Abstract:
OBJECTIVE:To assess the effectiveness of housestaff physician reporting as a method for identifying adverse events on a medical service and to compare the physician reporting mechanism with a retrospective record review mechanism. SETTING:Medical service of an urban, university-affiliated teaching hospital. DESIGN:Concurrent physician reporting mechanism using the hospital electronic mail system compared with a retrospective record review using a screening mechanism followed by structured, implicit physician review of the record. PATIENTS:All 3146 admissions to the medical service from 13 November 1990 to 14 March 1991. RESULTS:The housestaff physician reporting method identified nearly the same number (89) of adverse events as did the record review (85). However, the two methods identified only 41 of the same patients (kappa = 0.52). No statistically significant clinical or socioeconomic differences occurred between the patients identified as having had an adverse event, using the two reporting methods (physician versus record review). The housestaff did report statistically more preventable adverse events (62.5% compared with 32%; P = 0.003). The physician reporting mechanism was also less costly (approximately $15,000 compared with $54,000). CONCLUSION:An adverse event identification strategy based on physician self-referral uncovers as many adverse events as does a record review and is less costly. In addition, physician-identified events are more likely to be preventable and, thus, are targets for quality improvement.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
O'Neil AC,Petersen LA,Cook EF,Bates DW,Lee TH,Brennan TAdoi
10.7326/0003-4819-119-5-199309010-00004subject
Has Abstractpub_date
1993-09-01 00:00:00pages
370-6issue
5eissn
0003-4819issn
1539-3704journal_volume
119pub_type
杂志文章abstract:BACKGROUND:Although the efficacy of adjuvant chemotherapy in prolonging survival for women with breast cancer has been well documented, limited population-based information is available on the actual use of chemotherapy. OBJECTIVE:To examine the relationship between age and chemotherapy use. DESIGN:Cohort study. SET...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-138-2-200301210-00009
更新日期:2003-01-21 00:00:00
abstract:BACKGROUND:Physical activity has been related to enhanced bone mass and improved physical functioning and thus may reduce the risk for osteoporotic fracture. OBJECTIVE:To determine whether higher levels of physical activity are related to lower incidence of hip, wrist, and vertebral fractures. DESIGN:Prospective coho...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-129-2-199807150-00002
更新日期:1998-07-15 00:00:00
abstract:OBJECTIVE:To estimate relative risk of mortality and median life expectancy for patients with classic hemophilia by a life-table analysis, taking into account deaths that may have occurred in infancy or childhood before the onset of symptoms. DESIGN:Retrospective chart review of clinical series. SETTING:Referral-base...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章
doi:10.7326/0003-4819-114-8-641
更新日期:1991-04-15 00:00:00
abstract::Large-scale, epidemic transmission of tuberculosis to patients, nonprofessional staff, nurses, and physicians has been documented recently in hospitals, clinics, acquired immunodeficiency syndrome (AIDS) residencies, and correctional facilities. Prominent factors in these outbreaks have included human immunodeficiency...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-117-3-251
更新日期:1992-08-01 00:00:00
abstract::The cause of stroke in young patients frequently cannot be established. Eleven consecutive patients, age 50 and younger, had clinical evidence of cerebral embolization. Results of physical, radiographic, electrocardiographic, and two-dimensional echocardiographic examinations were normal in all patients. During normal...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-105-5-695
更新日期:1986-11-01 00:00:00
abstract::Much of what is formally taught in medicine is about the knowledge, skills, and behaviors required of a physician, including how to express compassion and respect for patients at the bedside. What is learned, however, includes not only admirable qualities but also behaviors and qualities that are inconsistent with eth...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M17-2058
更新日期:2018-04-03 00:00:00
abstract::Identical male twins had alveolar cell carcinoma with nearly synchronous onset and similar histopathologic features, both metastatic to the brain. The hypothesis is advanced that there are genes shared by these twins that determine not only the susceptibility of pulmonary cells to malignant transformation but also the...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-4-447
更新日期:1977-10-01 00:00:00
abstract:UNLABELLED:Chinese translation BACKGROUND:Black persons are more likely than white persons to be diagnosed with colorectal cancer and to die from it. The extent to which genetic or biological factors versus disparities in screening rates explain this variance remains controversial. OBJECTIVE:To define the prevalence ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-159-1-201307020-00004
更新日期:2013-07-02 00:00:00
abstract:BACKGROUND:Current magnetic resonance techniques generate high signal from venous blood and show thrombi as filling defects. Magnetic resonance direct thrombus imaging (MRDTI) directly visualizes acute thrombus. OBJECTIVE:To determine the accuracy of MRDTI for diagnosis of acute symptomatic deep venous thrombosis (DVT...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-136-2-200201150-00006
更新日期:2002-01-15 00:00:00
abstract:BACKGROUND:Hospitals are implementing discharge support programs to reduce readmissions, and these programs have had mixed success. OBJECTIVE:To examine whether a peridischarge, nurse-led intervention decreased emergency department (ED) visits or readmissions among ethnically and linguistically diverse older patients ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/M14-0094
更新日期:2014-10-07 00:00:00
abstract:BACKGROUND:Health care-associated infections from invasive medical devices in the intensive care unit (ICU) are a major threat to patient safety. Most published studies of ICU-acquired infections have come from industrialized western countries. In a Centers for Disease Control and Prevention (CDC) National Nosocomial I...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-145-8-200610170-00007
更新日期:2006-10-17 00:00:00
abstract:Background:A 2007 American College of Physicians guideline addressed pharmacologic options for low back pain. New evidence and medications have now become available. Purpose:To review the current evidence on systemic pharmacologic therapies for acute or chronic nonradicular or radicular low back pain. Data Sources:Ov...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-2458
更新日期:2017-04-04 00:00:00
abstract::Axial, dual spin-echo magnetic resonance (MR) images, taken at the level of the pulmonary arteries and gated to the cardiac cycle, were qualitatively and quantitatively evaluated in nine patients with primary pulmonary arterial hypertension and six controls. In controls and patients, intravascular signal intensity was...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-103-3-317
更新日期:1985-09-01 00:00:00
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 evalua...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-137-5_part_1-200209030-00012
更新日期:2002-09-03 00:00:00
abstract:BACKGROUND:The high prevalence of classic cardiac risk factors in patients with non-insulin-dependent diabetes mellitus does not explain the increased cardiovascular-related morbidity and mortality in these patients. Fibrinogen may have a role in this excess risk. OBJECTIVE:To evaluate the following in patients with n...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-125-8-199610150-00005
更新日期:1996-10-15 00:00:00
abstract:STUDY OBJECTIVE:To determine the effectiveness of chemotherapy and adjunctive surgery in managing patients with advanced seminoma. DESIGN:Nonrandomized prospective clinical trial of chemotherapy in a cohort of patients with advanced seminoma. SETTING:Referral cancer hospital. PATIENTS:Consecutive sample of 62 patien...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-4-513
更新日期:1988-04-01 00:00:00
abstract::Medicine has long sought to match diagnostic and treatment approaches to the particular needs and risks of individual patients. The decreasing cost and increasing ease of genetic sequencing have propelled the rise of precision medicine. Precision medicine aims to use genetic and other information to provide care tailo...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M18-0425
更新日期:2019-05-07 00:00:00
abstract::We evaluated bone disease in eight white men between the ages of 49 and 61 years who had been abusing alcohol for at least 10 years. The mean density of vertebral cancellous bone was 58% of normal, whereas the mean density of appendicular cortical bone was 90% of normal. Marked reduction in active bone resorption and ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-103-1-42
更新日期:1985-07-01 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:DESCRIPTION:Update of the 2005 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for abdominal aortic aneurysm (AAA). METHODS:The USPSTF commissioned a systematic review that assessed the evidence on the benefits and harms of screening for AAA and strategies for managing small (3.0 to 5.4 cm) sc...
journal_title:Annals of internal medicine
pub_type: 杂志文章,实务指引
doi:10.7326/M14-1204
更新日期:2014-08-19 00:00:00
abstract::Meningitis caused by enteric gram-negative bacilli is relatively uncommon but is very difficult to treat despite susceptibility in vitro to many antimicrobics. A major problem appears to be poor entry of many drugs into the central nervous system. Moxalactam is an investigational cephalosporin that attains concentrati...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-95-3-302
更新日期:1981-09-01 00:00:00
abstract::The exocrine pancreas secretes into the gut on demand more than 20 proteins that are indispensable for digestion. In-vivo autodigestion is prevented by an array of natural safeguards. In acute pancreatitis, inappropriate intrapancreatic activation and release of pancreatic hydrolases occur, but the pathogenetic mechan...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-103-1-86
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVE:To determine if polyvalent IgG is promising therapy for severe IgG nephropathy. DESIGN:Open prospective cohort study. SETTING:Referral nephrology unit. PATIENTS:11 adult patients with severe IgA nephropathy (9 who had idiopathic disease and 2 who had Henoch-Schönlein purpura) and indicators of poor prognos...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-120-6-199403150-00005
更新日期:1994-03-15 00:00:00
abstract:BACKGROUND:Primary aldosteronism is a common cause of treatment-resistant hypertension. However, evidence from local health systems suggests low rates of testing for primary aldosteronism. OBJECTIVE:To evaluate testing rates for primary aldosteronism and evidence-based hypertension management in patients with treatmen...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-4873
更新日期:2020-12-29 00:00:00
abstract::Molecular analysis of normal and abnormal human globin genes and their gene products has recently provided information on the precise genetic events that result in hemoglobinopathies. In the case of structurally abnormal hemoglobins, the following mechanisms can be invoked: single nucleotide base substitutions leading...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-91-4-605
更新日期:1979-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of a human immunodeficiency virus (HIV) vaccine given to uninfected volunteers on the interpretation of serodiagnostic HIV test results. DESIGN:Retrospective cohort study. SETTING:5 AIDS Vaccine Evaluation Units funded by the National Institute of Allergy and Infectious Diseases. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-121-8-199410150-00005
更新日期:1994-10-15 00:00:00
abstract:OBJECTIVE:To determine whether laboratory findings showing antibodies to hepatitis C virus (HCV) in patients with autoimmune hepatitis represent false-positive results and to identify possible explanations for true-positive results in these patients. DESIGN:Cross-sectional. SETTING:University-based hospital. PATIENT...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-116-1-21
更新日期:1992-01-01 00:00:00
abstract::There has been considerable change in the practice of internal medicine in the past quarter century, including the rise of specialization, increasing time pressure, the hospitalist movement, and the rapidly changing responsibilities of internists in inpatient and outpatient settings. Training programs have not adequat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-144-12-200606200-00010
更新日期:2006-06-20 00:00:00
abstract::Two patients developed severe hypomagnesemia, hypocalcemia, and hypokalemia as a result of renal wasting of magnesium and potassium shortly after being treated with large doses of gentamicin. When therapy with gentamicin was discontinued renal loss of magnesium and potassium ceased, and serum calcium, magnesium, and p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-82-5-646
更新日期:1975-05-01 00:00:00
abstract:BACKGROUND:Screening women for Chlamydia trachomatis in family planning clinics is associated with a reduced incidence of chlamydial sequelae. However, the question of whom to screen to maintain efficient use of resources remains controversial. OBJECTIVE:To assess the cost-effectiveness of chlamydial screening done ac...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-128-4-199802150-00005
更新日期:1998-02-15 00:00:00