Abstract:
BACKGROUND AND OBJECTIVES:Thyroid ultrasound (TUS) plays an important but limited role in the evaluation of some complaints related to the thyroid gland. This study was designed to examine how primary care physicians use TUS before referring patients to an endocrine clinic. DESIGN:We audited all charts of first-time referrals for appropriateness of TUS use. Recommendations in practice guidelines and current textbooks defined appropriate indications for TUS: (1) patients with a thyroid nodule and a history of head or neck irradiation; (2) follow-up of patients with nodules not surgically removed; and (3) evaluation of patients with amiodarone-induced thyrotoxicosis. SETTING:Endocrine referral clinic in a teaching hospital in Israel. RESULTS:Two hundred and eight unselected referrals were reviewed. Sixty-nine (33%) of the patients presented with a TUS. Documented reasons for TUS were suspected thyroid mass (n=35, 51%), thyroid dysfunction (n=21, 30%), neck pain (n=5, 7%), dyspnea (n=4, 6%), and dysphagia (n=2, 3%). Of the 69 TUS reviewed, 64 (93%) were not appropriate. CONCLUSIONS:Primary care clinicians obtain TUS studies in patients without recommended indications prior to referral to an endocrinologist.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Liel Y,Fraenkel Ndoi
10.1111/j.1525-1497.2005.0124.xsubject
Has Abstractpub_date
2005-08-01 00:00:00pages
766-8issue
8eissn
0884-8734issn
1525-1497pii
JGI05085journal_volume
20pub_type
杂志文章abstract:BACKGROUND:Changes to national guidelines for breast and cervical cancer screening have created confusion and controversy for women and their primary care providers. OBJECTIVE:To characterize women's primary health care provider attitudes towards screening and changes in practice in response to recent revisions in gui...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-015-3449-5
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Leaders play a crucial role in implementing and sustaining changes in clinical practice, yet there is limited evidence on the strategies to engage them in team problem solving and communication. OBJECTIVE:Examine the impact of an intervention focused on facilitating leadership during daily huddles on optimi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06487-6
更新日期:2021-01-26 00:00:00
abstract:BACKGROUND:Antibiotics are often prescribed for hospitalized patients with chronic obstructive pulmonary disease (COPD) exacerbations. The use of procalcitonin (PCT) in the management of pneumonia has safely reduced antibiotic durations, but limited data on the impact of PCT guidance on the management of COPD exacerbat...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4312-2
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Interpreter services for medical care increase physician-patient communication and safety, yet a "formal certification" process to demonstrate interpreter competence does not exist. Testing and training is left to individual health care facilities nationwide. Bilingual staff are often used to interpret, with...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0344-8
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Multi-faceted depression care programs based within the healthcare system have been found to be effective, but may not fully address the needs of African American Intimate Partner Violence (IPV) survivors, many of whom are not seeking depression care in healthcare settings. OBJECTIVES:To develop and evaluat...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-012-2270-7
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Teamwork is important for improving care across transitions between providers and for increasing patient safety. OBJECTIVE:This review's objective was to assess the characteristics and efficacy of published curricula designed to teach teamwork to medical students and house staff. DESIGN:The authors searche...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-008-0600-6
更新日期:2008-06-01 00:00:00
abstract::While great strides have been made recently in improving end-of-life care in the United States, people with dementia often die with inadequate pain control, with feeding tubes in place, and without the benefits of hospice care. In this paper, we discuss the most important and persistent challenges to providing excelle...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1111/j.1525-1497.2004.30329.x
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Integrating evidence-based innovations (EBIs) into sustained use is challenging; most implementations in health systems fail. Increasing frontline teams' quality improvement (QI) capability may increase the implementation readiness and success of EBI implementation. OBJECTIVES:Develop a QI training program ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06133-1
更新日期:2020-09-08 00:00:00
abstract:BACKGROUND:Extension for Community Healthcare Outcomes (ECHO) and related models of medical tele-education are rapidly expanding; however, their effectiveness remains unclear. This systematic review examines the effectiveness of ECHO and ECHO-like medical tele-education models of healthcare delivery in terms of improve...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05291-1
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:The use of aspirin for primary prevention of cardiovascular events in the general population is controversial. The purpose of this study was to create a versatile model to evaluate the effects of aspirin in the primary prevention of cardiovascular events in patients with different risk profiles. DESIGN:A Mar...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00246.x
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:To determine factors predicting adherence to a health care provider's screening mammography recommendation in a general internal medicine practice. DESIGN:Prospective observational study. SETTING:An urban academic general internal medicine practice. PATIENTS:Three hundred forty-nine asymptomatic women, age...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599947
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:Translating lessons from clinical trials on the prevention or delay of type 2 diabetes to populations in nonstudy settings remains a challenge. The purpose of this paper is to review, from the perspective of practicing clinicians, available evidence on lifestyle interventions or medication to prevent or delay...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1111/j.1525-1497.2005.0277.x
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Patients with limited literacy skills are routinely encountered in clinical practice, but they are not always identified by clinicians. OBJECTIVE:To evaluate 3 candidate questions to determine their accuracy in identifying patients with limited or marginal health literacy skills. METHODS:We studied 305 Eng...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00532.x
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:In an effort to prevent medical errors, it has been recommended that all healthcare organizations implement a standardized approach to communicating patient information during transitions of care between providers. Most research on these transitions has been conducted in the inpatient setting, with relativel...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11606-012-2206-2
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Studies on forgoing treatment often ignore treatments that are continued until death. OBJECTIVE:To investigate how often specific treatments are withdrawn or withheld before death and to describe the associated patient, physician, and care characteristics. DESIGN:National mortality follow-back study in Swi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05344-5
更新日期:2020-01-01 00:00:00
abstract::This paper deals with the varied sites and teachers that can and should be used in educating residents and medical students in ambulatory care. A basic premise is that sites other than academic medical centers and teachers other than physician faculty members should be among those used. The paper describes how institu...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600436
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Opioid-dependent patients often have co-occurring chronic illnesses requiring medications that interact with methadone. Methadone maintenance treatment (MMT) is typically provided separately from medical care. Hence, coordination of medical care and substance use treatment is important to preserve patient sa...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-1043-4
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:To measure primary care physicians' familiarity with, attitudes toward, and confidence in preventive care practice guidelines for the elderly and to determine whether their attitudes are associated with implementation of guidelines into clinical practice. DESIGN:A self-administered survey of physicians emplo...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599668
更新日期:1995-03-01 00:00:00
abstract::Although the benefit of population-level public facial masking to protect others during the COVID-19 pandemic has received a great deal of attention, we discuss for one of the first times the hypothesis that universal masking reduces the "inoculum" or dose of the virus for the mask-wearer, leading to more mild and asy...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06067-8
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Many employers offer worksite wellness programs, including financial incentives to achieve goals. Evidence supporting such programs is sparse. OBJECTIVE:To assess whether diabetes and cardiovascular risk factor control in employees improved with financial incentives for participation in disease management a...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3686-2
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Experts suggest an individualized approach to colon cancer screening to take into account variation in older adults' life expectancies and potential to benefit from screening. However, little is known about how physicians make decisions about colon cancer screening in adults age 75 and older. OBJECTIVE:To u...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-1006-9
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:A large proportion of deaths and chronic illnesses can be attributed to three modifiable risk factors: tobacco use, overweight/obesity, and physical inactivity. OBJECTIVE:To test whether telephone-based health coaching after completion of a comprehensive health risk assessment (HRA) increases patient activa...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-018-4398-6
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Due to a shortage of studies focusing on older adults, clinicians and policy makers frequently rely on clinical trials of the general population to provide supportive evidence for treating complex, older patients. OBJECTIVES:To examine the inclusion and analysis of complex, older adults in randomized contro...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-010-1629-x
更新日期:2011-07-01 00:00:00
abstract::Despite improved knowledge about the benefits and harms of treatments for chronic back pain in the past several decades, there is a large and consequential mismatch between treatments found safe and effective and those routinely covered by health insurance. As a result, care for back pain has, if anything, deteriorate...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05099-z
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:To determine patient knowledge about life-sustaining treatments and physician understanding of patient preferences for proxies and treatments after outpatient discussions about advance directives. DESIGN:Cross-sectional interview-based and questionnaire-based survey. SETTING:Two university general internal ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00133.x
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:Overall suicide mortality rates are higher among American Indians than in the general population and are particularly high among Indians residing in the upper Midwest. The identification, during encounters with health care providers, of individuals at high risk of suicide is a potential intervention strategy....
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599598
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:Assess impact of a computer-based patient support system on quality of life in younger women with breast cancer, with particular emphasis on assisting the underserved. DESIGN:Randomized controlled trial conducted between 1995 and 1998. SETTING:Five sites: two teaching hospitals (Madison, Wis, and Chicago, I...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1525-1497.2001.016007435.x
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:To assess the content and extent of HIV risk assessment by primary care physicians across a diverse panel of patients with unidentified HIV risk behaviors. DESIGN:Standardized patient examination to assess primary care physicians' skills at identifying and managing HIV infection and overall clinical skills. ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1997.00015.x
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Women veterans are generally less healthy than their nonveteran female counterparts or male veterans. Accumulating evidence suggests there may be barriers to women veterans' access to and use of Veterans Health Administration (VHA) care. OBJECTIVE:To document perceived and/or actual barriers to care in a na...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00370.x
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Primary care providers (PCPs) face many system- and patient-level challenges in providing multimodal care for patients with complex chronic pain as recommended in some pain management guidelines. Several models have been developed to improve the delivery of multimodal chronic pain care. These models vary in ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4328-7
更新日期:2018-05-01 00:00:00