Annals of Internal Medicine最新文献

{"title":"From Disparities to Equity in Chronic Disease Burden: Progress Requires Persistence.","authors":"Ali Aahil Noorali, Lisa A Cooper","doi":"10.7326/ANNALS-24-02986","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02986","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":19.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833324","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}

{"title":"Clinical Characteristics and Current Management of U.S. Adults at Elevated Risk for Heart Failure Using the PREVENT Equations: A Cross-Sectional Analysis.","authors":"Jeremy B Sussman, Linnea M Wilson, James F Burke, Boback Ziaeian, Timothy S Anderson","doi":"10.7326/ANNALS-24-01321","DOIUrl":"https://doi.org/10.7326/ANNALS-24-01321","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":19.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833315","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}

{"title":"Strategies to Address Racial and Ethnic Disparities in Health and Health Care for Chronic Conditions : An Evidence Map of Research From 2017 to 2024.","authors":"Toyin Lamina, Hamdi I Abdi, Kathryn Behrens, Romil Parikh, Kathleen Call, Amy M Claussen, Janette Dill, Stuart W Grande, Laura Houghtaling, Rhonda Jones-Webb, Manka Nkimbeng, Elizabeth A Rogers, Shahnaz Sultan, Rachel Widome, Timothy J Wilt, Mary Butler","doi":"10.7326/ANNALS-24-01262","DOIUrl":"https://doi.org/10.7326/ANNALS-24-01262","url":null,"abstract":"<p><strong>Background: </strong>Racial and ethnic disparities in health and health care persist in the United States, adversely affecting outcomes in prevention and treatment of chronic conditions among adults.</p><p><strong>Purpose: </strong>To map interventions aimed at reducing racial and ethnic disparities and improving health outcomes in the prevention and treatment of chronic conditions in adults.</p><p><strong>Data sources: </strong>Searches of MEDLINE, CINAHL, and Scopus from January 2017 to April 2024, supplemented with gray literature.</p><p><strong>Study selection: </strong>U.S.-based studies of interventions targeting racial and ethnic disparities in adults with chronic conditions.</p><p><strong>Data extraction: </strong>Information on intervention types, targets, outcomes, study designs, study settings, chronic conditions, and delivery personnel was extracted and categorized.</p><p><strong>Data synthesis: </strong>Among 174 unique studies, 12 intervention types were identified, with self-management support and patient navigation the most common. Most interventions targeted patient behaviors; few studies addressed disparities directly or focused on underrepresented racial and ethnic marginalized groups.</p><p><strong>Limitations: </strong>The lack of standardized terminology and the underrepresentation of certain racial and ethnic groups limit the evidence base. Although the literature search accurately reflects the current state of the literature, it also limits the body of evidence by excluding health disparities research conducted before January 2017, so significant findings from earlier studies may have been overlooked.</p><p><strong>Conclusion: </strong>The literature highlights diverse interventions targeting health disparities, but few studies evaluated their effectiveness in reducing the health disparities gaps. There is an urgent need for research focused on underrepresented racial and ethnic groups, particularly in promising areas such as patient navigation for cancer and diabetes self-management. Future research should prioritize robust study designs to assess the long-term effect and broader applicability of interventions, thus helping organizations and stakeholders to tailor strategies to community-specific needs.</p><p><strong>Primary funding source: </strong>Agency for Healthcare Research and Quality.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":19.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833448","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}

{"title":"Web Exclusive. Annals Video Summary - Strategies to Address Racial and Ethnic Disparities in Health and Health Care for Chronic Conditions.","authors":"","doi":"10.7326/ANNALS-24-02987-VS","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02987-VS","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"e2402987VS"},"PeriodicalIF":19.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833481","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}

{"title":"Correction: Deep Learning to Estimate Cardiovascular Risk From Chest Radiographs.","authors":"","doi":"10.7326/ANNALS-24-03386","DOIUrl":"https://doi.org/10.7326/ANNALS-24-03386","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":19.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833320","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}

{"title":"Development and Evaluation of a Comprehensive Prediction Model for Incident Coronary Heart Disease Using Genetic, Social, and Lifestyle-Psychological Factors: A Prospective Analysis of the UK Biobank.","authors":"Mohammadreza Naderian, Kristjan Norland, Daniel J Schaid, Iftikhar J Kullo","doi":"10.7326/ANNALS-24-00716","DOIUrl":"https://doi.org/10.7326/ANNALS-24-00716","url":null,"abstract":"<p><strong>Background: </strong>Clinical risk calculators for coronary heart disease (CHD) do not include genetic, social, and lifestyle-psychological risk factors.</p><p><strong>Objective: </strong>To improve CHD risk prediction by developing and evaluating a prediction model that incorporated a polygenic risk score (PRS) and a polysocial score (PSS), the latter including social determinants of health and lifestyle-psychological factors.</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Setting: </strong>United Kingdom.</p><p><strong>Participants: </strong>UK Biobank participants recruited between 2006 and 2010.</p><p><strong>Measurements: </strong>Incident CHD (myocardial infarction and/or coronary revascularization); 10-year clinical risk based on pooled cohort equations (PCE), Predicting Risk of cardiovascular disease EVENTs (PREVENT), and QRISK3; PRS (Polygenic Score Catalog identification: PGS000018) for CHD (PRS_CHD); and PSS_CHD from 100 related covariates. Machine-learning and time-to-event analyses and model performance indices.</p><p><strong>Results: </strong>In 388 224 participants (age, 55.5 [SD, 8.1] years; 42.5% men; 94.9% White), the hazard ratio for 1 SD increase in PSS_CHD for incident CHD was 1.43 (95% CI, 1.38 to 1.49; <i>P </i><<i> </i>0.001) and for 1 SD increase in PRS_CHD was 1.59 (CI, 1.53 to 1.66, <i>P </i>< 0.001). Non-White persons had higher PSS_CHD than White persons. The effects of PSS_CHD and PRS_CHD on CHD were independent and additive. At a 10-year CHD risk threshold of 7.5%, adding PSS_CHD and PRS_CHD to PCE reclassified 12% of participants, with 1.86 times higher CHD risk in the up- versus down-reclassified persons and showed superior performance compared with PCE as reflected by improved net benefit while maintaining good calibration relative to the clinical risk calculators. Similar results were seen when incorporating PSS_CHD and PRS_CHD into PREVENT and QRISK3.</p><p><strong>Limitation: </strong>A predominantly White cohort; possible healthy participant effect and ecological fallacy.</p><p><strong>Conclusion: </strong>A PSS_CHD was associated with incident CHD and its joint modeling with PRS_CHD improved the performance of clinical risk calculators.</p><p><strong>Primary funding source: </strong>National Human Genome Research Institute.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":19.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799115","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}

{"title":"Emerging and Resurging Vector-Borne Illnesses.","authors":"Christine Laine, Amir Qaseem, Darilyn V Moyer","doi":"10.7326/ANNALS-24-03714","DOIUrl":"https://doi.org/10.7326/ANNALS-24-03714","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":19.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799117","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}

{"title":"The Past, Present, and Future of Restrictive Covenants in Medicine in the United States : A Narrative Review.","authors":"Anand Prasad, Rishi Goswamy, Roger Bresnahan","doi":"10.7326/ANNALS-24-01670","DOIUrl":"https://doi.org/10.7326/ANNALS-24-01670","url":null,"abstract":"<p><p>Restrictive covenants (RCs) are clauses placed into employment agreements across various industries, and they are frequently used in health care-specifically within physician contracts. Given the most recent guidance and rule determined by the Federal Trade Commission in April 2024, the relevancy of RCs in health care has come under even more scrutiny in the latter half of 2024. This review will focus on the history of RC law and review the value of these clauses from the perspectives of the employer, practicing physician, and patient. We also provide the stakeholder responses to both the ban and the subsequent blockage of enforcement by a Texas federal court in August of 2024.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":19.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765619","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}

{"title":"A Framework for Considering the Value of Race and Ethnicity in Estimating Disease Risk.","authors":"Madison Coots, Soroush Saghafian, David M Kent, Sharad Goel","doi":"10.7326/M23-3166","DOIUrl":"https://doi.org/10.7326/M23-3166","url":null,"abstract":"<p><strong>Background: </strong>Accounting for race and ethnicity in estimating disease risk may improve the accuracy of predictions but may also encourage a racialized view of medicine.</p><p><strong>Objective: </strong>To present a decision analytic framework for considering the potential benefits of race-aware over race-unaware risk predictions, using cardiovascular disease, breast cancer, and lung cancer as case studies.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>NHANES (National Health and Nutrition Examination Survey), 2011 to 2018, and NLST (National Lung Screening Trial), 2002 to 2004.</p><p><strong>Patients: </strong>U.S. adults.</p><p><strong>Measurements: </strong>Starting with risk predictions from clinically recommended race-aware models, the researchers generated race-unaware predictions via statistical marginalization. They then estimated the utility gains of the race-aware over the race-unaware models, based on a simple utility function that assumes constant costs of screening and constant benefits of disease detection.</p><p><strong>Results: </strong>The race-unaware predictions were substantially miscalibrated across racial and ethnic groups compared with the race-aware predictions as the benchmark. However, the clinical net benefit at the population level of race-aware predictions over race-unaware predictions was smaller than expected. This result stems from 2 empirical patterns: First, across all 3 diseases, 95% or more of individuals would receive the same decision regardless of whether race and ethnicity are included in risk models; second, for those who receive different decisions, the net benefit of screening or treatment is relatively small because these patients have disease risks close to the decision threshold (that is, the theoretical \"point of indifference\"). When used to inform rationing, race-aware models may have a more substantial net benefit.</p><p><strong>Limitations: </strong>For illustrative purposes, the race-aware models were assumed to yield accurate estimates of risk given the input variables. The researchers used a simplified approach to generate race-unaware risk predictions from the race-aware models and a simple utility function to compare models.</p><p><strong>Conclusion: </strong>The analysis highlights the importance of foregrounding changes in decisions and utility when evaluating the potential benefit of using race and ethnicity to estimate disease risk.</p><p><strong>Primary funding source: </strong>The Greenwall Foundation.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":19.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765581","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}

{"title":"Death Need Be in All Caps: The Risk of \"Risk Calculation\" When Black Folk Are Dying.","authors":"Christina Hunter Chapman","doi":"10.7326/M24-0898","DOIUrl":"https://doi.org/10.7326/M24-0898","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":19.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765590","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}