Annals of family medicine
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Annals of family medicine · Nov 2020
Review Meta AnalysisCancer-Specific Mortality, All-Cause Mortality, and Overdiagnosis in Lung Cancer Screening Trials: A Meta-Analysis.
Benefit of lung cancer screening using low-dose computed tomography (LDCT) in reducing lung cancer-specific and all-cause mortality is unclear. We undertook a meta-analysis to assess its associations with outcomes. ⋯ This meta-analysis showing a significant reduction in lung cancer-specific mortality, albeit with a tradeoff of likely overdiagnosis, supports recommendations to screen individuals at elevated risk for lung cancer with LDCT.
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Annals of family medicine · Nov 2020
The "Foresty Way": My Mother's Brave Choice of Medical Aid in Dying.
I miss my mom, who died last year, and I want to tell the happy story of her death, or perhaps the story of her happy death through her choosing and accomplishing medical aid in dying. My mom was 85 when she died, had atypical presentation of lymphoma which took time to diagnose, and went through 3 painful months of surgery, radiation, and a single horrific round of chemotherapy. ⋯ When she was in the hospital recovering from chemo, I witnessed 3 amazing doctors being true to core values of their profession. But the most profound aspect and gift of the events surrounding her death was the way in which making an informed choice gave my mom back her presence-allowing her both peace and power in the end of her life.
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Annals of family medicine · Nov 2020
How Giving and Receiving Information Has Shaped My Cancer Journey.
I have been a nurse for 40 years and I now have metastatic breast cancer. I have learned a lot, especially about giving bad news, disclosing the diagnosis to others, and using the hospital's patient portal. First, how bad news is given to patients is important and should provide clear next steps for follow-up and treatment. ⋯ It is emotionally draining and time consuming, and support by primary care clinicians (PCCs) could make a difference. Finally, patient portals can be very beneficial, but their use in a complex diagnostic process like metastatic cancer can be problematic. Primary care clinicians should explicitly discuss use of portals with patients so that they receive the information they need in the way they want.
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Annals of family medicine · Nov 2020
Potentially Preventable Hospitalizations Among Older Adults: 2010-2014.
We undertook a study to examine national trends in potentially preventable hospitalizations-those for ambulatory care-sensitive conditions that could have been avoided if patients had timely access to primary care-across 3,200 counties and various subpopulations of older adults in the United States. ⋯ During 2010-2014, rates of potentially preventable hospitalization did not change in the majority of counties. At the population level, although the rate declined among all subpopulations, dually eligible patients and Black and Hispanic patients continued to have substantially higher rates compared with non-dually eligible and White patients, respectively.