Annals of family medicine
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Annals of family medicine · Nov 2004
Randomized Controlled Trial Multicenter Study Clinical TrialImproving test ordering in primary care: the added value of a small-group quality improvement strategy compared with classic feedback only.
We wanted to evaluate the added value of small peer-group quality improvement meetings compared with simple feedback as a strategy to improve test-ordering behavior. Numbers of tests ordered by primary care physicians are increasing, and many of these tests seem to be unnecessary according to established, evidence-based guidelines. ⋯ Compared with only disseminating comparative feedback reports to primary care physicians, the new strategy of involving peer interaction and social influence improved the physicians' test-ordering behavior. To be effective, feedback needs to be integrated in an interactive, educational environment.
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Annals of family medicine · Sep 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComfortably engaging: which approach to alcohol screening should we use?
We wanted to compare 2 screening instruments for problem drinking, the CAGE and a single question, assessing frequency of use, patient and clinician comfort, and patient engagement in change. ⋯ Clinicians and patients reported similar comfort with the CAGE questions and the single-question screening tools for problem drinking, and the 2 instruments were equal in their ability to engage the patient. In Missouri, the single question was more likely to be used.
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Annals of family medicine · May 2004
Randomized Controlled Trial Clinical TrialPatient pain in primary care: factors that influence physician diagnosis.
The accurate recognition of patient pain is a crucial, but sometimes difficult, task in medical care. This study explored factors related to the physician's diagnosis of pain in primary care patients. ⋯ The diagnosis of pain is influenced by the severity of patient pain, patient gender, and physician practice style. If the routine use of pain assessment tools is found to be effective in improving physician recognition and treatment of patients' pain, then application of these tools in patient care settings should be encouraged.
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Annals of family medicine · May 2003
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialGlycemic control in medical inpatients with type 2 diabetes mellitus receiving sliding scale insulin regimens versus routine diabetes medications: a multicenter randomized controlled trial.
Hospitalized patients with type 2 diabetes mellitus traditionally receive insulin on a sliding-scale regimen, but the benefits of this approach are unclear. The purpose of this study was to compare the effects of the sliding scale insulin regimen with those of routine diabetes medications on hyperglycemia, hypoglycemia and length of hospitalization in diabetic patients hospitalized for other conditions. ⋯ The use of the sliding scale insulin regimen in combination with routine diabetes medications does not affect the rate of hyperglycemia, hypoglycemia or length of hospitalization in patients with type 2 diabetes mellitus hospitalized for other conditions.
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Annals of family medicine · May 2003
Randomized Controlled Trial Clinical TrialPatient education for informed decision making about prostate cancer screening: a randomized controlled trial with 1-year follow-up.
The efficacy of prostate cancer screening is uncertain, and professional organizations recommend educating patients about potential harms and benefits. We evaluated the effect of a videotape decision aid on promoting informed decision making about prostate cancer screening among primary care patients. ⋯ Decision aids for prostate cancer screening can have a long-term effect on screening behavior and appear to promote informed decision making.