Abstract:
PURPOSE:To synthesize new data on breast cancer screening for the U.S. Preventive Services Task Force. DATA SOURCES:MEDLINE; the Cochrane Controlled Trials Registry; and reference lists of reviews, editorials, and original studies. STUDY SELECTION:Eight randomized, controlled trials of mammography and 2 trials evaluating breast self-examination were included. One hundred fifty-four publications of the results of these trials, as well as selected articles about the test characteristics and harms associated with screening, were examined. DATA EXTRACTION:Predefined criteria were used to assess the quality of each study. Meta-analyses using a Bayesian random-effects model were conducted to provide summary relative risk estimates and credible intervals (CrIs) for the effectiveness of screening with mammography in reducing death from breast cancer. DATA SYNTHESIS:For studies of fair quality or better, the summary relative risk was 0.84 (95% CrI, 0.77 to 0.91) and the number needed to screen to prevent one death from breast cancer after approximately 14 years of observation was 1224 (CrI, 665 to 2564). Among women younger than 50 years of age, the summary relative risk associated with mammography was 0.85 (CrI, 0.73 to 0.99) and the number needed to screen to prevent one death from breast cancer after 14 years of observation was 1792 (CrI, 764 to 10 540). For clinical breast examination and breast self-examination, evidence from randomized trials is inconclusive. CONCLUSIONS:In the randomized, controlled trials, mammography reduced breast cancer mortality rates among women 40 to 74 years of age. Greater absolute risk reduction was seen among older women. Because these results incorporate several rounds of screening, the actual number of mammograms needed to prevent one death from breast cancer is higher. In addition, each screening has associated risks and costs.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Humphrey LL,Helfand M,Chan BK,Woolf SHdoi
10.7326/0003-4819-137-5_part_1-200209030-00012subject
Has Abstractpub_date
2002-09-03 00:00:00pages
347-60issue
5 Part 1eissn
0003-4819issn
1539-3704pii
200209030-00012journal_volume
137pub_type
杂志文章,meta分析abstract:Background:Central line-associated bloodstream infection (CLABSI) remains prevalent in hospitals in the United States. Objective:To evaluate the impact of a multimodal intervention in hospitals with elevated rates of health care-associated infection. Design:Pre-post observational evaluation of a prospective, national...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/M18-3533
更新日期:2019-10-01 00:00:00
abstract::To assess the course and prognosis of salicylate-induced pulmonary edema, we reviewed the records of 36 consecutive patients admitted with serum salicylate levels greater than 30 mg/dL. Pulmonary edema developed in eight patients, and pulmonary infiltrates were never seen in 28 patients. Several features distinguished...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-95-4-405
更新日期:1981-10-01 00:00:00
abstract::Nine of 81 members of two families were found to have renal problems. Three patients in one family had renal-retinal dysplasia with probable recessive inheritance. Of the 6 patients in the second family, one received a kidney transplant from his brother who initially had no detectable renal abnormality but later devel...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-84-2-157
更新日期:1976-02-01 00:00:00
abstract::Hypophosphatemic osteomalacia that remits after resection of a coexisting tumor has been described in 35 patients. Because the associated neoplasms have been of mesenchymal origin, it has been inferred that this tumor-induced osteomalacia syndrome is uniquely related to tumours of this derivation. However, in the pres...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-2-275
更新日期:1980-08-01 00:00:00
abstract::Early defibrillation is the most important determinant of survival for victims of cardiac arrest due to ventricular fibrillation. The automated external defibrillator (AED) was developed as the result of the American Heart Association's Public Access Defibrillation initiative. The goal of this initiative is to place A...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-135-11-200112040-00011
更新日期:2001-12-04 00:00:00
abstract:PURPOSE:To review available information on the epidemiology, cause, diagnosis, prognosis, and treatment of acute myocardial infarction during pregnancy or in the early postpartum period and to develop guidelines for the management of this condition. DATA SOURCES:MEDLINE and Index Medicus searches and a manual search o...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-125-9-199611010-00009
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Corticosteroid injections (CSIs) and physical therapy are used to treat patients with the shoulder impingement syndrome (SIS) but have never been directly compared. OBJECTIVE:To compare the effectiveness of 2 common nonsurgical treatments for SIS. DESIGN:Randomized, single-blind, comparative-effectiveness,...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/M13-2199
更新日期:2014-08-05 00:00:00
abstract::Endocarditis is a relatively frequent infection in intravenous drug users. We compared features in the cases of 102 patients with those in intravenous drug users with other causes of fever to identify risk factors predictive of endocarditis. Logistic regression analysis showed cocaine use to be strongly associated wit...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-106-6-833
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:The accuracy and harms of brief cognitive tests for identifying clinical Alzheimer-type dementia (CATD) are uncertain. PURPOSE:To summarize evidence on accuracy and harms of brief cognitive tests for CATD in older adults with suspected cognitive impairment. DATA SOURCES:Electronic bibliographic databases (...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M19-3889
更新日期:2020-05-19 00:00:00
abstract:BACKGROUND:Tobacco use is the leading cause of preventable death in the United States. PURPOSE:To review the effectiveness and safety of pharmacotherapy and behavioral interventions for tobacco cessation. DATA SOURCES:5 databases and 8 organizational Web sites were searched through 1 August 2014 for systematic review...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M15-0171
更新日期:2015-10-20 00:00:00
abstract:STUDY OBJECTIVE:To determine the sensitivity of herpes simplex virus isolates to acyclovir and the importance of resistant isolates in hospitalized patients. DESIGN:Retrospective incidence cohort study. SETTING:All herpes simplex virus isolates cultured over 1 year from patients followed at a tertiary care center. P...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-76-3-112-6-416
更新日期:1990-03-15 00:00:00
abstract:BACKGROUND:Endoscopic retrograde cholangiopancreatography (ERCP) is a technically demanding procedure that can cause substantial complications. Competence in performing ERCP and the learning curve for achieving competence are poorly understood. OBJECTIVE:To evaluate the number of supervised ERCPs that physicians must ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-125-12-199612150-00009
更新日期:1996-12-15 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:Dietary trans fat increases risk for coronary heart disease. In 2006, New York City (NYC) passed the first regulation in the United States restricting trans fat use in restaurants. OBJECTIVE:To assess the effect of the NYC regulation on the trans and saturated fat content of fast-food purchases. DESIGN:Cro...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-157-2-201207170-00004
更新日期:2012-07-17 00:00:00
abstract:BACKGROUND:Timing of initiation of screening for breast cancer is controversial in the United States. OBJECTIVE:To determine the threshold relative risk (RR) at which the harm-benefit ratio of screening women aged 40 to 49 years equals that of biennial screening for women aged 50 to 74 years. DESIGN:Comparative model...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-156-9-201205010-00002
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Valid measurement of physician performance requires accurate identification of patients for whom a physician is responsible. Among all patients seen by a physician, some will be more strongly connected to their physician than others, but the effect of connectedness on measures of physician performance is not...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-150-5-200903030-00008
更新日期:2009-03-03 00:00:00
abstract::The clinical implications of newly acquired left bundle-branch block (LBBB) were examined prospectively in the Framingham Study population. During 18 years of observation 55 people developed LBBB. The mean age at the onset of LBBB was 62; LBBB occurred largely in people with antecedent hypertension, cardiac enlargemen...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-90-3-303
更新日期:1979-03-01 00:00:00
abstract:SOURCE CITATION:Mahady SE, Margolis KL, Chan A, et al. Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial. Gut. 2020. [Epub ahead of print.] 32747412. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/ACPJ202101190-004
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Injection insulin therapy is not readily accepted by patients and many health care providers; therefore, less invasive options for insulin therapy are desirable. PURPOSE:To examine the efficacy, safety, and patient acceptability of inhaled insulin therapy in nonpregnant adults with diabetes mellitus. DATA ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-145-9-200611070-00009
更新日期:2006-11-07 00:00:00
abstract:OBJECTIVE:To determine which procedures nephrologists do in practice, where they learned the procedures, and how much training they recommend to achieve and maintain clinical competence in each. DESIGN:Mailed survey. PARTICIPANTS:A random sample of 700 members of the American College of Physicians who were identified...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-113-5-392
更新日期:1990-09-01 00:00:00
abstract::Traditional educational methods change clinical practice only with considerable effort and difficulty. In particular, the teaching of critical appraisal in the setting of journal clubs does not increase the amount of medical research read by trainees. Experiential learning theory, corroborated by the success of proble...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-126-11-199706010-00006
更新日期:1997-06-01 00:00:00
abstract::Although the efficacy of hepatitis vaccine is well documented, the duration of immunity of healthy adults after vaccination is unknown. We studied 245 hospital employees 3 years after primary vaccination with hepatitis B vaccine to determine the prevalence of immunity indicated by levels of antibody to hepatitis B sur...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-2-185
更新日期:1988-02-01 00:00:00
abstract::Elevated serum digoxin concentrations and clinical toxicity have been reported in patients receiving quinidine. The present study was undertaken to ascertain whether a similar interaction occurs between quinidine and another cardiac glycoside, digitoxin, and if so to evaluate the pharmacokinetic basis in five healthy ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-1-35
更新日期:1981-01-01 00:00:00
abstract:PURPOSE:To review clinical scenarios in which nonelectrophysiologist physicians may interact with patients who have implantable defibrillators. DATA SOURCES:Peer-reviewed original articles and reviews addressing aspects of implantable defibrillator therapy that are relevant to the clinician. DATA SYNTHESIS:The capaci...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-122-10-199505150-00007
更新日期:1995-05-15 00:00:00
abstract::Of 476 patients with multiple myeloma treated during a 9-year period, 11 developed acute myelogenous leukemia or sideroblastic anemia. In all, the myeloma was in remission from chemotherapy with melphalan-prednisone combinations that had been continued for a median duration of 3 years. The incidence of acute leukemia ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-4-440
更新日期:1977-04-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the usefulness and safety of hydroxychloroquine in patients with decompensated, treatment-refractory noninsulin-dependent diabetes mellitus. DESIGN:Prospective, randomized, placebo, double-blind 6-month trial. PATIENTS:Thirty-eight patients with noninsulin-dependent diabetes resistant to c...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-112-9-678
更新日期:1990-05-01 00:00:00
abstract::The indications for treating patients with subclinical hypothyroidism (normal serum thyroxine and free thyroxine levels, but elevated serum thyrotrophin levels) are poorly defined. In this study, 33 patients with subclinical hypothyroidism were randomly assigned in a double-blind manner to receive placebo or L-thyroxi...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-101-1-18
更新日期:1984-07-01 00:00:00
abstract::Quality improvement (QI) activities can improve health care but must be conducted ethically. The Hastings Center convened leaders and scholars to address ethical requirements for QI and their relationship to regulations protecting human subjects of research. The group defined QI as systematic, data-guided activities d...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-146-9-200705010-00155
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To investigate the relation between the quantity of human immunodeficiency virus type 1 (HIV-1) RNA in plasma and the risk for the acquired immunodeficiency syndrome (AIDS) or a decline in the CD4+ T-cell count after seroconversion. DESIGN:Prospective study. PATIENTS:62 homosexual men with documented HIV-1 ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.7326/0003-4819-122-8-199504150-00003
更新日期:1995-04-15 00:00:00
abstract:BACKGROUND:Screening for hereditary hemochromatosis is traditionally done by using serum iron studies. However, mutation analysis of the hemochromatosis-associated HFE gene has recently become available. OBJECTIVE:To compare the cost-effectiveness of no screening with four screening strategies that incorporate HFE gen...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-132-4-200002150-00003
更新日期:2000-02-15 00:00:00