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FOR THE PRESS

Annals of Internal Medicine Tip Sheet
October 4, 2016


Below is information about articles being published in Annals of Internal Medicine. The information is not intended to substitute for the full article as a source of information. Annals of Internal Medicine attribution is required for all coverage.


1. Doctors go “Beyond the Guidelines” to discuss the benefits and risks of screening for diabetes in an asymptomatic patient

Abstract: http://www.annals.org/article.aspx?doi=10.7326/M16-1091

Should a 63 year-old man who is clinically obese but feeling healthy be screened for diabetes? An endocrinologist and primary care physician debate the topic in a multicomponent educational article being published in Annals of Internal Medicine.

Clinical guidelines from the U.S. Preventive Services Task Force recommend that overweight or obese adults aged 40 to 70 undergo blood glucose screening every 3 years even if they do not have symptoms of diabetes. The guidelines suggest that physicians discuss the benefits and harms of screening with their patients and consider their individual preferences and concerns. Since diabetes is a major risk factor for cardiovascular disease and other serious outcomes, the goal of screening is to reduce morbidity and mortality by detecting abnormal blood glucose and reducing progression to diabetes. For screening to have benefit, the patient needs to be willing to make lifestyle changes if an issue is detected. In this Beyond the Guidelines article, two internists debate the benefits and harms of screening for diabetes in an asymptomatic 63 year-old male who is obese, but otherwise feeling well, and has concerns about screening.

All Beyond the Guidelines papers are based on the Department of Medicine Grand Rounds at Beth Israel Deaconess Medical Center in Boston. Each session focuses on care of a patient who "falls between the cracks" in available evidence and for whom the optimal clinical management is unclear. Such situations include those in which a guideline finds evidence insufficient to make a recommendation, a patient does not fit criteria mapped out in recommendations, or different organizations provide conflicting recommendations. Debates are presented in a question and answer format, and include video interviews with the patient and physicians. A list of topics is available at www.annals.org/grandrounds.

2. NIH report highlights strategies for optimizing youth suicide prevention programs

Report abstract: http://www.annals.org/article.aspx?doi=10.7326/M16-1568
Review abstract: http://www.annals.org/article.aspx?doi=10.7326/M16-1281

The National Institutes of Health (NIH) has issued a final report from its Pathways to Prevention workshop on youth suicide prevention. The abridged version of the final report, published in Annals of Internal Medicine, provides a roadmap for optimizing youth suicide prevention efforts by highlighting strategies for guiding the next decade of research in the area. The strategies identified include recommendations for improving data systems, enhancing data collection and analysis methods, and strengthening the research and practice community.

An accompanying evidence review, also published in Annals of Internal Medicine, suggests that existing national, state, and community data systems should be linked to suicide prevention data as a way to evaluate and enhance suicide prevention efforts. The authors suggest that a national suicide outcomes data repository could be created combining data from several sources to achieve better coverage of suicidal ideation, suicide attempt, and suicide on a national level, and that guidelines could be developed to influence their development and use.

Also new in this issue:

Today's Doctor–Patient Relationship

Kartik S. Valluri, MD
Annals Graphic Medicine
Abstract: http://www.annals.org/article.aspx?doi=10.7326/G16-0014

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