Abstract:
:We varied the softness and nodularity of silicone breast models to assess the effects of age-related breast tissue characteristics on lump detection. In two sets of six silicone breast models manufactured to simulate premenopausal and postmenopausal breast tissue, respectively, 82 internal medicine attending and housestaff physicians more readily detected lumps among models simulating older breast tissue. The proportion of models with one or more false-positive findings was higher among models simulating postmenopausal breast tissue. We conclude that age-related changes in breast tissue most likely contribute to the higher sensitivity of clinical breast examination in older women.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
McDermott MM,Dolan NC,Huang J,Reifler D,Rademaker AWdoi
10.1007/BF02599588subject
Has Abstractpub_date
1996-02-01 00:00:00pages
112-4issue
2eissn
0884-8734issn
1525-1497journal_volume
11pub_type
杂志文章abstract:OBJECTIVE:To determine the effectiveness and costs of alternative management strategies for patients infected with the human immunodeficiency virus (HIV) who present with pulmonary symptoms. DESIGN:Decision analysis comparing initial testing (arterial blood gas analysis, induced sputum analysis, or bronchoscopy with b...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02598081
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:Previous studies indicate that medical trainees frequently experience discrimination by patients. Little is known about effective strategies to teach trainees to respond to this discrimination. AIM:To create a workshop for first-year residents utilizing standardized patients to improve skills in responding ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-04881-3
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Many scholars have written about the historical underpinnings and likely consequences of African Americans distrust in health care, yet little research has been done to understand if and how this distrust affects African Americans' current views of the trustworthiness of physicians. OBJECTIVE:To better unde...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1525-1497.2006.00485.x
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:With positive results from diabetes prevention studies, there is interest in convenient ways to incorporate screening for glucose intolerance into routine care and to limit the need for fasting diagnostic tests. OBJECTIVE:The aim of this study is to determine whether random plasma glucose (RPG) could be use...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0524-1
更新日期:2008-05-01 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:Electronic prescribing (e-prescribing) has the potential to improve the safety and efficiency of medication use, but uptake of e-prescribing in community-based settings has been limited to date. In April 2004, 2 large insurers in Massachusetts began a program to fund e-prescribing systems for targeted clinic...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0383-1
更新日期:2008-04-01 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:BACKGROUND:Adverse drug events after hospital discharge are common and often serious. These events may result from provider errors or patient misunderstanding. OBJECTIVE:To determine the prevalence of medication reconciliation errors and patient misunderstanding of discharge medications. DESIGN:Prospective cohort stu...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-012-2168-4
更新日期:2012-11-01 00:00:00
abstract::One of the most significant changes in US hospitals over the past decade has been the emergence of hospitalists as key providers of inpatient care. The number of hospitalists in both community and teaching hospitals is growing rapidly, and as the field burgeons, many are questioning where hospitalists should reside wi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0682-1
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:There is growing interest in developing systems to overcome barriers for acquiring and interpreting family health histories in primary care. OBJECTIVE:To examine the capacity of three different electronic portals to collect family history from patients and deposit valid data in an electronic health record (...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s11606-013-2442-0
更新日期:2013-12-01 00:00:00
abstract::This paper presents a case for careful consideration of theory in planning to implement evidence-based practices into clinical care. As described, theory should be tightly linked to strategic planning through careful choice or creation of an implementation framework. Strategies should be linked to specific interventio...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00362.x
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To identify differences between patients viewed as frustrating by their physicians and those considered typical and satisfying. DESIGN:This cross-sectional observational study focused on psychologically distressed high users of medical services. Frustrating patients were compared with typical and satisfying ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02598969
更新日期:1991-05-01 00:00:00
abstract::To describe the determinants of patient satisfaction with medical care, self-administered questionnaires were given to a consecutive sample of 237 patients coming to an ambulatory care practice for the treatment of upper respiratory infections (URIs). Patients' most important goal was to obtain a diagnosis (57%). They...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599162
更新日期:1992-07-01 00:00:00
abstract::To determine if physician specialty is associated with underutilization and underdosing of angiotensin-converting enzyme inhibitors among patients with heart failure, we reviewed the charts of 214 outpatients with decreased systolic function at an urban academic medical center. Regardless of whether patients were care...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1997.07110.x
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:To assess the risks and benefits of surgery for herniated lumbar discs (discectomy) and to evaluate the methodologic quality of the literature. DESIGN:Literature synthesis. STUDY SELECTION AND DATA ANALYSIS: A structured MEDLINE search identified studies of standard, microsurgical, or percutaneous discectomy...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,meta分析
doi:10.1007/BF02600110
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:High-cost patients account for a disproportionate share of healthcare spending. The proportion and distribution of potentially preventable spending among subgroups of high-cost patients are largely unknown. OBJECTIVE:To examine the distribution of potentially preventable spending among high-cost Medicare pa...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05691-8
更新日期:2020-10-01 00:00:00
abstract::This report examines alternative methods of paying for clinical preventive care services. First, the extent of coverage of preventive health care services in public and private health insurance plans is reviewed. Included in this review are Medicare, Medicaid, health maintenance organizations, and private health insur...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600851
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:There are no life-tables quantifying the average life-spans of post-hospitalized heart failure populations across various strata of risk. OBJECTIVE:To quantify the life-expectancies (i.e., average life-spans) of heart failure patients at the time of hospital discharge according to age, gender, predictive 30...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-012-2072-y
更新日期:2012-09-01 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:BACKGROUND:The Veterans Access, Choice and Accountability Act (hereafter, Choice Program) seeks to improve access to care by enabling eligible Veterans to receive care from community providers. Veterans Affairs (VA) primary care providers (PCPs) play a key role in making referrals to community specialists, but their fr...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4810-2
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Patient-centered medical home (PCMH) models of primary care have the potential to expand access, improve population health, and lower costs. Federally qualified health centers (FQHCs) were early adopters of PCMH models. OBJECTIVE:We measured PCMH capabilities in a diverse nationwide sample of FQHCs and asse...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-017-4078-y
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Most guidelines recommend against PSA-based screening for prostate cancer in men ≥ 70 years of age. Adherence to these guidelines is variable. OBJECTIVE:To determine whether the use of a "Best Practice Advisory" (BPA) intervention within the electronic medical record (EMR) system can alter the rate of PSA s...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06097-2
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Disorders of sex development (DSD) are a heterogeneous group of rare genetic disorders of sex determination or differentiation. Evidence-based guidelines concerning gender assignment and surgical and hormonal treatment are limited for many DSD entities, and health care is highly fragmented across various sub...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-2917-7
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:The shortage of primary care providers and the provisions of the Affordable Care Act (ACA) have spurred discussion about expanding the number, scope of practice (SOP), and independence of primary care nurse practitioners (NPs). Such discussions in the media and among professional organizations may insinuate ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3896-7
更新日期:2017-03-01 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:BACKGROUND:The World Health Organization encourages the development of youth friendly services, yet little is known on how youth currently present in general practice. OBJECTIVE:To describe the perspectives, expectations, and service receipt of young people presenting to family doctors to inform the development of you...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0177-5
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Only half of hypertensive adults achieve blood pressure (BP) control in the United States, and it is unclear how BP control rates may be improved most effectively and efficiently at the population level. OBJECTIVE:We sought to compare the potential effects of system-wide isolated improvements in medication ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3231-8
更新日期:2015-08-01 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::We surveyed employers of general internists at teaching hospitals to determine whether they prefer that new hires are graduates of general internal medicine (GIM) fellowships. We surveyed former GIM fellows who graduated between 1988 and 1994 to determine whether they found jobs with protected research time and whethe...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00121.x
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:Disparities can be caused by minorities receiving care in low-quality settings. The patient-centered medical home (PCMH) has been identified as a model of high-quality primary care that can eliminate disparities. However, Latinos are less likely to have PCMHs. OBJECTIVE:To identify Latino subgroup variation...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-1119-1
更新日期:2009-11-01 00:00:00