Abstract:
:Physical symptoms account for more than half of all outpatient visits, but the specific causes and treatments of many common symptoms are frequently not well established. Because clinical research has primarily targeted specific diseases, symptoms-based research is still an emerging field of scientific inquiry, and optimal methods are still being developed. This paper considers eight important issues in sampling and measurement. First, recognition of the exceptionally high base rates of many symptoms is an essential primary step in selecting appropriate case-patients and controls. Second, the type of population studied (community, primary care clinic, subspecialty clinic, or symptom clinic) can greatly influence the severity and other characteristics of the symptom being evaluated. Third, symptom detection relies on three types of symptoms: documented, elicited, and volunteered. Fourth, temporal factors include recency of onset, episodicity, and duration. Fifth, severity can be assessed with single- or multiple-item symptom-specific scales as well as evaluation of generic functional status and health-related quality-of- life measures. Sixth, recognition of a symptom's cause can be strengthened by explicit criteria, uniform assessment protocols, and multiple raters. Seventh, comorbidity that should be assessed includes medical disorders, psychiatric disorders, and other symptoms. And eighth, since death and serious illness are uncommon, alternative outcomes that might be measured include symptom alleviation, health-related quality of life, patient and provider satisfaction, and health care costs.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Kroenke Kdoi
10.7326/0003-4819-134-9_part_2-200105011-00008subject
Has Abstractpub_date
2001-05-01 00:00:00pages
844-53issue
9 Pt 2eissn
0003-4819issn
1539-3704pii
200105011-00008journal_volume
134pub_type
杂志文章,评审abstract:BACKGROUND:Leukotriene-receptor antagonists (LTRAs) are recommended as an alternative treatment in patients with mild asthma, but their effect compared with placebo is unclear. PURPOSE:To determine the benefits and harms of LTRAs as monotherapy or in combination with inhaled corticosteroids compared with placebo in ad...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/M15-1059
更新日期:2015-11-17 00:00:00
abstract::The prevalence of sleep apnea was studied in 46 middle- and older-aged men with "essential hypertension." Thirty-four age- and weight-similar normotensive men were also studied. Fourteen hypertensive men and three controls had sleep apnea syndrome, as defined as greater than ten apneas per hour of sleep. Hypertensive ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-103-2-190
更新日期:1985-08-01 00:00:00
abstract::Coronary artery spasm is an important pathogenetic mechanism in some forms of myocardial ischemic disease. Factors that may be important in the genesis of spasm include the autonomic nervous system, prostaglandins, endoperoxides, thromboxanes, and the calcium availability to the contractile apparatus. Spasm results in...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-91-3-441
更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:Certain medications are identified by the U.S. Food and Drug Administration (FDA) as class D or X because they increase the risk for birth defects if used during pregnancy. OBJECTIVE:To assess pregnancy rates and the frequency of contraceptive counseling documented with prescriptions for class D or X drugs ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-147-6-200709180-00006
更新日期:2007-09-18 00:00:00
abstract:BACKGROUND:A sensitive and acceptable screening regimen for women at high risk for breast cancer is essential. Contrast-enhanced magnetic resonance imaging (MRI) of the breast is highly sensitive for diagnosis of breast cancer but has variable specificity. PURPOSE:To summarize the sensitivity, specificity, likelihood ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-148-9-200805060-00007
更新日期:2008-05-06 00:00:00
abstract::In patients with end-stage renal disease, nervous system dysfunction remains a major cause of disability. Patients with chronic renal failure who have not yet received dialysis may have symptoms ranging from mild sensorial clouding to delirium and coma. Dialysis itself is associated with at least three distinct disord...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-109-2-143
更新日期:1988-07-15 00:00:00
abstract::Differences in blood levels of thyroid hormones have been reported when patients taking synthetic L-thyroxine were shifted from one manufactured form of the hormone to another. Because recent formulation changes have rendered these earlier data obsolete, we did a crossover study to determine differences in bioavailabi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-102-6-770
更新日期:1985-06-01 00:00:00
abstract::Recent studies have indicated that outcomes in patients with atrial fibrillation who are managed with rate control and anticoagulation are similar to those in patients who have maintenance of sinus rhythm. These studies did not include important groups of patients with atrial fibrillation in whom antiarrhythmic therap...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-141-9-200411020-00015
更新日期:2004-11-02 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and safety of fluconazole for prevention of fungal infections. DESIGN:A randomized, placebo-controlled, double-blind, multicenter trial. PATIENTS:Adults (257) undergoing chemotherapy for acute leukemia. INTERVENTION:Patients were randomly assigned to receive either fluconazole (400...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-118-7-199304010-00003
更新日期:1993-04-01 00:00:00
abstract::Immediately after the liberation of Kuwait by a coalition of allied forces in March 1991, representatives of Physicians for Human Rights traveled to Kuwait and conducted an inquiry into human rights violations allegedly perpetrated by Iraqi forces. The inquiry focused on the abuses that were said to have occurred in h...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-117-1-78
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:No effective oral therapy exists for early coronavirus disease 2019 (COVID-19). OBJECTIVE:To investigate whether hydroxychloroquine could reduce COVID-19 severity in adult outpatients. DESIGN:Randomized, double-blind, placebo-controlled trial conducted from 22 March through 20 May 2020. (ClinicalTrials.gov...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/M20-4207
更新日期:2020-10-20 00:00:00
abstract::Care of persons with non-insulin-dependent diabetes mellitus (NIDDM) in the United Kingdom resembles that in the United States. However, health care practice in Europe is being influenced by the Saint Vincent Declaration, the joint European World Health Organization-International Diabetes Federation initiative, which ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-124-1_part_2-199601011-00015
更新日期:1996-01-01 00:00:00
abstract::More than 18 million Americans currently have diabetes mellitus. The economic and human cost of the disease is devastating. In the United States, diabetes is the most common cause of blindness among working-age adults, the most common cause of nontraumatic amputations and end-stage renal disease, and the sixth most co...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-140-11-200406010-00036
更新日期:2004-06-01 00:00:00
abstract::Sixty-eight patients clinically suspected of having (33), or at high risk for (35), deep venous thrombosis were studied with contrast venography, radiofibrinogen leg scanning, and impedance plethysmography as well as ventilation and perfusion lung scans. Thrombosis limited to the veins in the calf of the leg (unilater...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-4-439
更新日期:1981-04-01 00:00:00
abstract::We report a case of combined idiopathic immune neutropenia and immune thrombocytopenia (thromboneutropenia). Therapy with prednisone was ineffective. Treatment with vincristine raised the patient's platelet count but did not increase the neutrophil count. Splenectomy led to a prompt complete remission. Using radioimmu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-5-704
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:Few treatments for back pain are supported by strong scientific evidence. Conventional treatments, although widely used, have had limited success. Dissatisfied patients have, therefore, turned to complementary and alternative medical therapies and providers for care for back pain. PURPOSE:To provide a rigor...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-138-11-200306030-00011
更新日期:2003-06-03 00:00:00
abstract:BACKGROUND:Fibromyalgia is a common chronic pain condition for which patients frequently use acupuncture. OBJECTIVE:To determine whether acupuncture relieves pain in fibromyalgia. DESIGN:Randomized, sham-controlled trial in which participants, data collection staff, and data analysts were blinded to treatment group. ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-143-1-200507050-00005
更新日期:2005-07-05 00:00:00
abstract:BACKGROUND:Testing has been advocated for all persons with newly diagnosed colorectal cancer to identify families with the Lynch syndrome, an autosomal dominant cancer-predisposition syndrome that is a paradigm for personalized medicine. OBJECTIVE:To estimate the effectiveness and cost-effectiveness of strategies to i...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-155-2-201107190-00002
更新日期:2011-07-19 00:00:00
abstract::The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including PIER (Physicians' Information and Education Resource) and MKSAP (Medical Knowledge and Self Assessment Program). Annals of Internal Medicine editors develop In the Clinic f...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-151-11-200912010-01006
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Motor vehicle crashes (MVCs) remain a leading cause of injury-related deaths in the United States. Primary seat belt laws allow vehicle occupants to be ticketed solely for not wearing seat belts, and secondary laws allow ticketing only for failure to wear seat belts in the setting of other violations. OBJEC...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M14-2368
更新日期:2015-08-04 00:00:00
abstract:BACKGROUND:The news media are often criticized for exaggerated coverage of weak science. Press releases, a source of information for many journalists, might be a source of those exaggerations. OBJECTIVE:To characterize research press releases from academic medical centers. DESIGN:Content analysis. SETTING:Press rele...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-150-9-200905050-00007
更新日期:2009-05-05 00:00:00
abstract:BACKGROUND:Exercise rehabilitation programs increase treadmill walking performance in patients with peripheral arterial disease (PAD) and intermittent claudication. However, it is unknown whether patients with PAD who walk for exercise regularly have less functional decline than those with less walking activity. OBJEC...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-144-1-200601030-00005
更新日期:2006-01-03 00:00:00
abstract:Description:Recommendation on screening for urinary incontinence in women by the Women's Preventive Services Initiative (WPSI), a national coalition of women's health professional organizations and patient representatives. The WPSI's recommendations are intended to guide clinical practice and coverage of services for t...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/M18-0595
更新日期:2018-09-04 00:00:00
abstract::Smoking remains the leading cause of preventable death in the United States, yet it is still regarded by many as merely a bad habit. Most smokers want to quit but find it difficult. Behavioral counseling and pharmacotherapies are available, safe, and effective in the treatment of tobacco dependence. Nicotine replaceme...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-148-7-200804010-00012
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Treatment of chronic hepatitis C virus (HCV) infection with direct-acting antivirals (DAAs) for 6 weeks achieves sustained virologic response (SVR) rates of 95% in some patients. If effective, shorter therapeutic courses could improve adherence and treatment costs. OBJECTIVE:To determine factors predictive ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/M15-0642
更新日期:2015-12-15 00:00:00
abstract::Young adults with cystic fibrosis have lower blood pressures than control subjects of similar age and sex. The low blood pressure may be related to the excessive loss of salt in the sweat of these patients. A beneficial effect of the cystic fibrosis gene may be protection against developing hypertension in both the ho...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-82-6-806
更新日期:1975-06-01 00:00:00
abstract::[Figure: see text]. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-1897
更新日期:2020-05-19 00:00:00
abstract:BACKGROUND:Home-based primary care for homebound seniors is complex, and practice constraints are unique. No quality-of-care standards exist. OBJECTIVE:To identify process quality indicators that are essential to high-quality, home-based primary care. DESIGN:An expert development panel reviewed established and new qu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-146-3-200702060-00008
更新日期:2007-02-06 00:00:00
abstract:BACKGROUND:Mucositis can be a serious complication of cancer treatment. Palifermin reduces mucositis when given in multiple doses to patients undergoing hematopoietic stem-cell transplantation. OBJECTIVE:To evaluate the efficacy of palifermin given as a single dose before each cycle in patients receiving multicycle ch...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/0003-4819-153-6-201009210-00003
更新日期:2010-09-21 00:00:00
abstract:OBJECTIVE:To determine whether the detection of tuberculostearic acid (TBSA) in bronchial aspirate and bronchoalveolar lavage specimens is useful for the rapid diagnosis of active pulmonary tuberculosis in patients suspected of having the disease. SETTING:A pulmonary clinic in a teaching hospital. PATIENTS:Forty pati...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-8-650
更新日期:1989-10-15 00:00:00