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 Showing 41-60 of 81 Articles
Editorial 
Eleni Linos, MD, DrPH; Kenneth A. Katz, MD, MSc, MSCE; Graham A. Colditz, MD, DrPH

This Editorial discusses the US Preventive Services Task Force recommendation statement on screening for skin cancer and considers the importance of skin cancer prevention.

Perspective 
Margaret Lowenstein, MD, MPhil

“But I want all the tests.”

Editorial 
Brad Spellberg, MD

In ad 321, Roman Emperor Constantine the Great codified that there would be 7 days in a week. Even in the modern era of evidence-based-medicine, this 1695-year-old decree remains a primary reference for duration of antibiotic therapy: it leads physicians to treat infections in intervals of 7 days. ...

Original Investigation 
James C. Robinson, PhD; Christopher Whaley, BA; Timothy T. Brown, PhD

Importance  Prices for laboratory and other clinical services vary widely. Employers and insurers increasingly are adopting “reference pricing” policies to create incentives for patients to select lower-priced facilities.

Objective  To measure the association between implementation of reference pricing and patient choice of laboratory, test prices, patient ...

Invited Commentary: Consumer-Oriented Approaches to Cost Containment; Paul B. Ginsburg, PhD
Original Investigation 
Halima Amjad, MD, MPH; Donald Carmichael, MDiv; Andrea M. Austin, PhD; Chiang-Hua Chang, PhD; Julie P. W. Bynum, MD, MPH
Includes: Supplemental Content

Importance  Poor continuity of care may contribute to high health care spending and adverse patient outcomes in dementia.

Objective  To examine the association between medical clinician continuity and health care utilization, testing, and spending in older adults with dementia.

Design, Setting, and Participants  This was ...

Invited Commentary: Medical Care When Memory Fails; Eric B. Larson, MD, MPH
Original Investigation 
Ane Uranga, MD; Pedro P. España, MD; Amaia Bilbao, MSc, PhD; Jose María Quintana, MD, PhD; Ignacio Arriaga, MD; Maider Intxausti, MD; Jose Luis Lobo, MD, PhD; Laura Tomás, MD; Jesus Camino, MD; Juan Nuñez, MD; Alberto Capelastegui, MD, PhD
Includes: Supplemental Content

Importance  The optimal duration of antibiotic treatment for community-acquired pneumonia (CAP) has not been well established.

Objective  To validate Infectious Diseases Society of America/American Thoracic Society guidelines for duration of antibiotic treatment in hospitalized patients with CAP.

Design, Setting, and Participants  This study was a ...

Original Investigation 
Kimon Bekelis, MD; Nancy J. Marth, MS, MSN; Kendrew Wong, BS; Weiping Zhou, MS; John D. Birkmeyer, MD; Jonathan Skinner, PhD
Includes: Supplemental Content

Importance  Physicians often must decide whether to treat patients with acute stroke locally or refer them to a more distant Primary Stroke Center (PSC). There is little evidence on how much the increased risk of prolonged travel time offsets benefits of a specialized PSC care.

Objectives  ...

Invited Commentary: Admitting the Patient With Acute Stroke to the Right House; Lee H. Schwamm, MD
Invited Commentary 
Eric B. Larson, MD, MPH

In the 1980s, we called dementia a “silent epidemic.”1 Recognition of the condition grew, especially with the announcement of former President Ronald Reagan’s affliction with the most common form, Alzheimer disease. Originally, efforts to improve dementia care seemed to focus on the difficulty of detection and differential ...

Invited Commentary 
Paul B. Ginsburg, PhD

The study by Robinson and colleagues1 of Safeway’s experience with reference pricing for laboratory services adds to a valuable, and promising, body of work examining approaches to contain health care costs. By the third year of the program, they found that the average amount spent per laboratory ...

The goal of any prehospital sorting function is to allocate patients to the most appropriate destination that will maximize their outcomes as defined by their preferences, goals, needs, and resources. In much the same way, the Sorting Hat at Hogwarts School of Witchcraft and Wizardry in J. K. ...

Electronic medical records (EMRs) are now ubiquitous and proficiency in their use is a necessary component of undergraduate medical education. Clerkship directors of medical schools have set national standards for how students should learn to access, document, and write orders in an EMR.1 However, these standards minimally ...

Research Letter 
Gregory E. Brisson, MD; Patrick D. Tyler, MD

This survey study describes how and why medical students use the electronic health record to follow patients they are no longer caring for.

Research Letter 
Peter K. Lindenauer, MD, MSc; Mihaela S. Stefan, MD, PhD; Laura C. Feemster, MD, MS; Meng-Shiou Shieh, PhD; Shannon S. Carson, MD; David H. Au, MD, MS; Jerry A. Krishnan, MD, PhD

This study uses medical record data from Premier Alliance to describe the receipt, type, and timing of antibiotic therapy in patients with asthma in 2013 and 2014.

Perspective 
Erik Rifkin, PhD; Andy Lazris, MD, CMD

As an environmental scientist and expert on evaluating risk, I’ve become something of a therapeutic nihilist. I rarely see my physician (Andy Lazris, MD, my coauthor, encouraged me to share and helped write my story)—and want no screening tests when I do. But when I had a heart ...

Original Investigation 
Michael Klompas, MD, MPH; Lingling Li, PhD; Ken Kleinman, ScD; Paul M. Szumita, PharmD; Anthony F. Massaro, MD
Includes: Supplemental Content

Importance  Ventilator bundles, including head-of-bed elevation, sedative infusion interruptions, spontaneous breathing trials, thromboprophylaxis, stress ulcer prophylaxis, and oral care with chlorhexidine gluconate, are ubiquitous, but the absolute and relative value of each bundle component is unclear.

Objective  To evaluate associations between individual and collective ventilator bundle ...

Invited Commentary: Care Bundles; Andrew Auerbach, MD, MPH; Peter Lindenauer, MD, MSc
Original Investigation 
Sara G. Rasmussen, MHS; Elizabeth L. Ogburn, PhD; Meredith McCormack, MD; Joan A. Casey, PhD; Karen Bandeen-Roche, PhD; Dione G. Mercer, BS; Brian S. Schwartz, MD, MS
Includes: Supplemental Content

Importance  Asthma is common and can be exacerbated by air pollution and stress. Unconventional natural gas development (UNGD) has community and environmental impacts. In Pennsylvania, UNGD began in 2005, and by 2012, 6253 wells had been drilled. There are no prior studies of UNGD and objective respiratory ...

Original Investigation 
Frank Bloos, MD, PhD; Evelyn Trips, MSc; Axel Nierhaus, MD, EIDEC; Josef Briegel, MD; Daren K. Heyland, MD; Ulrich Jaschinski, MD; Onnen Moerer, MD; Andreas Weyland, MD; Gernot Marx, MD; Matthias Gründling, MD; Stefan Kluge, MD; Ines Kaufmann, MD; Klaus Ott, MD; Michael Quintel, MD; Florian Jelschen, MD; Patrick Meybohm, MD; Sibylle Rademacher, MD; Andreas Meier-Hellmann, MD; Stefan Utzolino, MD; Udo X. Kaisers, MD; Christian Putensen, MD; Gunnar Elke, MD; Maximilian Ragaller, MD; Herwig Gerlach, MD, PhD, MBA; Katrin Ludewig, MD; Michael Kiehntopf, MD; Holger Bogatsch, MD; Christoph Engel, MD; Frank M. Brunkhorst, MD; Markus Loeffler, MD; Konrad Reinhart, MD; for SepNet Critical Care Trials Group
Includes: Supplemental Content

Importance  High-dose intravenous administration of sodium selenite has been proposed to improve outcome in sepsis by attenuating oxidative stress. Procalcitonin-guided antimicrobial therapy may hasten the diagnosis of sepsis, but effect on outcome is unclear.

Objective  To determine whether high-dose intravenous sodium selenite treatment and procalcitonin-guided anti-infectious ...

Invited Commentary 
Andrew Auerbach, MD, MPH; Peter Lindenauer, MD, MSc

The concept of a bundle as a way to implement multiple best practices together to support quality improvement and better patient outcomes has great appeal.1,2 However, little is known about how bundles work and whether the individual components or the group are most important to ...

Teachable Moment 
Patrick D. Tyler, MD; Marc R. Larochelle, MD, MPH; John N. Mafi, MD, MPH

This Teachable Moment discusses the how the Centers for Disease Control and Prevention guidelines for opioid prescribing can play a major role in limiting the impact of this epidemic.

Challenges in Clinical Electrocardiography 
Joshua R. Shak, MD, PhD; Amanda K. Johnson, MD, MBA; Nora Goldschlager, MD

A man in his 20s presented to the emergency department with 1 day of chest pressure. He reported no medical history. Four days prior to presentation he had experienced subjective fevers, rhinorrhea, a dry cough, and sinus congestion. The day prior to presentation he had experienced 3 hours ...

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