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 Showing 1-20 of 76 Articles
Original Investigation 
Adrian C. Traeger, MPhty; Markus Hübscher, PhD; Nicholas Henschke, PhD; G. Lorimer Moseley, PhD; Hopin Lee, MPhty; James H. McAuley, PhD
Includes: Supplemental Content

Importance  Reassurance is a core aspect of daily medical practice, yet little is known on how it can be achieved.

Objective  To determine whether patient education in primary care increases reassurance in patients with acute or subacute low back pain (LBP).

Data Sources  Medline, EMBASE, ...

Invited Commentary: Reassuring Patients About Low Back Pain; Roger Chou, MD
Original Investigation 
Kirsti Uusi-Rasi, PhD; Radhika Patil, MSc; Saija Karinkanta, PhD; Pekka Kannus, MD, PhD; Kari Tokola, MSc; Christel Lamberg-Allardt, PhD; Harri Sievänen, DSc
Includes: Supplemental Content

Importance  While vitamin D supplementation and exercise are recommended for prevention of falls for older people, results regarding these 2 factors are contradictory.

Objective  To determine the effectiveness of targeted exercise training and vitamin D supplementation in reducing falls and injurious falls among older women.

Design, ...

Invited Commentary: Vitamin D and Falls; Erin S. LeBlanc, MD, MPH; Roger Chou, MD
Original Investigation 
Jean S. Kutner, MD, MSPH; Patrick J. Blatchford, PhD; Don H. Taylor, PhD; Christine S. Ritchie, MD; Janet H. Bull, MD; Diane L. Fairclough, DrPH; Laura C. Hanson, MD; Thomas W. LeBlanc, MD; Greg P. Samsa, PhD; Steven Wolf, MS; Noreen M. Aziz, MD, PhD; David C. Currow, BMed; Betty Ferrell, PhD; Nina Wagner-Johnston, MD; S. Yousuf Zafar, MD; James F. Cleary, MD; Sandesh Dev, MD; Patricia S. Goode, MD; Arif H. Kamal, MD; Cordt Kassner, PhD; Elizabeth A. Kvale, MD; Janelle G. McCallum, RN, MSN; Adeboye B. Ogunseitan, MD; Steven Z. Pantilat, MD; Russell K. Portenoy, MD; Maryjo Prince-Paul, PhD; Jeff A. Sloan, PhD; Keith M. Swetz, MD; Charles F. Von Gunten, MD, PhD; Amy P. Abernethy, MD, PhD
Includes: Supplemental Content

Importance  For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy for patients with limited life expectancy.

Objective  To evaluate the ...

Invited Commentary: Deprescribing of Statins; Holly M. Holmes, MD, MS; Adam Todd, PhD, MPharm
Case Report/Case Series 
Kashish Goel, MBBS; Marysia Tweet, MD; Timothy M. Olson, MD; Joseph J. Maleszewski, MD; Rajiv Gulati, MD, PhD; Sharonne N. Hayes, MD

Importance  Spontaneous coronary artery dissection (SCAD) is a major cause of acute coronary syndrome in young women, especially among those without traditional cardiovascular risk factors. Prior efforts to study SCAD have been hampered by underrecognition and lack of registry-based studies. Risk factors and pathogenesis remain largely undefined, ...

Invited Commentary 
Erin S. LeBlanc, MD, MPH; Roger Chou, MD
Vitamin D is of great interest to the medical and lay communities. Numerous observational studies (often cross-sectional) have examined the association between serum levels of 25-hydroxyvitamin D (25[OH]D) and various conditions. Low levels of 25(OH)D have been associated with increased risk of falls, fractures, cardiovascular disease, colorectal cancer, type 2 ...
Invited Commentary 
Roger Chou, MD
Low back pain is one of the most commonly encountered conditions in clinical practice. Despite trends showing increasing use of advanced imaging tests, opioids, and invasive surgical and interventional procedures, with attendant increases in costs, the prevalence and burdens associated with low back pain appear to be on the rise.1 ...
Invited Commentary 
Holly M. Holmes, MD, MS; Adam Todd, PhD, MPharm
Along with acknowledgment of the many advantages of statins, increasing focus has been placed on diminishing benefits and, in some cases, harms of this drug class when used in patients with limited life expectancy. Statins are prescribed for only preventive purposes, without symptomatic benefit to patients. As such, in some ...
Special Communication 
Ian A. Scott, MBBS, FRACP, MHA, MEd; Sarah N. Hilmer, MBBS, FRACP, PhD; Emily Reeve, BPharm (Hons), PhD; Kathleen Potter, PhD, FRACGP; David Le Couteur, PhD, FRACP; Deborah Rigby, BPharm, GradDipClinPharm, FASCP, FACP, FAICD; Danijela Gnjidic, PhD; Christopher B. Del Mar, MB, BChir, MD, FRACGP; Elizabeth E. Roughead, PhD; Amy Page, MClinPharm; Jesse Jansen, MPsych, PhD; Jennifer H. Martin, MB, ChB, FRACP, PhD

Inappropriate polypharmacy, especially in older people, imposes a substantial burden of adverse drug events, ill health, disability, hospitalization, and even death. The single most important predictor of inappropriate prescribing and risk of adverse drug events in older patients is the number of prescribed drugs. Deprescribing is the process ...

Invited Commentary: Deprescribing of Statins; Holly M. Holmes, MD, MS; Adam Todd, PhD, MPharm
Original Investigation 
Lona Mody, MD; Sarah L. Krein, PhD; Sanjay K. Saint, MD; Lillian C. Min, MD; Ana Montoya, MD; Bonnie Lansing, LPN; Sara E. McNamara, MPH; Kathleen Symons, BA; Jay Fisch, BS; Evonne Koo, MPH; Ruth Anne Rye, BS; Andrzej Galecki, MD, PhD; Mohammed U. Kabeto, MS; James T. Fitzgerald, PhD; Russell N. Olmsted, MPH; Carol A. Kauffman, MD; Suzanne F. Bradley, MD
Includes: Supplemental Content

Importance  Indwelling devices (eg, urinary catheters and feeding tubes) are often used in nursing homes (NHs). Inadequate care of residents with these devices contributes to high rates of multidrug-resistant organisms (MDROs) and device-related infections in NHs.

Objective  To test whether a multimodal targeted infection program (TIP) ...

Invited Commentary: Reducing Antimicrobial Resistance in Nursing Homes; Nimalie D. Stone, MD, MS
Original Investigation 
Daniel J. Niven, MD, MSc; Gordon D. Rubenfeld, MD, MSc; Andrew A. Kramer, PhD; Henry T. Stelfox, MD, PhD
Includes: Supplemental Content

Importance  Little is known about the deadoption of ineffective or harmful clinical practices. A large clinical trial (the Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation [NICE-SUGAR] trial) demonstrated that strict blood glucose control (tight glycemic control) in patients admitted to adult intensive care ...

Invited Commentary: On the Undiffusion of Established Practices; Frank Davidoff, MD, MACP
Original Investigation 
Louise A. Beveridge, MB, ChB; Allan D. Struthers, MD; Faisel Khan, PhD; Rolf Jorde, PhD; Robert Scragg, MBBS, PhD; Helen M. Macdonald, PhD; Jessica A. Alvarez, PhD, RD; Rebecca S. Boxer, MD, MS; Andrea Dalbeni, MD; Adam D. Gepner, MD; Nicole M. Isbel, MBBS, PhD; Thomas Larsen, MD, PhD; Jitender Nagpal, MBBS, MD; William G. Petchey, BM, PhD; Hans Stricker, MD; Franziska Strobel, MD; Vin Tangpricha, MD, PhD; Laura Toxqui, PhD; M. Pilar Vaquero, PhD; Louise Wamberg, MD, PhD; Armin Zittermann, PhD; Miles D. Witham, BM, BCh, PhD; for the D-PRESSURE Collaboration
Includes: Supplemental Content

Importance  Low levels of vitamin D are associated with elevated blood pressure (BP) and future cardiovascular events. Whether vitamin D supplementation reduces BP and which patient characteristics predict a response remain unclear.

Objective  To systematically review whether supplementation with vitamin D or its analogues reduce BP....

Invited Commentary 
Nimalie D. Stone, MD, MS
The need to address transmission of multidrug-resistant organisms (MDROs) has never been more critical for nursing homes. Nursing home care is increasing in complexity as growing proportions of residents are entering homes directly from acute care hospitals. The post–acute care population experiences health care exposures such as invasive medical devices, ...
Invited Commentary 
Frank Davidoff, MD, MACP
Everett Rogers’ classic monograph on the diffusion of innovations represents the process by which we adopt new ideas and practices as a smooth S-shaped curve. In this curve, the percentage of adoption increases incrementally over time, then shoots up exponentially and begins to level off as it approaches 90%.1 The ...
Editor's Note 
Mitchell H. Katz, MD
This Editorial Note discusses the effect of health policy on aggressive treatment of illness in end-of-life care.
Special Communication 
Kim A. Eagle, MD; Prashant Vaishnava, MD; James B. Froehlich, MD

The field of perioperative medicine has garnered legitimacy during the past 3 decades. Adverse cardiovascular events in the perioperative period account for significant morbidity and mortality. Although testing patients preoperatively to detect ischemia and identify those who may benefit from modifications in care is a tempting strategy, risk ...

Invited Commentary: On the Undiffusion of Established Practices; Frank Davidoff, MD, MACP
Research Letter 
Mihaela S. Stefan, MD; Randa Jaber, MD; Peter K. Lindenauer, MD, MSc; Jane L. Garb, MS; Janet Fitzgerald, RN, MS; Michael B. Rothberg, MD, MPH
The Affordable Care Act established the Value-Based Purchasing Program, launched in 2013, which uses risk-standardized mortality rates as a benchmark to penalize or reward hospitals.1 The risk-standardized mortality rate is calculated using administrative data and includes patients with life-threatening illnesses for whom pneumonia may be the last insult in the ...
Research Letter 
Michael T. M. Wang; Greg Gamble, MSc; Andrew Grey, MD
Medical reversal—when a current practice is found to be no better than, or inferior to, a prior standard—is common1 and inconsistently translated into practice.2 Continuing use of ineffective treatments wastes resources and harms patients.3 There may be multiple reasons for persistence of reversed practices. Commercial entities may resist evidence of ...
Invited Commentary: On the Undiffusion of Established Practices; Frank Davidoff, MD, MACP
Teachable Moment 
Stephanie Chen, MD; Sammy Zakaria, MD, MPH
Perspective 
Ami Schattner, MD
I was going through my usual weekly early-afternoon clinic when I suddenly noticed that my manner with the patients was anything but usual.
Original Investigation 
Michael J. Orlich, MD, PhD; Pramil N. Singh, DrPH; Joan Sabaté, MD, DrPH; Jing Fan, MS; Lars Sveen; Hannelore Bennett, MS; Synnove F. Knutsen, MD, PhD; W. Lawrence Beeson, DrPH; Karen Jaceldo-Siegl, DrPH, MS; Terry L. Butler, DrPH; R. Patti Herring, PhD; Gary E. Fraser, PhD, MD

Importance  Colorectal cancers are a leading cause of cancer mortality, and their primary prevention by diet is highly desirable. The relationship of vegetarian dietary patterns to colorectal cancer risk is not well established.

Objective  To evaluate the association between vegetarian dietary patterns and incident colorectal cancers....

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