Yuichi Mori, MD, PhD; Shin-ei Kudo, MD, PhD; Masashi Misawa, MD, PhD; Yutaka Saito, MD, PhD; Hiroaki Ikematsu, MD, PhD; Kinichi Hotta, MD; Kazuo Ohtsuka, MD, PhD; Fumihiko Urushibara, MD, PhD; Shinichi Kataoka, MD; Yushi Ogawa, MD; Yasuharu Maeda, MD, PhD; Kenichi Takeda, MD, PhD; Hiroki Nakamura, MD; Katsuro Ichimasa, MD, PhD; Toyoki Kudo, MD, PhD; Takemasa Hayashi, MD, PhD; Kunihiko Wakamura, MD, PhD; Fumio Ishida, MD, PhD; Haruhiro Inoue, MD, PhD; Hayato Itoh, PhD; Masahiro Oda, PhD; Kensaku Mori, PhD
Confident identification during colonoscopy of polyps that do not require resection could reduce costs. This study evaluated the performance of real-time computer-aided diagnosis with endocytoscopes in differentiating nonneoplastic from neoplastic colorectal polyps during colonoscopy.
Pauline Raaschou, MD, PhD; Jonas Söderling, MSE, PhD; Carl Turesson, MD (Professor); Johan Askling, MD (Professor); for the ARTIS Study Group
Clinical guidelines have issued cautions about use of tumor necrosis factor inhibitors (TNFi) in patients with a history of cancer because these drugs may have tumor-promoting effects. Thus, use of TNFi in patients with rheumatoid arthritis and a history of cancer is a clinical conundrum. This population-based cohort study from Sweden examined the risk for cancer recurrence in patients with rheumatoid arthritis and a history of cancer who were prescribed TNFi.
Heidi D. Nelson, MD, MPH; Amy Cantor, MD, MPH; Miranda Pappas, MA; Liev Miller, BA
This systematic review addresses evidence for the Women's Preventive Services Initiative recommendation for screening for urinary incontinence in women.
Robin J. Bell, MBBS, PhD, MPH; Susan R. Davis, MBBS, PhD
The Women's Preventive Services Initiative recommends that clinicians screen women of all ages for urinary incontinence annually and, if appropriate, refer them for further evaluation and treatment. This editorial discusses the recommendation and advises caution regarding widespread screening on the basis of limited, indirect evidence.
Øyvind Holme, MD, PhD; Lars Aabakken, MD, PhD
Mori and colleagues report promising findings from a study using computer-aided diagnosis to characterize colonic polyps. The editorialists discuss these results and what is needed before such technology can be incorporated into routine colorectal cancer screening practice.
Nancy O'Reilly, MHS; Heidi D. Nelson, MD, MPH; Jeanne M. Conry, MD, PhD; Jennifer Frost, MD; Kimberly D. Gregory, MD, MPH; Susan M. Kendig, JD, WHNP-BC; Maureen Phipps, MD, MPH; Alina Salganicoff, PhD; Diana Ramos, MD, MPH; Christopher Zahn, MD; Amir Qaseem, MD, PhD, MHA; for the Women's Preventive Services Initiative
This article reports the Women's Preventive Services Initiative (WPSI) recommendations on screening for urinary incontinence in women. The WPSI is a national coalition of women's health professional organizations and patient representatives whose recommendations are intended to guide clinical practice and coverage of services for the Health Resources and Services Administration and other stakeholders.
Rebecca O'Brien, MD; Eric Johnson, MS; Sebastien Haneuse, PhD; Karen J. Coleman, PhD; Patrick J. O'Connor, MD, MA, MPH; David P. Fisher, MD; Stephen Sidney, MD, MPH; Andy Bogart, MS; Mary Kay Theis, MA, MS; Jane Anau, BS; Emily B. Schroeder, MD, PhD; David Arterburn, MD, MPH
It is well established that bariatric surgery results in improved glycemic control in patients with type 2 diabetes mellitus and severe obesity. Whether bariatric surgery affects incidence of microvascular disease is uncertain. This long-term observational study compares the incidence of diabetic retinopathy, nephropathy, and neuropathy in severely obese patients with type 2 diabetes who either had bariatric surgery or received usual medical care.
Peter P. Reese, MD, MSCE; Peter L. Abt, MD; Emily A. Blumberg, MD; Vivianna M. Van Deerlin, MD, PhD; Roy D. Bloom, MD; Vishnu S. Potluri, MD, MPH; Matthew Levine, MD, PhD; Paige Porrett, MD, PhD; Deirdre Sawinski, MD; Susanna M. Nazarian, MD, PhD; Ali Naji, MD, PhD; Richard Hasz, BS, MFS; Lawrence Suplee, MS; Jennifer Trofe-Clark, PharmD; Anna Sicilia, BS; Maureen McCauley, BA; Caren Gentile, MS; Jennifer Smith, BS; Bijan A. Niknam, BS, BA; Melissa Bleicher, MD; K. Rajender Reddy, MD; David S. Goldberg, MD, MSCE
Recent trials have found favorable short-term results with transplant of hepatitis C virus (HCV)–infected kidneys into HCV-negative recipients, but intermediate-term end points, such as durable HCV cure and 1-year graft function, remain unknown. The authors conducted a single-center, open-label, nonrandomized trial to describe 12-month HCV treatment outcomes, estimated glomerular filtration rate, and quality of life for 20 HCV-negative kidney transplant recipients.
Gerald W. Smetana, MD; Jennifer Beach, MD; Lewis Lipsitz, MD; Howard Libman, MD
The optimum threshold above which to begin antihypertensive therapy as well as the optimum target blood pressure to achieve with medication are areas of controversy, especially in older adults. Two guidelines published in 2017 address this issue. In this Beyond the Guidelines, 2 experts debate application of these guidelines to the care of a 79-year-old man with hypertension.
Scott Manaker, MD, PhD; M. Douglas Leahy, MD
The proposed rule for the 2019 Medicare Physician Fee Schedule contains a bold proposal to eliminate mandated documentation guidelines for outpatient evaluation and management services in exchange for a flat, fixed payment rate and relief from audit burdens. This commentary discusses the advantages and disadvantages of the new coding and reimbursement scheme and why the authors believe the Centers for Medicare & Medicaid Services and the physician community should proceed with caution.
Atul Grover, MD, PhD; Gayle Lee, JD
The changes to Medicare payment documentation guidelines proposed by the Centers for Medicare & Medicaid Services may potentially simplify documentation requirements. However, this commentary argues that it is more likely that the proposal to condense rates under the physician fee schedule will result in reductions in payments to many physicians for services provided to medically vulnerable patients.
Joel Tsevat, MD, MPH; Christopher Moriates, MD
Value-based health care (VBHC), cost-effectiveness analysis, and value-based payment (a component of VBHC) are 3 approaches for addressing “bang for the health care buck.” In this article, the authors compare these approaches to efficient resource allocation and emphasize the need for them to better align in order to provide the best possible care at the lowest possible costs for patients.
Carel W. le Roux, MD, PhD; Philip R. Schauer, MD
In their article, O'Brien and colleagues investigate the relationship between bariatric surgery and incident microvascular complications of type 2 diabetes mellitus. The editorialists discuss the findings and why they believe that bariatric surgery is safe and is, at present, our most evidence-based treatment to put hyperglycemia into remission. Surgery should not be a last resort. Prevention is definitely better than cure.
Adnan Sharif, MBChB, MD
Despite favorable short-term results with transplant of hepatitis C virus (HCV)–positive kidneys into HCV-negative recipients, the American Society of Transplantation's enthusiasm for this approach is muted. In this issue, Reese and colleagues provide evidence for the benefits of this approach in the current era of direct-acting antiviral agents. The editorialist discusses the promise these results hold for improving outcomes among patients requiring kidney transplant.
Milda R. Saunders, MD, MPH; Barbara J. Turner, MD, MSEd
Read and colleagues report on a cross-sectional 2017 survey of internists that shows that the salary gap between women and men in the medical profession has long been an unfortunate, unconscionable norm that persists in internal medicine. The editorialists discuss the findings and speculate about strategies that could promote gender equity in physician compensation.
Lyssa Weatherly, MD
That morning, I became more aware than ever of the limits of medicine.
Gaetan Sgro, MD
Darren B. Taichman, MD, PhD
Kenneth Schmader, MD
Robert M. Centor, MD; Robert M. McLean, MD
In this episode of Annals On Call, Dr. Centor discusses targeting treatment for gout with Dr. Robert McLean, a rheumatologist and a co-author of the American College of Physicians clinical guidelines on the management of gout.
Kimberly R. Myers, MA, PhD; Molly Osborne, MD, PhD; Charlotte A. Wu, MD; Zoe S. Schein, MA
Annals Graphic Medicine brings together original graphic narratives, comics, animation/video, and other creative forms by those who provide or receive health care. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.
Shiuh-Wen Luoh, MD, PhD; Keith T. Flaherty, MD
Matching unique features of cancer types with effective therapies is a cornerstone of precision medicine. Recent advances have found that the success of biomarker-driven cancer therapy may be relevant across sites of origin. Several large, ongoing clinical trials with a “basket” design are combining tumor tissue genomics with potential off-the-shelf therapies in drug development, and more tissue-agnostic biomarker therapies are reaching the bedside.
Michael F. Murray, MD
Geisinger Health System received considerable attention in May 2018 when it announced that DNA sequencing would become a routine part of its clinical care. This commentary discusses why identifying persons with genetic risk and effectively mitigating that risk is a worthy goal and emphasizes that the timing of the introduction of genetic data into routine clinical care is contingent on further demonstrations of clinical utility and proven implementation models.
Salomeh Keyhani, MD, MPH; Stacey Steigerwald, MSSA; Julie Ishida, MD, MAS; Marzieh Vali, MS; Magdalena Cerdá, DrPH; Deborah Hasin, PhD; Camille Dollinger, BS; Sodahm R. Yoo, BS; Beth E. Cohen, MD, MAS
Although evidence is limited regarding the potential health benefits and safety of marijuana, legal access to it is increasing and marijuana products are being aggressively marketed to the public. This nationally representative U.S. survey evaluated public perceptions regarding the health benefits and risks of marijuana use.
Joel Kupfer, MD; Rachel S. Witmer, MHA; Viet Do, DO
Congress recently passed the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018. This act removes barriers to veterans' access to community-based health care providers and permanently establishes the commercial health care marketplace as another provider of health care to veterans. The authors of this commentary discuss the implications of expanding private sector health care for veterans on veterans' health care experiences and outcomes and on the Veterans Affairs health system.
Michael J. Pencina, PhD; Frank W. Rockhold, PhD; Ralph B. D'Agostino Sr., PhD
Experts and regulators have called for methods used in traditional trials to be adapted to “real-world” settings. This article describes 3 promising approaches that meld rigorous methodology with real-world data.
Aïda Bafeta, PhD; Mitsuki Koh, MPH; Carolina Riveros, MSc; Philippe Ravaud, MD, PhD
This systematic review describes whether and how harms were reported in 384 randomized controlled trials of probiotics, prebiotics, or synbiotics.
Lisa S. Rotenstein, MD, MBA; Rebecca A. Berman, MD; Joel T. Katz, MD; Maria A. Yialamas, MD
Female physicians are less likely to become full professors and are paid lower salaries than their male colleagues. This article describes the discovery of a gender disparity in “shout-outs” in a residency program and actions that rectified the disparity.
Daniel S. Graciaa, MD, MPH; Matthew H. Collins, MD, PhD; Henry M. Wu, MD
Since it peak in 2016, the prevalence of Zika virus has decreased; at the same time, travel to Zika-affected countries has rebounded. Many gaps remain in our knowledge about key features of this viral infection, making it difficult to counsel patients who are contemplating travel to Zika-affected countries and to determine appropriate testing strategies on their return. The authors outline what is currently known and unknown about this unprecedented viral infection and suggest an approach to shared decision making between travel medicine providers and patients.
Darren B. Taichman, MD, PhD; Christine Laine, MD, MPH
The editorialist discusses Tannenbaum and colleagues' findings, the recently adopted requirement for data sharing statements, and how each relates to efforts to ensure that the scientific community learns all it can from clinical trials.
Sandra A. Springer, MD; P. Todd Korthuis, MD, MPH; Carlos del Rio, MD
Implementation and scaling up of effective treatment for opioid use disorder (OUD) in health care settings are urgently needed to address the intersecting epidemics of OUD and its infectious disease consequences. In this article, the authors discuss 5 action steps from a recent workshop on the integration of infectious disease considerations and responses to the OUD epidemic.
Darios Getahun, MD, PhD, MPH; Rebecca Nash, MPH; W. Dana Flanders, MD, MPH, DSc; Tisha C. Baird, MD; Tracy A. Becerra-Culqui, PhD; Lee Cromwell, MS; Enid Hunkeler, MA; Timothy L. Lash, PhD; Andrea Millman, MA; Virginia P. Quinn, PhD; Brandi Robinson, MPH; Douglas Roblin, PhD; Michael J. Silverberg, PhD; Joshua Safer, MD; Jennifer Slovis, MD; Vin Tangpricha, MD, PhD; Michael Goodman, MD, MPH
The electronic medical records of Kaiser Permanente sites in Georgia and northern and southern California were examined to compare the risk for venous thromboembolic disease, ischemic stroke, and myocardial infarction among transgender versus cisgender persons.
Mark H. Eckman, MD, MS; E. Steve Woodle, MD; Charuhas V. Thakar, MD; Flavio Paterno, MD, MPH; Kenneth E. Sherman, MD, PhD
New antiviral drugs now cure nearly everyone with hepatitis C virus (HCV) infection, including those who have end-stage renal disease. In addition, patients with HCV who need a kidney transplant can receive an uninfected or an infected organ. This study examines whether it is better for someone who has HCV infection to receive an infected kidney first and then be treated after the transplant or to be treated first and then receive an uninfected kidney.
Michael Bretthauer, MD, PhD; Mette Kalager, MD, PhD; David S. Weinberg, MD, MSc
On 30 May 2018, the American Cancer Society (ACS) released updated guidelines for colorectal cancer (CRC) screening. Whereas nearly all previous guidelines recommended screening beginning at age 50 years, the ACS recommended that an additional 22 million Americans aged 45 to 49 years also participate in CRC screening. This commentary discusses concerns about the evidence behind and implications of the ACS recommendation to expand CRC screening to younger persons.
David S. Goldberg, MD, MSCE; Peter P. Reese, MD, MSCE
Direct-acting antiviral therapy for hepatitis C virus (HCV) infection has introduced a dilemma for kidney transplantation in HCV-infected patients: Pursue an HCV cure first, or accept an HCV-infected donor organ and receive treatment afterward? In their article, Eckman and colleagues report a decision model that concludes that the second option is superior. The editorialists believe that this information should lead to better care for some patients and wider use of HCV-infected kidneys, but regional variation in the availability of HCV-infected organs and patient preferences will sometimes make treatment first a reasonable choice.
Jennifer J. Stuart, ScD; Lauren J. Tanz, ScD; Stacey A. Missmer, ScD; Eric B. Rimm, ScD; Donna Spiegelman, ScD; Tamarra M. James-Todd, PhD; Janet W. Rich-Edwards, ScD
Women with a history of hypertensive disorders of pregnancy (HDP) are more likely to develop cardiovascular disease (CVD) than those who are normotensive during pregnancy. Guidelines recommend that clinicians evaluate CVD risk by screening for a history of HDP, but data on which risk factors to screen for and the frequency and timing of screening are lacking. The authors examined associations of gestational hypertension and preeclampsia with development of chronic hypertension, type 2 diabetes, and hypercholesterolemia among a sample of women from the Nurses' Health Study II.
Abigail Fraser, BA, MA, MPH, PhD
In this issue, Stuart and colleagues, using data from the Nurses' Health Study II, report associations between a history of a first pregnancy complicated by a hypertensive disorder of pregnancy and physician-diagnosed hypertension, hypercholesterolemia, and type 2 diabetes over the course of 3 decades after pregnancy. The editorialist discusses the findings and the need to invest in research on this topic to reduce the burden of cardiovascular disease in women.
Irl B. Hirsch, MD; Jay S. Skyler, MD
This commentary was selected for publication from among several submitted in response to a call for readers' perspectives on treatment targets for type 2 diabetes.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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