Pub Date : 2012-11-26DOI: 10.1001/2013.jamainternmed.53
Marco Huesch, Darius Lakdawalla
{"title":"Freedom to innovate: the perils of centralized medical research.","authors":"Marco Huesch, Darius Lakdawalla","doi":"10.1001/2013.jamainternmed.53","DOIUrl":"https://doi.org/10.1001/2013.jamainternmed.53","url":null,"abstract":"","PeriodicalId":8290,"journal":{"name":"Archives of internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/2013.jamainternmed.53","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31075814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-11-26DOI: 10.1001/2013.jamainternmed.56
Justin Kung, Ram R Miller, Philip A Mackowiak
BACKGROUND In March 2011, the Institute of Medicine (IOM) issued a new set of standards for clinical practice guidelines intended to enhance the quality of guidelines being produced. To our knowledge, no systematic review of adherence to such standards has been undertaken since one published over a decade ago. METHODS Two reviewers independently screened 130 guidelines selected at random from the National Guideline Clearinghouse (NGC) website for compliance with 18 of 25 IOM standards. RESULTS The overall median number (percentage) of IOM standards satisfied (out of 18) was 8 (44.4%), with an interquartile range of 6.5 (36.1%) to 9.5 (52.8%). Fewer than half of the guidelines surveyed met more than 50% of the IOM standards. Barely a third of the guidelines produced by subspecialty societies satisfied more than 50% of the IOM standards surveyed. Information on conflicts of interest (COIs) was given in fewer than half of the guidelines surveyed. Of those guidelines including such information, COIs were present in over two-thirds of committee chairpersons (71.4%) and 90.5% of co-chairpersons. Except for US government agency–produced guidelines, criteria used to select committee members and the selection process were rarely described. Committees developing guidelines rarely included an information scientist or a patient or patient representative. Non-English literature, unpublished data, and/or abstracts were rarely considered in developing guidelines; differences of opinion among committee members generally were not aired in guidelines; and benefits of recommendations were enumerated more often than potential harms. Guidelines published from 2006 through 2011 varied little with regard to average number of IOM standards satisfied. CONCLUSION Analysis of a random sample of clinical practice guidelines archived on the NGC website as of June 2011 demonstrated poor compliance with IOM standards, with little if any improvement over the past 2 decades.
{"title":"Failure of clinical practice guidelines to meet institute of medicine standards: Two more decades of little, if any, progress.","authors":"Justin Kung, Ram R Miller, Philip A Mackowiak","doi":"10.1001/2013.jamainternmed.56","DOIUrl":"https://doi.org/10.1001/2013.jamainternmed.56","url":null,"abstract":"BACKGROUND\u0000In March 2011, the Institute of Medicine (IOM) issued a new set of standards for clinical practice guidelines intended to enhance the quality of guidelines being produced. To our knowledge, no systematic review of adherence to such standards has been undertaken since one published over a decade ago.\u0000\u0000\u0000METHODS\u0000Two reviewers independently screened 130 guidelines selected at random from the National Guideline Clearinghouse (NGC) website for compliance with 18 of 25 IOM standards.\u0000\u0000\u0000RESULTS\u0000The overall median number (percentage) of IOM standards satisfied (out of 18) was 8 (44.4%), with an interquartile range of 6.5 (36.1%) to 9.5 (52.8%). Fewer than half of the guidelines surveyed met more than 50% of the IOM standards. Barely a third of the guidelines produced by subspecialty societies satisfied more than 50% of the IOM standards surveyed. Information on conflicts of interest (COIs) was given in fewer than half of the guidelines surveyed. Of those guidelines including such information, COIs were present in over two-thirds of committee chairpersons (71.4%) and 90.5% of co-chairpersons. Except for US government agency–produced guidelines, criteria used to select committee members and the selection process were rarely described. Committees developing guidelines rarely included an information scientist or a patient or patient representative. Non-English literature, unpublished data, and/or abstracts were rarely considered in developing guidelines; differences of opinion among committee members generally were not aired in guidelines; and benefits of recommendations were enumerated more often than potential harms. Guidelines published from 2006 through 2011 varied little with regard to average number of IOM standards satisfied.\u0000\u0000\u0000CONCLUSION\u0000Analysis of a random sample of clinical practice guidelines archived on the NGC website as of June 2011 demonstrated poor compliance with IOM standards, with little if any improvement over the past 2 decades.","PeriodicalId":8290,"journal":{"name":"Archives of internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/2013.jamainternmed.56","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30996268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-11-26DOI: 10.1001/2013.jamainternmed.269
Sara Kalkhoran, Pamela M Ling
{"title":"Extending the health benefits of clean indoor air policies.","authors":"Sara Kalkhoran, Pamela M Ling","doi":"10.1001/2013.jamainternmed.269","DOIUrl":"https://doi.org/10.1001/2013.jamainternmed.269","url":null,"abstract":"","PeriodicalId":8290,"journal":{"name":"Archives of internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/2013.jamainternmed.269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31010603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-11-26DOI: 10.1001/2013.jamainternmed.206
Vinay Prasad, Jason Rho, Adam Cifu
{"title":"Freedom to innovate: the perils of centralized medical research-reply.","authors":"Vinay Prasad, Jason Rho, Adam Cifu","doi":"10.1001/2013.jamainternmed.206","DOIUrl":"https://doi.org/10.1001/2013.jamainternmed.206","url":null,"abstract":"","PeriodicalId":8290,"journal":{"name":"Archives of internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/2013.jamainternmed.206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31495504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-11-26DOI: 10.1001/archinte.172.21.1619
{"title":"About this journal.","authors":"","doi":"10.1001/archinte.172.21.1619","DOIUrl":"https://doi.org/10.1001/archinte.172.21.1619","url":null,"abstract":"","PeriodicalId":8290,"journal":{"name":"Archives of internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31495506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-11-26DOI: 10.1001/archinternmed.2012.4444
Joel Lexchin
{"title":"New drugs and safety: what happened to new active substances approved in Canada between 1995 and 2010?","authors":"Joel Lexchin","doi":"10.1001/archinternmed.2012.4444","DOIUrl":"https://doi.org/10.1001/archinternmed.2012.4444","url":null,"abstract":"","PeriodicalId":8290,"journal":{"name":"Archives of internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archinternmed.2012.4444","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30961244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-11-26DOI: 10.1001/archinternmed.2012.4430
Arnaud Chiolero
{"title":"There is nothing personal.","authors":"Arnaud Chiolero","doi":"10.1001/archinternmed.2012.4430","DOIUrl":"https://doi.org/10.1001/archinternmed.2012.4430","url":null,"abstract":"","PeriodicalId":8290,"journal":{"name":"Archives of internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archinternmed.2012.4430","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31075813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-11-26DOI: 10.1001/archinternmed.2012.4427
Mark Adrian Faasse
{"title":"Lactobacilli vs antibiotics to prevent recurrent urinary tract infections: an inconclusive, not inferior, outcome.","authors":"Mark Adrian Faasse","doi":"10.1001/archinternmed.2012.4427","DOIUrl":"https://doi.org/10.1001/archinternmed.2012.4427","url":null,"abstract":"","PeriodicalId":8290,"journal":{"name":"Archives of internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archinternmed.2012.4427","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31075812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-11-26DOI: 10.1001/2013.jamainternmed.258
Edward P Havranek, Rebecca Hanratty, Channing Tate, L Miriam Dickinson, John F Steiner, Geoffrey Cohen, Irene A Blair
Background: Communication between African American patients and white health care providers has been shown to be of poorer quality when compared with race-concordant patient-provider communication. Fear on the part of patients that providers stereotype them negatively might be one cause of this poorer communication. This stereotype threat may be lessened by a values-affirmation intervention.
Methods: In a blinded experiment, we randomized 99 African American patients with hypertension to perform a values-affirmation exercise or a control exercise before a visit with their primary care provider. We compared patient-provider communication for the 2 groups using audio recordings of the visit analyzed with the Roter Interaction Analysis System. We also evaluated visit satisfaction, trust, stress, and mood after the visit by means of a questionnaire.
Results: Patients in the intervention group requested and provided more information about their medical condition (mean [SE] number of utterances, 66.3 [6.8] in the values-affirmation group vs 48.1 [5.9] in the control group [P = .03]). Patient-provider communication in the intervention group was characterized as being more interested, friendly, responsive, interactive, and respectful (P = .02) and less depressed and distressed (P = .03). Patient questionnaires did not detect differences in visit satisfaction, trust, stress, or mood. Mean visit duration did not differ significantly between the groups (19.2 minutes in the control group vs 20.5 minutes in the intervention group [P = .29]).
Conclusions: A values-affirmation exercise improves aspects of patient-provider communication in race-discordant primary care visits. The clinical impact of the intervention must be defined before widespread implementation can be recommended.
{"title":"The effect of values affirmation on race-discordant patient-provider communication.","authors":"Edward P Havranek, Rebecca Hanratty, Channing Tate, L Miriam Dickinson, John F Steiner, Geoffrey Cohen, Irene A Blair","doi":"10.1001/2013.jamainternmed.258","DOIUrl":"https://doi.org/10.1001/2013.jamainternmed.258","url":null,"abstract":"<p><strong>Background: </strong>Communication between African American patients and white health care providers has been shown to be of poorer quality when compared with race-concordant patient-provider communication. Fear on the part of patients that providers stereotype them negatively might be one cause of this poorer communication. This stereotype threat may be lessened by a values-affirmation intervention.</p><p><strong>Methods: </strong>In a blinded experiment, we randomized 99 African American patients with hypertension to perform a values-affirmation exercise or a control exercise before a visit with their primary care provider. We compared patient-provider communication for the 2 groups using audio recordings of the visit analyzed with the Roter Interaction Analysis System. We also evaluated visit satisfaction, trust, stress, and mood after the visit by means of a questionnaire.</p><p><strong>Results: </strong>Patients in the intervention group requested and provided more information about their medical condition (mean [SE] number of utterances, 66.3 [6.8] in the values-affirmation group vs 48.1 [5.9] in the control group [P = .03]). Patient-provider communication in the intervention group was characterized as being more interested, friendly, responsive, interactive, and respectful (P = .02) and less depressed and distressed (P = .03). Patient questionnaires did not detect differences in visit satisfaction, trust, stress, or mood. Mean visit duration did not differ significantly between the groups (19.2 minutes in the control group vs 20.5 minutes in the intervention group [P = .29]).</p><p><strong>Conclusions: </strong>A values-affirmation exercise improves aspects of patient-provider communication in race-discordant primary care visits. The clinical impact of the intervention must be defined before widespread implementation can be recommended.</p>","PeriodicalId":8290,"journal":{"name":"Archives of internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/2013.jamainternmed.258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31026783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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