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 Showing 1-20 of 36 Articles
Original Investigation 
Mads E. Jørgensen, MB; Mark A. Hlatky, MD; Lars Køber, MD, DSc; Robert D. Sanders, MD, PhD, FRCA; Christian Torp-Pedersen, MD, DSc; Gunnar H. Gislason, MD, PhD; Per Føge Jensen, MD, PhD; Charlotte Andersson, MD, PhD
Includes: Supplemental Content

Importance  Perioperative β-blocker strategies are important to reduce risks of adverse events. Effectiveness and safety may differ according to patients’ baseline risk.

Objective  To determine the risk of major adverse cardiovascular events (MACEs) associated with long-term β-blocker therapy in patients with uncomplicated hypertension undergoing noncardiac surgery....

Original Investigation 
Chien-Chang Lee, MD, ScD; Meng-tse Gabriel Lee, PhD; Yueh-Sheng Chen, MD; Shih-Hao Lee, MA; Yih-Sharng Chen, MD, PhD; Shyr-Chyr Chen, MD, MBA; Shan-Chwen Chang, MD, PhD
Includes: Supplemental Content

Importance  Fluoroquinolones have been associated with collagen degradation, raising safety concerns related to more serious collagen disorders with use of these antibiotics, including aortic aneurysm and dissection.

Objective  To examine the relationship between fluoroquinolone therapy and the risk of developing aortic aneurysm and dissection.

Design, Setting, ...

Editor's Note: Global Drug Safety Insights From Taiwan; Joseph S. Ross, MD, MHS
Editor's Note 
Joseph S. Ross, MD, MHS; Mitchell H. Katz, MD

When a patient is made to wait a long time to receive care from a physician or other health care professional, the implicit message is clear: the patient’s time is less important than the clinician’s. Although patients are understanding of waits due to professional emergencies (eg, when an ...

Editor's Note 
Joseph S. Ross, MD, MHS

The investments made by the government of Taiwan to create the Taiwan National Health Insurance Research Database continue to realize global population health benefits. The database has been used to conduct numerous studies of drug safety and efficacy, diagnostic test utility, disease progression, and risk factor prognosis, generating ...

Challenges in Clinical Electrocardiography 
Philip S. Hall, MD; Babak Nazer, MD; Randall J. Lee, MD, PhD

A woman in her 50s with a history of intravenous drug use and hepatitis C was admitted with a diagnosis of community-acquired pneumonia. Physical examination demonstrated violaceous plaques on her ears, fingertips, hands, elbows, and ankles. She reported recent injection use of cocaine, 2 days prior to admission. ...

Research Letter 
Kristin N. Ray, MD, MS; Amalavoyal V. Chari, PhD; John Engberg, PhD; Marnie Bertolet, PhD; Ateev Mehrotra, MD, MPH

This Research Letter examined data from the American Time Use Survey and found that time waiting for or obtaining medical care was significantly longer for racial/ethnic minorities, individuals with less education, and individuals who are unemployed.

Editor's Note: No Time to Wait; Joseph S. Ross, MD, MHS; Mitchell H. Katz, MD
Research Letter 
Nynne Nyboe Andersen, MD; Björn Pasternak, MD, PhD; Mikael Andersson, MSc; Nete Munk Nielsen, MD, PhD; Tine Jess, MD, DMSc

This population-based cohort study suggests a possible 2-fold increased relative risk but a low absolute risk of central demyelinating diseases associated with anti-TNF exposure in patients with irritable bowel syndrome.

Teachable Moment 
Claire K. Larson, MD; Helen Kao, MD

This Teachable Moment highlights the risk of polypharmacy in the treatment of neuropsychiatric symptoms, the complexity of prognostication in dementia, and the importance of a multifaceted approach to neuropsychiatric symptoms.

Original Investigation 
Annie LeBlanc, PhD; Jeph Herrin, PhD; Mark D. Williams, MD; Jonathan W. Inselman; Megan E. Branda, MSc; Nilay D. Shah, PhD; Emma M. Heim; Sara R. Dick, MSc; Mark Linzer, MD; Deborah H. Boehm, MPH; Kristen M. Dall-Winther, MD; Marc R. Matthews, MD; Kathleen J. Yost, PhD; Kathryn K. Shepel; Victor M. Montori, MD
Includes: Supplemental Content

Importance  For antidepressants, the translation of evidence of comparative effectiveness into practice is suboptimal. This deficit directly affects outcomes and quality of care for patients with depression. To overcome this problem, we developed the Depression Medication Choice (DMC) encounter decision aid, designed to help patients and clinicians ...

Invited Commentary: The Role of Decision Aids in Depression Care; Kurt Kroenke, MD
Original Investigation 
Kenneth E. Freedland, PhD; Robert M. Carney, PhD; Michael W. Rich, MD; Brian C. Steinmeyer, MS; Eugene H. Rubin, MD, PhD
Includes: Supplemental Content

Importance  Depression and inadequate self-care are common and interrelated problems that increase the risks of hospitalization and mortality in patients with heart failure (HF).

Objective  To determine the efficacy of an integrative cognitive behavior therapy (CBT) intervention for depression and HF self-care.

Design, Setting, and Participants...

Editor's Note: Reframing Depression Treatment in Heart Failure; Patrick G. O’Malley, MD, MPH
Original Investigation 
Constance D. Lehman, MD, PhD; Robert D. Wellman, MS; Diana S. M. Buist, PhD; Karla Kerlikowske, MD; Anna N. A. Tosteson, ScD; Diana L. Miglioretti, PhD; For the Breast Cancer Surveillance Consortium

Importance  After the US Food and Drug Administration (FDA) approved computer-aided detection (CAD) for mammography in 1998, and the Centers for Medicare and Medicaid Services (CMS) provided increased payment in 2002, CAD technology disseminated rapidly. Despite sparse evidence that CAD improves accuracy of mammographic interpretations and costs ...

Invited Commentary: Time to Stop Paying for Computer-Aided Mammography; Joshua J. Fenton, MD, MPH
Invited Commentary 
Kurt Kroenke, MD

Clarion calls about enhancing detection and management of depression in primary care have reiterated several truisms: Depression is as prevalent as many common medical disorders, treatable yet frequently undertreated, responsible for enormous occupational and social impairment as well as adverse effects on the costs, treatment outcomes, and mortality ...

Invited Commentary 
Joshua J. Fenton, MD, MPH

Computer-aided detection (CAD) is a technology designed to address the problem of screening mammography’s imperfect sensitivity. Now used on over 90% of US mammograms, CAD essentially acts like an automated second reader by marking potentially suspicious spots for radiologists to review before making final recommendations. Early studies suggested ...

Editor's Note 
Patrick G. O’Malley, MD, MPH

Congestive heart failure and depression are 2 common and disabling chronic conditions. When depression occurs in patients with heart failure, which is often, the illness burden and management complexity increase multifold. Freedland et al1 tested the hypothesis that the effective treatment of comorbid depression with cognitive behavior ...

Thomas A. Farley, MD, MPH

This Viewpoint details how mass media, often overlooked as a medical tool, can be used to help prevent disease and save lives by communicating simple messages that nearly every patient needs to hear.

Editor's Note: Mass Media Campaigns to Prevent Chronic Disease; Rachel J. Stern, MD
Teachable Moment 
Arjun Gupta, MD; Purav Mody, MD; Ambarish Pandey, MD

This case illustrates how unnecessary antibiotic use might cause life-threatening adverse events in the context of certain types of heart disease.

Original Investigation 
Aaron L. Schwartz, PhD; Michael E. Chernew, PhD; Bruce E. Landon, MD, MBA, MSc; J. Michael McWilliams, MD, PhD
Includes: Supplemental Content

Importance  Wasteful practices are widespread in the US health care system. It is unclear if payment models intended to improve health care efficiency, such as the Medicare accountable care organization (ACO) programs, discourage the provision of low-value services.

Objective  To assess whether the first year of ...

Invited Commentary: Precision Health Care Efficiencies Via Accountable Care Organizations; Arnold Milstein, MD, MPH
Invited Commentary 
Arnold Milstein, MD, MPH

The ratio of heat from political conflict to light remains high with respect to Medicare's value-based payment policies and, specifically, whether Accountable Care Organizations (ACOs) can slow health care spending growth without jeopardizing the quality of care.

Editor's Note 
Joseph S. Ross, MD, MHS; Rita F. Redberg, MD, MSc

As part of the 2012 US Food and Drug Administration (FDA) Safety and Innovation Act, Section 9021 created a new regulatory review designation—breakthrough therapy—that would expedite the development and FDA review of as-yet unapproved drugs and biologic agents intended to treat serious or life-threatening diseases and for ...

Editor's Note 
Rachel J. Stern, MD

In 2009, New York City embarked on a mass media campaign and policy initiative to highlight the link between obesity and “sugary beverages”—drinks containing more than 25 calories per 8 ounces (other than milk and 100% juice). This initiative led to a substantial reduction in sugary drink consumption ...

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