrew W. Kirkpatrick, MD; Aussama Nassar, MD; Michael G. Fehlings, MD; Gregory W.J. Hawryluk, MD; Saleh A. Almenawer, MD
This meta-analysis of 71 studies examines the accuracy of bedside optic nerve ultrasound for diagnosing increased intracranial pressure in persons with either traumatic or nontraumatic brain injury.
Kristen E. D'Anci, PhD; Stacey Uhl, MS; Jeffrey Oristaglio, PhD; Nancy Sullivan, BA; Amy Y. Tsou, MD, MSc
This review of 19 systematic reviews and 37 randomized trials summarizes evidence about the benefits and harms of nonpharmacologic and pharmacologic treatments for motor deficits and mood disorders in adults with stroke.
Scott R. Evans, PhD; Robert Bigelow, PhD; Christy Chuang-Stein, PhD; Susan S. Ellenberg, PhD; Paul Gallo, PhD; Weili He, PhD; Qi Jiang, PhD; Frank Rockhold, PhD
Data monitoring committees (DMCs) protect clinical trial participants by conducting benefit–risk assessments during the course of a clinical trial. To be effective, DMCs should have access to all data, including efficacy data, at each interim review and should produce reports with graphical summaries that clearly integrate the benefits and harms of interventions.
James Sall, PhD; Blessen C. Eapen, MD; Johanna Elizabeth Tran, MD; Amy O. Bowles, MD; Andrew Bursaw, DO; M. Eric Rodgers, PhD
This synopsis of a 2019 guideline from the U.S. Department of Veterans Affairs and U.S. Department of Defense summarizes key recommendations for rehabilitation care of patients who have suffered a stroke. Six areas, including timing and approach; motor therapy; dysphagia management; cognitive, speech, and sensory therapy; mental health therapy; and other functions, such as returning to work and driving, are addressed.
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.
Kathleen Y. Ogle, MD; Resa E. Lewiss, MD
In their systematic review, Koziarz and colleagues examine optic nerve ultrasonography for diagnosing increased intracranial pressure in children and adults. The editorialists encourage cautious interpretation of the findings because measurement of the optic nerve sheath diameter is more challenging than other bedside ultrasonography clinical applications.
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.
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 (Predictive Approaches to Treatment effect Heterogeneity) Statement presents modeling approaches that facilitate prediction of individualized treatment effects. This explanation and elaboration document details PATH recommendations, underpinning concepts, and implications.
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 “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.
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.
Michelle M. Mello, JD, PhD
In this issue, Delamater and colleagues project the percentage of California schoolchildren with a vaccination exemption under 3 scenarios: California law as it has stood since the 2015 passage of Senate Bill 277, which permits medical but not personal belief exemptions; the law as amended by Senate Bill 276, an attempt to tighten the circumstances for medical exemptions; and a hypothetical world in which neither law was implemented. The editorialist discusses the findings and proposes 5 provisions that laws narrowing vaccination exemptions should include.
Jonah Tischler, BA; Katherine D. Crew, MD, MS; Wendy K. Chung, MD, PhD
Genetic testing has improved the care of women with breast cancer, informing therapeutic and preventive management decisions. As a result of increasing availability and use of genetic testing, physicians frequently need to address patients' questions and concerns about the meaning of test results. The authors explain the importance of somatic and germline mutation analyses and their implications for patients and their families.
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.
John R. Stone, MD, PhD
Steinberg and colleagues report high but slowly declining U.S. mortality trends in patients with antineutrophil cytoplasmic autoantibody–associated vasculitides. The editorialist discusses the findings and why he believes that the apparently better outcomes observed in typically disadvantaged patient groups may hold clues to structural causes of health disparities.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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