Annals of internal medicine
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Multicenter Study
Patient-physician connectedness and quality of primary care.
Valid measurement of physician performance requires accurate identification of patients for whom a physician is responsible. Among all patients seen by a physician, some will be more strongly connected to their physician than others, but the effect of connectedness on measures of physician performance is not known. ⋯ National Cancer Institute.
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Randomized Controlled Trial Multicenter Study
Immediate listing for liver transplantation versus standard care for Child-Pugh stage B alcoholic cirrhosis: a randomized trial.
Liver transplantation improves survival of patients with end-stage (Child-Pugh stage C) alcoholic cirrhosis, but its benefit for patients with stage B disease is uncertain. ⋯ The French National Program for Clinical Research.
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Randomized Controlled Trial Multicenter Study
Association between statin use and risk for keratinocyte carcinoma in the veterans affairs topical tretinoin chemoprevention trial.
Recent evidence suggests that statins may prevent cancer. ⋯ These data show no conclusive or consistent relationship between long-term statin use and risk for keratinocyte carcinoma.
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Although many physicians worry that openly discussing a poor prognosis will cause patients and families to lose hope, surrogate decision makers' perspectives on this topic are largely unknown. ⋯ Most surrogates of critically ill patients do not view withholding prognostic information as an acceptable way to maintain hope, largely because timely discussions about prognosis help families begin to prepare emotionally, existentially, and practically for the possibility that a patient will die.
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Multicenter Study
Surgical treatment of spinal stenosis with and without degenerative spondylolisthesis: cost-effectiveness after 2 years.
The SPORT (Spine Patient Outcomes Research Trial) reported favorable surgery outcomes over 2 years among patients with stenosis with and without degenerative spondylolisthesis, but the economic value of these surgeries is uncertain. ⋯ The economic value of spinal stenosis surgery at 2 years compares favorably with many health interventions. Degenerative spondylolisthesis surgery is not highly cost-effective over 2 years but could show value over a longer time horizon.