Journal of general internal medicine
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Comparative Study
Osteoporosis risk assessment and ethnicity: validation and comparison of 2 clinical risk stratification instruments.
Dual energy x-ray absorptiometry (DXA), coupled with early treatment, may reduce morbidity and mortality associated with osteoporosis. Clinical tools to enhance selection of women for DXA screening have not been developed or validated in an ethnically diverse population. ⋯ The performance of the ORAI and SCORE instrument differed significantly from previous reports. Although both can reduce the use of DXA scans for screening for osteoporosis, lower sensitivities resulted in underrecognition of osteoporosis and may limit their clinical usefulness in an ethnically diverse population.
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Randomized Controlled Trial
Predictors of quitting among African American light smokers enrolled in a randomized, placebo-controlled trial.
To examine the predictors of quitting among African American (AA) light smokers (<10 cigarettes per day) enrolled in a smoking cessation trial. ⋯ Individual characteristics may decrease the likelihood of quitting; however, the provision of directive, advice-oriented counseling focused on the addictive nature of nicotine, health consequences of smoking, benefits of quitting, and development of a concrete quit plan may be an important and effective facilitator of quitting among AA light smokers.
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As educators seek confirmation of successful trainee achievement, medical education must move toward a more evidence-based approach to teaching and evaluation. Although medical training often provides physicians with a general background in biostatistics, many are not prepared to apply these skills. ⋯ This paper is intended to be a concise educational tool and guide for choosing and interpreting statistical tests aimed toward medical education assessment. It includes guidelines and examples that clinician-educators can use when analyzing and interpreting studies and when writing methods and results sections of reports.
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Multicenter Study
Primary care provider concerns about management of chronic pain in community clinic populations.
Chronic pain is a common patient complaint in primary care, yet providers and patients are often dissatisfied with treatment processes and outcomes. ⋯ A substantial proportion of adult primary care appointments involve patients with chronic pain complains. Dissatisfaction with training and substantial concerns about patient self-management and about opioid prescribing suggest areas for improving medical education and postgraduate training. Emphasis on patient-centered approaches to chronic pain management, including skills for assessing risk of opioid abuse and addiction, is required.
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Comparative Study
Attitudes of urban American Indians and Alaska Natives regarding participation in research.
To determine what factors influence participation in health research among American Indians and Alaska Natives. ⋯ Close attention to study type, institutional sponsorship, community involvement, potential risks and benefits, and topic are essential to conceptualizing, designing, and implementing successful health research with American Indian and Alaska Native populations.