Journal of general internal medicine
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Randomized Controlled Trial Clinical Trial
The outcome of physical symptoms with treatment of depression.
This study examined the prevalence, impact on health-related quality of life (HRQoL), and outcome of physical symptoms in depressed patients during 9 months of antidepressant therapy. ⋯ Physical symptoms are prevalent in depressed patients and initially improve in the first month of SSRI treatment. Unlike depression, however, improvement in physical symptoms typically plateaus with minimal resolution in subsequent months.
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To describe the willingness of insured citizens to trade off their own health benefits to cover the uninsured. ⋯ In the context of tradeoffs with their own health insurance benefits, groups of Minnesotans presented value-based arguments about covering the uninsured. All 29 groups and two thirds of individuals chose to contribute a portion of their premium to insure all children and most groups chose also to insure uninsured adults.
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The Accreditation Council on Graduate Medical Education (ACGME) requires that house officers demonstrate competencies in "practice-based learning and improvement" and in "the ability to effectively call on system resources to provide care that is of optimum value." Anticipating this requirement, faculty at a Boston teaching hospital developed a 3-week elective for medical house officers in quality improvement (QI). The objectives of the elective were to enhance residents' understanding of QI concepts, their familiarity with the hospital's QI infrastructure, and to gain practical experience with root-cause analysis and QI initiatives. ⋯ The elective enrolled 26 residents in 3 years. Sixty-three percent of resident respondents said that the elective increased their understanding of QI in health care; 88% better understood QI in their own institution.
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Review Meta Analysis
Should aspirin be continued in patients started on warfarin?
Clinicians frequently face the decision of whether to continue aspirin when starting patients on warfarin. We performed a meta-analysis to characterize the tradeoffs involved in this common clinical dilemma. ⋯ For mechanical heart valve patients, the benefits of continuing aspirin when starting warfarin therapy are clear. For other routine warfarin indications, there are not adequate data to guide this common clinical decision.
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Randomized Controlled Trial Clinical Trial
Randomized trial examining the effect of two prostate cancer screening educational interventions on patient knowledge, preferences, and behaviors.
To assess the effect of video and pamphlet interventions on patient prostate cancer (CaP) screening knowledge, decision-making participation, preferences, and behaviors. ⋯ Mailed interventions enhance patient knowledge and self-reported participation in decision making, and alter screening preferences. The pamphlet and video interventions evaluated are comparable in effectiveness. The lower-cost pamphlet approach is an attractive option for clinics with limited resources.