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Web Exclusive. Annals Video Summary - Artificial Intelligence-Assisted Colonoscopy for Polyp Detection. 网络独家。Annals 视频摘要 - 人工智能辅助结肠镜检查息肉检测。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2024-10-22 DOI: 10.7326/ANNALS-24-02604-VS
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引用次数: 0
Colorectal Cancer Screening Completion and Yield in Patients Aged 45 to 50 Years : An Observational Study. 45 至 50 岁患者的结直肠癌筛查完成率和收益率：一项观察性研究。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2024-10-22 DOI: 10.7326/M24-0743
Theodore R Levin, Christopher D Jensen, Natalia Udaltsova, Andrea A Burnett-Hartman, Aruna Kamineni, Chun R Chao, Joanne E Schottinger, Nirupa R Ghai, Gaia Pocobelli, Larissa L White, Malia Oliver, Hina Chowdhry, Brian P Hixon, Jessica M Badalov, Shauna R Goldberg, Susan C Bradford, Charles P Quesenberry, Jeffrey K Lee

Background: Guidelines now recommend initiating colorectal cancer (CRC) screening at age 45 years rather than 50 years, but little is known about screening completion and yield among people aged 45 to 49 years.

Objective: To evaluate fecal immunochemical test (FIT) completion and yield in patients aged 45 to 49 versus 50 years.

Design: Retrospective cohort study.

Setting: Kaiser Permanente Northern California, Washington, and Colorado.

Patients: Those distributed a FIT kit during January to September 2022.

Measurements: FIT completion within 3 months, FIT positivity, receipt of colonoscopy within 3 months after a positive FIT result, and colonoscopy yield.

Results: A total of 267 732 FIT kits were distributed: 213 928 (79.9%) to patients aged 45 to 49 years, and 53 804 (20.1%) to those aged 50 years. Overall, FIT completion was slightly higher in patients aged 45 to 49 years (38.9% vs. 37.5%; adjusted risk ratio [aRR], 1.05 [95% CI, 1.04 to 1.06]), although at Colorado, those aged 45 to 49 years were substantially less likely to complete a FIT (30.7% vs. 40.2%; aRR, 0.77 [CI, 0.73 to 0.80]). Overall, FIT positivity was lower in patients aged 45 to 49 years (3.6% vs. 4.0%; aRR, 0.91 [CI, 0.84 to 0.98]), and receipt of colonoscopy after a positive FIT result was similar between groups (64.9% vs. 67.4%; aRR, 1.00 [CI, 0.94 to 1.05]). Adenoma detection was lower in the younger group (58.8% vs. 67.7%; aRR, 0.88 [CI, 0.83 to 0.95]). Yields were similar for adenoma with advanced histology (13.2% vs. 15.9%; aRR, 0.86 [CI, 0.69 to 1.07]), polyp with high-grade dysplasia (3.4% vs. 5.1%; aRR, 0.68 [CI, 0.44 to 1.04]), sessile serrated lesion (10.3% vs. 11.7%; aRR, 0.92 [CI, 0.71 to 1.21]), and CRC (2.8% vs. 2.7%; aRR, 1.10 [CI, 0.62 to 1.96]).

Limitation: The small number of neoplasia events contributed to wide CIs.

Conclusion: Similar FIT completion and yield rates in people aged 45 to 50 years support initiation of CRC screening at age 45 years.

Primary funding source: Kaiser Permanente Sidney R. Garfield Memorial Fund.

背景：现在的指南建议在 45 岁而不是 50 岁开始进行结直肠癌（CRC）筛查，但人们对 45 至 49 岁人群的筛查完成度和筛查率知之甚少：评估 45 至 49 岁与 50 岁患者的粪便免疫化学检验（FIT）完成率和筛查率：设计：回顾性队列研究：地点：北加州、华盛顿州和科罗拉多州的凯撒医疗机构：患者：2022 年 1 月至 9 月期间获得 FIT 套件的患者：测量指标：3 个月内完成 FIT、FIT 阳性、FIT 阳性后 3 个月内接受结肠镜检查和结肠镜检查率：共发放了 267 732 套 FIT 套件：其中 213 928 套（79.9%）发放给 45 至 49 岁的患者，53 804 套（20.1%）发放给 50 岁的患者。总体而言，45 至 49 岁患者的 FIT 完成率略高（38.9% 对 37.5%；调整风险比 [aRR]，1.05 [95% CI，1.04 至 1.06]），但在科罗拉多，45 至 49 岁患者完成 FIT 的可能性要低得多（30.7% 对 40.2%；aRR，0.77 [CI，0.73 至 0.80]）。总体而言，45 至 49 岁患者的 FIT 阳性率较低（3.6% 对 4.0%；aRR，0.91 [CI，0.84 至 0.98]），两组患者在 FIT 阳性后接受结肠镜检查的比例相似（64.9% 对 67.4%；aRR，1.00 [CI，0.94 至 1.05]）。年轻组的腺瘤检出率较低（58.8% 对 67.7%；aRR，0.88 [CI，0.83 对 0.95]）。晚期组织学腺瘤（13.2% 对 15.9%；aRR，0.86 [CI，0.69 至 1.07]）、高级别发育不良息肉（3.4% 对 5.1%；aRR，0.68[CI，0.44至1.04]）、无柄锯齿状病变（10.3% vs. 11.7%；aRR，0.92[CI，0.71至1.21]）和CRC（2.8% vs. 2.7%；aRR，1.10[CI，0.62至1.96]）：局限性：肿瘤事件的数量较少导致CI值较宽：结论：45 岁至 50 岁人群中相似的 FIT 完成率和收益率支持在 45 岁开始进行 CRC 筛查：主要资金来源：Kaiser Permanente Sidney R. Garfield Memorial Fund。
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引用次数: 0
Qualitative Analysis of Patients' and Physicians' Attitudes and Behaviors Toward Billing Patient Portal Messages. 定性分析患者和医生对计费患者门户网站信息的态度和行为。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2024-10-15 DOI: 10.7326/ANNALS-24-00560
Jordan M Alpert, Elizabeth Pfoh, Victoria Criswell, Maria C Tang, Elizabeth E Stanley, Sandra Hong, Robert Saper, Eric Yudelevich Blumrosen, Michael B Rothberg
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引用次数: 0
Opportunities for Innovation in Smoking Cessation Therapies: A Perspective From the National Institutes of Health and U.S. Food and Drug Administration. 戒烟疗法的创新机会：美国国立卫生研究院和美国食品和药物管理局的观点。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2024-10-15 DOI: 10.7326/ANNALS-24-02318
Haider J Warraich, Brian A King, Wilson M Compton, Evan S Herrmann, Mary Thanh Hai, Robert M Califf, Monica M Bertagnolli
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引用次数: 0
Annals Graphic Medicine - Imposter. 图形医学年鉴》--冒名顶替。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2024-10-01 Epub Date: 2024-09-24 DOI: 10.7326/G23-0058
Rachel Weber
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引用次数: 0
In adults with hypertension and high CV risk, intensive vs. standard BP-lowering therapy reduced major vascular events. 在患有高血压和高心血管风险的成年人中，强化降压疗法与标准降压疗法相比，可减少主要血管事件的发生。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2024-10-01 DOI: 10.7326/ANNALS-24-02321-JC
Mayer B Davidson

Source citation: Liu J, Li Y, Ge J, et al; ESPRIT Collaborative Group. Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial. Lancet. 2024;404:245-255. 38945140.

来源引用：Liu J, Li Y, Ge J, et al; ESPRIT 合作小组。将伴有或不伴有糖尿病或既往中风的心血管高危患者的收缩压降至低于 120 mm Hg 与低于 140 mm Hg 的对比：一项开放标签、盲法结果、随机试验。柳叶刀。2024;404:245-255.38945140.
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引用次数: 0
Comparing Cardiovascular Risk Classification of U.S. Adults According to Pooled Cohort Equations and PREVENT Equations: Cross-Sectional Analysis of the National Health and Nutrition Examination Survey. 根据汇集队列方程和 PREVENT 方程比较美国成年人的心血管风险分类：全国健康与营养调查的横断面分析》。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2024-10-01 Epub Date: 2024-09-03 DOI: 10.7326/ANNALS-24-00074
Abdul Mannan Khan Minhas, Salim S Virani, Erin D Michos, Vijay Nambi, Roger S Blumenthal, Alexander C Razavi, Layla Abushamat, Christie M Ballantyne, Dmitry Abramov
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引用次数: 0
Annals for Educators - October 2024. 教育工作者年鉴》--2024 年 10 月。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2024-10-01 DOI: 10.7326/ANNALS-24-02774-ED
Christine Laine
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引用次数: 0
In advanced CKD, ACEis or ARBs reduce kidney failure vs. placebo or non-RAAS inhibitors at 34 mo. 对于晚期 CKD 患者，与安慰剂或非 RAAS 抑制剂相比，ACEis 或 ARB 可在 34 个月时减少肾衰竭。
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2024-10-01 DOI: 10.7326/ANNALS-24-02169-JC
Carlos E Aguilar Bolona, Wolfgang C Winkelmayer

Source citation: Ku E, Inker LA, Tighiouart H, et al. Angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers for advanced chronic kidney disease: a systematic review and retrospective individual participant-level meta-analysis of clinical trials. Ann Intern Med. 2024;177:953-963. 38950402.

来源引用：Ku E, Inker LA, Tighiouart H, et al. 血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂治疗晚期慢性肾脏病：临床试验的系统综述和个人参与者水平的回顾性荟萃分析。Ann Intern Med.2024;177:953-963.38950402.
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引用次数: 0
Annals Graphic Medicine - Second Year Medical School: Facade, Facader, Facadest. Annals Graphic Medicine - 医学院二年级：Facade, Facader, Facadest.
IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2024-10-01 Epub Date: 2024-10-08 DOI: 10.7326/G23-0054
Merlin Kochunilathil
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引用次数: 0
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