Annals of family medicine
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Annals of family medicine · Nov 2008
Off the roadmap? Family medicine's grant funding and committee representation at NIH.
Family medicine is challenged to develop its own research infrastructure and to inform and contribute to a national translational-research agenda. Toward these ends, understanding family medicine's engagement with the National Institutes of Health (NIH) is important. ⋯ Departments of family medicine, and family physicians in particular, receive a miniscule proportion of NIH grant funding and have correspondingly minimal representation on standing NIH advisory committees. Family medicine's engagement at the NIH remains near well-documented historic lows, undermining family medicine's potential for translating medical knowledge into community practice, and advancing knowledge to improve health care and health for the US population as a whole.
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Annals of family medicine · Nov 2008
Comparative StudyEthnic disparities in blood pressure management in patients with hypertension after the introduction of pay for performance.
Little is known about the impact of pay-for-performance incentives on health care disparities. We examined ethnic disparities in the management of hypertension among patients with and without cardiovascular comorbidities after the implementation of a major pay-for-performance incentive scheme in UK primary care. ⋯ Ethnic disparities in the management of hypertension have persisted in the United Kingdom despite major investment in quality improvement initiatives, including pay for performance. These disparities are particularly marked among patients with multiple cardiovascular conditions.
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Annals of family medicine · Nov 2008
Comparative StudyRacial disparity in hypertension control: tallying the death toll.
Black Americans with hypertension have poorer blood pressure control than their white counterparts, but the impact of this disparity on mortality among black adults is not known. We assessed differences in systolic blood pressure (SBP) control among white and black adults with a diagnosis of hypertension, and measured the impact of that difference on cardiovascular and cerebrovascular mortality among blacks. ⋯ Eliminating racial disparity in blood pressure control among adults with hypertension would substantially reduce the number of deaths among blacks from both heart disease and stroke. Primary care clinicians should be particularly diligent when managing hypertension in black patients.
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Annals of family medicine · Nov 2008
Predicting future risk of depressive episode in adolescents: the Chicago Adolescent Depression Risk Assessment (CADRA).
A risk prediction index, similar to those used for other disorders, such as cardiovascular disease, would facilitate depression prevention by identifying those who would benefit most from preventative measures in primary care settings. ⋯ Our model predicts a depressive episode and other depressive outcomes at 1-year follow-up. Positive and negative predictive values could enable primary care physicians and families to intervene on adolescents at highest risk.