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 Showing 21-40 of 95 Articles
Teachable Moment 
Michael J. Nabozny, MD; Nicole M. Steffens, MPH; Margaret L. Schwarze, MD, MPP
Editorial 
Gail R. Wilensky, PhD; Rita F. Redberg, MD, MSc

This year has already seen a major piece of significant bipartisan legislation1 as well as continued unfolding of many challenges in achieving meaningful health care reform.

Original Investigation 
Elyse R. Park, PhD, MPH; Ilana F. Gareen, PhD; Sandra Japuntich, PhD; Inga Lennes, MD; Kelly Hyland, BA; Sarah DeMello, MS; JoRean D. Sicks, MS; Nancy A. Rigotti, MD
Includes: Supplemental Content

Importance  The National Lung Screening Trial (NLST) found a reduction in lung cancer mortality among participants screened with low-dose computed tomography vs chest radiography. In February 2015, Medicare announced its decision to cover annual lung screening for patients with a significant smoking history. These guidelines promote smoking ...

Invited Commentary: Tobacco Cessation; Michael K. Ong, MD, PhD
Original Investigation 
Samuel Pannick, MA, MBBS, MRCP; Rachel Davis, PhD; Hutan Ashrafian, PhD, MRCS; Ben E. Byrne, MB, BChir; Iain Beveridge, MB, BChir, FRCP; Thanos Athanasiou, MD, PhD; Robert M. Wachter, MD; Nick Sevdalis, PhD
Includes: Supplemental Content

Importance  Improving the quality of health care for general medical patients is a priority, but the organization of general medical ward care receives less scrutiny than the management of specific diseases. Optimizing teams’ performance improves patient outcomes in other settings, and interdisciplinary practice is a major target ...

Invited Commentary: Inpatient Interdisciplinary Care; Hilary J. Mosher, MFA, MD; Peter J. Kaboli, MD, MS
Original Investigation 
Quyen Q. Tiet, PhD; Yani E. Leyva, PhD; Rudolf H. Moos, PhD; Susan M. Frayne, MD, MPH; Lars Osterberg, MD, MPH; Brandy Smith, BA
Includes: Supplemental Content

Importance  Illicit drug use is prevalent, and primary care provides an ideal setting in which to screen for drug use disorders (DUDs) and negative consequences of drug use (NCDU). Comprehensive reviews have concluded that existing drug use screening instruments are not appropriate for routine use in primary ...

Editor's Note: Assessment of Drug Use Disorders; Mitchell H. Katz, MD
Invited Commentary 
Michael K. Ong, MD, PhD

Tobacco use continues to be the leading preventable cause of mortality in the United States, despite a decrease in the overall prevalence of cigarette smoking. In this issue of JAMA Internal Medicine, Siegel et al1 report that cigarette smoking continues to be the attributable cause of ...

Invited Commentary 
Hilary J. Mosher, MFA, MD; Peter J. Kaboli, MD, MS

For some years, medical students at our institution have started orientation with a team-building exercise. Using paper, rubber bands, paper clips, popsicle sticks, and drinking straws, groups of 5 students are instructed to build a contraption to safely transport a raw egg from an atrium balcony to the ...

Editor's Note 
Mitchell H. Katz, MD

This Editor’s Note discusses the use of a new brief screening instrument for drug use disorders that can be used in the primary care setting.

Research Letter 
Pranav Kansara, MD, MS; Kristi Jackson, BS; Robert Dressler, MD; Henry Weiner, MD; Roger Kerzner, MD; William S. Weintraub, MD; Andrew Doorey, MD

This study used the current American Heart Association guidelines to determine whether telemetry alarms affect patient management and found that, even with the alarms designated as emergency, there were few episodes of clinically important arrhythmias and change in patient management was uncommon.

Research Letter 
Rebecca L. Siegel, MPH; Eric J. Jacobs, PhD; Christina C. Newton, MSPH; Diane Feskanich, ScD; Neal D. Freedman, PhD; Ross L. Prentice, PhD; Ahmedin Jemal, DVM, PhD

This study estimated the number of deaths attributable to cigarette smoking for 12 smoking-related cancers and found that continued progress in reducing cancer mortality requires more comprehensive tobacco control.

Invited Commentary: Tobacco Cessation; Michael K. Ong, MD, PhD
Perspective 
Shunichi Nakagawa, MD

After long training years in both general surgery and internal medicine, I recently became an attending physician in palliative medicine. One thing has become increasingly clear each day as I conduct family meetings and teach trainees how to break bad news. Palliative care, traditionally thought of as a ...

Invited Commentary: Searching for Joy in Residency by Listening to Our Patients; Blake Charlton, MD; Rachel J. Stern, MD
Teachable Moment 
Sanjiv M. Baxi, MS, MD, MPH; Joshua R. Lakin, MD
Invited Commentary: The Conundrum of Unnecessary Preoperative Testing; Gerald W. Smetana, MD
Original Investigation 
Alana E. Sigmund, MD; Elizabeth R. Stevens, MPH; Jeanna D. Blitz, MD; Joseph A. Ladapo, MD, PhD
Includes: Supplemental Content

Importance  The value of routine preoperative testing before most surgical procedures is widely considered to be low. To improve the quality of preoperative care and reduce waste, 2 professional societies released guidance on use of routine preoperative testing in 2002, but researchers and policymakers remain concerned about ...

Invited Commentary: The Conundrum of Unnecessary Preoperative Testing; Gerald W. Smetana, MD
Original Investigation 
Brian L. Strom, MD, MPH; Rita Schinnar, MPA; Jason Karlawish, MD; Sean Hennessy, PharmD, PhD; Valerie Teal, MS; Warren B. Bilker, PhD
Includes: Supplemental Content

Importance  Reports on the association between statins and memory impairment are inconsistent.

Objective  To assess whether statin users show acute decline in memory compared with nonusers and with users of nonstatin lipid-lowering drugs (LLDs).

Design, Setting, and Participants  Using The Health Improvement Network database during ...

Original Investigation 
Kelvin K. F. Tsoi, PhD; Joyce Y. C. Chan, MPH; Hoyee W. Hirai, MSc; Samuel Y. S. Wong, MD; Timothy C. Y. Kwok, MD, PhD
Includes: Supplemental Content

Importance  Dementia is a global public health problem. The Mini-Mental State Examination (MMSE) is a proprietary instrument for detecting dementia, but many other tests are also available.

Objective  To evaluate the diagnostic performance of all cognitive tests for the detection of dementia.

Data Sources  Literature ...

Invited Commentary: Copyright in Cognitive Testing; John C. Newman, MD, PhD
Invited Commentary 
Gerald W. Smetana, MD

Old habits die hard. Physicians continue to order low-value preoperative tests that add unnecessary costs and the potential for subsequent testing that could convey risk to their patients. In 2002, the American Society of Anesthesiologists issued a practice advisory on the preanesthesia evaluation, which stated, “Preoperative tests should ...

Invited Commentary 
Blake Charlton, MD; Rachel J. Stern, MD

As medical trainees, we have come to appreciate that today’s health care systems can be chaotic, fragmented, and filled with menial administrative tasks—in short, often joyless. Recently, Sinsky et al1 argued that such joylessness is one reason why fewer trainees choose primary care and why seasoned primary ...

Research Letter 
Louise Y. Sun, MD, SM, FRCPC; Andrea S. Gershon, MD, MSc, FRCPC; Dennis T. Ko, MD, MSc, FRCPC; Stephan R. Thilen, MD, MS; Lingsong Yun, MSc; W. Scott Beattie, MD, PhD, FRCPC; Duminda N. Wijeysundera, MD, PhD, FRCPC

Preoperative pulmonary function tests (PFTs) assess the severity of known pulmonary disease, diagnose causes of respiratory symptoms, and may help identify patients who are at risk for postoperative pulmonary complications. While useful in selected patients, unnecessary testing is costly.1 Few guidelines for the appropriate use of preoperative ...

Invited Commentary: The Conundrum of Unnecessary Preoperative Testing; Gerald W. Smetana, MD

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