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 Showing 21-40 of 77 Articles
Teachable Moment 
Daniel Schneider, MD, PhD; Douglas Arenberg, MD
Editorial: Selecting the Best Candidates for Lung Cancer Screening; Tanner Caverly, MD, MPH
Tanner Caverly, MD, MPH
The Center for Medicare and Medicaid Services (CMS) recently decided to reimburse for annual lung cancer screening with low-dose computed tomography (LDCT) among persons who meet the inclusion criteria for the National Lung Cancer Screening Trial (NLST).1 Those who have smoked for more than 30 pack-years, continue to smoke, or ...
Original Investigation 
Elizabeth Dzeng, MD, MPH, MPhil, MS; Alessandra Colaianni, BA, MPhil; Martin Roland, BM BCh, DM; Geetanjali Chander, MD, MPH; Thomas J. Smith, MD; Michael P. Kelly, PhD; Stephen Barclay, BM BCh, MD; David Levine, MD, MHS, ScD
Includes: Supplemental Content

Importance  Controversy exists regarding whether the decision to pursue a do-not-resuscitate (DNR) order should be grounded in an ethic of patient autonomy or in the obligation to act in the patient’s best interest (beneficence).

Objective  To explore how physicians’ approaches to DNR decision making at the ...

Invited Commentary: Resuscitation Discussions; Lynnea Mills, MD; Wendy Anderson, MD, MS
Original Investigation  FREE
Lawrence Oresanya, MD; Shoujun Zhao, MD, PhD; Siqi Gan, MPH; Brant E. Fries, PhD; Philip P. Goodney, MD, MS; Kenneth E. Covinsky, MD, MPH; Michael S. Conte, MD; Emily Finlayson, MD, MS

Importance  Lower extremity revascularization often seeks to allow patients with peripheral arterial disease to maintain the ability to walk, a key aspect of functional independence. Surgical outcomes in patients with high levels of functional dependence are poorly understood.

Objective  To determine functional status trajectories, changes in ...

Invited Commentary: Revascularization in Nursing Home Residents; William J. Hall, MD, MACP
Original Investigation 
Hannah Arem, MHS, PhD; Steven C. Moore, PhD; Alpa Patel, PhD; Patricia Hartge, ScD; Amy Berrington de Gonzalez, DPhil; Kala Visvanathan, MBBS, MPH; Peter T. Campbell, PhD; Michal Freedman, JD, PhD; Elisabete Weiderpass, MD, MSc, PhD; Hans Olov Adami, MD, PhD; Martha S. Linet, MD; I.-Min Lee, MBBS, ScD; Charles E. Matthews, PhD
Includes: Supplemental Content

Importance  The 2008 Physical Activity Guidelines for Americans recommended a minimum of 75 vigorous-intensity or 150 moderate-intensity minutes per week (7.5 metabolic-equivalent hours per week) of aerobic activity for substantial health benefit and suggested additional benefits by doing more than double this amount. However, the upper limit ...

Invited Commentary: Achieving the Most Public Health Bang for the Buck; Todd M. Manini, PhD
Original Investigation 
Klaus Gebel, PhD; Ding Ding, PhD; Tien Chey, MAppStats; Emmanuel Stamatakis, PhD; Wendy J. Brown, PhD; Adrian E. Bauman, PhD

Importance  Few studies have examined how different proportions of moderate and vigorous physical activity affect health outcomes.

Objective  To examine whether the proportion of total moderate to vigorous activity (MVPA) that is achieved through vigorous activity is associated with all-cause mortality independently of the total amount ...

Invited Commentary  FREE
William J. Hall, MD, MACP
The number of older adults residing in long-term care facilities in the United States is increasing at an unprecedented rate; at present, there are approximately 1.5 million nursing home residents, and this number will double to 3 million by 2030.1 More than half will be older than 85 years. Most ...
Invited Commentary 
Lynnea Mills, MD; Wendy Anderson, MD, MS
Prior work1 has indicated that institutional cultural, political, and policy-driven factors affect physicians’ decisions and recommendations surrounding end-of-life care. However, until now, to our knowledge, no published study has aimed to verify this effect specifically on discussions of resuscitation status and to understand cultural effects on trainees’ development of their ...
Invited Commentary 
Todd M. Manini, PhD
The overall health benefits of physical activity have been known for several decades. It is clear that consistent participation in physical activity leads to large physiologic adaptations that are closely connected to improved cardiorespiratory, vascular, musculoskeletal, mental, and metabolic health. These effects are pervasive across the lifespan. In fact, there ...
Challenges in Clinical Electrocardiography 
Brooks M. Walsh, MD; Rehan Karim; Stephen W. Smith, MD
A man in his 70s with a history of myocardial infarction (MI) and coronary artery bypass surgery, as well as an ejection fraction of 25% and biventricular pacemaker (BVP) placement, was brought to the emergency department for dull chest pain of 2 hours’ duration. An electrocardiogram (ECG) was obtained (Figure ...
Anna D. Sinaiko, PhD; Alyna T. Chien, MD, MS; Meredith B. Rosenthal, PhD
This Viewpoint recommends actions for states to improve the content, availability, and salience of publicly available health care price information.
Teachable Moment 
Stephanie E. Rogers, MD, MS, MPH, PA; Liviu Klein, MD, MS; Carla Maria Perissinotto, MD, MHS
Original Investigation 
Matthew A. Davis, DC, MPH, PhD; Julie P. W. Bynum, MD, MPH; Brenda E. Sirovich, MD, MS
Includes: Supplemental Content

Importance  Fruit consumption is believed to have beneficial health effects, and some claim, “An apple a day keeps the doctor away.”

Objective  To examine the relationship between eating an apple a day and keeping the doctor away.

Design, Setting, and Participants  A cross-sectional study of ...

Editor's Note: The Prescription Is Laughter; Rita F. Redberg, MD, MSc
Original Investigation 
Rohan Khera, MD; Peter Cram, MD, MBA; Xin Lu, MS; Ankur Vyas, MD, MS; Alicia Gerke, MD, MS; Gary E. Rosenthal, MD; Phillip A. Horwitz, MD; Saket Girotra, MD, SM
Includes: Supplemental Content

Importance  Percutaneous ventricular assist devices (PVADs) provide robust hemodynamic support compared with intra-aortic balloon pumps (IABPs), but clinical use patterns are unknown.

Objective  To examine contemporary patterns in PVAD use in the United States and compare them with use of IABPs.

Design, Setting, and Participants  ...

Editor's Note: High-Risk Medical Devices; Joseph S. Ross, MD, MHS
Original Investigation 
David B. Bekelman, MD, MPH; Mary E. Plomondon, PhD, MSPH; Evan P. Carey, MS; Mark D. Sullivan, MD, PhD; Karin M. Nelson, MD, MSHS; Brack Hattler, MD; Connor F. McBryde, MD; Kenneth G. Lehmann, MD; Katherine Gianola, MD; Paul A. Heidenreich, MD; John S. Rumsfeld, MD, PhD
Includes: Supplemental Content

Importance  Heart failure (HF) has a major effect on patients’ health status, including their symptom burden, functional status, and health-related quality of life.

Objective  To determine the effectiveness of a collaborative care patient-centered disease management (PCDM) intervention to improve the health status of patients with HF....

Original Investigation 
Joanna L. Hart, MD, MSHP; Michael O. Harhay, MPH, MBE; Nicole B. Gabler, PhD, MHA; Sarah J. Ratcliffe, PhD; Caroline M. Quill, MD, MSHP; Scott D. Halpern, MD, PhD
Includes: Supplemental Content

Importance  Although the end-of-life care patients receive is known to vary across nations, regions, and centers, these differences are best explored within a group of patients with presumably similar care preferences.

Objective  To examine the proportions of patients admitted to the intensive care unit (ICU) with ...

Invited Commentary: ICU Treatment Escalation Despite Preexisting Limitations; Amber E. Barnato, MD, MPH, MS; Elizabeth Dzeng, MD, MPH, MPhil, MS
Original Investigation 
Marius Henriksen, PT, MSc, PhD; Robin Christensen, PhD; Louise Klokker, MSc; Cecilie Bartholdy, MSc; Elisabeth Bandak, MSc; Karen Ellegaard, PhD; Mikael P. Boesen, PhD; Robert G. Coumine Riis, MD; Else M. Bartels, PhD; Henning Bliddal, DMSc
Includes: Supplemental Content

Importance  Osteoarthritis (OA) of the knee is the most frequent form of arthritis and a cause of pain and disability. Combined nonpharmacologic and pharmacologic treatments are recommended as the optimal treatment approach, but no evidence supports the recommendation.

Objective  To assess the clinical benefits of an ...

Original Investigation 
Yousif Ahmad, MRCP; Sayan Sen, PhD; Matthew J. Shun-Shin, MRCP; Jing Ouyang, BA; Judith A. Finegold, MRCP; Rasha K. Al-Lamee, MRCP; Justin E. R. Davies, PhD; Graham D. Cole, MRCP; Darrel P. Francis, MD
Includes: Supplemental Content

Importance  Intra-aortic balloon pump (IABP) therapy is a widely used intervention for acute myocardial infarction with cardiogenic shock. Guidelines, which previously strongly recommended it, have recently undergone substantial change.

Objective  To assess IABP efficacy in acute myocardial infarction.

Data Sources  Human studies found in Pubmed, ...

Editor's Note: High-Risk Medical Devices; Joseph S. Ross, MD, MHS
Invited Commentary 
Amber E. Barnato, MD, MPH, MS; Elizabeth Dzeng, MD, MPH, MPhil, MS
In this issue of JAMA Internal Medicine, Hart and colleagues 1 provide, to our knowledge, the first known epidemiologic data on treatment patterns among patients admitted to the intensive care unit (ICU) with preexisting treatment limitations. Treatment limitations are explicit statements by the patient, documented in the medical record, refusing ...
Editor's Note 
Rita F. Redberg, MD, MSc
Although we take seriously the statement, “An apple a day keeps the doctor away”1 (and the importance of a good parachute), these articles launch our first April Fool’s issue. At least once per year, and more is likely better (but needs to be tested), laughter is the best medicine. We ...

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