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 Showing 41-60 of 71 Articles
Editor's Note 
Deborah Grady, MD, MPH
We commend the American Society of Anesthesiologists for using solid and transparent methods to develop a “top-five” list of low-value activities that should be avoided. We published this list1 in an ongoing effort to support the American Board of Internal Medicine Foundation’s “Choosing Wisely” campaign aimed at engaging specialty medical ...
Invited Commentary 
David M. Shahian, MD
In the current issue, Brinkman and colleagues1 use the Society of Thoracic Surgeons National Database (STS-ND) to study the effect of preoperative β-blockade on postoperative coronary artery bypass grafting (CABG) outcomes. Their results show no mortality advantage and a paradoxically increased incidence of atrial fibrillation (AF) in patients receiving preoperative ...
Invited Commentary 
Beverly B. Green, MD, MPH; Gloria D. Coronado, PhD
Colorectal cancer (CRC) is a leading cause of cancer death in the United States. Many CRC deaths could be averted by screening because screening decreases both CRC incidence and mortality by 30% to 60%.1 Although CRC screening rates have risen in recent years, with 65% of Americans aged 50 to ...
Invited Commentary 
Paul Arthur James, MD
High-quality health care is often summarized as delivering the right care to the right patient every time. In this issue of JAMA Internal Medicine, Rodriguez and colleagues1 publish an important study using data from the Atherosclerosis Risk in Communities (ARIC) Study to further inform the debate about which patients should ...
Invited Commentary 
Dhruv S. Kazi, MD, MSc, MS; Mark A. Hlatky, MD
Despite the introduction of several novel oral anticoagulants, warfarin remains the most widely used anticoagulation agent worldwide. Physicians have extensive experience with warfarin, it is inexpensive, its effects are easily reversible, and its activity can be monitored with a simple blood test. However, warfarin has a narrow therapeutic index and ...
Topics: warfarin; genes; genotype
Research Letter 
Viengneesee Thao, MS; Katy B. Kozhimannil, PhD; Will Thomas, PhD; Ezra Golberstein, PhD
Hematopoietic cell transplantation (HCT) using the patient’s own (autologous) or a donor’s (allogeneic) HCT progenitor cells is a highly effective but costly therapy for life-threatening blood disorders and cancers. Despite the small number of annual procedures (20 000 a year in the United States), HCT hospitalization spending increased from $684 ...
Research Letter 
Daichi Shimbo, MD; Rikki M. Tanner, MPH; Paul Muntner, PhD
For more than 20 years, US Joint National Committee (JNC) hypertension guidelines, including JNC 7, have recommended systolic and diastolic blood pressure (BP) thresholds of 140/90 mm Hg for the initiation of antihypertensive medication and a goal during treatment for individuals without diabetes or chronic kidney disease.1,2 The 2014 report ...
Original Investigation 
David W. Baker, MD, MPH; Tiffany Brown, MPH; David R. Buchanan, MD, MS; Jordan Weil, BA; Kate Balsley, MPH; Lauren Ranalli, MPH; Ji Young Lee, MS; Kenzie A. Cameron, PhD, MPH; M. Rosario Ferreira, MD; Quinn Stephens, BA; Shira N. Goldman, MPH; Alred Rademaker, PhD; Michael S. Wolf, PhD

Importance  Colorectal cancer (CRC) screening rates are lower among Latinos and people living in poverty. Fecal occult blood testing (FOBT) is one recommended screening modality that may overcome cost and access barriers. However, the ability of FOBT to reduce CRC mortality depends on high rates of adherence ...

Original Investigation 
William Brinkman, MD; Morley A. Herbert, PhD; Sean O’Brien, PhD; Giovanni Filardo, PhD; Syma Prince, RN; Todd Dewey, MD; Mitchell Magee, MD; William Ryan, MD; Michael Mack, MD
Includes: Supplemental Content

Importance  Use of preoperative β-blockers has been associated with a reduction in perioperative mortality for patients undergoing coronary artery bypass grafting (CABG) surgery in observational research studies, which led to the adoption of preoperative β-blocker therapy as a national quality standard.

Objective  To determine whether preoperative ...

Original Investigation 
Kathleen Stergiopoulos, MD, PhD; David L. Brown, MD
Includes: Supplemental Content

Importance  Significant variations in dose requirements of warfarin and its analogues (acenocoumarol and phenprocoumon) make selecting the appropriate dose for an individual patient difficult. Genetic factors account for approximately one-third of the variation in dose requirement. The clinical usefulness of genotype-guided dosing of warfarin has been previously ...

Topics: warfarin; genotype
Original Investigation 
Carlos J. Rodriguez, MD, MPH; Katrina Swett, MS; Sunil K. Agarwal, MD, PhD; Aaron R. Folsom, MD, MPH; Ervin R. Fox, MD, MPH; Laura R. Loehr, MD, PhD; Hanyu Ni, PhD, MPH; Wayne D. Rosamond, PhD; Patricia P. Chang, MD, MHS
Includes: Supplemental Content

Importance  Studies document a progressive increase in heart disease risk as systolic blood pressure (SBP) rises above 115 mm Hg, but it is unknown whether an SBP lower than 120 mm Hg among adults with hypertension (HTN) lowers heart failure, stroke, and myocardial infarction risk.

Objective  ...

Perspective 
John H. Davidson, MD
She showed up on the afternoon of Christmas Eve to be seen as a new patient. She indicated that she had come at the insistence of her family. They were worried about her diabetes. She offered that over the previous decade she had seen more than 20 physicians. She said ...
Perspective 
Timothy Sullivan, MD
Special Communication 
Onyi C. Onuoha, MD, MPH; Valerie A. Arkoosh, MD, MPH; Lee A. Fleisher, MD
Includes: Supplemental Content

To develop a “top-five” list of unnecessary medical services in anesthesiology, we undertook a multistep survey of anesthesiologists, most of whom were in academic practice, and a consequent iterative process with the committees of the American Society of Anesthesiologists. We generated a list of 18 low-value perioperative activities ...

Original Investigation 
Jennifer S. Albrecht, PhD; Xinggang Liu, MD, PhD; Mona Baumgarten, PhD; Patricia Langenberg, PhD; Gail B. Rattinger, PharmD, PhD; Gordon S. Smith, MB, ChB, MPH; Steven R. Gambert, MD; Stephen S. Gottlieb, MD; Ilene H. Zuckerman, PharmD, PhD

Importance  The increased risk of hemorrhage associated with anticoagulant therapy following traumatic brain injury creates a serious dilemma for medical management of older patients: Should anticoagulant therapy be resumed after traumatic brain injury, and if so, when?

Objective  To estimate the risk of thrombotic and hemorrhagic ...

Case Report/Case Series 
David C. Peritz, MD; Aaron Vaughn, MD; Mario Ciocca, MD; Eugene H. Chung, MD

Importance  Left ventricular noncompaction (LVNC) is a rare cause of progressive cardiomyopathy thought to result from incomplete myocardial development. It has been associated with an increased risk of sudden death, especially in those with a depressed left ventricular ejection fraction. Thus, the current recommendation for patients with ...

Editor's Note 
Joseph S. Ross, MD, MHS
Over the past 15 years, interactions between physicians and the pharmaceutical and medical device industries have received ever greater scrutiny. While the benefits of research collaboration have always been recognized, there are growing concerns that financial relationships are threatening the integrity of research, professional education, patient care, and the public’s ...
Invited Commentary 
Beatrice Alexandra Golomb, MD, PhD
Statins (3-hydroxy-3-methylglutaryl coenzyme A [HMG-CoA] reductase inhibitors) are medications taken by patients at high risk of cardiovascular disease, for whom physical activity is an important part of behavioral treatment recommendations. However, statins are also linked to muscle symptoms and fatigue, which may lead to reduced physical activity.
Invited Commentary 
Judith J. Prochaska, PhD, MPH
This year marked the 50th anniversary of the Surgeon General’s 1964 report on the health consequences of smoking.1 Tobacco use is causally linked to diseases of nearly all bodily organs, overall deficits in health, and considerable medical costs. Annually, 480 000 deaths in the United States are attributed to tobacco, ...
Original Investigation 
Peter Cunningham, PhD

Importance  Increased patient engagement with health and health care is considered crucial to increasing the quality of health care and patient self-management of health.

Objective  To examine whether patients with high levels of engagement during medical encounters are more likely to receive advice and counseling about ...

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