Abstract:
OBJECTIVE:To compare generalists' and cardiologists' estimates of baseline cardiovascular risk and the outcomes of preventive therapy. DESIGN:Cross-sectional mail survey using written case simulations of typical patients from primary prevention trials for hypercholesterolemia and isolated systolic hypertension, and tertiary prevention studies of coronary artery bypass surgery for chronic stable angina with left main coronary stenosis. PARTICIPANTS:Nationally representative sample of 599 practicing family physicians, general internists, and cardiologists selected from the American Medical Association masterfile. Among eligible physicians, 84 (44%) of 191 family physicians, 77 (40%) of 194 general internists, and 66 (34%) of 194 cardiologists responded. MEASUREMENTS:Estimates of risk at baseline and after therapy, and whether therapy generally would be recommended. RESULTS:For both primary prevention case simulations (scenarios), cardiologists provided lower, more accurate estimates of baseline cardiovascular risk and of absolute therapeutic benefit than either family physicians or general internists. The range of the generalists' estimates was extremely wide. Perceptions of relative risk reduction and treatment recommendations for the primary prevention scenarios did not differ among specialties. Overall, generalists who would not recommend primary preventive therapy in these scenarios appeared to give more accurate estimates than did generalists who would recommend such therapy. CONCLUSIONS:Many generalists have inflated perceptions of cardiovascular risk without treatment and of the benefit of risk-modifying medical treatment. Further study should assess the reasons for these misperceptions and their effect on counseling about primary preventive therapy.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Friedmann PD,Brett AS,Mayo-Smith MFdoi
10.7326/0003-4819-124-4-199602150-00005subject
Has Abstractpub_date
1996-02-15 00:00:00pages
414-21issue
4eissn
0003-4819issn
1539-3704journal_volume
124pub_type
杂志文章abstract::In studies of the cause of gastrointestinal symptoms in homosexual men, Campylobacter jejuni was recovered from 10 of 158 men with, and 2 of 75 men without, intestinal symptoms. In addition, a heterogeneous group of Campylobacter-like organisms was identified in 26 symptomatic and 6 asymptomatic homosexual men, but in...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-101-2-187
更新日期:1984-08-01 00:00:00
abstract::Bulimarexia, an eating disorder that is characterized by binge eating followed by self-induced vomiting or abuse of cathartic or diuretic drugs, has been defined as both a sequela of anorexia nervosa and a distinct eating disorder. In this review the presentation, prevalence, and complications of the various eating di...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-99-6-800
更新日期:1983-12-01 00:00:00
abstract:BACKGROUND:Common diseases, particularly dementia, have large social costs for the U.S. population. However, less is known about the end-of-life costs of specific diseases and the associated financial risk for individual households. OBJECTIVE:To examine social costs and financial risks faced by Medicare beneficiaries ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M15-0381
更新日期:2015-11-17 00:00:00
abstract::All practicing physicians should be prepared to respond to requests from patients for advice about participating in clinical trials research. Even physicians who choose not to conduct clinical trials but rather devote their practice to clinical care may have patients who consider volunteering for research. In advising...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-138-8-200304150-00015
更新日期:2003-04-15 00:00:00
abstract::During a 4.4-year period, nonspecific interstitial pneumonitis was seen in 41 of 110 (38%) patients with the acquired immunodeficiency syndrome and accounted for 32% (48/152) of all episodes of clinical pneumonitis. Diffuse alveolar damage was typically a feature of nonspecific interstitial pneumonitis, but neither lu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-1-7
更新日期:1987-07-01 00:00:00
abstract::The management of asymptomatic hyperuricemia is controversial. Reported benefits from treatment prevention of acute gouty arthritis, chronic tophaceous gout, urolithiasis, or gouty nephropathy. A review of experimental and clinical data suggests that the risks of asymptomatic hyperuricemia are small or unknown and the...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-88-5-666
更新日期:1978-05-01 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:BACKGROUND:Dietary and lifestyle modification efforts are the primary treatments for people who are obese or overweight. The effect of dietary counseling on long-term weight change is unclear. PURPOSE:To perform a meta-analysis of the effect of dietary counseling compared with usual care on body mass index (BMI) over ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-147-1-200707030-00007
更新日期:2007-07-03 00:00:00
abstract::The clinical significance of anatomic substage was assessed in 130 patients with Hodgkin's disease in pathologic stage III-A: stage III1-A includes involvement of spleen, or splenic, celiac, or portal nodes, or any combination of these; stage III2-A includes involvement of para-aortic, iliac, or mesenteric nodes, with...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-2-159
更新日期:1980-02-01 00:00:00
abstract::The safety of using inhaled beclomethasone dipropionate for the treatment of severe asthma during pregnancy was evaluated during 45 pregnancies in 40 women. Despite chronic administration of theophylline and, in some women, ephedrine, the asthma was so severe that corticosteroids were essential to prevent emergency ro...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-4-478
更新日期:1983-04-01 00:00:00
abstract::This issue provides a clinical overview of sickle cell disease focusing on prevention, diagnosis, treatment, practice improvement, and patient information. Readers can complete the accompanying CME quiz for 1.5 credits. Only ACP members and individual subscribers can access the electronic features of In the Clinic. No...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-155-5-201109060-01003
更新日期:2011-09-06 00:00:00
abstract::Congenital adrenal hyperplasia describes a group of inherited autosomal recessive disorders characterized by an enzymatic defect in cortisol biosynthesis, compensatory increases in corticotropin secretion, and adrenocortical hyperplasia. 21-Hydroxylase deficiency is responsible for more than 95% of cases and is one of...
journal_title:Annals of internal medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.7326/0003-4819-136-4-200202190-00012
更新日期:2002-02-19 00:00:00
abstract::A model of activation, proliferation, and differentiation of human lymphocyte responses is described, and the complex immunoregulatory modulation of this system discussed with regard to normal immune function and the aberrancies expressed in diseases characterized by abnormalities of immune function. Recent advances i...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-99-1-61
更新日期:1983-07-01 00:00:00
abstract::A 34-year-old man had polar extremes of B cell dysfunction: systemic lupus erythematosus evolving into common variable hypogammaglobulinemia. He presented in 1974 with seizures and six other criteria for systemic lupus erythematosus; his antinuclear antibody titer was 1:1024 and IgG level, 2870 mg/dL. After 5 months o...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-99-1-32
更新日期:1983-07-01 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:STUDY OBJECTIVE:To assess the effect of weight-bearing exercise training and subsequent detraining on lumbar bone mineral content in postmenopausal women. DESIGN:Non-randomized, controlled, short-term (9 months) trial and long-term (22 months) exercise training and detraining (13 months). SETTING:Section of applied p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-6-824
更新日期:1988-06-01 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::The four main conceptual paradigms of basic biomedical research are that the explication of mechanisms is a primary goal of science; that scientific data must be "hard"; that formulation of hypotheses and counter-hypotheses is a principal creative challenge; and that experiments are the main mechanism for using scient...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-99-3-393
更新日期:1983-09-01 00:00:00
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::The approximately 1.2 million inmates in U.S. correctional institutions have a high prevalence of communicable diseases, such as human immunodeficiency virus (HIV) infection, tuberculosis, hepatitis B virus infection, and gonorrhea. Before their incarceration, most inmates had limited access to health care, which, tog...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-118-2-199301150-00010
更新日期:1993-01-15 00:00:00
abstract:BACKGROUND:Urine tests for Chlamydia trachomatis permit expansion of screening beyond traditional clinic environments. Prevention of infection in teenagers is a high priority. OBJECTIVE:To define the prevalence of C. trachomatis among teenagers by using the ligase chain reaction assay on urine specimens and to evaluat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-127-9-199711010-00004
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Sleep-related accidents often involve healthy young persons who are driving at night. Coffee and napping restore alertness, but no study has compared their effects on real nighttime driving performances. OBJECTIVE:To test the effects of 125 mL of coffee (half a cup) containing 200 mg of caffeine, placebo (d...
journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/0003-4819-144-11-200606060-00004
更新日期:2006-06-06 00:00:00
abstract::Gentamicin and tobramycin were compared for cost effectiveness in the treatment of adult patients with serious infections in a general medical service. We used data from a randomized double-blind trial in which the only observed difference between the clinical effects of these aminoglycosides was the incidence of neph...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-101-6-764
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) frequently develop exacerbations, leading to major clinical and health resource use ramifications. OBJECTIVE:To prospectively evaluate the effectiveness of a long-acting inhaled anticholinergic bronchodilator, tiotropium, in reducing COPD exacerbati...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-143-5-200509060-00007
更新日期:2005-09-06 00:00:00
abstract::We have seen two patients whose hepatitis was due to the administration of aprindine, a new antiarrhythmic agent. In both patients evidence of hepatitis appeared within 3 weeks of initiating aprindine therapy and resolved rapidly when the drug was withdrawn. The reintroduction of aprindine in one patient was associate...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-3-359
更新日期:1978-09-01 00:00:00
abstract::An unusual cluster of 11 patients with Pneumocystis carinii pneumonia occurred in a 3-month period at Memorial Hospital, New York. Ten of the 11 patients had lymphoma or leukemia. In 7 patients, corticosteroid therapy was decreased or stopped shortly before pneumocystis pneumonia was diagnosed. The pediatric patients ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-82-6-722
更新日期:1975-06-01 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
abstract:BACKGROUND:Tumor necrosis factor-alpha is present in arteries in giant cell arteritis. OBJECTIVE:To evaluate the efficacy of infliximab, an anti-tumor necrosis factor-alpha agent, in giant cell arteritis. DESIGN:Randomized, controlled trial. SETTING:22 sites in the United States, the United Kingdom, Belgium, Italy, ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-146-9-200705010-00004
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:The established International Prognostic Index for lymphomas has not included patients with systemic AIDS-related non-Hodgkin lymphoma. OBJECTIVE:To establish the most appropriate prognostic index for use in patients with systemic AIDS-related non-Hodgkin lymphoma. DESIGN:A prospective study involving univ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-143-4-200508160-00007
更新日期:2005-08-16 00:00:00
abstract::Antibody to native DNA was measured by five techniques: the Crithidia luciliae immunofluorescence (CL-IF) test; filter radioimmunoassays using either untreated human KB DNA, endonuclease-treated KB DNA, or a synthetic polynucleotide (poly dAT); and the Farr immunoprecipitation assay using KB DNA. The specificity and s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-2-186
更新日期:1978-08-01 00:00:00