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. In a day of testing, physicians saw 13-16 standardized patients (SPs) with diverse case presentations. In analyses presented here, physician performance was examined with nine SPs who had unidentified risks for HIV, which they offered if asked. SETTING:An academic clinic. PARTICIPANTS:We randomly selected 134 paid volunteers (general internists and family/general practitioners) after stratifying by specialty, experience caring for patients with HIV infection, and year of medical school graduation. MEASUREMENTS AND MAIN RESULTS:Performance at initiating HIV risk screening and identifying patients' HIV risk behaviors were the main outcome measures. Physicians performed variably at HIV risk screening with different patients and across different HIV risk screening topics. Although physicians initiated screening with 60% of patients, they identified only 49% of risk behaviors and included HIV in the differential diagnosis for less than half of at-risk patients. Physicians performed better with cases in which there was a higher probability of HIV infection based on symptoms, but often did not screen at-risk patients without obvious symptoms suggestive of HIV. Board-certified general internists initiated screening and identified risk behaviors with more patients than board-certified family practitioners. Medical school graduation year also influenced performance. CONCLUSIONS:Our data suggest that primary care physicians do not routinely perform HIV risk assessments with patients who have risk behaviors for HIV infection. Methods are needed to develop, standardize, and disseminate better screening techniques to identify patients with or at risk of developing HIV infection, such as written HIV risk screening questions for use in medical intake forms.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Wenrich MD,Curtis JR,Carline JD,Paauw DS,Ramsey PGdoi
10.1046/j.1525-1497.1997.00015.xsubject
Has Abstractpub_date
1997-02-01 00:00:00pages
107-13issue
2eissn
0884-8734issn
1525-1497journal_volume
12pub_type
杂志文章abstract::Intravascular hemolysis is a rare but potentially life threatening cause of red urine characterized by brisk hemolysis and release of large amounts of hemoglobin into the urine. We present an unusual case of red urine in a 20-year-old male who was subsequently diagnosed with intravascular hemolysis due to an aorto-atr...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-010-1430-x
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Food insecurity refers to limited or uncertain access to food resulting from inadequate financial resources. There is a clear association between food insecurity and obesity among women, but little is known about the relationship between food insecurity and type 2 diabetes. OBJECTIVE:To evaluate whether the...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0192-6
更新日期:2007-07-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02600847
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abstract:BACKGROUND:Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the Caribbean region. OBJECTIVE:This study explored the concept of a health network, relationships focused on health-related matters, and examined associations with CVD risk factors in the Eastern Caribbean. DESIGN:The Eastern ...
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journal_title:Journal of general internal medicine
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更新日期:1998-07-01 00:00:00
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journal_title:Journal of general internal medicine
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doi:10.1007/s11606-009-0952-6
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:To describe a novel method of time analysis for health care settings by quantifying internal medicine housestaff's work activities and contacts. DESIGN:Observational work sampling study based on random sampling technique. SETTING:General medicine service in a university hospital. PARTICIPANTS:All housestaf...
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更新日期:1994-05-01 00:00:00
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journal_title:Journal of general internal medicine
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doi:10.1007/s11606-020-05734-0
更新日期:2020-08-01 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:INTRODUCTION:Although women will account for almost 11% of veterans by 2040, we know little about their health and functioning, particularly compared to men. OBJECTIVE:To compare women and men veterans' health-related quality of life (HRQOL) and VA health care utilization and to see if previously described association...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
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更新日期:2007-09-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-010-1605-5
更新日期:2011-05-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
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更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The patient-centered medical home (PCMH) model aims to provide patient-centered care, lower costs, and improve health outcomes. Medical students have not been meaningfully integrated in this model. AIM:To test the feasibility of a longitudinal clerkship based on PCMH principles and anchored by PCMH educatio...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-013-2389-1
更新日期:2013-08-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1363-4
更新日期:2010-09-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00401.x
更新日期:2006-04-01 00:00:00
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journal_title:Journal of general internal medicine
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doi:10.1007/s11606-018-4628-y
更新日期:2018-12-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00008.x
更新日期:1998-01-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-017-4030-1
更新日期:2017-08-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1525-1497.2003.20114.x
更新日期:2003-01-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:1991-01-01 00:00:00
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更新日期:2010-08-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:1986-03-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2000.10006.x
更新日期:2000-08-01 00:00:00
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journal_title:Journal of general internal medicine
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更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Patient reminders for influenza vaccination, delivered via electronic health record (EHR) patient portal messages and interactive voice response (IVR) calls, offer an innovative approach to improving patient care. OBJECTIVE:To test the effectiveness of portal and IVR outreach in improving rates of influenza...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-017-4266-9
更新日期:2018-05-01 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
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更新日期:2020-11-01 00:00:00
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journal_title:Journal of general internal medicine
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doi:10.1046/j.1525-1497.2003.21133.x
更新日期:2003-11-01 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...
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更新日期:2017-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s11606-020-05759-5
更新日期:2020-05-01 00:00:00