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 Showing 61-73 of 73 Articles
Katherine T. Hamilton, MD; Benjamin J. Lee, MD
Original Investigation 
Nicolas Garin, MD; Daniel Genné, MD; Sebastian Carballo, MD, DPhil; Christian Chuard, MD; Gerhardt Eich, MD; Olivier Hugli, MD, MPH; Olivier Lamy, MD; Mathieu Nendaz, MD, MHPE; Pierre-Auguste Petignat, MD; Thomas Perneger, MD, PhD; Olivier Rutschmann, MD, MPH; Laurent Seravalli, MD; Stephan Harbarth, MD, MS; Arnaud Perrier, MD
Includes: Supplemental Content

Importance  The clinical benefit of adding a macrolide to a β-lactam for empirical treatment of moderately severe community-acquired pneumonia remains controversial.

Objective  To test noninferiority of a β-lactam alone compared with a β-lactam and macrolide combination in moderately severe community-acquired pneumonia.

Design, Setting, and Participants  ...

Original Investigation 
Peter K. Lindenauer, MD, MSc; Tara Lagu, MD, MPH; Joseph S. Ross, MD, MHS; Penelope S. Pekow, PhD; Amy Shatz, MPH; Nicholas Hannon, BS; Michael B. Rothberg, MD, MPH; Evan M. Benjamin, MD
Includes: Supplemental Content

Importance  Public reporting of quality is considered a key strategy for stimulating improvement efforts at US hospitals; however, little is known about the attitudes of hospital leaders toward existing quality measures.

Objectives  To describe US hospital leaders’ attitudes toward hospital quality measures found on the Centers ...

Original Investigation 
Jin Wang, MD; Pan Wang, BPharm; Xinghe Wang, PhD; Yingdong Zheng, PhD; Yonghong Xiao, MD, PhD
Includes: Supplemental Content

Importance  Appropriate antibiotic use is a key strategy to control antibacterial resistance. The first step in achieving this is to identify the major problems in antibiotic prescription in health care facilities, especially in primary health care settings, which is where most patients receive medical care.

Objective  ...

Original Investigation 
Nancy R. Cook, ScD; Paul M Ridker, MD
Includes: Supplemental Content

Importance  While the pooled cohort equations from the recent American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the Assessment of Cardiovascular Risk have overestimated cardiovascular risk in multiple external cohorts, the reasons for the discrepancy are unclear.

Objective  To determine whether increased use of statins ...

Invited Commentary 
Steven E. Nissen, MD
Thomas Jefferson, the third American President and author of the Declaration of Independence, famously opined, “Governments derive their just powers from the consent of the governed.” The principle underlying this simple statement is an essential component of any collection of rules that govern how individuals conform to behavioral standards. Clinical ...
Invited Commentary 
Michael Bell, MD
Antibiotics are an essential medical resource. The ability to treat infections not only saves lives but provides a safety net for medical advances that now seem routine: trauma surgery, cancer chemotherapy, and stem cell and organ transplantation—each inherently reliant on effective antibiotics in order to deliver their life-saving potential. Antibiotic ...
Invited Commentary 
Lara Goitein, MD
Is there too much focus on measuring and reporting quality rather than on the conditions needed for improving it? The Centers for Medicare & Medicaid Services (CMS) and other organizations require physicians and hospitals to publicly report performance on quality measures, and the CMS and private payers are tying reimbursement ...
Invited Commentary 
Jonathan S. Lee, MD; Michael J. Fine, MD, MSc
Although our understanding of pneumonia dates back thousands of years to when symptoms were recognized by Hippocrates, the first typical bacterial pathogen responsible for causing community-acquired pneumonia (CAP), Streptococcus pneumoniae, was not isolated until the late 19th century. Another half a century passed before 3 atypical bacteria were discovered as ...
Challenges in Clinical Electrocardiography 
Curtis M. Steyers III, MD; Prashant D. Bhave, MD
A 64-year-old white woman presented to the emergency department for evaluation of episodic palpitations and chest tightness. On arrival to the emergency department, her symptoms had entirely resolved. A 12-lead electrocardiogram (ECG) was obtained while she was asymptomatic and is shown in Figure 1A. Minutes later, the patient developed recurrence ...
Research Letter 
Jeffrey A. Linder, MD, MPH; Jason N. Doctor, PhD; Mark W. Friedberg, MD, MPP; Harry Reyes Nieva, BA; Caroline Birks, MD; Daniella Meeker, PhD; Craig R. Fox, PhD
Clinicians make many patient care decisions each day. The cumulative cognitive demand of these decisions may erode clinicians’ abilities to resist making potentially inappropriate choices. Psychologists, who refer to the erosion of self-control after making repeated decisions as decision fatigue,1,2 have found evidence that it affects nonmedical professionals. For example, ...
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.
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 ...

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