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 Showing 21-40 of 66 Articles
Editor's Note 
Mitchell H. Katz, MD
Despite the emphasis on delivering patient-centered medicine, patients are rarely asked directly what they want or think. That is why I liked this study by Howard-Anderson et al.1 In the context of major national policy initiatives and hospital quality initiatives focused on preventing readmission, the authors asked patients who were ...
Invited Commentary 
Elisabeth M. Dietrich, MPH; Joshua M. Sharfstein, MD
The past 5 years have ushered in major, much-needed changes in the oversight of medical devices in the United States. Although several efforts remain works in progress, the US Food and Drug Administration (FDA) is taking important steps to improve premarket device review and postmarket device surveillance.
Research Letter 
Muhammad Rizwan Sardar, MD; Marwan Badri, MBChB, MRCP; Catherine T. Prince, DO, PhD, MPH; Jonathan Seltzer, MD, MBA, MA; Peter R. Kowey, MD
The American College of Cardiology/American Heart Association (ACC/AHA) guidelines are frequently used to guide cardiovascular care. Randomized controlled trials (RCTs) are considered to be the highest level of evidence and are cited in these guidelines whenever available. However, RCTs can have limited external validity. To examine their generalizability, we examined ...
Research Letter 
Jessica Howard-Anderson, MD; Sarah Lonowski, MBA; Sitaram Vangala, MS; Chi-hong Tseng, PhD; Ashley Busuttil, MD; Nasim Afsar-manesh, MD
The patient perspective on readmissions is lacking in the literature despite evidence that improved patient satisfaction is associated with decreased 30-day readmission rates1 and that patient-centered communication may improve health outcomes and reduce expenditures.2,3 In the emerging era of patient engagement in which patients increasingly desire to participate in their ...
Original Investigation 
Diana Zuckerman, PhD; Paul Brown, BS; Aditi Das, PhD
Includes: Supplemental Content

Importance  Under the 510(k) process, the US Food and Drug Administration (FDA) clears about 400 implanted medical devices that are considered moderate to high risk for market each year without requiring clinical testing. Instead, the FDA requires the applicant to provide scientific evidence that the new device ...

Original Investigation 
Ian S. Reynolds, MPH; Joshua P. Rising, MD; Allan J. Coukell, BScPharm; Kirsten H. Paulson, MS; Rita F. Redberg, MD, MSc
Includes: Supplemental Content

Importance  Postmarketing surveillance is critical to evaluating the safety and effectiveness of medical devices. The US Food and Drug Administration (FDA) may order the manufacturer of a high-risk device to conduct postmarketing surveillance studies, known as postapproval studies (PASs), at the time of approval.

Objectives  To ...

Original Investigation 
Samir Bipin Pancholy, MD; Ghanshyam Palamaner Subash Shantha, MD, MPH; Toralben Patel, MD, MPH; Lawrence J. Cheskin, MD
Includes: Supplemental Content

Importance  Although outcomes in patients with ST-segment elevation myocardial infarction (STEMI) have improved in the past 2 decades, a sex disparity exists in survival, with women having higher mortality than men.

Objective  To conduct a meta-analysis of observational studies that examined differences in mortality by sex ...

Special Communication 
Allan S. Brett, MD; Joshua D. Levine, MD

Carotid ultrasonography is performed frequently to identify carotid stenosis in patients with no history of carotid-territory cerebrovascular ischemia. The premises of such testing are that the potential benefit of endarterectomy or stenting exceeds the potential harm in patients with asymptomatic stenosis and that discovery of asymptomatic stenosis may ...

This Viewpoint describes the Food and Drug Administration’s unique device identification system for medical devices and recommends that federal agencies, specialty societies, and health care organizations collaborate to ensure that the system’s potential is fulfilled.
Patricia J. Zettler, JD; Henry T. Greely, JD
State “right-to-try” laws that purport to allow patients to be treated with unapproved drugs or devices seem likely to be futile.
Invited Commentary 
Amy E. Doran, MD; Neeral L. Shah, MD
Hepatic encephalopathy is a well-known neuropsychiatric complication of cirrhosis with symptoms ranging from mild confusion and sleep disturbance to obtundation. It is highly associated with increased mortality and health care costs.1 As the population of patients with cirrhosis grows, so do these burdens on the health care system. Lactulose treatment ...
Invited Commentary 
Nader Najafi, MD
Technology evolves quickly; scientific evidence builds slowly. This is as true for inpatient cardiac telemetry monitoring as it is for other medical interventions. Telemetry was invented in 1949 and saw widespread use in the 1960s for detecting arrhythmias in patients with myocardial infarction.1 Today the use of telemetry is ubiquitous ...
Research Letter 
Robert Dressler, MD, MBA; Marylou M. Dryer, MD, CMQ; Christian Coletti, MD; Donna Mahoney, MHCDS, CPHQ; Andrew J. Doorey, MD
Arrhythmia detection is reported to affect the clinical management of care in 3.4% to 12.7% of patients.1 The American Heart Association’s (AHA’s)2 published recommendations addressing the use of non–intensive care unit (non-ICU) cardiac telemetry stratify patients into 3 categories: cardiac telemetry is indicated, may provide benefit, or is unlikely to ...
Research Letter 
Song Hee Hong, PhD; Sunghee H. Tak, PhD, MPH, RN
The generic discount drug program (GDDP) that allows patients to pay nominal fees ($4) for filling prescriptions with generic drugs was introduced in 2006 by Walmart. The program can reduce medication costs and help patients to access their needed drug therapy, especially the elderly, poor, sicker, and racial/ethnic minority populations. ...
Topics: generic drugs
Research Letter 
Philippe Courtet, MD, PhD; Jorge Lopez-Castroman, MD, PhD; Isabelle Jaussent, BS, PhD; Philip A. P. M. Gorwood, MD, PhD
In a recent issue of JAMA Internal Medicine, Miller and colleagues1 proposed that the risk of a suicide attempt doubles among patients 24 years or younger if the initial prescription of selective serotonin reuptake inhibitors (SSRIs) exceeds the recommended dosage. Their findings unveiled the importance of antidepressant dosage on suicidal ...
Research Letter 
Emily G. McDonald, MD; Vera Dounaevskaia, MD; Todd C. Lee, MD, MPH
A recent commentary in JAMA1(p2169) suggested that patients should be encouraged to wear their own clothing so they might “maintain their self-esteem and orientation and also remind their care professionals to recognize them as people.” Other articles suggest that traditional patient gowns are associated with a loss of dignity, the ...
Topics: clothing; inpatient
Original Investigation 
Robert S. Rahimi, MD, MS; Amit G. Singal, MD, MS; Jennifer A. Cuthbert, MD; Don C. Rockey, MD
Includes: Supplemental Content

Importance  Hepatic encephalopathy (HE) is a common cause of hospitalization in patients with cirrhosis. Pharmacologic treatment for acute (overt) HE has remained the same for decades.

Objective  To compare polyethylene glycol 3350–electrolyte solution (PEG) and lactulose treatments in patients with cirrhosis admitted to the hospital for ...

Bo Wang, PharmD; Steven Joffe, MD, MPH; Aaron S. Kesselheim, MD, JD, MPH
Wang et al discuss chemo laws.
Challenges in Clinical Electrocardiography 
Lindee Strizich Tull, MD, MS; Zachary D. Goldberger, MD, MS
A man in his 30s with a medical history of remote pulmonary embolus (PE) and antiphosholipid antibody (APLA) syndrome presented to the emergency department with progressive dyspnea on exertion of 3 months’ duration. He also reported subacute, occasional, dull, substernal and right-sided exertional chest pain and a 10-pound unintentional weight ...
Invited Commentary 
Alex D. Federman, MD, MPH; Theresa Soriano, MD, MPH
A 75-year-old man lives alone and struggles to manage his heart failure, diabetes mellitus, hyperlipidemia, and chronic arthritis. He is prescribed 12 medications, including some he must take or inject 3 times a day. He cannot walk more than 30 feet without discomfort and rarely leaves home. Undertreated depression compounds ...

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