Rebecca S. Lipner, PhD; Bradley G. Brossman, PhD; Kelli M. Samonte, PhD; Steven J. Durning, MD, PhD
Closed-book medical certification examinations have been criticized for not mimicking real-life practice, in which physicians frequently look up information to inform care. This randomized trial assessed whether allowing examinees to use an online medical information resource altered the test's ability to differentiate those who perform adequately from those who do not.
Maya E. O'Neil, PhD; Shannon M. Nugent, PhD; Benjamin J. Morasco, PhD; Michele Freeman, MPH; Allison Low, BA; Karli Kondo, PhD; Bernadette Zakher, MBBS; Camille Elven, MD; Makalapua Motu'apuaka, BA; Robin Paynter, MLIS; Devan Kansagara, MD, MCR
This systematic review summarizes evidence regarding the benefits and harms of plant-based cannabis for treating posttraumatic stress disorder in adults and describes several ongoing studies that may soon provide important results.
Shannon M. Nugent, PhD; Benjamin J. Morasco, PhD; Maya E. O'Neil, PhD; Michele Freeman, MPH; Allison Low, BA; Karli Kondo, PhD; Camille Elven, MD; Bernadette Zakher, MBBS; Makalapua Motu'apuaka, BA; Robin Paynter, MLIS; Devan Kansagara, MD, MCR
This systematic review examines evidence from 27 trials about the benefits of plant-based cannabis preparations for treating chronic pain in adults and evidence from 32 primary studies and 11 systematic reviews about potential harms of cannabis use in the general population.
Neal L. Benowitz, MD
In late July 2017, the U.S. Food and Drug Administration announced a new plan for tobacco regulation that focuses on regulating nicotine itself to reduce the nicotine content of cigarettes to nonaddictive levels. This commentary discusses the rationale behind this move and the promise it holds for reducing premature deaths due to combustible cigarette smoking.
John E. Cornell, PhD; Joshua M. Liao, MD, MSc; Catharine B. Stack, PhD, MS; Cynthia D. Mulrow, MD, MSc
In meta-analyses, researchers combine data from individual studies into a summary measure to describe the benefits or harms of an intervention. This installment of the “Understanding Clinical Research” series addresses issues that readers should consider when evaluating the meaning of a summary estimate and understanding to whom and under what circumstances it applies.
David W. Baker, MD, MPH; Mark R. Chassin, MD, MPP, MPH
Increasingly, such outcomes as readmission rates and mortality are being emphasized for public reporting of care quality and in determining payments. The measures used to assess outcomes, however, may not yet be sufficient. The Joint Commission outlines the criteria an outcome measure must meet before it is used to assess the quality of care an institution provides.
Sachin Patel, MD, PhD
There is increasing interest in the scientific evidence for medical cannabis use. This issue includes systematic reviews evaluating the evidence for cannabis in the treatment of pain and posttraumatic stress disorder. The editorialist discusses the lack of high-quality data from which to draw firm conclusions about the efficacy of cannabis for these conditions, for which cannabis is both sanctioned and commonly used.
Helen Burstin, MD, MPH; Shantanu Agrawal, MD; Amir Qaseem, MD
In their article for Annals, Baker and Chassin present 4 criteria to assess outcome measures. The editorialists discuss these criteria and the need to strive for fairness and precision in measurement and to reduce burden from measures that do not add value. They advocate for measures that matter and motivate change with information provided at the point of care on the basis of the best possible data sources, including the critical voice of the patient.
Steven E. Weinberger, MD
In recent years, the Maintenance of Certification (MOC) program of the American Board of Internal Medicine has generated substantial controversy. In their current Annals article, Lipner and colleagues report a study demonstrating that allowing access to a single informational resource did not adversely affect the performance of the examination. The editorialist discusses the findings and the need for continuing modifications to make the MOC process more relevant, more valuable, less burdensome, and less time consuming.
Reema Shah, MD
Lorraine L. Lipscombe, MD, MSc
Thomas Fekete, MD, MACP
Noel Chan, MBBS, FRACP; Jeffrey Weitz, MD, FRCPC
Fergal O’Donoghue, MB, BCh, PhD; Christine McDonald, MBBS (Hons), PhD
Susan M. Ott, MD
Kate Rowland, MD, MS
Ronald L. Koretz, MD
Benton R. Hunter, MD
Jennifer A. Rymer, MD; Christopher B. Granger, MD
Geno J. Merli, MD; Howard H. Weitz, MD
Annals Consult Guys brings a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations.
Darren B. Taichman, MD, PhD
David H. Wesorick, MD; Vineet Chopra, MD, MSc
Luci K. Leykum, MD, MBA, MSc; Kevin O'Leary, MD, MS
A growing literature focuses on teams and teamwork in health care, noting the importance of relationships, communication, and coordination; however, it is surprisingly mixed in terms of the association between team performance and patient outcomes. How might we explain this inconsistency? One possible answer lies in how teams “make sense,” or how they establish a shared understanding of a patient's situation.
Sarah Kattakuzhy, MD; Chloe Gross, RN; Benjamin Emmanuel, MPH; Gebeyehu Teferi, MD; Veronica Jenkins, MD; Rachel Silk, RN, MPH; Elizabeth Akoth, RN, MS; Aurielle Thomas, BA; Charisse Ahmed, BS; Michelle Espinosa; Angie Price, CRNP; Elana Rosenthal, MD; Lydia Tang, MD; Eleanor Wilson, MD, MS; Soren Bentzen, PhD; Henry Masur, MD; Shyam Kottilil, MD, PhD; and the ASCEND Providers
The number of patients with hepatitis C virus infection who would benefit from treatment with direct-acting antiviral therapy greatly exceeds the current workforce capacity of specialists in infectious disease and hepatology. In a unique partnership between the National Institutes of Health and federally qualified health centers in the District of Columbia, treatment outcomes were compared among patients treated by these specialists, nurse practitioners, and primary care physicians.
Shabbir M.H. Alibhai, MD, MSc; Katherine Zukotynski, MD; Cindy Walker-Dilks, MLS; Urban Emmenegger, MD; Antonio Finelli, MD, MSc; Scott C. Morgan, MD, MSc; Sebastién J. Hotte, MD, MSc; George A. Tomlinson, PhD; Eric Winquist, MD, MSc
Maintaining bone health is a significant issue for many men with prostate cancer. This systematic review summarizes evidence about the effectiveness of drug, supplement, and lifestyle interventions aimed at fracture prevention, improving bone mineral density, or preventing or delaying osteoporosis in men with nonmetastatic prostate cancer.
Azeez Farooki, MD; Howard I. Scher, MD
Alibhai and colleagues report a systematic review of therapies to maintain bone health in patients receiving hormonal therapy for prostate cancer. The editorialists discuss the findings and the need for comparative effectiveness studies of the available agents to better define their benefits and harms.
Beth Han, MD, PhD, MPH; Wilson M. Compton, MD, MPE; Carlos Blanco, MD, PhD; Elizabeth Crane, PhD, MPH; Jinhee Lee, PharmD; Christopher M. Jones, PharmD, MPH
Despite the continuing epidemic of opioid misuse, data about the prevalence and correlates of misuse are scarce. This study used data from the National Survey on Drug Use and Health to estimate the prevalence of prescription opioid use, misuse, and use disorders among civilian, noninstitutionalized U.S. adults.
Karen E. Lasser, MD, MPH
In this issue, Han and colleagues present striking results from an analysis of the 2015 National Survey on Drug Use and Health. Although improved access to evidence-based pain management and a decrease in excessive prescribing are needed, the editorialist discusses why the way out of the opioid crisis requires a much broader policy approach that alleviates social contributors to poor health.
Steffie Woolhandler, MD, MPH; David U. Himmelstein, MD
About 28 million Americans are currently uninsured and millions more could lose coverage under policy reforms proposed in Congress. At the same time, a growing number of policy leaders have called for a national health insurance system that would cover every American. In 2002, an Institute of Medicine (IOM) review concluded that lack of insurance increases mortality, but several relevant studies have appeared since that time. This article summarizes current evidence concerning the relationship of insurance and mortality.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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