Michael Fralick, MD, PhD, SM; Sarah K. Chen, MD, MPH; Elisabetta Patorno, MD, DrPH; Seoyoung C. Kim, MD, ScD, MSCE
Sodium–glucose cotransporter-2 (SGLT2) inhibitors block the reabsorption of glucose in the kidneys, resulting in glucosuria and increased excretion of uric acid. The association between SGLT2 inhibitor use and risk for gout is unclear. This analysis of health insurance claims data compares the risk for gout with use of SGLT2 inhibitors versus another second-line medication for type 2 diabetes mellitus.
J. Marc Overhage, MD, PhD; David McCallie Jr., MD
The amount of time that providers spend using electronic health records (EHRs) to support care delivery is a concern for the U.S. health care system. This study describes the amount of time ambulatory medical subspecialists and primary care physicians across several U.S. health care systems spend on various EHR functions.
Heidi D. Nelson, MD, MPH; Amy Cantor, MD, MPH; Jesse Wagner, MA; Rebecca Jungbauer, DrPH, MPH, MA; Ana Quiñones, PhD, MS; Lucy Stillman, BS; Karli Kondo, PhD, MA
This systematic review examines the effects of provider and population barriers on adoption and implementation of 10 preventive services, as well as the effectiveness of interventions (provider–patient approaches, health information technologies, and health organization and system interventions) to improve adoption and implementation of the services in populations adversely affected by disparities.
Timothy S. Carey, MD, MPH*; Betty Bekemeier, PhD, MPH, RN†; Doug Campos-Outcalt, MD, MPA†; Susan Koch-Weser, ScD, MSc†; Sandra Millon-Underwood, PhD, RN†; Steven Teutsch, MD, MPH†
This position paper, from the National Institutes of Health Pathways to Prevention Workshop, presents 26 research recommendations to reduce health disparities in the use of effective preventive services.
Douglas S. Krakower, MD; Demetre C. Daskalakis, MD; Judith Feinberg, MD; Julia L. Marcus, PhD
In October 2019, the U.S. Food and Drug Administration approved tenofovir alafenamide with emtricitabine (TAF–FTC) as a new option for preexposure prophylaxis (PrEP) for HIV prevention. In this essay, the authors compare and contrast TAF–FTC versus tenofovir disoproxil fumarate with emtricitabine, which was the only option for PrEP until recently. They ask whether clinicians should abandon the old treatment for the new treatment.
Michael Bretthauer, MD, PhD; Mette Kalager, MD, PhD
The review by Nelson and colleagues and position paper by Carey and colleagues focus on the National Institutes of Health's Pathways to Prevention Workshop for health equity in preventive services. The editorialists discuss these articles and note the importance of recognizing that disparities might be reduced not only by increasing participation in preventive services by minority groups, but also by reducing participation by majority populations.
Julia Adler-Milstein, PhD
Overhage and McCallie add to a growing number of studies that quantify the amount of time outpatient physicians spend using the electronic health record. The editorialist discusses the findings and the questions these data raise in the quest to make the electronic health record a tool that productively serves its many masters.
Sharon Ostfeld-Johns, 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.
Joan Walter, MD, PhD; Jeanne du Fay de Lavallaz, MD, PhD; Luca Koechlin, MD; Tobias Zimmermann, MD; Jasper Boeddinghaus, MD; Ursina Honegger, MSc; Ivo Strebel, MSc; Raphael Twerenbold, MD; Melissa Amrein, MSc; Thomas Nestelberger, MD; Desiree Wussler, MD; Christian Puelacher, MD, PhD; Patrick Badertscher, MD; Michael Zellweger, MD; Gregor Fahrni, MD; Raban Jeger, MD; Christoph Kaiser, MD; Tobias Reichlin, MD; Christian Mueller, MD
Previous work has shown that very low blood concentrations of high-sensitivity cardiac troponin (hs-cTn) can exclude inducible myocardial ischemia in most patients who have coronary artery disease but do not have symptoms of their disease. This study examined whether this strategy also is effective when used for similar patients with symptoms.
Susan J. Diem, MD, MPH; Nancy L. Greer, PhD; Roderick MacDonald, MS; Lauren G. McKenzie, MPH; Philipp Dahm, MD, MHSc; Nacide Ercan-Fang, MD; Allison Estrada, MD; Laura S. Hemmy, PhD; Christina E. Rosebush, MPH; Howard A. Fink, MD, MPH; Timothy J. Wilt, MD, MPH
This systematic review and meta-analysis of 38 randomized trials and 20 long-term observational studies describes the benefits and harms of testosterone treatment for men without underlying organic causes of hypogonadism.
Amir Qaseem, MD, PhD, MHA; Carrie A. Horwitch, MD, MPH; Sandeep Vijan, MD, MS; Itziar Etxeandia-Ikobaltzeta, PhD; Devan Kansagara, MD, MCR; for the Clinical Guidelines Committee of the American College of Physicians
This clinical guideline from the American College of Physicians, endorsed by the American Academy of Family Physicians, provides recommendations about testosterone treatment in adult men with age-related low testosterone.
David U. Himmelstein, MD; Terry Campbell, MHA; Steffie Woolhandler, MD, MPH
Before Canada implemented a single-payer health system, its health costs and the number of health administrative personnel per capita were similar to the United States. By 1999, administration accounted for 31% of U.S. health expenditures versus 16.7% in Canada. This study compares administrative costs of health care in the 2 countries in 2017.
E. Victor Adlin, MD
The American College of Physicians Clinical Guidelines Committee provides recommendations for the use of testosterone treatment in men with age-related low testosterone. The editorialist discusses the recommendations and the importance of evidence-based use of testosterone replacement.
Katy J.L. Bell, MBChB, MMed(Clin Epi), PhD; Christopher Semsarian, MBBS, PhD, MPH; Jenny Doust, BMBS, PhD
In their article, Walter and colleagues investigate whether high-sensitivity cardiac troponin tests could be used to rule out inducible ischemia in patients with stable angina and conclude that they cannot. The editorialists discuss the findings and question whether stable obstructive disease needs excluding in the first place.
Lauren F. Collins, MD
We must do better. These men deserve better.
Jenny C. Dohlman, MD
Was it the weight of the shackles that prevented him from wiping the tear away, or was it something else?
Darren B. Taichman, MD, PhD
Joshua Elliott Rubin, MD; Sheila E. Crowe, MD
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.
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
Annie Zhu, BHSc; Arnav Agarwal, MD
Philip G. Conaghan, MBBS, PhD; Michael A. Bowes, PhD; Sarah R. Kingsbury, PhD; Alan Brett, PhD; Gwenael Guillard, PhD; Biljana Rizoska, PhD; Niclas Sjögren, PhLic; Philippa Graham, MBChB; Åsa Jansson, MSc(Pharm); Cecilia Wadell, PhD; Richard Bethell, DPhil; John Öhd, MD, PhD
Preclinical studies suggest that MIV-711, a selective and reversible cathepsin K inhibitor, has beneficial effects on bone and cartilage. This phase 2a randomized controlled trial examined the efficacy, safety, and tolerability of MIV-711 in participants with symptomatic, radiographically confirmed osteoarthritis of the knee.
Mark S. Lachs, MD, MPH; Augustine M.K. Choi, MD
Free medical school tuition is an idea that is gaining traction. This commentary proposes alternative solutions to the problem of overwhelming educational debt: making medical school debt-free for students with financial need and fully subsidizing loan repayment during training for those choosing less lucrative fields, such as geriatrics.
Jeffrey N. Katz, MD, MSc
Conaghan and colleagues report the findings of a 26-week randomized trial comparing placebo with 2 different doses of MIV-711, a reversible inhibitor of cathepsin K, in persons with moderately severe knee osteoarthritis. The editorialist discusses the findings and why they suggest promise for new models of treatment of this debilitating condition.
Emmanuelle Duceppe, MD; Ameen Patel, MD; Matthew T.V. Chan, MBBS, PhD; Otavio Berwanger, MD, PhD; Gareth Ackland, PhD; Peter A. Kavsak, PhD; Reitze Rodseth, PhD; Bruce Biccard, PhD; Clara K. Chow, PhD; Flavia K. Borges, MD, PhD; Gordon Guyatt, MD, MSc; Rupert Pearse, MD; Daniel I. Sessler, MD; Diane Heels-Ansdell, MSc; Andrea Kurz, MD; Chew Yin Wang, MBChB; Wojciech Szczeklik, MD, PhD; Sadeesh Srinathan, MD, MSc; Amit X. Garg, MD, PhD; Shirley Pettit, RN; Erin N. Sloan, MD; James L. Januzzi Jr., MD; Matthew McQueen, MB, PhD; Giovanna Lurati Buse, MD, MSc; Nicholas L. Mills, MD; Lin Zhang, PhD; Robert Sapsford, MBBS, MD; Guillaume Paré, MD, MSc; Michael Walsh, MD, PhD; Richard Whitlock, MD, PhD; Andre Lamy, MD, MSc; Stephen Hill, PhD; Lehana Thabane, PhD; Salim Yusuf, MBBS, DPhil; P.J. Devereaux, MD, PhD
Studies suggest that N-terminal pro-B-type natriuretic peptide (NT-proBNP) may improve perioperative cardiovascular risk prediction. This study examined whether NT-proBNP provided added predictive value beyond a clinical score for identifying risk for major cardiovascular events and death in a large cohort of patients undergoing noncardiac surgery.
Ariane Lewis, MD; Richard J. Bonnie, LLB; Thaddeus Pope, JD, PhD
Since 1981, the Uniform Determination of Death Act (UDDA) has provided the legal basis for defining brain death in the United States, but ambiguities in its language have led to different interpretations across states. This article proposes revising the UDDA to help standardize the definition of brain death.
Arman Qamar, MD, MPH; Sripal Bangalore, MD, MHA
Duceppe and colleagues report that the addition of N-terminal pro–B-type natriuretic peptide (NT-proBNP) improves risk stratification of patients having noncardiac surgery. The editorialists discuss the findings and the need for further study to determine whether NT-proBNP–driven perioperative management reduces the risk for cardiovascular events.
David M. Levine, MD, MPH, MA; Kei Ouchi, MD, MPH; Bonnie Blanchfield, ScD; Agustina Saenz, MD, MPH; Kimberly Burke, BA; Mary Paz, BA; Keren Diamond, RN, MBA; Charles T. Pu, MD; Jeffrey L. Schnipper, MD, MPH
Studies suggest that hospital-level care provided in the patient's home may have beneficial effects on outcomes, but few trials of home hospital care have been done in the United States. This randomized controlled trial compared the effects of home hospital versus usual hospital care on direct costs and other outcomes among patients who required hospital admission.
John B. Wong, MD; Joshua T. Cohen, PhD
In their article, Levine and colleagues report a clinical trial that compared in-hospital care with potentially less expensive hospital care at home, finding that at-home care resulted in less health care use and more benefits, including less sedentary time, fewer readmissions within 30 days, and 38% lower mean direct costs. The editorialists discuss the findings and speculate about barriers to wider adoption of home hospital care.
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.
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.
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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