Journal of general internal medicine
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Multicenter Study
Medical center characteristics associated with PSA screening in elderly veterans with limited life expectancy.
Although guidelines recommend against prostate-specific antigen (PSA) screening in elderly men with limited life expectancy, screening is common. ⋯ Substantial practice variation exists for PSA screening in older men with limited life expectancy across VAs. The high center-specific correlation of screening among men with limited and favorable life expectancies indicates that PSA screening is poorly targeted according to life expectancy.
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Survey data suggest that many people fear genetic discrimination by health insurers or employers. In fact, such discrimination has not yet been a significant problem. ⋯ It concludes that medical providers and health care institutions must be familiar with the general intent and specific terms of GINA, and should continue to collect genetic information that can contribute to the high quality provision of medical treatment. Not doing so violates their medical mission and diminishes the quality of care patients deserve.
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This article discusses techniques that are appropriate when developing search strategies for systematic reviews of medical tests. This includes general advice for searching for systematic reviews and issues specific to systematic reviews of medical tests. ⋯ A comprehensive search should include multiple databases and sources of grey literature. A list of subject-specific databases is included in this article.
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Comparative Study
Performance of health literacy tests among older adults with diabetes.
Knowing a patient's health literacy can help clinicians and researchers anticipate a patient's ability to understand complex health regimens and deliver better patient-centered instructions and information. Poor health literacy has been linked with lower ability to function adequately in health care systems. ⋯ A large segment of older adults is unable to complete short-form assessments of health literacy. Among those who were able to complete assessments, the REALM-SF and NVS performed comparably, but their relatively low convergence with the S-TOFHLA raises questions about instrument selection when studying health literacy of older adults.
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There is a growing awareness that patients should be more active and effective managers of their health and health care. Recent studies have found patient activation--or having the knowledge, skills, and confidence to manage one's health, to be related to health-related outcomes. These studies have often relied on self-reported outcomes and often have used small samples. ⋯ This cross sectional study finds that patient activation is strongly related to a broad range of health-related outcomes, which suggests improving activation has great potential. Future work should examine the effectiveness of interventions to support patient activation.