Sonia Singh, PhD; Ruiguang Song, PhD; Anna Satcher Johnson, MPH; Eugene McCray, MD; H. Irene Hall, PhD
Data from the National HIV Surveillance System were used to estimate recent changes in HIV incidence and prevalence, as well as in the percentage of undiagnosed HIV infection, in men who have sex with men. Such data may inform efforts to reduce undiagnosed HIV infection, improve access to care, and optimize treatment in this population.
Arleen F. Brown, MD, PhD; Li-Jung Liang, PhD; Stefanie D. Vassar, MS; Jose J. Escarce, MD, PhD; Sharon Stein Merkin, PhD; Eric Cheng, MD, MSHS; Adam Richards, MD, PhD; Teresa Seeman, PhD; W.T. Longstreth Jr., MD, MPH
Cardiovascular disease is a leading cause of morbidity and mortality in the United States and disproportionately affects minority adults. Despite national efforts to reduce health disparities, trends in optimal cardiovascular health across different racial/ethnic subgroups are not well-understood. This article presents U.S. trends in optimal cardiovascular health and individual cardiovascular risk factors by race/ethnicity and nativity.
Miguel A. Hernán, MD, DrPH; Daniel Scharfstein, ScD
Intention-to-treat (ITT) analyses of randomized trials have been favored because they alleviate concerns about baseline confounding, but ITT analyses estimate the effect of being assigned to an intervention rather than that of actually receiving it. Regulators, pharmaceutical companies, and academics are advocating approaches to complement ITT analyses. This commentary presents specifications to consider for such approaches.
Victor J. Dzau, MD; Alan I. Leshner, PhD
Firearm violence is a defining public health challenge of our time. Effective public health strategies have reduced other threats to public health and are built on research to identify patterns of risk, illuminate productive targets for intervention, and assess the effectiveness of interventions. The authors discuss priorities for a research agenda developed by the Institute of Medicine and the National Research Council to reduce the threat of firearm-related violence.
Bruce N. Calonge, MD, MPH; Helene D. Gayle, MD, MPH
Since the Institute of Medicine last evaluated abortion services in 1975, there have been many advances. The National Academies of Sciences, Engineering, and Medicine was asked to answer a series of questions on the appropriate use of different types of abortion services, associated health risks, safety and quality of care, necessary facility requirements, health care provider skills, safeguards for different interventions, safe provision of pain management, and the research gaps. This paper provides a synopsis of the report
Todd M. Olszewski, PhD
From 1978 to 2013, the Consensus Development Program of the National Institutes of Health was a major means of development and dissemination of medical evidence in the United States. Although framed as advisory, the program engendered political debate about the role of the federal government in medical practice and was seen by many as challenging physician autonomy.
Annals of Internal Medicine is committed to helping to end the public health emergency of firearm-related harm and is working to do so by publishing high-quality research in this understudied area, as well as influential reviews, commentaries, and position papers.
George A. Mensah, MD
Disparities in cardiovascular health remain pervasive in the United States, with higher mortality in blacks than whites. Within this context, the report from Brown and colleagues showing a narrowing of the black–white gap in cardiovascular health would seem encouraging—but the devil is in the detail. In fact, the report adds an unexpected but important wrinkle to the health disparities saga.
Barbara W. Trautner, MD, PhD
I have not yet found time to be angry about having cancer. This is not a path anyone would choose to walk; however, it is my path, and I strive to walk it with grace.
Saher Lalani, MPH
Lawrence J. Hergott, MD
Susan M. Ott, MD
William J. Hall, MD, MACP
Alexander W. Chessman, MD
Anne M. Holbrook, MD, PharmD, MSc
Anupam Goel, MD
Giannoula S. Tansarli, MD; Eleftherios Mylonakis, MD, PhD, FIDSA
Dennis G. Maki, MD, MACP
René Rodriguez-Gutierrez, MD, MSc; Victor M. Montori, MD, MSc
Ken Uchino, MD
Micelle Haydel, MD
Darren B. Taichman, MD, PhD
David H. Wesorick, MD; Vineet Chopra, MD, MSc
Patrick P. Kneeland, MD; Marisha Burden, MD
This Inpatient Notes discusses the importance of a shared definition of patient experience, provides a brief description of the Hospital Consumer Assessment of Hospitals and Providers Survey as the primary Centers for Medicare & Medicaid Services metric for the inpatient experience, and emphasizes the need for innovation in measuring and improving patient experience.
Charles J. Kahi, MD, MSc; Heiko Pohl, MD; Laura J. Myers, PhD; Dalia Mobarek, MD, MSc; Douglas J. Robertson, MD; Thomas F. Imperiale, MD
Inconsistent findings have led to uncertainty about whether colonoscopy is associated with decreased mortality from both left- and right-sided colorectal cancer (CRC). This study used data from the largest integrated health provider in the United States, the Veterans Health Administration, to assess whether colonoscopy was associated with reduced mortality from left- and right-sided CRC.
David P. Miller Jr., MD, MS; Nancy Denizard-Thompson, MD; Kathryn E. Weaver, PhD, MPH; L. Doug Case, PhD; Jennifer L. Troyer, PhD; John G. Spangler, MD, MPH; Donna Lawler; Michael P. Pignone, MD, MPH
Despite several guidelines recommending routine colorectal cancer screening in adults aged 50 years or older, more than 30% of eligible adults are unscreened. Several barriers contribute to low screening rates. This randomized controlled trial examines the efficacy of a digital health intervention targeting multilevel barriers to colorectal cancer screening in a socioeconomically diverse population.
Abigail M. Judge, PhD; Jennifer A. Murphy, PhD; Jose Hidalgo, MD; Wendy Macias-Konstantopoulos, MD, MPH
Victims of human trafficking often interact with the health care system. However, once they present for care, they encounter barriers that may challenge engagement and retention and prevent positive outcomes. New models of care are needed to better serve this most vulnerable patient population.
Shivan J. Mehta, MD, MBA, MSHP; David A. Asch, MD, MBA
Miller and colleagues report the results of a randomized trial of an iPad-based decision aid and patient self-ordering intervention that achieved a 30% colorectal cancer screening rate, compared with 15% among control patients. The editorialists speculate on what aspect of the intervention might account for the effect observed and how an even more effective intervention could be designed.
Arianne M. Lachapelle Henry, BA; Michael A. Grodin, MD
In their current article in Annals, Judge and colleagues make a valuable contribution by analyzing the nature, scope, and challenges associated with caring for victims of human trafficking. The editorialists discuss the article and the need for empirical evidence to define how to best care for this vulnerable population.
Christine M. Durand, MD; Mary G. Bowring, MPH; Diane M. Brown, MSN; Michael A. Chattergoon, MD, PhD; Guido Massaccesi, BS; Nichole Bair, BSN; Russell Wesson, MBChB; Ashraf Reyad, MBBBCh; Fizza F. Naqvi, MD; Darin Ostrander, PhD; Jeremy Sugarman, MD; Dorry L. Segev, MD, PhD; Mark Sulkowski, MD; Niraj M. Desai, MD
The mortality rate is high among patients with end-stage kidney disease who are awaiting a transplant. In a small nonrandomized clinical trial, investigators studied the tolerability and feasibility of transplanting kidneys from donors infected with hepatitis C virus to uninfected recipients who have received direct-acting antiviral therapy.
Amir Qaseem, MD, PhD, MHA; Timothy J. Wilt, MD, MPH; Devan Kansagara, MD, MCR; Carrie Horwitch, MD, MPH; Michael J. Barry, MD; Mary Ann Forciea, MD; for the Clinical Guidelines Committee of the American College of Physicians
Guidelines recommend different hemoglobin A1c targets in type 2 diabetes. The American College of Physicians reviewed available recommendations to guide clinicians in selecting targets for pharmacologic treatment of type 2 diabetes in nonpregnant outpatient adults.
Suzanne Delbanco, PhD; Tom Delbanco, MD
With patients and clinicians confronting daunting uncertainties in health care, arguments rage about quality, costs, and how to improve the lives of both those who seek and those who provide care. In light of rapidly evolving health information technologies, the authors anticipate that widespread societal movement toward greater transparency will spur important advances.
Beverly E. Thorn, PhD; Joshua C. Eyer, PhD; Benjamin P. Van Dyke, MA; Calia A. Torres, MA; John W. Burns, PhD; Minjung Kim, PhD; Andrea K. Newman, MA; Lisa C. Campbell, PhD; Brian Anderson, PsyD; Phoebe R. Block, MA; Bentley J. Bobrow, MD; Regina Brooks; Toya T. Burton, DC, MPH; Jennifer S. Cheavens, PhD; Colette M. DeMonte, PsyD; William D. DeMonte, PsyD; Crystal S. Edwards; Minjeong Jeong, PhD; Mazheruddin M. Mulla, MA, MPH; Terence Penn, BS; Laura J. Smith, BA; Deborah H. Tucker, MBA
Guidelines encourage the use of nonpharmacologic therapies, such as cognitive behavioral therapy (CBT), for pain management. Low-income patients with pain may have decreased access to CBT because of low health literacy or limited time and resources. This randomized controlled trial compared the efficacy of group-based, literacy-adapted CBT or an educational program versus usual care among socioeconomically disadvantaged patients with chronic pain symptoms.
Lisa Soleymani Lehmann, MD, PhD; Lois Snyder Sulmasy, JD; Sanjay Desai, MD; for the ACP Ethics, Professionalism and Human Rights Committee
Hidden curricula are lessons learned that are embedded in culture and are not explicitly intended. In the field of medicine, the hidden curriculum powerfully influences student and resident norms and values. This position paper from the American College of Physicians focuses on ethics, professionalism, and the hidden curriculum and identifies challenges, opportunities, and strategies for optimizing learning environments.
Krisda H. Chaiyachati, MD, MPH, MSHP; Jay Bhatt, DO, MPH, MPA; Jane M. Zhu, MD, MPP
Evidence suggests that the current growth in value-based payment models may unintentionally worsen health care disparities by disadvantaging hospitals caring for socially at-risk populations. To address this tension, value-based payment models should adopt a disparities-sensitive frame shift to integrate measures of equity into hospitals' financial calculus, incentivizing hospitals to tackle the disparities challenge without losing sight of quality.
Robert D. Kerns, PhD
In their current article for Annals, Thorn and colleagues report the successful results from a clinical trial of a patient-centered cognitive behavioral treatment approach for chronic pain in a vulnerable population. The editorialist believes that this study shows that an engaged health care organization and staff, small financial incentives for patient travel, and a patient-centered approach to service delivery can overcome at least some of the known barriers to psychological approaches to treating chronic pain.
Michael A. LaCombe, MD
In this editorial, a response to the American College of Physicians position paper on the hidden curriculum, the writer presents a fictional narrative that illustrates how teaching by example might work.
François-Xavier Mahon, MD, PhD; Carla Boquimpani, MD; Dong-Wook Kim, MD, PhD; Noam Benyamini, MD; Nelma Cristina D. Clementino, MD; Vasily Shuvaev, MD; Sikander Ailawadhi, MD; Jeffrey Howard Lipton, MD, PhD; Anna G. Turkina, MD; Raquel De Paz, MD, PhD; Beatriz Moiraghi, MD; Franck E. Nicolini, MD, PhD; Jolanta Dengler, MD; Tomasz Sacha, MD, PhD; Naoto Takahashi, MD, PhD; Rafik Fellague-Chebra, MD, MSc; Sandip Acharya, MSc; Stephane Wong, PhD, MSc; Yu Jin, MSc; Timothy P. Hughes, MD
For patients with chronic myeloid leukemia who achieve sustained deep molecular response (DMR) after treatment with imatinib, treatment-free remission (TFR) is possible. A single-group, phase 2 clinical trial investigated TFR in patients who achieved sustained DMR only after switching from imatinib to nilotinib.
Dominique J. Pepper, MBChB, MD; Dharmvir Jaswal, MD; Junfeng Sun, PhD; Judith Welsh, BSN, MLS; Charles Natanson, MD; Peter Q. Eichacker, MD
This systematic review examines whether the Centers for Medicare & Medicaid Services sepsis performance measure (which requires up to 5 hemodynamic interventions, as many as 141 tasks, and 3 hours to document for a single patient) has been shown to improve survival in adults with sepsis.
John P. Kress, MD; Jesse B. Hall, MD
Regulatory agencies evaluate hospitals' care of patients with sepsis according to their completion of the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) performance measure. Pepper and colleagues found that evidence is lacking to support a survival benefit of SEP-1 or its hemodynamic interventions. The editorialists discuss this study's importance in light of the many hours it may require for clinicians to comply with SEP-1's documentation requirements.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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