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Effect of Four Hemoglobin Transfusion Threshold Strategies in Patients With Acute Myocardial Infarction and Anemia : A Target Trial Emulation Using MINT Trial Data. 四种血红蛋白输注阈值策略对急性心肌梗死和贫血患者的影响 :利用 MINT 试验数据进行目标试验模拟。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 Epub Date: 2024-10-01 DOI: 10.7326/M24-0571
Gerard T Portela, Jeffrey L Carson, Sonja A Swanson, John H Alexander, Paul C Hébert, Shaun G Goodman, Philippe Gabriel Steg, Marnie Bertolet, Jordan B Strom, Dean A Fergusson, Tabassome Simon, Harvey D White, Howard A Cooper, J Dawn Abbott, Sunil V Rao, Bernard R Chaitman, Christopher B Fordyce, Renato D Lopes, Benoit Daneault, Maria M Brooks

Background: The optimal hemoglobin threshold to guide red blood cell (RBC) transfusion for patients with acute myocardial infarction (MI) and anemia is uncertain.

Objective: To estimate the efficacy of 4 individual hemoglobin thresholds (<10 g/dL [<100 g/L], <9 g/dL [<90 g/L], <8 g/dL [<80 g/L], and <7 g/dL [<70 g/L]) to guide transfusion in patients with acute MI and anemia.

Design: Prespecified secondary analysis of the MINT (Myocardial Ischemia and Transfusion) trial using target trial emulation methods. (ClinicalTrials.gov: NCT02981407).

Setting: 144 clinical sites in 6 countries.

Participants: 3492 MINT trial participants with acute MI and a hemoglobin level below 10 g/dL.

Intervention: Four transfusion strategies to maintain patients' hemoglobin concentrations at or above thresholds of 10, 9, 8, or 7 g/dL. Protocol exceptions were permitted for specified adverse clinical events.

Measurements: Data from the MINT trial were leveraged to emulate 4 transfusion strategies and estimate per protocol effects on the composite outcome of 30-day death or recurrent MI (death/MI) and 30-day death using inverse probability weighting.

Results: The 30-day risk for death/MI was 14.8% (95% CI, 11.8% to 18.4%) for a <10-g/dL strategy, 15.1% (CI, 11.7% to 18.2%) for a <9-g/dL strategy, 15.9% (CI, 12.4% to 19.0%) for a <8-g/dL strategy, and 18.3% (CI, 14.6% to 22.0%) for a <7-g/dL strategy. Absolute risk differences and risk ratios relative to the <10-g/dL strategy for 30-day death/MI increased as thresholds decreased, although 95% CIs were wide. Findings were similar and imprecise for 30-day death.

Limitation: Unmeasured confounding may have persisted despite adjustment.

Conclusion: The 30-day risks for death/MI and death among patients with acute MI and anemia seem to increase progressively with lower hemoglobin concentration thresholds for transfusion. However, the imprecision around estimates from this target trial analysis precludes definitive conclusions about individual hemoglobin thresholds.

Primary funding source: National Heart, Lung, and Blood Institute.

背景:指导急性心肌梗死(MI)和贫血患者输注红细胞(RBC)的最佳血红蛋白阈值尚不确定:目的:估算 4 种不同血红蛋白阈值的疗效(设计:设计:采用目标试验仿真方法对 MINT(心肌缺血与输血)试验进行预设二次分析。(ClinicalTrials.gov:NCT02981407):6个国家的144个临床研究机构:3492 名患有急性心肌梗死且血红蛋白水平低于 10 g/dL 的 MINT 试验参与者:干预措施:四种输血策略,将患者的血红蛋白浓度维持在或高于 10、9、8 或 7 g/dL 的阈值。对于特定的不良临床事件,允许协议例外:利用 MINT 试验的数据来模拟 4 种输血策略,并采用反概率加权法估算每项方案对 30 天死亡或复发性心肌梗死(死亡/心肌梗死)和 30 天死亡的复合结局的影响:限制因素:未测量的混杂因素可能会影响输血效果:尽管进行了调整,但未测量的混杂因素可能仍然存在:急性心肌梗死合并贫血患者的 30 天死亡/心肌梗死风险和死亡风险似乎随着输血血红蛋白浓度阈值的降低而逐渐增加。结论:急性心肌梗死和贫血患者的 30 天死亡/心肌梗死和死亡风险似乎随着输血血红蛋白浓度阈值的降低而逐渐增加。然而,由于该目标试验分析的估计值不精确,因此无法就单个血红蛋白阈值得出明确结论:国家心肺血液研究所。
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引用次数: 0
Cardiovascular Disease Mortality Among Native Hawaiian and Pacific Islander Adults Aged 35 Years or Older, 2018 to 2022. 2018 年至 2022 年夏威夷原住民和太平洋岛民中 35 岁或以上成年人的心血管疾病死亡率。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 Epub Date: 2024-10-15 DOI: 10.7326/M24-0801
Rebecca C Woodruff, Joseph Keawe'aimoku Kaholokula, Lorinda Riley, Xin Tong, LaTonia C Richardson, Kotryna Diktonaite, Fleetwood Loustalot, Adam S Vaughan, Omoye E Imoisili, Donald K Hayes

Background: Native Hawaiian and Pacific Islander (NHPI) adults have historically been grouped with Asian adults in U.S. mortality surveillance. Starting in 2018, the 1997 race and ethnicity standards from the U.S. Office of Management and Budget were adopted by all states on death certificates, enabling national-level estimates of cardiovascular disease (CVD) mortality for NHPI adults independent of Asian adults.

Objective: To describe CVD mortality among NHPI adults.

Design: Race-stratified age-standardized mortality rates (ASMRs) and rate ratios were calculated using final mortality data from the National Vital Statistics System for 2018 to 2022.

Setting: Fifty states and the District of Columbia.

Participants: Adults aged 35 years or older at the time of death.

Measurements: CVD deaths were identified from International Classification of Diseases, 10th Revision codes indicating CVD (I00 to I99) as the underlying cause of death.

Results: From 2018 to 2022, 10 870 CVD deaths (72.6% from heart disease; 19.0% from cerebrovascular disease) occurred among NHPI adults. The CVD ASMR for NHPI adults (369.6 deaths per 100 000 persons [95% CI, 362.4 to 376.7]) was 1.5 times higher than for Asian adults (243.9 deaths per 100 000 persons [CI, 242.6 to 245.2]). The CVD ASMR for NHPI adults was the third highest in the country, after Black adults (558.8 deaths per 100 000 persons [CI, 557.4 to 560.3]) and White adults (423.6 deaths per 100 000 persons [CI, 423.2 to 424.1]).

Limitation: Potential misclassification of underlying cause of death or race group.

Conclusion: NHPI adults have a high rate of CVD mortality, which was previously masked by aggregation of the NHPI population with the Asian population. The results of this study support the need for continued disaggregation of the NHPI population in public health research and surveillance to identify opportunities for intervention.

Primary funding source: National Institute of General Medical Sciences, National Institutes of Health.

背景:在美国死亡率监测中,夏威夷原住民和太平洋岛民(NHPI)成年人历来与亚裔成年人归为一类。从 2018 年开始,各州的死亡证明都采用了美国管理和预算办公室 1997 年制定的种族和民族标准,从而能够在国家层面估算出独立于亚裔成人的夏威夷原住民和太平洋岛民成人心血管疾病(CVD)死亡率:描述非太平洋岛屿族裔成年人的心血管疾病死亡率:设计:利用国家生命统计系统提供的 2018 年至 2022 年最终死亡率数据,计算种族分层年龄标准化死亡率(ASMRs)和比率比:五十个州和哥伦比亚特区:死亡时年龄在 35 岁或以上的成年人:根据《国际疾病分类》第 10 版代码确定心血管疾病死亡,代码显示心血管疾病(I00 至 I99)为基本死因:从 2018 年到 2022 年,10 870 例心血管疾病死亡(72.6% 死于心脏病;19.0% 死于脑血管疾病)发生在 NHPI 成年人中。非华裔成年人的心血管疾病ASMR(每10万人369.6例死亡[95% CI,362.4至376.7])是亚裔成年人(每10万人243.9例死亡[CI,242.6至245.2])的1.5倍。非太平洋岛屿族裔成年人心血管疾病ASMR在全国排名第三,仅次于黑人成年人(每10万人中558.8例死亡[CI,557.4至560.3])和白人成年人(每10万人中423.6例死亡[CI,423.2至424.1]):局限性:潜在死因或种族组别可能存在分类错误:结论:非高危人群中的成年人心血管疾病死亡率较高,而之前将非高危人群与亚裔人群合并的结果掩盖了这一事实。这项研究的结果支持了在公共卫生研究和监测中继续对 NHPI 人口进行分类以确定干预机会的必要性:主要资金来源:美国国立卫生研究院国家普通医学科学研究所。
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引用次数: 0
Correction: Annals Consult Guys - A Perplexing Case of Muscle Weakness. 更正:Annals Consult Guys - A Perplexing Case of Muscle Weakness.
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 Epub Date: 2024-10-15 DOI: 10.7326/ANNALS-24-02306
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引用次数: 0
In adults with TBI and anemia, liberal vs. restrictive RBC transfusion did not reduce unfavorable neurologic outcomes by 10% at 6 mo. 在患有创伤性脑损伤和贫血的成人患者中,6 个月时,自由输注与限制性输注红细胞并不能将不利的神经系统预后降低 10%。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.7326/ANNALS-24-02456-JC
Albahi Malik, Greg S Martin

Source citation: Turgeon AF, Fergusson DA, Clayton L, et al; HEMOTION Trial Investigators on behalf of the Canadian Critical Care Trials Group, the Canadian Perioperative Anesthesia Clinical Trials Group, and the Canadian Traumatic Brain Injury Research Consortium. Liberal or restrictive transfusion strategy in patients with traumatic brain injury. N Engl J Med. 2024;391:722-735. 38869931.

来源引用:Turgeon AF、Fergusson DA、Clayton L 等;HEMOTION 试验研究者代表加拿大重症监护试验组、加拿大围术期麻醉临床试验组和加拿大脑外伤研究联合会。创伤性脑损伤患者的自由或限制性输血策略。N Engl J Med.2024;391:722-735.38869931.
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引用次数: 0
Long-Term Autoimmune Inflammatory Rheumatic Outcomes of COVID-19. COVID-19 的长期自身免疫性风湿病结果
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 DOI: 10.7326/ANNALS-24-01952
Amr H Sawalha
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引用次数: 0
Diabetes Risk Factors in People With HIV Receiving Pitavastatin Versus Placebo for Cardiovascular Disease Prevention : A Randomized Trial. 为预防心血管疾病而服用匹伐他汀与安慰剂的艾滋病病毒感染者的糖尿病风险因素:随机试验。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 Epub Date: 2024-10-08 DOI: 10.7326/ANNALS-24-00944
Kathleen V Fitch, Markella V Zanni, Jennifer Manne-Goehler, Marissa R Diggs, Arijeet K Gattu, Judith S Currier, Gerald S Bloomfield, Chiu-Bin Hsiao, Samir K Gupta, Judith A Aberg, Carlos D Malvestutto, Carl J Fichtenbaum, Michael T Lu, Pamela S Douglas, Heather J Ribaudo, Steven K Grinspoon

Background: REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) led to new guidelines for statin use among people with HIV (PWH) with low to moderate risk for atherosclerotic cardiovascular disease (ASCVD). Little is known about the natural history of diabetes mellitus (DM) or mechanisms contributing to statin effects on DM among this population.

Objective: To determine the contribution of known DM risk factors to excess risk for DM with pitavastatin in REPRIEVE.

Design: Phase 3, primary ASCVD prevention trial over a median of 5.6 years of follow-up. (ClinicalTrials.gov: NCT02344290).

Setting: Global, multicenter trial.

Participants: 7731 PWH aged 40 to 75 years with low to moderate ASCVD risk (by the pooled cohort equations from the American College of Cardiology and American Heart Association) without DM at study entry.

Intervention: Random 1:1 assignment to pitavastatin, 4 mg daily, or placebo.

Measurements: New-onset DM was determined at each visit by clinical diagnosis requiring initiation of medication treatment for DM. The incidence of new-onset DM was assessed in relation to predefined demographic and metabolic risk factors, stratified by treatment group. Treatment effects of pitavastatin on progression to new DM in key subgroups were determined.

Results: Participants with at least 3 DM risk factors (vs. no risk factors) had increased risk for DM in each treatment group (incidence rate, 3.24 per 100 person-years [PY] vs. 0.34 per 100 PY [pitavastatin] and 2.66 per 100 PY vs. 0.27 per 100 PY [placebo]). The incidence of DM was highest in South Asia. In adjusted analyses, high body mass index, prediabetes, and metabolic syndrome components were strongly associated with new-onset DM (all P < 0.005).

Limitation: Pitavastatin was the only statin assessed; DM was assessed clinically.

Conclusion: Metabolic risk factors, including prediabetes and obesity, contributed to new-onset DM in statin- and placebo-treated participants. A clinically significant effect of pitavastatin on DM was seen primarily among those with multiple risk factors for DM at entry. Strategies targeting key metabolic risk factors, like obesity and prediabetes, may help protect against DM among PWH.

Primary funding source: National Heart, Lung, and Blood Institute of the National Institutes of Health.

背景:REPRIEVE(预防艾滋病血管事件的随机试验)为具有中低度动脉粥样硬化性心血管疾病(ASCVD)风险的艾滋病病毒感染者(PWH)使用他汀类药物制定了新的指南。人们对这一人群中糖尿病(DM)的自然史或他汀类药物对糖尿病影响的机制知之甚少:目的:确定已知糖尿病风险因素对REPRIEVE中使用匹伐他汀治疗糖尿病超额风险的影响:设计:3期ASCVD一级预防试验,中位随访5.6年。(ClinicalTrials.gov:NCT02344290):全球多中心试验:7731名年龄在40至75岁之间、具有低至中度ASCVD风险(根据美国心脏病学会和美国心脏协会的汇集队列方程)、入组时无糖尿病的老年人:干预措施:1:1随机分配匹伐他汀,每天4毫克,或安慰剂:每次就诊时,根据需要开始药物治疗的临床诊断确定新发糖尿病。根据预先确定的人口统计学和代谢风险因素评估新发糖尿病的发病率,并按治疗组进行分层。确定了匹伐他汀对关键亚组新发糖尿病进展的治疗效果:结果:在每个治疗组中,至少有3个DM风险因素(与无风险因素相比)的参与者发生DM的风险增加(发病率为每100人-年[PY]3.24例与每100人-年[匹伐他汀]0.34例相比,每100人-年2.66例与每100人-年[安慰剂]0.27例相比)。南亚地区的糖尿病发病率最高。在调整分析中,高体重指数、糖尿病前期和代谢综合征成分与新发糖尿病密切相关(P均<0.005):局限性:仅评估了匹伐他汀一种他汀类药物;糖尿病是通过临床评估的:结论:代谢风险因素,包括糖尿病前期和肥胖,是他汀类药物和安慰剂治疗参与者新发DM的原因。匹伐他汀对糖尿病的临床疗效主要体现在入组时有多种糖尿病风险因素的人群中。针对主要代谢风险因素(如肥胖和糖尿病前期)的策略可能有助于预防肥胖和糖尿病前期人群中的糖尿病:主要资金来源:美国国立卫生研究院国家心肺血液研究所。
{"title":"Diabetes Risk Factors in People With HIV Receiving Pitavastatin Versus Placebo for Cardiovascular Disease Prevention : A Randomized Trial.","authors":"Kathleen V Fitch, Markella V Zanni, Jennifer Manne-Goehler, Marissa R Diggs, Arijeet K Gattu, Judith S Currier, Gerald S Bloomfield, Chiu-Bin Hsiao, Samir K Gupta, Judith A Aberg, Carlos D Malvestutto, Carl J Fichtenbaum, Michael T Lu, Pamela S Douglas, Heather J Ribaudo, Steven K Grinspoon","doi":"10.7326/ANNALS-24-00944","DOIUrl":"10.7326/ANNALS-24-00944","url":null,"abstract":"<p><strong>Background: </strong>REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) led to new guidelines for statin use among people with HIV (PWH) with low to moderate risk for atherosclerotic cardiovascular disease (ASCVD). Little is known about the natural history of diabetes mellitus (DM) or mechanisms contributing to statin effects on DM among this population.</p><p><strong>Objective: </strong>To determine the contribution of known DM risk factors to excess risk for DM with pitavastatin in REPRIEVE.</p><p><strong>Design: </strong>Phase 3, primary ASCVD prevention trial over a median of 5.6 years of follow-up. (ClinicalTrials.gov: NCT02344290).</p><p><strong>Setting: </strong>Global, multicenter trial.</p><p><strong>Participants: </strong>7731 PWH aged 40 to 75 years with low to moderate ASCVD risk (by the pooled cohort equations from the American College of Cardiology and American Heart Association) without DM at study entry.</p><p><strong>Intervention: </strong>Random 1:1 assignment to pitavastatin, 4 mg daily, or placebo.</p><p><strong>Measurements: </strong>New-onset DM was determined at each visit by clinical diagnosis requiring initiation of medication treatment for DM. The incidence of new-onset DM was assessed in relation to predefined demographic and metabolic risk factors, stratified by treatment group. Treatment effects of pitavastatin on progression to new DM in key subgroups were determined.</p><p><strong>Results: </strong>Participants with at least 3 DM risk factors (vs. no risk factors) had increased risk for DM in each treatment group (incidence rate, 3.24 per 100 person-years [PY] vs. 0.34 per 100 PY [pitavastatin] and 2.66 per 100 PY vs. 0.27 per 100 PY [placebo]). The incidence of DM was highest in South Asia. In adjusted analyses, high body mass index, prediabetes, and metabolic syndrome components were strongly associated with new-onset DM (all <i>P</i> < 0.005).</p><p><strong>Limitation: </strong>Pitavastatin was the only statin assessed; DM was assessed clinically.</p><p><strong>Conclusion: </strong>Metabolic risk factors, including prediabetes and obesity, contributed to new-onset DM in statin- and placebo-treated participants. A clinically significant effect of pitavastatin on DM was seen primarily among those with multiple risk factors for DM at entry. Strategies targeting key metabolic risk factors, like obesity and prediabetes, may help protect against DM among PWH.</p><p><strong>Primary funding source: </strong>National Heart, Lung, and Blood Institute of the National Institutes of Health.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1449-1461"},"PeriodicalIF":19.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In older inpatients with polypharmacy, medication optimization did not improve outcomes at 48 wk. 在使用多种药物的老年住院患者中,药物优化并不能改善 48 周后的疗效。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.7326/ANNALS-24-02771-JC
Jacob A Lebin, Elizabeth Goldberg

Source citation: Ie K, Hirose M, Sakai T, et al. Medication optimization protocol efficacy for geriatric inpatients: a randomized clinical trial. JAMA Netw Open. 2024;7:e2423544. 39078632.

来源引用:Ie K, Hirose M, Sakai T, et al. 老年住院患者用药优化方案疗效:随机临床试验。JAMA Netw Open.2024;7:e2423544.39078632.
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引用次数: 0
In adults with BMI ≥27 kg/m2 and CVD, but without diabetes, semaglutide reduced MACE, regardless of baseline HbA1c level. 对于体重指数≥27 kg/m2、患有心血管疾病但未患糖尿病的成年人,无论基线 HbA1c 水平如何,semaglutide 都能降低 MACE。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.7326/ANNALS-24-02457-JC
Doreen Zhu, William G Herrington

Source citation: Lingvay I, Deanfield J, Kahn SE, et al; SELECT Trial Investigators. Semaglutide and cardiovascular outcomes by baseline HbA1c and change in HbA1c in people with overweight or obesity but without diabetes in SELECT. Diabetes Care. 2024;47:1360-1369. 38907684.

来源引用:Lingvay I、Deanfield J、Kahn SE 等;SELECT 试验研究者。根据 SELECT 中超重或肥胖但无糖尿病患者的基线 HbA1c 和 HbA1c 变化分析塞马鲁肽和心血管预后。糖尿病护理》。2024;47:1360-1369.38907684.
{"title":"In adults with BMI ≥27 kg/m<sup>2</sup> and CVD, but without diabetes, semaglutide reduced MACE, regardless of baseline HbA<sub>1c</sub> level.","authors":"Doreen Zhu, William G Herrington","doi":"10.7326/ANNALS-24-02457-JC","DOIUrl":"10.7326/ANNALS-24-02457-JC","url":null,"abstract":"<p><strong>Source citation: </strong>Lingvay I, Deanfield J, Kahn SE, et al; SELECT Trial Investigators. <b>Semaglutide and cardiovascular outcomes by baseline HbA<sub>1c</sub> and change in HbA<sub>1c</sub> in people with overweight or obesity but without diabetes in SELECT.</b> Diabetes Care. 2024;47:1360-1369. 38907684.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"JC122"},"PeriodicalIF":19.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Getting the Balance of Safety and Speed of Medical Device Approval Right. 正确平衡医疗器械审批的安全性和速度。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 Epub Date: 2024-09-17 DOI: 10.7326/ANNALS-24-01840
Ezekiel J Emanuel
{"title":"Getting the Balance of Safety and Speed of Medical Device Approval Right.","authors":"Ezekiel J Emanuel","doi":"10.7326/ANNALS-24-01840","DOIUrl":"10.7326/ANNALS-24-01840","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1582-1583"},"PeriodicalIF":19.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
National Institutes of Health COVID-19 Treatment Guidelines Panel: Perspectives and Lessons Learned. 美国国立卫生研究院 COVID-19 治疗指南小组:观点和经验教训。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 Epub Date: 2024-10-01 DOI: 10.7326/ANNALS-24-00464
Roy M Gulick, Alice K Pau, Eric Daar, Laura Evans, Rajesh T Gandhi, Pablo Tebas, Renée Ridzon, Henry Masur, H Clifford Lane, Adaora A Adimora, Jason Baker, Lisa Baumann Kreuziger, Roger Bedimo, Pamela Belperio, Anoopindar Bhalla, Timothy Burgess, Danielle Campbell, Stephen Cantrill, Kara Chew, Kathleen Chiotos, Craig Coopersmith, Richard Davey, Amy Dzierba, Derek Eisnor, Gregory Eschenauer, Joseph Francis, John Gallagher, David Glidden, Neil Goldenberg, Birgit Grund, Alison Han, Erica Hardy, Carly Harrison, Lauren Henderson, Elizabeth Higgs, Carl Hinkson, Brenna Hughes, Steven Johnson, Marla Keller, Arthur Kim, Richard Knight, Safia Kuriakose, Jeffrey Lennox, Andrea Lerner, Mitchell Levy, Jonathan Li, Christine MacBrayne, Greg Martin, Nandita Nadig, Martha Nason, Pragna Patel, Andrew Pavia, Michael Proschan, Grant Schulert, Nitin Seam, Virginia Sheikh, Steven Simpson, Kanal Singh, Susan Swindells, Phyllis Tien, Timothy Uyeki, Alpana Waghmare, Cameron Wolfe, Jinoos Yazdany, Judith Aberg

Description: In March 2020, the White House Coronavirus Task Force determined that clinicians in the United States needed expert treatment guidelines to optimally manage patients with COVID-19, a potentially life-threatening disease caused by a new pathogen for which no specific treatments were known to be effective.

Methods: The U.S. Department of Health and Human Services requested that the National Institutes of Health (NIH) take the lead in expeditiously convening a panel of experts to create "living" guidelines that would be widely accessible and capable of frequent updating as important new information became available.

Recommendations: The purpose of this article is to expand on the experiences of the NIH COVID-19 Treatment Guidelines Panel (the Panel) over the past 4 years, summarize the Panel's final recommendations for COVID-19, highlight some challenges and unanswered questions about COVID-19 management, and inform future responses to public health emergencies. The Panel was formed in March 2020, and the first iteration of the guidelines was released in April 2020. Now that the public health emergency has ended, the NIH COVID-19 Treatment Guidelines have sunsetted. This role will now fall to professional societies and organizations, such as the American College of Physicians, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the World Health Organization, all of which have been active in this area.

内容简介2020 年 3 月,白宫冠状病毒特别工作组(White House Coronavirus Task Force)认为,美国的临床医生需要专家治疗指南来优化 COVID-19 患者的治疗:方法:美国卫生与公众服务部要求美国国立卫生研究院(NIH)牵头,尽快召集专家小组制定 "活 "指南,该指南将被广泛使用,并可在获得重要新信息时经常更新:本文旨在介绍美国国立卫生研究院 COVID-19 治疗指南专家小组(专家小组)过去 4 年的经验,总结专家小组对 COVID-19 的最终建议,强调 COVID-19 管理方面的一些挑战和未决问题,并为未来应对公共卫生突发事件提供参考。专家小组于 2020 年 3 月成立,并于 2020 年 4 月发布了第一版指南。现在,公共卫生突发事件已经结束,美国国立卫生研究院的 COVID-19 治疗指南也已日落西山。这一角色现在将由专业协会和组织承担,如美国内科医师学会、美国传染病学会、儿科传染病学会和世界卫生组织,它们都在这一领域积极开展工作。
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引用次数: 0
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