JAMA internal medicine
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JAMA internal medicine · Oct 2014
Comparative Study Observational StudyAssociation of treatment with carvedilol vs metoprolol succinate and mortality in patients with heart failure.
The β-blockers carvedilol and metoprolol succinate both reduce mortality in patients with heart failure (HF), but the comparative clinical effectiveness of these drugs is unknown. ⋯ These findings from real-world clinical practice indicate that the effectiveness of carvedilol and metoprolol succinate in patients with HF is similar.
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JAMA internal medicine · Oct 2014
How cardiologists present the benefits of percutaneous coronary interventions to patients with stable angina: a qualitative analysis.
Patients with stable coronary artery disease (CAD) attribute greater benefit to percutaneous coronary interventions (PCI) than indicated in clinical trials. Little is known about how cardiologists' presentation of the benefits and risks may influence patients' perceptions. ⋯ Few cardiologists discussed the evidence-based benefits of angiogram and PCI for stable CAD, and some implicitly or explicitly overstated the benefits. The etiology of patient misunderstanding is likely multifactorial, but if future quantitative studies support the findings of this hypothesis-generating analysis, modifications to cardiologists' approach to describing the risks and benefits of the procedure may improve patient understanding.
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JAMA internal medicine · Oct 2014
Hypoglycemia after antimicrobial drug prescription for older patients using sulfonylureas.
Certain antimicrobial drugs interact with sulfonylureas to increase the risk of hypoglycemia. ⋯ Prescription of interacting antimicrobial drugs to patients on sulfonylureas is very common, and is associated with substantial morbidity and increased costs.
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JAMA internal medicine · Oct 2014
Cancer screening rates in individuals with different life expectancies.
Routine cancer screening has unproven net benefit for patients with limited life expectancy. ⋯ A substantial proportion of the US population with limited life expectancy received prostate, breast, cervical, and colorectal cancer screening that is unlikely to provide net benefit. These results suggest that overscreening is common in both men and women, which not only increases health care expenditure but can lead to net patient harm.
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JAMA internal medicine · Oct 2014
Trends in dietary quality among adults in the United States, 1999 through 2010.
Many changes in the economy, policies related to nutrition, and food processing have occurred within the United States since 2000, and the net effect on dietary quality is not clear. These changes may have affected various socioeconomic groups differentially. ⋯ Although a steady improvement in AHEI-2010 was observed across the 12-year period, the overall dietary quality remains poor. Better dietary quality was associated with higher socioeconomic status, and the gap widened with time. Future efforts to improve nutrition should address these disparities.