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 Showing 21-40 of 67 Articles
Invited Commentary 
Lewis S. Nelson, MD; David N. Juurlink, MD, PhD
Pain is one of the leading reasons why patients seek medical attention, and over the past 2 decades, clinicians, health care institutions, medical organizations, and regulators have become increasingly attentive to its management. Yet despite the importance of pain as a clinical entity, the well of approved pharmacologic options is ...
Invited Commentary 
Marc J. Claeys, MD, PhD
The current guidelines for the management of ST-segment elevation myocardial infarction (STEMI) recommend primary percutaneous coronary intervention (pPCI) as the preferred treatment strategy if it can be conducted in a timely fashion by an experienced catheterization team.1 Because of the restricted availability of hospitals providing pPCI support 24 hours 7 ...
Research Letter 
Jonathan Bergman, MD, MPH; Christopher S. Saigal, MD, MPH; Mark S. Litwin, MD, MPH
Recently released Medicare physician utilization and payment data1 illuminate the reasons that physician payments from the Centers for Medicare & Medicaid Services vary. One could expect that while physician payments may vary widely based on the type of physician service, payments indexed to unique patients should not. In addition, physician ...
Research Letter 
Earl S. Ford, MD, MPH; Julie C. Will, PhD; Carla I. Mercado, PhD; Fleetwood Loustalot, PhD, FNP
Risk assessment has become an important tool to assess an individual’s future risk for cardiovascular disease. Recently, the American College of Cardiology/American Heart Association (ACC/AHA) released a report that presented updated risk equations, the Pooled Cohort Risk Equations, for cardiovascular disease.1 Race and ethnicity-specific estimates were novel to the new ...
Research Letter 
Catherine S. Hwang, MSPH; Lydia W. Turner, MHS; Stefan P. Kruszewski, MD; Andrew Kolodny, MD; G. Caleb Alexander, MD, MS
Chronic pain is one of the most common reasons for seeking medical attention in the United States, and such pain is frequently treated with prescription opioids. The clinical use of these products nearly doubled between 2000 and 2010,1 with simultaneous increases in the incidence of opioid abuse, addiction, injury, and ...
Perspective 
Christie Aschwanden
At a routine appointment a few days after my 40th birthday, my gynecologist gave me a prescription for a mammogram. There was no discussion, no explanation. Just a slip of paper, handed to me without a word as I left the examination room. When I asked the doctor what she’d ...
Perspective 
Tom Bartol, MN
A family friend recently shared the experience of her 83-year-old mother, a relatively healthy woman who lives independently at home. She has 3 daughters who check in on her and support her. The only notable medical history was a stroke about a year and a half prior that resulted in ...
Original Investigation 
Jessica M. Peña, MD, MPH; Sara Aspberg, MD, PhD; Jean MacFadyen, BA; Robert J. Glynn, ScD; Daniel H. Solomon, MD, MPH; Paul M Ridker, MD, MPH
Includes: Supplemental Content

Importance  Osteoporosis and cardiovascular disease may share common biological pathways, with inflammation playing a role in the development of both. Although observational studies have suggested that statin use is associated with a lower risk of fractures, randomized trial data addressing this issue are scant.

Objective  To ...

Invited Commentary 
Miriam Kuppermann, PhD, MPH; George F. Sawaya, MD
In this issue of JAMA Internal Medicine, 2 poignant accounts of experiences with breast cancer screening are presented: that of a 40-year-old trying to engage her physician in shared decision-making regarding mammography, which she ultimately decides to forgo,1 and the account of an 83-year-old who has the test, perhaps without ...
Invited Commentary 
Grace Y. Jenq, MD; Mary E. Tinetti, MD
At the time of discharge from an acute care hospital many patients are not able to return home and need a short or extended stay at skilled nursing facilities. This is not a new phenomenon. However, using the National Hospital Discharge Survey data, Burke et al1 found a 49% increase ...
Research Letter 
Bradley M. Gray, PhD; Jonathan L. Vandergrift, MS; Guodong (Gordon) Gao, PhD; Jeffrey S. McCullough, PhD; Rebecca S. Lipner, PhD
One-third of consumers in the United States who consulted physician website ratings reported selecting and/or avoiding physicians because of these ratings.1 However, little is known about the validity of these ratings. Available studies have focused mostly on hospital website ratings or non-US website ratings.2,3 We partially address this gap by ...
Research Letter 
Matthew D. Galsky, MD; Kristian D. Stensland, MD; Russell B. McBride, PhD; Asma Latif, MD; Erin Moshier, MS; William K. Oh, MD; Juan Wisnivesky, MD, DrPH
Clinical trials yield critical evidence to guide the care of patients with cancer. According to commonly used practice guidelines, “...the best management of any cancer patient is in a clinical trial.”1 Nonetheless, only about 2% to 7% of US adult patients with cancer participate in clinical trials.2 Poor accrual to ...
Research Letter 
Robert E. Burke, MD; Elizabeth Juarez-Colunga, PhD; Cari Levy, MD, PhD; Allan V. Prochazka, MD, MSc; Eric A. Coleman, MD, MPH; Adit A. Ginde, MD, MPH
Medicare’s payment reforms in the 1990s significantly affected hospital length of stay and post–acute care (PAC) (eg, skilled nursing or rehabilitation) facility use.1,2 However, few studies describe contemporary length of stay and postdischarge care trends in a nationally representative sample of Medicare and non-Medicare patients. We sought to understand these ...
Viewpoint 
James N. Kirkpatrick, MD; Paul J. Hauptman, MD; Sarah J. Goodlin, MD
Modern cardiovascular therapies offer unprecedented opportunities to improve survival and quality of life. Cardiovascular morbidity and mortality have significantly declined, owing in a large part to preventive therapies and technological advances such as coronary revascularization, implantable cardioverter defibrillators (ICDs), and ventricular assist devices (VADs). Newer therapies like transcatheter aortic valve ...
Original Investigation 
Jason F. Okulicz, MD; Tuan D. Le, MD, DrPH; Brian K. Agan, MD; Jose F. Camargo, MD; Michael L. Landrum, MD; Edwina Wright, MD; Matthew J. Dolan, MD; Anuradha Ganesan, MD; Tomas M. Ferguson, MD; Davey M. Smith, MD; Douglas D. Richman, MD; Susan J. Little, MD; Robert A. Clark, MD; Weijing He, MD; Sunil K. Ahuja, MD
Includes: Supplemental Content

Importance  In individuals with human immunodeficiency virus 1 (HIV-1) infection who are receiving antiretroviral therapy (ART), factors that promote full immune recovery are not well characterized.

Objective  To investigate the influence of the timing of ART relative to HIV-1 infection on normalization of CD4+ T-cell ...

Original Investigation 
Prachi Sanghavi, BS; Anupam B. Jena, MD, PhD; Joseph P. Newhouse, PhD; Alan M. Zaslavsky, PhD
Includes: Supplemental Content

Importance  Most out-of-hospital cardiac arrests receiving emergency medical services in the United States are treated by ambulance service providers trained in advanced life support (ALS), but supporting evidence for the use of ALS over basic life support (BLS) is limited.

Objective  To compare the effects of ...

Original Investigation 
Danny R. Hughes, PhD; Miao Jiang, PhD; Richard Duszak Jr, MD
Includes: Supplemental Content

Importance  Little is known about the use of diagnostic testing, such as medical imaging, by advanced practice clinicians (APCs), specifically, nurse practitioners and physician assistants.

Objective  To examine the use of diagnostic imaging ordered by APCs relative to that of primary care physicians (PCPs) following office-based ...

Original Investigation 
James Krieger, MD, MPH; Lin Song, PhD; Miriam Philby, MA
Includes: Supplemental Content

Importance  Asthma is often poorly controlled. Home visitation by community health workers (CHWs) to improve control among adults has not been adequately evaluated.

Objective  To test the hypothesis that CHW home visits for adults with uncontrolled asthma improve outcomes relative to usual care.

Design, Setting, and ...

Invited Commentary 
Timothy W. Schacker, MD
Two critically important issues in human immunodeficiency virus (HIV) therapeutics are when to start antiretroviral therapy and how well these medications restore immunity. In this issue of JAMA Internal Medicine, Okulicz et al1 describe a prospective cohort study of 1119 US military service persons with known seroconversion dates who were ...
Invited Commentary 
Harrison J. Alter, MD, MS
“The medical care system in the United States is being restructured, with the goal of containing rising health care expenditures. Cost-containment strategies…have as their major purpose restraining the use of high-cost medical services. Yet little attention has been paid to how patients’ health and level of functioning in everyday activities ...

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