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 Showing 1-20 of 75 Articles
Invited Commentary 
Katherine Baicker, PhD; Meredith Rosenthal, PhD
In an era in which the term patient-centered is ubiquitous in health care, the payment and delivery systems remain stubbornly anything but. Although many proposed reforms aim to align the financial incentives faced by all of the people and institutions in the health care system with the delivery of high-value ...
Invited Commentary 
Joshua J. Gagne, PharmD, ScD
Apophenia is the perception of meaningful patterns and causal connections among random data. Are case reports of severe impulsive behaviors associated with the use of dopamine receptor agonist drugs examples of apophenia or of a causal connection between the drugs and impulse control disorders?
Invited Commentary 
Howard D. Weiss, MD; Gregory M. Pontone, MD
The discovery of striatal dopamine deficiency and the introduction of levodopa in the 1960s as treatment for the motor symptoms of Parkinson disease revolutionized neurology and neurotherapeutics. For the first time, patients with an apparently hopeless chronic degenerative brain disorder were able to regain function and return to the mainstream ...
Research Letter 
Alexis A. Krumme, MS; Niteesh K. Choudhry, MD, PhD; William H. Shrank, MD, MSHS; Troyen A. Brennan, MD, JD, MPH; Olga S. Matlin, PhD; Gregory Brill, MS; Joshua J. Gagne, PharmD, ScD
Cigarette smoking can make managing chronic diseases more difficult. For instance, in patients with certain respiratory conditions, smoking increases the risk of acute exacerbation, can worsen disease control, and may limit the effectiveness of inhaled corticosteroids.1 Similarly, by raising blood pressure, smoking can make it challenging to effectively control hypertension ...
Original Investigation 
Thomas J. Moore, AB; Joseph Glenmullen, MD; Donald R. Mattison, MD, MS

Importance  Severe impulse control disorders involving pathological gambling, hypersexuality, and compulsive shopping have been reported in association with the use of dopamine receptor agonist drugs in case series and retrospective patient surveys. These agents are used to treat Parkinson disease, restless leg syndrome, and hyperprolactinemia.

Objectives  ...

Original Investigation 
David A. Fiellin, MD; Richard S. Schottenfeld, MD; Christopher J. Cutter, PhD; Brent A. Moore, PhD; Declan T. Barry, PhD; Patrick G. O’Connor, MD, MPH

Importance  Prescription opioid dependence is increasing and creates a significant public health burden, but primary care physicians lack evidence-based guidelines to decide between tapering doses followed by discontinuation of buprenorphine hydrochloride and naloxone hydrochloride therapy (hereinafter referred to as buprenorphine therapy) or ongoing maintenance therapy.

Objective  ...

Jason H. Maley, MD; Erin C. Kiskis, BA
Special Communication 
Rachelle E. Bernacki, MD, MS; Susan D. Block, MD; for the American College of Physicians High Value Care Task Force
Includes: Supplemental Content

An understanding of patients’ care goals in the context of a serious illness is an essential element of high-quality care, allowing clinicians to align the care provided with what is most important to the patient. Early discussions about goals of care are associated with better quality of life, ...

Special Communication 
Harald Schmidt, PhD; Ezekiel J. Emanuel, MD, PhD

Current approaches to controlling health care costs have strengths and weaknesses. We propose an alternative, “inclusive shared savings,” that aims to lower medical costs through savings that are shared by physicians and patients. Inclusive shared savings may be particularly attractive in situations in which treatments, such as those ...

Editor's Note 
Robert Steinbrook, MD
Lung cancer, the vast majority of cases of which are caused by smoking, is the leading cause of cancer deaths in both men and women in the United States. In 2014, about 160 000 people are expected to die from lung cancer, accounting for about 27% of all cancer deaths.1 ...
Invited Commentary 
Wylie Burke, MD, PhD; Kenneth Thummel, PhD
Individual differences in response to medications are an important challenge in clinical practice. Drugs that work well for some patients are ineffective for others, and individuals vary markedly in their experience of adverse drug reactions. Some of this variation is associated with individual differences in the genes involved in drug ...
Invited Commentary  FREE
Steven A. Schroeder, MD
The most striking statistic on the harms of smoking is the number of estimated deaths from tobacco exposure. There are an estimated 480 000 annual deaths caused by tobacco use in the United States,1 and approximately 5.7 million deaths each year globally, making smoking the most common cause of preventable ...
Original Investigation  FREE
Brian L. Rostron, PhD, MPH; Cindy M. Chang, PhD, MPH; Terry F. Pechacek, PhD
Includes: Supplemental Content

Importance  Cigarette smoking has been found to harm nearly every bodily organ and is a leading cause of preventable disease, but current estimates of smoking-attributable morbidity by condition for the United States are generally unavailable.

Objective  To estimate the burden of major medical conditions attributable to ...

Original Investigation 
Bo Wang, PharmD; William J. Canestaro, MSc; Niteesh K. Choudhry, MD, PhD
Includes: Supplemental Content

Importance  Genetic biomarkers that predict a drug’s efficacy or likelihood of toxicity are assuming increasingly important roles in the personalization of pharmacotherapy, but concern exists that evidence that links use of some biomarkers to clinical benefit is insufficient. Nevertheless, information about the use of biomarkers appears in ...

Edward N. Murphy, MD; Richard Miranda, MD
Special Communication 
Douglas E. Wood, MD, FRCSEd

The National Lung Screening Trial has provided convincing evidence of a substantial mortality benefit of lung cancer screening with low-dose computed tomography (CT) for current and former smokers at high risk. The United States Preventive Services Task Force has recommended screening, triggering coverage of low-dose CT by private ...

Special Communication 
Steven H. Woolf, MD, MPH; Russell P. Harris, MD, MPH; Doug Campos-Outcalt, MD, MPA

In 2013, the US Preventive Services Task Force (USPSTF) recommended low-dose computed tomographic (CT) screening for high-risk current and former smokers with a B recommendation (indicating a level of certainty that it offered moderate to substantial net benefit). Under the Affordable Care Act, the USPSTF recommendation requires commercial ...

Viewpoint  FREE
Michael T. Osterholm, PhD, MPH; Kristine A. Moore, MD, MPH; Lawrence O. Gostin, JD
This Viewpoint discusses several key public health lessons learned from the current West Africa Ebola epidemic that are changing the way we think about emerging infectious disease threats.
Challenges in Clinical Electrocardiography 
Curtis M. Steyers III, MD; Prashant D. Bhave, MD
A 64-year-old white woman presented to the emergency department for evaluation of episodic palpitations and chest tightness. On arrival to the emergency department, her symptoms had entirely resolved. A 12-lead electrocardiogram (ECG) was obtained while she was asymptomatic and is shown in Figure 1A. Minutes later, the patient developed recurrence ...
Invited Commentary 
Steven E. Nissen, MD
Thomas Jefferson, the third American President and author of the Declaration of Independence, famously opined, “Governments derive their just powers from the consent of the governed.” The principle underlying this simple statement is an essential component of any collection of rules that govern how individuals conform to behavioral standards. Clinical ...

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