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 Showing 21-40 of 73 Articles
Chelsea Bowman, MD; Eric Widera, MD
Original Investigation 
Walid F. Gellad, MD, MPH; Xinhua Zhao, PhD; Carolyn T. Thorpe, PhD, MPH; Maria K. Mor, PhD; Chester B. Good, MD, MPH; Michael J. Fine, MD, MSc

Importance  Self-monitoring of blood glucose is a costly component of care for diabetes mellitus, with unclear benefits for patients not taking insulin. Veterans with dual Department of Veterans Affairs (VA) and Medicare benefits have access to test strips through both systems, raising the potential for overuse.


Original Investigation 
Martha L. Bruce, PhD, MPH; Patrick J. Raue, PhD; Catherine F. Reilly, MPH; Rebecca L. Greenberg, MS; Barnett S. Meyers, MD; Samprit Banerjee, PhD; Yolonda R. Pickett, MD, MS; Thomas F. Sheeran, PhD, ME; Angela Ghesquiere, PhD; Diane M. Zukowski, RN, BSN; Vianca H. Rosas, MPH; Jeanne McLaughlin, MSN, MSEd; Lori Pledger, RN-BC; Joan Doyle, RN, MSN, MBA; Pamela Joachim, RN, MA; Andrew C. Leon, PhD
Includes: Supplemental Content

Importance  Among older home health care patients, depression is highly prevalent, is often inadequately treated, and contributes to hospitalization and other poor outcomes. Feasible and effective interventions are needed to reduce this burden of depression.

Objective  To determine whether, among older Medicare Home Health recipients who ...

Invited Commentary 
Constantine G. Lyketsos, MD, MHS
The rapid aging of the population is accompanied by commensurate growth in the number of individuals who have complex chronic medical conditions (diabetes mellitus, heart disease, lung disease, etc). These people are increasingly less able to interact with health care services outside of their homes. At the same time, those ...
Invited Commentary 
R. William Vandivier, MD
Secondhand tobacco smoke (SHS) consists of a combination of mainstream smoke that is exhaled from a smoker and sidestream smoke that is given off by a burning cigarette. There is no known safe level of SHS exposure, and it is associated with multiple health risks including sinorespiratory disease, cancer, and ...
Special Communication 
Sanjay Sharma, MD, FRCP(UK), FESC; Ahmed Merghani, MRCP(UK); Sabiha Gati, BSc(Hons), MRCP(UK)

Deaths of young athletes from cardiac disease are uncommon but receive considerable media attention and intermittently galvanize debates about cardiac screening prior to participation in sports. Both the American Heart Association (AHA) and European Society of Cardiology (ESC) endorse preparticipation screening in athletes; however, there is disagreement about ...

Research Letter 
Sandra J. Japuntich, PhD; Michelle A. Eilers, BA; Sharon Shenhav, BA; Elyse R. Park, PhD, MPH; Jonathan P. Winickoff, MD; Neal L. Benowitz, MD; Nancy A. Rigotti, MD
Exposure to secondhand tobacco smoke (SHS) increases adult nonsmokers’ risk of cardiovascular disease by 25% to 30%.1 Among nonsmokers hospitalized with acute coronary syndrome, SHS exposure is associated with a higher likelihood of subsequent cardiovascular and all-cause mortality as well as reinfarction.2,3 Hospitalized nonsmokers with coronary heart disease (CHD) should ...
Mori J. Krantz, MD; Sanjay Kaul, MD
This Viewpoint questions the benefit-risk balance of vorapaxar use as a component of 3-drug antiplatelet therapy for cardiovascular disease.
Dan Merenstein, MD
I must have won. That is what everyone tells me. At the beginning there were a few telephone calls, followed by e-mails, and now every talk I give someone brings up how happy I must feel for winning. What I purportedly won was the new recommendations against routine checking for ...
Original Investigation 
Inmaculada Hernandez, PharmD; Seo Hyon Baik, PhD; Antonio Piñera, MD; Yuting Zhang, PhD
Includes: Supplemental Content

Importance  It remains unclear whether dabigatran etexilate mesylate is associated with higher risk of bleeding than warfarin sodium in real-world clinical practice.

Objective  To compare the risk of bleeding associated with dabigatran and warfarin using Medicare data.

Design, Setting, and Participants  In this retrospective cohort ...

Original Investigation 
David A. Cook, MD, MHPE; Eric S. Holmboe, MD; Kristi J. Sorensen, MSEd; Richard A. Berger, MD, PhD; John M. Wilkinson, MD
Includes: Supplemental Content

Importance  Despite general support for the goals of maintenance of certification (MOC), concerns have been raised about its effectiveness, relevance, and value.

Objective  To identify barriers and enabling features associated with MOC and how MOC can be changed to better accomplish its intended purposes.

Design, Setting, ...

Editor's Note 
Rita F. Redberg, MD, MSc
Dabigatran was approved by the Food and Drug Administration (FDA) in 2010 via the accelerated pathway after a 6-month review. The haste to approve novel drugs places an increasing importance on postapproval data to help better understand risks and benefits. Thus, the postapproval data on the use of dabigatran in ...
Special Communication 
Daniel J. Morgan, MD, MS; Scott M. Wright, MD; Sanket Dhruva, MD
Includes: Supplemental Content

Importance  Overuse of medical care, consisting primarily of overdiagnosis and overtreatment, is a common clinical problem.

Objective  To identify and highlight the most significant clinical articles published in 2013 related to medical overuse.

Evidence Review  A systematic review of English-language articles published in 2013 that ...

Research Letter 
Christina Nelson, MD, MPH; Sarah Elmendorf, MD; Paul Mead, MD, MPH
Clinical features of Lyme disease include erythema migrans rash, facial palsy, arthritis, and peripheral neuropathy. In endemic areas, patients with erythema migrans can be diagnosed clinically. Otherwise, diagnosis is based on the history of possible exposure, compatible clinical features, and positive 2-tier serologic testing.1
They say that the most dangerous kind of ignorance is not knowing what you don’t know. It took me a long time to realize I had statin-related cognitive impairment because I had no idea what it was.
Original Investigation 
Seth A. Berkowitz, MD, MPH; Alexis A. Krumme, MS; Jerry Avorn, MD; Troyen Brennan, MD, MPH, JD; Olga S. Matlin, PhD; Claire M. Spettell, PhD; Edmund J. Pezalla, MD, MPH; Gregory Brill, MS; William H. Shrank, MD, MSHS; Niteesh K. Choudhry, MD, PhD
Includes: Supplemental Content

Importance  Although many classes of oral glucose-lowering medications have been approved for use, little comparative effectiveness evidence exists to guide initial selection of therapy for diabetes mellitus.

Objective  To determine the effect of initial oral glucose-lowering agent class on subsequent need for treatment intensification and 4 ...

Original Investigation 
Judith I. Tsui, MD, MPH; Jennifer L. Evans, MS; Paula J. Lum, MD, MPH; Judith A. Hahn, PhD; Kimberly Page, PhD, MPH

Importance  Injection drug use is the primary mode of transmission for hepatitis C virus (HCV) infection. Prior studies suggest opioid agonist therapy may reduce the incidence of HCV infection among injection drug users; however, little is known about the effects of this therapy in younger users.


Original Investigation 
Peter K. Lindenauer, MD, MSc; Mihaela S. Stefan, MD; Meng-Shiou Shieh, PhD; Penelope S. Pekow, PhD; Michael B. Rothberg, MD, MPH; Nicholas S. Hill, MD
Includes: Supplemental Content

Importance  Small clinical trials have shown that noninvasive ventilation (NIV) is efficacious in reducing the need for intubation and improving short-term survival among patients with severe exacerbations of chronic obstructive pulmonary disease (COPD). Little is known, however, about the effectiveness of NIV in routine clinical practice.


Invited Commentary 
Jodi B. Segal, MD, MPH; Nisa M. Maruthur, MD, MHS
Berkowitz and colleagues1 assert that there is little comparative effectiveness evidence to guide initial selection of therapy for diabetes mellitus. They therefore conducted this rigorous study to determine effects attributable to initial oral glucose-lowering agents. With a retrospective cohort design using 4 years of recent claims data from a large ...
Challenges in Clinical Electrocardiography 
P. Elliott Miller, MD; Eric L. Scholten, MD; Chintan S. Desai, MD; Ryan J. Tedford, MD
A woman in her 70s presented to our hospital with progressive shortness of breath, fatigue, and lower extremity edema. Her history included nonischemic cardiomyopathy with a left ventricular ejection fraction of 25%, New York Heart Association functional class IIIb to IV heart failure, cardiac resynchronization therapy for a left bundle ...

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