Annals of Internal Medicine最新文献

{"title":"In patients with NSTE-ACS and previous CABG, routine invasive vs. conservative management does not improve outcomes.","authors":"Debabrata Mukherjee","doi":"10.7326/ANNALS-24-01577-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-24-01577-JC","url":null,"abstract":"<p><strong>Source citation: </strong>Kelham M, Vyas R, Ramaseshan R, et al. <b>Non-ST-elevation acute coronary syndromes with previous coronary artery bypass grafting: a meta-analysis of invasive vs. conservative management</b>. Eur Heart J. 2024;45:2380-2391. 38805681.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118785","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":"Annals On Call - Responsible Use of Artificial Intelligence in Health Care.","authors":"Robert M Centor, Nadia Daneshvar, Deepti Pandita","doi":"10.7326/ANNALS-24-02302-OC","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02302-OC","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118777","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":"Comparative Performance of Common Fecal Immunochemical Tests : A Cross-Sectional Study.","authors":"Barcey T Levy, Yinghui Xu, Jeanette M Daly, Richard M Hoffman, Jeffrey D Dawson, Navkiran K Shokar, Marc J Zuckerman, Jennifer Molokwu, Daniel S Reuland, Seth D Crockett","doi":"10.7326/M24-0080","DOIUrl":"https://doi.org/10.7326/M24-0080","url":null,"abstract":"<p><strong>Background: </strong>Despite widespread use of fecal immunochemical tests (FITs) for colorectal cancer (CRC) screening, data to guide test selection are limited.</p><p><strong>Objective: </strong>To compare the performance characteristics of 5 commonly used FITs, using colonoscopy as the reference standard.</p><p><strong>Design: </strong>Cross-sectional study. (ClinicalTrials.gov: NCT03264898).</p><p><strong>Setting: </strong>Three U.S. academic medical centers and affiliated endoscopy units.</p><p><strong>Participants: </strong>Patients aged 50 to 85 years undergoing screening or surveillance colonoscopy.</p><p><strong>Intervention: </strong>Participants completed 5 different FITs before their colonoscopy, including 4 qualitative tests (Hemoccult ICT, Hemosure iFOB, OC-Light S FIT, QuickVue iFOB) and 1 quantitative test (OC-Auto FIT, which was run at the manufacturer's threshold for positivity of >100 ng/mL).</p><p><strong>Measurements: </strong>The primary outcome was test performance (sensitivity and specificity) for each of the 5 FITs for advanced colorectal neoplasia (ACN), defined as advanced polyps or CRC. Positivity rates, positive and negative predictive values, and rates of unevaluable tests were compared. Multivariable models were used to identify factors affecting sensitivity.</p><p><strong>Results: </strong>A total of 3761 participants were enrolled, with a mean age of 62.1 years (SD, 7.8); 63.2% of participants were female, 5.7% were Black, 86.4% were White, and 28.7% were Hispanic. There were 320 participants with ACN (8.5%), including 9 with CRC (0.2%). The test positivity rate varied 4-fold (3.9% to 16.4%) across FITs. Rates of unevaluable FITs ranged from 0.2% to 2.5%. The sensitivity for ACN varied from 10.1% to 36.7%, and specificity varied from 85.5% to 96.6%. Differences in sensitivity between FITs were all statistically significantly different except between Hemosure iFOB and QuickVue iFOB, and specificity differences were all statistically significantly different from one another. In addition to FIT brand, distal location of ACN was also associated with higher FIT sensitivity.</p><p><strong>Limitation: </strong>The study did not assess the programmatic sensitivity of annual FIT.</p><p><strong>Conclusion: </strong>Although considered a single class, FITs have varying test performance for detecting ACN and should not be considered interchangeable.</p><p><strong>Primary funding source: </strong>National Institutes of Health.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118779","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":"In persons smoking after 6 wk of varenicline or combined NRT, increasing dose or switching combined NRT to varenicline increased cessation.","authors":"Lenard I Lesser","doi":"10.7326/ANNALS-24-01842-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-24-01842-JC","url":null,"abstract":"<p><strong>Source citation: </strong>Cinciripini PM, Green CE, Shete S, et al. <b>Smoking cessation after initial treatment failure with varenicline or nicotine replacement: a randomized clinical trial.</b> JAMA. 2024;331:1722-1731. 38696203.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118786","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":"Time From Approval to Reimbursement of New Drugs: A Comparative Analysis Between the United States, England, Germany, France, and Switzerland (2011-2022).","authors":"Camille E G Glaus, Miquel Serra-Burriel, Stacie B Dusetzina, Kerstin N Vokinger","doi":"10.7326/ANNALS-24-00614","DOIUrl":"https://doi.org/10.7326/ANNALS-24-00614","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118829","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":"Association Between False-Positive Results and Return to Screening Mammography in the Breast Cancer Surveillance Consortium Cohort.","authors":"Diana L Miglioretti, Linn Abraham, Brian L Sprague, Christoph I Lee, Michael C S Bissell, Thao-Quyen H Ho, Erin J A Bowles, Louise M Henderson, Rebecca A Hubbard, Anna N A Tosteson, Karla Kerlikowske","doi":"10.7326/M24-0123","DOIUrl":"https://doi.org/10.7326/M24-0123","url":null,"abstract":"<p><strong>Background: </strong>False-positive results on screening mammography may affect women's willingness to return for future screening.</p><p><strong>Objective: </strong>To evaluate the association between screening mammography results and the probability of subsequent screening.</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Setting: </strong>177 facilities participating in the Breast Cancer Surveillance Consortium (BCSC).</p><p><strong>Patients: </strong>3 529 825 screening mammograms (3 184 482 true negatives and 345 343 false positives) performed from 2005 to 2017 among 1 053 672 women aged 40 to 73 years without a breast cancer diagnosis.</p><p><strong>Measurements: </strong>Mammography results (true-negative result or false-positive recall with a recommendation for immediate additional imaging only, short-interval follow-up, or biopsy) from 1 or 2 screening mammograms. Absolute differences in the probability of returning for screening within 9 to 30 months of false-positive versus true-negative screening results were estimated, adjusting for race, ethnicity, age, time since last mammogram, BCSC registry, and clustering within women and facilities.</p><p><strong>Results: </strong>Women were more likely to return after a true-negative result (76.9% [95% CI, 75.1% to 78.6%]) than after a false-positive recall for additional imaging only (adjusted absolute difference, -1.9 percentage points [CI, -3.1 to -0.7 percentage points]), short-interval follow-up (-15.9 percentage points [CI, -19.7 to -12.0 percentage points]), or biopsy (-10.0 percentage points [CI, -14.2 to -5.9 percentage points]). Asian and Hispanic/Latinx women had the largest decreases in the probability of returning after a false positive with a recommendation for short-interval follow-up (-20 to -25 percentage points) or biopsy (-13 to -14 percentage points) versus a true negative. Among women with 2 screening mammograms within 5 years, a false-positive result on the second was associated with a decreased probability of returning for a third regardless of the first screening result.</p><p><strong>Limitation: </strong>Women could receive care at non-BCSC facilities.</p><p><strong>Conclusion: </strong>Women were less likely to return to screening after false-positive mammography results, especially with recommendations for short-interval follow-up or biopsy, raising concerns about continued participation in routine screening among these women at increased breast cancer risk.</p><p><strong>Primary funding source: </strong>National Cancer Institute.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118778","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":"Annals Graphic Medicine - Am I Elevating the Uterus, or Is the Uterus Elevating Me?","authors":"Juliet Bramante","doi":"10.7326/G23-0041","DOIUrl":"https://doi.org/10.7326/G23-0041","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071793","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":"Endoscopic Ultrasound-Guided Rendezvous Technique Versus Precut Sphincterotomy as Salvage Technique in Patients With Benign Biliary Disease and Difficult Biliary Cannulation : A Randomized Controlled Trial.","authors":"Arup Choudhury, Jayanta Samanta, Gaurav Muktesh, Jahnvi Dhar, Antriksh Kumar, Jimil Shah, Marco Spadaccini, Pankaj Gupta, Alessandro Fugazza, Vikas Gupta, Thakur Deen Yadav, Rakesh Kochhar, Cesare Hassan, Alessandro Repici, Antonio Facciorusso","doi":"10.7326/M24-0092","DOIUrl":"https://doi.org/10.7326/M24-0092","url":null,"abstract":"<p><strong>Background: </strong>The standard salvage technique used for difficult bile duct cannulation is precut sphincterotomy, whereas endoscopic ultrasound-guided rendezvous technique (EUS-RV) is a relatively newer method. Prospective comparative data between these 2 techniques as salvage for biliary access in patients with benign biliary disease and difficult bile duct cannulation is lacking.</p><p><strong>Objective: </strong>To compare EUS-RV and precut sphincterotomy as salvage technique for difficult bile duct cannulation in benign biliary obstruction.</p><p><strong>Design: </strong>Participant-masked, parallel-group, superiority, randomized controlled trial. (Clinical Trials Registry of India: CTRI/2020/07/026613).</p><p><strong>Setting: </strong>Tertiary care academic institute from July 2020 to May 2021.</p><p><strong>Participants: </strong>All patients with benign biliary disease and difficult bile duct cannulation requiring salvage strategy.</p><p><strong>Intervention: </strong>Patients were randomly assigned by computer-generated randomized blocks sequence in 1:1 fashion to either EUS-RV or precut sphincterotomy. Patients with failure in EUS-RV were crossed over to precut sphincterotomy and vice versa.</p><p><strong>Measurements: </strong>The primary outcome measure was technical success. The other outcome measures included procedure time, radiation dose, and adverse events.</p><p><strong>Results: </strong>In total, 100 patients were randomly assigned to EUS-RV (<i>n</i> = 50) and precut sphincterotomy (<i>n</i> = 50). The technical success rate (92% vs. 90%; <i>P</i> = 1.00; relative risk, 1.02 [95% CI, 0.90 to 1.16]), median procedure time (10.1 vs. 9.75 minutes), and overall complication rate (12% vs. 10%; relative risk, 1.20 [CI, 0.39 to 3.68]) were similar between the 2 groups. Five patients (10%) in the EUS-RV group and 5 patients (10%) in the precut sphincterotomy group had developed post-endoscopic retrograde cholangiopancreatography pancreatitis. All failed cases in either salvage group could be successfully cannulated when crossed over to the other group.</p><p><strong>Limitation: </strong>Single center study done by experts.</p><p><strong>Conclusion: </strong>Endoscopic ultrasound-guided rendezvous technique and precut sphincterotomy have similar success rates as salvage techniques in the technically challenging cohort of difficult bile duct cannulation for benign biliary disease, with acceptable complications rates.</p><p><strong>Primary funding source: </strong>None.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071795","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":"Estimating New Eligibility and Maximum Costs of Expanded Medicare Coverage of Semaglutide for Cardiovascular Risk Prevention.","authors":"Alexander Chaitoff, Liam Bendicksen, William B Feldman, Alexander R Zheutlin, Hussain S Lalani","doi":"10.7326/ANNALS-24-00308","DOIUrl":"https://doi.org/10.7326/ANNALS-24-00308","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071796","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":"Meeting the Artificial Intelligence Needs of U.S. Health Systems.","authors":"Patrick G Lyons, David A Dorr, Genevieve B Melton, Karandeep Singh, Philip R O Payne","doi":"10.7326/ANNALS-24-00396","DOIUrl":"https://doi.org/10.7326/ANNALS-24-00396","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071797","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}