Journal of general internal medicine
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To determine if the public consumption of herbs, vitamins, and supplements changes in light of emerging negative evidence. ⋯ Results reporting harm may have a greater impact on supplement consumption than those demonstrating lack of efficacy. In order for clinical trial evidence to influence public behavior, there needs to be a better understanding of the factors that influence the translation of evidence in the public.
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Pain specialists often advocate discontinuing use of the term "narcotic," with the negative connotations it bears for many patients, in favor of the term "opioid." To contribute empirical data to this argument, we elicited and compared patient understandings of the terms "narcotic" and "opioid." ⋯ Most patients were unfamiliar with the term opioid, while a substantial percentage identified a narcotic as an illegal drug and most reported adverse consequences as the outcome of long term use. Our findings, while preliminary, suggest that "opioid" is a more unfamiliar term, but raise questions about whether simply using different terminology would affect patient fears about this class of medications.
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Assessment of authorship contribution is often based on unreliable questionnaires. ⋯ Ordinal scales for reporting authors' contributions to manuscripts were more sensitive than tick boxes for assessing the appropriateness of authorship. The exception is "Final approval of the article," which should be considered a dichotomous variable and may not be appropriate for the ICMJE definition of authorship.
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Opportunistic screening using hemoglobin A1c (HbA1c) may improve detection of undiagnosed diabetes but remains controversial. ⋯ Risk stratification improves the predictive validity of HbA1c in screening for undiagnosed diabetes in the US population. Although opportunistic screening with HbA1c would improve detection of undiagnosed diabetes, cost-effectiveness studies are needed before implementation of specific screening strategies using HbA1c.
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Limited community-based data describe weight change after diabetes diagnosis. ⋯ A small-but-substantial group of patients had a mean weight trajectory that included a clinically significant weight loss. Weight-loss trajectories were strongly associated with better glycemic control when compared to weight gain. Patients with certain characteristics may need more support for weight loss.