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 Showing 61-76 of 76 Articles
Original Investigation 
Amit N. Vora, MD, MPH; DaJuanicia N. Holmes, MS; Ivan Rokos, MD; Matthew T. Roe, MD, MHS; Christopher B. Granger, MD; William J. French, MD, PhD; Elliott Antman, MD; Timothy D. Henry, MD; Laine Thomas, PhD; Eric R. Bates, MD; Tracy Y. Wang, MD, MHS, MSc
Includes: Supplemental Content

Importance  Guidelines for patients with ST-segment elevation myocardial infarction (STEMI) recommend timely reperfusion with primary percutaneous coronary intervention (pPCI) or fibrinolysis. Among patients with STEMI who require interhospital transfer, it is unclear how reperfusion strategy selection and outcomes vary with interhospital drive times.

Objective  To assess ...

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 ...
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 ...

A man clutches his chest and collapses on the sidewalk. Call 911. Surely we want the most advanced life support (ALS) available—paramedics capable of intubating, administering intravenous medications, and managing complex arrhythmias, as well as transport to the hospital. Or do we?
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