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 Showing 1-20 of 89 Articles
Original Investigation 
Katherine A. Ornstein, PhD, MPH; Melissa D. Aldridge, PhD, MPH, MBA; Melissa M. Garrido, PhD; Rebecca Gorges, MS; Diane E. Meier, MD; Amy S. Kelley, MD, MS
Includes: Supplemental Content

Importance  Family caregivers of individuals with serious illness are at risk for depressive symptoms and depression. Hospice includes the provision of support services for family caregivers, yet evidence is limited regarding the effect of hospice use on depressive symptoms among surviving caregivers.

Objective  To determine the ...

Invited Commentary: The Antidepressant Effect of Hospice; Holly G. Prigerson, PhD; Kelly Trevino, PhD
Original Investigation 
Nathan P. Clark, PharmD; Daniel M. Witt, PharmD; Loren E. Davies, PharmD; Edward M. Saito, PharmD; Kathleen H. McCool, PharmD; James D. Douketis, MD; Kelli R. Metz, PharmD; Thomas Delate, PhD

Importance  The risk of bleeding and recurrent venous thromboembolism (VTE) among patients receiving long-term warfarin sodium therapy for secondary VTE prevention who require temporary interruption of anticoagulant therapy for surgery or invasive diagnostic procedures has not been adequately described.

Objective  To describe the rates of clinically ...

Invited Commentary: Overuse of Bridging Anticoagulation for Patients With VTE; Daniel J. Brotman, MD; Michael B. Streiff
Original Investigation 
Katherine A. Ornstein, PhD, MPH; Bruce Leff, MD; Kenneth E. Covinsky, MD; Christine S. Ritchie, MD, MSPH; Alex D. Federman, MD, MPH; Laken Roberts, MPH; Amy S. Kelley, MD, MSHS; Albert L. Siu, MD, MSPH; Sarah L. Szanton, PhD

Importance  Increasing numbers of older, community-dwelling adults have functional impairments that prevent them from leaving their homes. It is uncertain how many people who live in the United States are homebound.

Objectives  To develop measures of the frequency of leaving and ability to leave the home ...

Original Investigation 
Barbara W. Trautner, MD, PhD; Larissa Grigoryan, MD, PhD; Nancy J. Petersen, PhD; Sylvia Hysong, PhD; Jose Cadena, MD; Jan E. Patterson, MD, MS; Aanand D. Naik, MD
Includes: Supplemental Content

Importance  Overtreatment of asymptomatic bacteriuria (ASB) in patients with urinary catheters remains high. Health care professionals have difficulty differentiating cases of ASB from catheter-associated urinary tract infections.

Objectives  To evaluate the effectiveness and sustainability of an intervention to reduce urine culture ordering and antimicrobial prescribing for ...

Invited Commentary: Changing Clinicians’ Behavior; Manisha Juthani-Mehta, MD
Invited Commentary 
Holly G. Prigerson, PhD; Kelly Trevino, PhD

Although caring for a terminally ill spouse can be gratifying, it can also be depressing. Research1,2 has shown that caregiving poses risks to a spouse’s mental health both before and after the ill spouse dies. Depending on the circumstances of the death, psychological distress may ...

Invited Commentary 
Daniel J. Brotman, MD; Michael B. Streiff

Patients receiving anticoagulation for venous thromboembolism (VTE) have varying risks of recurrence on cessation of the therapy. Time from the most recent thrombotic event is perhaps the most important determinant of short-term VTE recurrence because patients who stop anticoagulation therapy before the stabilization of an active thrombus are ...

Invited Commentary 
Manisha Juthani-Mehta, MD

Asymptomatic bacteriuria (ASB) is one of the most common reasons for inappropriate antimicrobial use.1 Despite the recommendation for decades that patients with indwelling urinary catheters should not be screened for ASB or treated with antimicrobial therapy, this practice is still commonplace.2 In an effort to have ...

Invited Commentary 
Ralph G. Brindis, MD, MPH; M. Eugene Sherman, MD

With the need and desire for Congress and the Centers for Medicare & Medicaid Services (CMS) to reduce the nation’s unsustainable financial burden of Medicare, substantial reduction in payments of many imaging tests and procedures has been implemented for in-office provision of these services. Imaging was chosen because ...

Research Letter 
Theora Cimino, BS; Michael A. Steinman, MD; Susan L. Mitchell, MD, MPH; Yinghui Miao, MPH; Monica Bharel, MD, MPH; Caroline E. Barnhart, BA; Rebecca T. Brown, MD, MPH

This observational study suggests monitoring of older homeless adults to identify appropriate services.

Research Letter 
Zirui Song, MD, PhD; Jacob Wallace, BA; Hannah T. Neprash, BA; Michael R. McKellar, MHSA; Michael E. Chernew, PhD; J. Michael McWilliams, MD, PhD

Physician practices are increasingly integrating with hospitals.1 For physicians, the expansion of accountable care organization contracts, centered on clinicians taking responsibility for population spending and quality, makes independent practice more challenging. For hospitals and health systems, acquiring practices helps them control referral patterns, coordinate care, and improve ...

Invited Commentary: Medicare Fee Cuts and Hospital- vs Office-Based Imaging; Ralph G. Brindis, MD, MPH; M. Eugene Sherman, MD
Research Letter 
Lori Uscher-Pines, PhD, MSc; Andrew Mulcahy, PhD; David Cowling, PhD; Gerald Hunter, MS; Rachel Burns, MPH; Ateev Mehrotra, MD, MPH

This study uses health plan claims to assess antibiotic prescribing rates for acute respiratory infection, comparing between a direct-to-consumer telemedicine company vs physician offices.

Editorial: Addressing Overuse of Medical Services One Decision at a Time; Grace A. Lin, MD, MAS; Rita F. Redberg, MD, MSc
Invited Commentary: Decision Aids in Serious Illness; James A. Tulsky, MD
Original Investigation 
Max J. Romano, MPH; Jodi B. Segal, MD, MPH; Craig Evan Pollack, MD, MHS
Includes: Supplemental Content

Importance  Both the overuse of unnecessary medical procedures and poor continuity of care are thought to contribute to high health care spending and poor patient outcomes.

Objective  To investigate the association between care continuity and use of potentially unnecessary procedures.

Design, Setting, and Participants  Observational ...

Invited Commentary: Understanding the Value of Continuity in the 21st Century; S. Ryan Greysen, MD, MHS; Allan S. Detsky, MD, PhD
Original Investigation 
Michael B. Rothberg, MD, MPH; Senthil K. Sivalingam, MD; Reva Kleppel, MSW, MPH; Marc Schweiger, MD; Bo Hu, PhD; Karen R. Sepucha, PhD
Includes: Supplemental Content

Importance  Patients with stable coronary disease undergoing percutaneous coronary intervention (PCI) are frequently misinformed about the benefits of PCI. Little is known about the quality of decision making before angiography and possible PCI.

Objective  To assess the quality of informed decision making and its association with ...

Editorial: Addressing Overuse of Medical Services One Decision at a Time; Grace A. Lin, MD, MAS; Rita F. Redberg, MD, MSc
Invited Commentary: Decision Aids in Serious Illness; James A. Tulsky, MD
Original Investigation 
Michael B. Weinstock, MD; Scott Weingart, MD; Frank Orth, DO; Douglas VanFossen, MD; Colin Kaide, MD; Judy Anderson, MS, MAS; David H. Newman, MD

Importance  Patients with potentially ischemic chest pain are commonly admitted to the hospital or observed after a negative evaluation in the emergency department (ED) owing to concern about adverse events. Previous studies have looked at 30-day mortality, but no current large studies have examined the most important ...

Editorial: Addressing Overuse of Medical Services One Decision at a Time; Grace A. Lin, MD, MAS; Rita F. Redberg, MD, MSc
Invited Commentary: Decision Aids in Serious Illness; James A. Tulsky, MD
Original Investigation 
Patricia C. Silveira, MD; Ivan K. Ip, MD; Samuel Z. Goldhaber, MD; Gregory Piazza, MD, MS; Carol B. Benson, MD; Ramin Khorasani, MD, MPH

Importance  The Wells score to determine the pretest probability of deep vein thrombosis (DVT) was validated in outpatient settings, but it is unclear whether it applies to inpatients.

Objective  To evaluate the utility of the Wells score for risk stratification of inpatients with suspected DVT.

Design, ...

Invited Commentary: The Wells Deep Vein Thrombosis Score for Inpatients; Erika Leemann Price, MD, MPH; Tracy Minichiello, MD
Original Investigation 
Ashok Reddy, MD; Craig E. Pollack, MD, MHS; David A. Asch, MD, MBA; Anne Canamucio, MS; Rachel M. Werner, MD, PhD
Includes: Supplemental Content

Importance  Primary care provider (PCP) turnover is common and can disrupt patient continuity of care. Little is known about the effect of PCP turnover on patient care experience and quality of care.

Objective  To measure the effect of PCP turnover on patient experiences of care and ...

Invited Commentary: Understanding the Value of Continuity in the 21st Century; S. Ryan Greysen, MD, MHS; Allan S. Detsky, MD, PhD
Invited Commentary 
S. Ryan Greysen, MD, MHS; Allan S. Detsky, MD, PhD

For most of the 20th century, patients commonly received care from a small number of physicians over a long period of time. Both generalists and specialists followed a large panel of patients in both the ambulatory and hospital setting for many years. In the United States, physicians' first ...

Invited Commentary 
Erika Leemann Price, MD, MPH; Tracy Minichiello, MD

This Invited Commentary discusses the poor utility of the Wells score for deep vein thrombosis in inpatients and suggests alternative approaches to stratify the risk of deep vein thrombosis.

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