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Basic View | Expanded View
 Showing 21-40 of 76 Articles
Invited Commentary 
Yael Schenker, MD, MAS; Alex John London, PhD
Conducting a Google search for a disease is how many people get information about their illness and possible treatments. In a national survey sponsored by the Pew Research Center, 72% of adult Internet users reported looking online for health information in the past 12 months and 43% reported searching for ...
Research Letter 
Lisa-Ann Fraser, MD, MSc; Kuan Liu, MMath; Kyla L. Naylor, MES; Y. Joseph Hwang, MSc; Stephanie N. Dixon, PhD; Salimah Z. Shariff, PhD; Amit X. Garg, MD, PhD
Antipsychotic medications are commonly used in elderly persons to treat dementia and other behavioral disturbances.1 Several articles have linked these medications to an increased risk of fracture.2,3 It is unclear whether this fracture risk is limited to older conventional antipsychotic medications or if the risk extends to newer atypical antipsychotics4 ...
Research Letter 
Shun Yu, MD; Gopi K. Nayak, MD; Jeffrey M. Levsky, MD, PhD; Linda B. Haramati, MD, MS
A substantial proportion of computed tomographic pulmonary angiography (CTPA) results are degraded by patient-related and technical factors, yielding a limited negative interpretation, which qualifies the definitive exclusion of pulmonary embolism. This leads to diagnostic uncertainty and may affect patient management. A multicenter randomized clinical trial of CTPA vs ventilation-perfusion scintigraphy ...
Research Letter 
Mariah L. Kincaid, BS; Lee A. Fleisher, MD; Mark D. Neuman, MD, MSc
Adequate presentation of risks and benefits of medical therapies is essential to informed decision making by patients.1 Transcatheter aortic valve replacement (TAVR) has been recently approved by the US Food and Drug Administration for the treatment of severe aortic stenosis among carefully selected patients; recent randomized clinical trials have identified ...
Viewpoint 
Katherine Baicker, PhD; Helen Levy, PhD
The second open-enrollment period for coverage through the Health Insurance Marketplace extends from November 15, 2014, to February 15, 2015; millions of people in the United States are once again choosing from a menu of plans. Although federal law dictates some aspects of the plans, shopping for coverage—even on health ...
Perspective 
Jonathan Liu, MD
“The ear has pain, very pain. And pus, lots of pus,” the patient’s daughter said with a grimace, as if she were tasting the cloudy, bacteria-laden fluid while she described it. She recounted, as best as she could, the recent plight of her mother, who was seated on the examination ...
Perspective 
Sandra Zimmerman, RN
My husband had been experiencing tremor in his hands for approximately 2 years. He is 69 years old, had worked for many years for a telecommunications company, and is now retired. The tremors come and go unexpectedly. One night they flared up when he was carving a ham. Sometimes he ...
Original Investigation  FREE
Teresa M. Waters, PhD; Michael J. Daniels, ScD; Gloria J. Bazzoli, PhD; Eli Perencevich, MD; Nancy Dunton, PhD; Vincent S. Staggs, PhD; Catima Potter, MPH; Naleef Fareed, PhD; Minzhao Liu, MS, PhD; Ronald I. Shorr, MD, MS

Importance  In 2008, Medicare implemented the Hospital-Acquired Conditions (HACs) Initiative, a policy denying incremental payment for 8 complications of hospital care, also known as never events. The regulation’s effect on these events has not been well studied.

Objective  To measure the association between Medicare’s nonpayment ...

Original Investigation 
Hongyu Wu, PhD; Alan J. Flint, MD, ScD; Qibin Qi, PhD; Rob M. van Dam, PhD; Laura A. Sampson, RD; Eric B. Rimm, ScD; Michelle D. Holmes, MD, DrPH; Walter C. Willett, MD, DrPH; Frank B. Hu, MD, PhD; Qi Sun, MD, ScD
Includes: Supplemental Content

Importance  Higher intake of whole grains has been associated with a lower risk of major chronic diseases, such as type 2 diabetes mellitus and cardiovascular disease (CVD), although limited prospective evidence exists regarding whole grains’ association with mortality.

Objective  To examine the association between dietary whole ...

Metformin hydrochloride is the first-line drug for type 2 diabetes mellitus (T2DM)1 and is the only oral diabetes drug with evidence for improved cardiovascular outcomes. Despite this, half of the patients with T2DM do not take metformin. Even in patients who are taking other oral T2DM drugs, only about 70% ...
Research Letter 
Amitkumar R. Patel, MD, MBA; Frank J. Zadravecz, MPH; Robert S. Young, MD, MS; Mark V. Williams, MD; Matthew M. Churpek, MD, MPH, PhD; Dana P. Edelson, MD, MS
Hospitals routinely use rapid response teams (RRTs) to treat and triage unstable patients, but early and reliable identification of high-risk patients remains challenging.1 Objective, vital sign–based risk prediction scores, such as the Modified Early Warning Score (MEWS), have been developed but have limited accuracy.2 The Patient Acuity Rating (PAR), a ...
Research Letter 
Robert W. Yeh, MD, MSc; Laura Mauri, MD, MSc; Robert E. Wolf, MS; Iyah K. Romm, BS; Ann Lovett, RN, MA; David Shahian, MD; Sharon-Lise Normand, PhD
Improvements in prevention have led to declines in rates of myocardial infarction (MI).1 Simultaneously, evidence from randomized trials has confirmed the role of medical therapy as a first-line treatment for stable coronary disease.2 Together, these forces could lead to significant declines in population-wide rates of coronary revascularization. We examined recent ...
Viewpoint 
Paul Lochhead, MBChB, MRCP; Andrew T. Chan, MD, MPH
When Norman Barrett described columnar metaplasia in the esophagus in 1950, he could not have predicted the controversies that would arise from the condition that now bears his name. In response to chronic injury from reflux esophagitis, the normally squamous-lined lower esophagus becomes reepithelialized with intestinal-type (mucus-secreting) columnar epithelium, giving ...
Original Investigation 
Misa Imaizumi, MD, PhD; Waka Ohishi, MD, PhD; Eiji Nakashima, PhD; Nobuko Sera, MD, PhD; Kazuo Neriishi, MD, PhD; Michiko Yamada, MD, PhD; Yoshimi Tatsukawa, MD, PhD; Ikuno Takahashi, MD, PhD; Saeko Fujiwara, MD, PhD; Keizo Sugino, MD, PhD; Takao Ando, MD, PhD; Toshiro Usa, MD, PhD; Atsushi Kawakami, MD, PhD; Masazumi Akahoshi, MD, PhD; Ayumi Hida, MD, PhD
Includes: Supplemental Content

Importance  Few studies have evaluated the association of radiation dose with thyroid nodules among adults exposed to radiation in childhood.

Objective  To evaluate radiation dose responses on the prevalence of thyroid nodules in atomic bomb survivors exposed in childhood.

Design, Setting, and Participants  This survey ...

Original Investigation 
Seth A. Berkowitz, MD, MPH; James B. Meigs, MD, MPH; Darren DeWalt, MD, MPH; Hilary K. Seligman, MD, MAS; Lily S. Barnard; Oliver-John M. Bright, BA; Marie Schow, BA; Steven J. Atlas, MD, MPH; Deborah J. Wexler, MD, MSc
Includes: Supplemental Content

Importance  Increasing access to care may be insufficient to improve the health of patients with diabetes mellitus and unmet basic needs (hereinafter referred to as material need insecurities). How specific material need insecurities relate to clinical outcomes and the use of health care resources in a setting ...

Original Investigation 
Peter Hajek, PhD; Hayden McRobbie, MB, ChB, PhD; Katherine Myers Smith, DPsych; Anna Phillips, BSc; Danielle Cornwall, MSc; Al-Rehan Dhanji, MB, BS
Includes: Supplemental Content

Importance  Standard varenicline tartrate dosing was formulated to avoid adverse effects (primarily nausea), but some patients may be underdosed. To our knowledge, no evidence-based guidance exists for physicians considering increasing varenicline dose if there is no response to the standard dosage.

Objective  To determine whether increasing ...

Invited Commentary 
Nancy A. Rigotti, MD
Despite decades of progress in the public health fight to reduce tobacco use, smoking remains the leading preventable cause of death in the United States.1 For the approximately 40 million US smokers left, the epidemiological evidence is clear: they will benefit from stopping smoking no matter how long they have ...
Editor's Note 
Joseph S. Ross, MD, MHS
For more than 20 years, steady progress has been made along the road to clinical trial transparency. What started with steps taken by medical journals, including disclosure of trial funding, disclosure of authors’ conflicts of interest, publication of trial protocols, and statements of authors’ contributions, has been strengthened by recent ...
Research Letter 
Ross J. Fleischman, MD; Amy H. Kaji, MD, PhD; Vivian Mae Diaz, RN; Kimberly McKenzie, BSN, MSN; Patricia Soltero, RN, BSN, MAOM; Timothy L. Van Natta, MD; Brad Spellberg, MD
Improving the flow of patients from the emergency department (ED) through the inpatient setting is one of the most vexing problems in hospital management. At Harbor-UCLA Medical Center, a public hospital and level 1 trauma center, patient flow from the ED to the inpatient setting is a serious and constant ...
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