JAMA internal medicine
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JAMA internal medicine · Aug 2016
ReviewAspirin for Primary Prevention of Atherosclerotic Cardiovascular Disease: Advances in Diagnosis and Treatment.
Clinical decision making regarding the appropriate use of aspirin for the primary prevention of atherosclerotic cardiovascular disease (ASCVD) events is complex, and requires an individualized benefit to risk assessment. ⋯ Balancing the benefit of ASCVD reduction with the risk of bleeding from low-dose aspirin is difficult but essential for informed decision making and achieving a net clinical benefit from aspirin for primary prevention. This is facilitated by a free and readily available evidence-based clinical decision support tool.
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JAMA internal medicine · Jul 2016
Review Meta AnalysisEfficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: A Systematic Review and Meta-analysis.
Opioid analgesics are commonly used for low back pain, however, to our knowledge there has been no systematic evaluation of the effect of opioid dose and use of enrichment study design on estimates of treatment effect. ⋯ For people with chronic low back pain who tolerate the medicine, opioid analgesics provide modest short-term pain relief but the effect is not likely to be clinically important within guideline recommended doses. Evidence on long-term efficacy is lacking. The efficacy of opioid analgesics in acute low back pain is unknown.
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JAMA internal medicine · Sep 2015
Review Meta AnalysisCognitive Tests to Detect Dementia: A Systematic Review and Meta-analysis.
Dementia is a global public health problem. The Mini-Mental State Examination (MMSE) is a proprietary instrument for detecting dementia, but many other tests are also available. ⋯ Besides the MMSE, there are many other tests with comparable diagnostic performance for detecting dementia. The Mini-Cog test and the ACE-R are the best alternative screening tests for dementia, and the Montreal Cognitive Assessment is the best alternative for mild cognitive impairment.