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 Showing 1-20 of 54 Articles
Invited Commentary 
Michael B. Rothberg, MD, MPH
In medicine, the quality and safety movement attempts to improve processes of care through careful measurement and application of industrial quality improvement techniques. When outcomes are publicly reported or tied to reimbursement, hospitals’ ability to improve their performance has been impressive. On the other hand, choosing what to measure has ...
Invited Commentary 
Cary P. Gross, MD
Invited Commentary 
Christopher Moriates, MD; Neel Shah, MD, MPP
A social “campaign” consists of a group of strategies and tactics that organize people to change existing norms. Few areas in our profession demand a campaign more than the imperative to reduce waste in health care. Underuse of health care has been long recognized as harmful to patients; however, the ...
Research Letter 
David W. Schopfer, MD, MAS; Steven Takemoto, PhD; Kelly Allsup, BS; Christian D. Helfrich, PhD; P. Michael Ho, MD; Daniel E. Forman, MD; Mary A. Whooley, MD
Includes: Supplemental Content
Referral to exercise-based cardiac rehabilitation (CR) is 1 of 9 performance measures for secondary prevention after hospitalization for myocardial infarction (MI), percutaneous coronary intervention (PCI), and/or coronary artery bypass graft (CABG).1,2 Although CR programs significantly reduce morbidity and mortality in patients with ischemic heart disease (IHD),3 they are vastly underused ...
Research Letter 
Julia A. McMillan, MD; Roy C. Ziegelstein, MD, MACP
The important role of training program directors to educate residents and fellows about the value of cost-conscious diagnostic and management strategies is clear.1 Indeed, a suggestion has been made that cost-conscious care should be added as a seventh general competency by the Accreditation Council for Graduate Medical Education and the ...
Research Letter 
Sosena Kebede, MD, MPH; Hasan M. Shihab, MBChB, MPH; Zackary D. Berger, MD, PhD; Nina G. Shah, MS; Hsin-Chieh Yeh, PhD; Daniel J. Brotman, MD
Effective communication is a health care quality indicator. Patients with a good understanding of their health are likely to be more satisfied with it and more adherent to their treatment plans.1,2 We sought to examine shared understanding between patients and clinicians in the hospital and how it might affect patient ...
Research Letter 
Gudrun Jonasdottir Bergman, PhD; Staffan Khan; Bengt Danielsson, MD, PhD; Natalia Borg, PhD
Calcium channel blockers (CCBs), with Anatomical and Therapeutic Chemical Classification code C08,1 are frequently used for the treatment of cardiovascular disease, mostly hypertension. JAMA InternalMedicine recently published an article2 with a commentary3 showing that 10 years or more of exposure to CCBs is associated with an increased odds of developing ...
Original Investigation 
Scott A. Flanders, MD; M. Todd Greene, PhD, MPH; Paul Grant, MD; Scott Kaatz, DO, MSc; David Paje, MD; Bobby Lee, MD; James Barron, MD; Vineet Chopra, MD, MSc; David Share, MD, MPH; Steven J. Bernstein, MD, MPH
Includes: Supplemental Content

Importance  Hospitalization for acute medical illness is associated with increased risk of venous thromboembolism (VTE). Although efforts designed to increase use of pharmacologic VTE prophylaxis are intended to reduce hospital-associated VTE, whether higher rates of prophylaxis reduce VTE in medical patients is unknown.

Objective  To examine ...

Original Investigation 
Frank van Hees, MSc; Ann G. Zauber, PhD; Carrie N. Klabunde, PhD; S. Luuk Goede, MSc; Iris Lansdorp-Vogelaar, PhD; Marjolein van Ballegooijen, MD, PhD
Includes: Supplemental Content

Importance  Many Medicare beneficiaries undergo more intensive colonoscopy screening than recommended. Whether this is favorable for beneficiaries and efficient from a societal perspective is uncertain.

Objective  To determine whether more intensive colonoscopy screening than recommended is favorable for Medicare beneficiaries (ie, whether it results in a ...

Original Investigation 
Trevor J. Royce, MD, MS; Laura H. Hendrix, MS; William A. Stokes, MD; Ian M. Allen, MD, MPH; Ronald C. Chen, MD, MPH
Includes: Supplemental Content

Importance  Routine cancer screening has unproven net benefit for patients with limited life expectancy.

Objective  To examine the patterns of prostate, breast, cervical, and colorectal cancer screening in the United States in individuals with different life expectancies.

Design, Setting, and Participants  Data from the population-based ...

Original Investigation 
Susan L. Mitchell, MD, MPH; Michele L. Shaffer, PhD; Mark B. Loeb, MD, MSc; Jane L. Givens, MD, MSCE; Daniel Habtemariam, BA; Dan K. Kiely, MPH, MA; Erika D’Agata, MD, MPH
Includes: Supplemental Content

Importance  Infection management in advanced dementia has important implications for (1) providing high-quality care to patients near the end of life and (2) minimizing the public health threat posed by the emergence of multidrug-resistant organisms (MDROs).

Design, Setting, and Participants  Prospective cohort study of 362 residents ...

Rajat Kalra, MBChB; Ryan R. Kraemer, MD
Research Letter  FREE
Christine M. Cheng, PharmD; Jaekyu Shin, PharmD, MS; B. Joseph Guglielmo, PharmD
Includes: Supplemental Content
Boxed warnings describe potentially life-threatening risks associated with certain prescription drugs.1 The warnings are surrounded by a border or “box” in the drug label and may be present at the time of drug approval (ie, a premarket warning) or added during the postmarket period (ie, a postmarket warning). Despite the ...
A newly proposed US Food and Drug Administration guidance could undermine the agency's drug safety laws and regulations by allowing pharmaceutical companies to claim their drugs are less risky than stated in the approved label.
Editor's Note 
Joseph S. Ross, MD, MHS
Reconciling the results of randomized clinical trials (RCTs) and observational studies remains a substantial challenge for clinical medicine. There are numerous examples of studies showing that therapies seemed effective, or perhaps conferred risk, when investigated by observational methods that were later contradicted by evidence from RCTs, and vice versa. A ...
Invited Commentary 
Alan H. B. Wu, PhD
I was coming home from a long work week at the hospital and thought of stopping by the video store to rent a copy of the latest Hollywood blockbuster video. I called my wife from my office telephone to tell her I’d be late. I wasn’t sure where the store ...
Research Letter 
Gautam R. Shroff, MBBS; Brooke M. Heubner, MS; Charles A. Herzog, MD
We examined temporal trends in the incidence of acute coronary syndrome (ACS) among US Medicare beneficiaries.
Research Letter 
Helmut Schröder, PhD; Jordi Salas-Salvadó, MD, PhD; Miguel Angel Martínez-González, MD, PhD; Montserrat Fíto, MD, PhD; Dolores Corella, DPharm, PhD; Ramón Estruch, MD, PhD; Emilio Ros, MD, PhD
Lifestyle modification, particularly dietary changes, is the cornerstone of population-based strategies for cardiovascular disease (CVD) prevention.1 Recently the Prevención con Dieta Mediterránea (PREDIMED) study,2 a 5-year randomized primary prevention trial (isrctn.org Identifier: ISRCTN35739639), showed a 30% reduction in incident CVD with Mediterranean diet (MeDiet) intervention in comparison with a control ...
Research Letter 
Jesse Theisen-Toupal, MD; Gary Horowitz, MD; Anthony Breu, MD
Since the United States began folic acid fortification in 1998, the prevalence of folate deficiency in the general population has decreased.1 Despite this, folate testing continues to be recommended for the evaluation of macrocytic anemia2,3 and is commonly performed to evaluate macrocytosis without anemia, normocytic anemia, dementia, delirium, and peripheral ...
Original Investigation 
Trisha F. Hue, PhD, MPH; Steven R. Cummings, MD; Jane A. Cauley, DrPH; Douglas C. Bauer, MD; Kristine E. Ensrud, MD; Elizabeth Barrett-Connor, MD; Dennis M. Black, PhD

Importance  Studies have shown that bisphosphonates may have antitumor and antimetastatic properties. Recently, observational studies have suggested a possible protective effect of bisphosphonates on breast cancer, but the effect of bisphosphonate use on risk of breast cancer has not been tested in randomized trials.

Objective  To ...

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