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, deteriorated in recent decades-expenses are higher, harms are greater, and use of ineffective treatments is more common. Deficiencies in health care delivery processes and payment models are centrally involved in the failure to improve care for back pain. A key step for accelerating progress is changing insurance coverage policies to facilitate use of the safest and most helpful approaches while discouraging riskier and less effective treatments. Relatively simple changes in reimbursement policies may minimize harm and improve quality of life for many patients with chronic back and similar pain syndromes. Such changes might also reduce health care expenditures because the costs of treatments currently covered by insurance and their associated harms may well outweigh the costs of the relatively safe and effective treatments recommended by current guidelines but poorly covered by insurance. There is no justification for continuing the status quo-patients and clinicians deserve better.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Cherkin DC,Deyo RA,Goldberg Hdoi
10.1007/s11606-019-05099-zsubject
Has Abstractpub_date
2019-09-01 00:00:00pages
1910-1912issue
9eissn
0884-8734issn
1525-1497pii
10.1007/s11606-019-05099-zjournal_volume
34pub_type
杂志文章abstract：BACKGROUND:Despite significant investment in colorectal cancer (CRC) screening, 40% of US adults are not up-to-date. Commitment devices, which are psychologically tailored approaches to enforce health goals, may be an effective method to increase CRC screening. OBJECTIVE:Compare the effectiveness of a commitment devic...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06392-y
更新日期：2021-01-20 00:00:00
abstract：:In the HTML version of this paper, Ms. Goddu was incorrectly listed. The correct citation should be AP Goddu. Exposure to the stigmatizing language note was associated with more negative attitudes towards the patient (20.3 stigmatizing vs. 25.1 neutral, p < 0.001). Reading the stigmatizing language note was associated...
journal_title：Journal of general internal medicine
pub_type： 已发布勘误
doi：10.1007/s11606-018-4583-7
更新日期：2019-01-01 00:00:00
abstract：:We sought to determine whether an Internet-based continuing medical education (CME) program could improve physician confidence, knowledge, and clinical skills in managing pigmented skin lesions. The CME program provided an interactive, customized learning experience and incorporated well-established guidelines for rec...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：
更新日期：2001-01-01 00:00:00
abstract：BACKGROUND:Development of electronic health record (EHR) prediction models to improve palliative care delivery is on the rise, yet the clinical impact of such models has not been evaluated. OBJECTIVE:To assess the clinical impact of triggering palliative care using an EHR prediction model. DESIGN:Pilot prospective be...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05169-2
更新日期：2019-09-01 00:00:00
abstract：:Using survey items from Kern et al. (1985), 192 former residents rated their preparation in, and the importance of, three content areas of their residency training ("basic skill and knowledge areas," "allied medical disciplines," and "areas related to the practice of medicine"). Mean ratings replicated those reported ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02597402
更新日期：1989-07-01 00:00:00
abstract：BACKGROUND:Global health measures represent an attractive option for researchers and clinicians seeking a brief snapshot of a patient's overall perspective on his or her health. Because scores on different global health measures are not comparable, comparative effectiveness research (CER) is challenging. OBJECTIVE:To ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-015-3453-9
更新日期：2015-10-01 00:00:00
abstract：:Evaluations of intensive care have largely focused on survival, cost, or functional status; however, these may not be the only outcomes of interest to patients, families, and health care providers. Quality of life is an important consideration in evaluating intensive care because it influences decisions about the use ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02596335
更新日期：1988-05-01 00:00:00
abstract：:The Accreditation Council of Graduate Medical Education (ACGME) and the Residency Review Committee require a competency-based, accessible evaluation system. The paper system at our institution did not meet these demands and suffered from low compliance. A diverse committee of internal medicine faculty, program directo...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2004.30065.x
更新日期：2004-05-01 00:00:00
abstract：BACKGROUND:Access to health care varies according to a person's race and ethnicity. Delaying treatment is one measure of access with important health consequences. OBJECTIVE:Determine whether perceptions of unfair treatment because of race or ethnicity are associated with reported treatment delays, controlling for eco...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2005.0123.x
更新日期：2005-07-01 00:00:00
abstract：OBJECTIVE:Patients' self-management practices have substantial consequences on morbidity and mortality in diabetes. While the quality of patient-physician relations has been associated with improved health outcomes and functional status, little is known about the impact of different patient-physician interaction styles...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2002.10905.x
更新日期：2002-04-01 00:00:00
abstract：OBJECTIVE:Community physicians in the United States prescribe antibiotics to 80% to 90% of smokers with acute bronchitis. We performed a systematic review of the literature to determine the efficacy of antibiotics for smokers with acute bronchitis. DESIGN:A medline search was done using the keywords bronchitis, cough,...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1046/j.1525-1497.2002.10405.x
更新日期：2002-03-01 00:00:00
abstract：BACKGROUND:Genotype-guided initial warfarin dosing may reduce over-anticoagulation and serious bleeding compared to a one-dose-fits-all dosing method. OBJECTIVE:The objective of this review was to investigate the safety and efficacy of genotype-guided dosing of warfarin in reducing the occurrence of serious bleeding e...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-009-0949-1
更新日期：2009-05-01 00:00:00
abstract：OBJECTIVE:To characterize the informed consent process in routine, primary care office practice. DESIGN:Cross-sectional, descriptive evaluation of audiotaped encounters. SETTING:Offices of primary care physicians in Portland, Oregon. PARTICIPANTS:Internists (54%) and family physicians (46%), and their patients. MEA...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.1997.00057.x
更新日期：1997-06-01 00:00:00
abstract：OBJECTIVE:To determine whether the results of the Internal Medicine In-Training Examination (ITE) can predict subsequent performance on the American Board of Internal Medicine certifying examination (ABIMCE). DESIGN:Retrospective data review. SETTING:A mixture of six community hospital and university-based internal m...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599105
更新日期：1992-01-01 00:00:00
abstract：BACKGROUND:The 2016 presidential election and the controversial policy agenda of its victor have raised concerns about how the election may have impacted mental health. OBJECTIVE:Assess how mental health changed from before to after the November 2016 election and how trends differed in states that voted for Donald Tru...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06328-6
更新日期：2020-10-31 00:00:00
abstract：BACKGROUND:Aspirin reduces mortality for men and women with coronary heart disease (CHD). Previous research suggests women with acute coronary syndromes receive less aggressive care, including less frequent early administration of aspirin. The presence of gender differences in aspirin use for secondary prevention is le...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0116-5
更新日期：2007-01-01 00:00:00
abstract：OBJECTIVE:To examine the impact of the New Haven Community Health Care Van (CHCV), a mobile needle exchange-based health care delivery system, in reducing emergency department (ED) use among out-of-treatment injection drug users (IDUs) between January 1, 1996 and December 31, 1998. DESIGN:A pre-post comparison of ED u...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：
更新日期：2002-05-01 00:00:00
abstract：:To train more generalist physicians, structural changes must be made along the continuum of medical education. Future generalists require in-depth exposure to primary care practice, with substantive experience in the longitudinal management of patient panels and the opportunity to work with successful generalist role ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/BF02598115
更新日期：1994-04-01 00:00:00
abstract：BACKGROUND:Hyperglycemia is common among diabetic inpatients, and has been linked to adverse outcomes. However, antihyperglycemic treatment is seldom intensified in noncritical care patients, and the relationship between intensification frequency and glucose control is poorly understood. We evaluated the relationship b...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0468-x
更新日期：2008-02-01 00:00:00
abstract：:Patients with medically unexplained symptoms (MUS) have little or no demonstrable disease explanation for the symptoms, and comorbid psychiatric disorders are frequent. Although common, costly, distressed, and often receiving ill-advised testing and treatments, most MUS patients go unrecognized, which precludes effect...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-006-0067-2
更新日期：2007-05-01 00:00:00
abstract：:Writing a meaningful and valuable letter of reference is not an easy task. Several factors influence the quality of any letter of reference. First, the accuracy and reliability of the writer's impressions and judgment depend on how well he knows the individual being described. Second, the writer's frame of reference, ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2004.30142.x
更新日期：2004-05-01 00:00:00
abstract：BACKGROUND:The three-item Brief Health Literacy Screen (BHLS) has been validated in research settings, but not in routine practice, administered by clinical personnel. OBJECTIVE:As part of the Health Literacy Screening (HEALS) study, we evaluated psychometric properties of the BHLS to validate its administration by cl...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-013-2568-0
更新日期：2014-01-01 00:00:00
abstract：BACKGROUND:The patient-centered medical home (PCMH) model has several components to improve care for patients with high comorbidity, including greater access to face-to-face primary care. OBJECTIVE:We examined whether high-comorbidity patients had larger increases in primary care provider (PCP) visits attributable to ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-016-3833-9
更新日期：2016-12-01 00:00:00
abstract：:Starfield and colleagues have suggested four overarching attributes of good primary care: "first-contact access for each need; long-term person- (not disease) focused care; comprehensive care for most health needs; and coordinated care when it must be sought elsewhere." As this series on reinventing primary care highl...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-016-3945-2
更新日期：2017-04-01 00:00:00
abstract：BACKGROUND:Hypertensive urgencies and emergencies are common clinical occurrences in hypertensive patients. Treatment practices vary considerably to because of the lack of evidence supporting the use of one therapeutic agent over another. This paper was designed to review the evidence for various pharmacotherapeutic re...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1046/j.1525-1497.2002.20389.x
更新日期：2002-12-01 00:00:00
abstract：:Chronic care facility stay has been shown to be an independent risk factor for venous thromboembolism. Review of the literature, however, reveals a paucity of data addressing the issue of venous thromboembolism in nursing home residents. The purpose of this study was to determine the incidence of venous thromboembolic...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2003.21133.x
更新日期：2003-11-01 00:00:00
abstract：:Mycophenolate mofetil (MM) is commonly used in patients with autoimmune diseases or who have undergone transplantation. Common side effects of MM include anemia, leukopenia, mucositis and opportunistic infections. We report an unusual case of pulmonary alveolar proteinosis (PAP) in a 67-year-old woman on MM for Wegene...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-010-1433-7
更新日期：2010-10-01 00:00:00
abstract：BACKGROUND:Despite evidence of inadequate physical examination skills among medical students, teaching these skills has declined. One method of enhancing inspection skills is teaching "visual literacy," the ability to reason physiology and pathophysiology from careful and unbiased observation. OBJECTIVE:To improve stu...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-008-0667-0
更新日期：2008-07-01 00:00:00
abstract：BACKGROUND:Healthcare providers use a life expectancy of at least 5 to 10 years in shared clinical decision-making with older adults about cancer screening, major surgeries, and disease prevention interventions. At present, few prognostic indexes predict long-term mortality beyond 10 years or are suited for use in prim...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06132-2
更新日期：2020-08-20 00:00:00
abstract：BACKGROUND:Inappropriate antibiotic use contributes to the emergence and spread of drug resistant infections. Though injection drug users are at increased risk for drug resistant infections, few studies have examined antibiotic use in this population. OBJECTIVE:To understand patterns and determinants of antibiotic use...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0859-7
更新日期：2009-02-01 00:00:00
