Julie M. Donohue, PhD; Jason N. Kennedy, MS; Christopher W. Seymour, MD, MSc; Timothy D. Girard, MD, MSCI; Wei-Hsuan Lo-Ciganic, MSPharm, PhD; Catherine H. Kim, PharmD, BCPS, BCCCP; Oscar C. Marroquin, MD; Patience Moyo, PhD; Chung-Chou H. Chang, PhD; Derek C. Angus, MD, MPH
The opioid epidemic has prompted development of guidelines to reduce opioid prescribing for patients at high risk for opioid use disorder. Many of these efforts have focused on patients seen in the outpatient setting, but inpatient opioid use has received less attention. This study describes patterns in timing, duration, and setting of opioid administration among inpatients who were opioid-naive before admission.
Adam A. Markovitz, BS; John M. Hollingsworth, MD, MS; John Z. Ayanian, MD, MPP; Edward C. Norton, PhD; Phyllis L. Yan, MS; Andrew M. Ryan, PhD
An accountable care organization (ACO) is an organization of hospitals, doctors, and other clinicians who receive higher payments from Medicare if the ACO provides better-quality care that is less expensive. Previous research has found that ACOs create modest savings. This study suggests that some of the savings result from high-cost doctors leaving the ACO.
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.
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.
Lynn E. Fiellin, MD; Darilyn V. Moyer, MD
As in other industries, sexual harassment is a pervasive problem in health care and medicine, reported by up to 50% of medical students, faculty, and staff. This commentary describes the priorities of the nonprofit organization TIME'S UP Healthcare and its collaborative efforts with the American College of Physicians to address sexual harassment and ensure workplace safety and equity in health care.
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.
Marc R. Larochelle, MD, MPH; Amy S.B. Bohnert, PhD, MHS
In this issue, Donohue and colleagues examine inpatient opioid prescribing practices in a large health system over a 5-year period and report that among nearly 200 000 hospital admissions of opioid-naive patients, nearly half involved administration of an opioid analgesic. The editorialists believe that opioid stewardship is an important goal, but it is unlikely to have a substantial effect by itself on opioid-related harms. Efforts to deliver harm reduction services and treatment for opioid use disorder are also urgently needed.
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.
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.
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.
Dean Gianakos, MD
I asked myself, “How could I be so wrong about this? Am I possibly ending her life prematurely?”
Lynette Lamp, MD
Eric R. Bates, MD
Jonathan M. Kirschner, MD; Benton R. Hunter, MD
Ang Li, MD, MS; David A. Garcia, MD
Justin Lee, BScPhm, MD; Anne Holbrook, MD, PharmD
Michael J. Jacka, MD, MSc, MBA
Andrea Cervi, MD; James Douketis, MD
Jeffery Gray, MD; Patrick O’Malley, MD, MPH, FACP
Panagiotis I. Georgianos, MD, PhD; Rajiv Agarwal, MD, MBBS
John C. O’Horo, MD, MPH, FACP; Aaron J. Tande, MD
Clive Kearon, MB, FRCPC, PhD
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.
Darren B. Taichman, MD, PhD
David H. Wesorick, MD; Vineet Chopra, MD, MSc
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.
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.
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.
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.
Dan Li, MD; Elizabeth Hoodfar, MS, LCGC; Sheng-Fang Jiang, MS; Natalia Udaltsova, PhD; Nhung P. Pham, MD; Yves Jodesty, MD; Mary Anne Armstrong, MA; Yun-Yi Hung, PhD; Robin J. Baker, MD; Debbie Postlethwaite, RNP, MPH; Uri Ladabaum, MD, MS; Theodore R. Levin, MD; Douglas A. Corley, MD, PhD; JoAnn Bergoffen, MD
Guidelines recommend screening all patients with newly diagnosed colorectal cancer (CRC) for Lynch syndrome (LS), but the efficiency of universal LS screening in elderly persons has not been well studied. In this retrospective cohort study in a large community-based health care system, the authors investigated the performance of CRC tumor–based LS screening among different age groups.
Lauren J. Ralph, PhD; Eleanor Bimla Schwarz, MD; Daniel Grossman, MD; Diana Greene Foster, PhD
This study examines the self-reported physical health of women who sought abortion over 5 years after either receiving or being denied abortion services. Although some argue that abortion is detrimental to women's health, these data provide evidence that suggest otherwise.
Lisa H. Harris, MD, PhD; Vanessa Dalton, MD, MPH
In this issue, Ralph and colleagues compare long-term physical health outcomes between women who had an abortion and those who gave birth after being denied abortion care because of clinic gestational age limits. The editorialists discuss the findings and suggest that that the health of women may depend not only on not having a reason to seek abortion but also on being able to receive abortion should the need arise.
Tamara Beetham, BA; Brendan Saloner, PhD; Sarah E. Wakeman, MD; Marema Gaye, MA; Michael L. Barnett, MD, MS
Despite increasing attention on opioid addiction and overdoses, most persons with opioid use disorder have not received care within the past year. This study assessed how often and how quickly callers posing as patients seeking care for heroin use were offered appointments by publicly listed buprenorphine prescribers.
David Paje, MD, MPH; Mary A.M. Rogers, PhD, MS; Anna Conlon, PhD; Scott A. Flanders, MD; Steven J. Bernstein, MD, MPH; Vineet Chopra, MD, MSc
Guidelines from professional societies recommend that clinicians avoid placing peripherally inserted central catheters (PICCs) in patients with chronic kidney disease (CKD). This study used data from a multi-institutional quality collaborative in Michigan on a sample of hospitalized patients who received PICCs to describe the frequency and characteristics of placement in patients with CKD.
Pooja A. Lagisetty, MD, MSc; Amy Bohnert, PhD
Beetham and colleagues reported a “secret shopper” study that describes barriers patients face when seeking clinicians who provide buprenorphine treatment for opioid use disorders. The editorialists believe that the most pressing challenge is connecting patients to willing prescribers.
Marcia R. Silver, MD
In their article, Paje and colleagues report a study of peripherally inserted central catheter use in patients with chronic kidney disease (CKD). The editorialist discusses how vein protection depends on decision making by nonnephrologists caring for complex patients with CKD and the critical importance of education of the general medical community.
David Blumenthal, MD; Melinda K. Abrams, MS
In their article, DesRoches and colleagues report data that suggest that patients' access to their physicians' visit notes may improve their adherence to medication regimens. The editorialists discuss the findings and share their belief that the question is no longer whether patients should have full access to their health records but how to ensure that shared health care information improves patient outcomes.
Bruce Baird Struminger, MD, MA; Sanjeev Arora, MD
In their brief research report, Drake and colleagues call needed attention to rural America's poor health care access with their exploration of broadband Internet availability. The editorialists discuss the findings and recommend strategies to increase telehealth access that go beyond improving Internet service.
Joshua D. Wallach, MS, PhD; Harlan M. Krumholz, MD, SM
In their brief research report, Tatsioni and colleagues report the characteristics of large, registered, randomized controlled trials with long-unreported or unpublished results. The editorialists discuss the findings and believe that failure to report clinical trial results should be considered academic misconduct at the individual and institutional levels.
Howard A. Fink, MD, MPH; Roderick MacDonald, MS; Mary L. Forte, PhD, DC; Christina E. Rosebush, MPH; Kristine E. Ensrud, MD, MPH; John T. Schousboe, MD, PhD; Victoria A. Nelson, MSc; Kristen Ullman, MPH; Mary Butler, PhD, MBA; Carin M. Olson, MD, MS; Brent C. Taylor, MPH, PhD; Michelle Brasure, PhD, MSPH, MLIS; Timothy J. Wilt, MD, MPH
This systematic review of 48 studies examines the benefits and harms of long-term osteoporosis drug treatment, as well as the benefits and harms of treatment discontinuation and holidays.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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