Abstract：
OBJECTIVES:To characterize prostate-specific antigen (PSA) testing practices in a hospital-based primary care clinic, and to determine the outcomes of PSA testing, including urology referrals, biopsies, cancers detected, and cancer treatments. DESIGN:Retrospective cohort study. Data were obtained from computerized Department of Veterans Affairs (VA) files and the statewide New Mexico Surveillance, Epidemiology, and End Results (SEER) tumor registry. SETTING:Primary care clinics in a university-affiliated VA Medical Center. PATIENTS:Subjects were 1,448 men without cancer undergoing PSA testing in 1993 with follow-up through 1994. MAIN RESULTS:Twenty-one percent of clinic enrollees at least 40 years of age were tested with PSA, including 58 who were 75 years of age or older. By the end of 1994, 40.0% (95% confidence interval [CI] 37.2%, 42.8%) were retested; 25.6% (95% CI 21.7%, 29.5%) of initial retesting occurred within 6 months. Overall, 20.7% (95% CI 18.9%, 22.5%) of PSA tests in the cohort were for men aged 75 years or older and were repeated within 6 months. Among the 193 subjects with PSA values > or = 4.0 ng/mL, 86.0% (95% CI 81.1%, 90.9%) were followed-up in urology clinic, and 46.1% (95% CI 39.1%, 53.1%) underwent biopsy. Only 11 of 51 men aged 75 years or older who were referred to urologists for an elevated PSA underwent biopsy. Forty cancers were diagnosed-a detection rate of 2.8% (95% CI 2.0%, 3.6%). Of these, 28 were organ-confined, 7 had regional invasion, and 3 had distant metastases. CONCLUSIONS:Primary care providers frequently ordered PSA tests, but a substantial proportion of testing occurred outside recommended age ranges and screening intervals. Older patients with elevated PSA values often did not complete diagnostic workups. Better adherence to screening guidelines may limit the number of both PSA tests and urology referrals.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Hoffman RM,Blume P,Gilliland Fdoi
10.1046/j.1525-1497.1998.00026.xsubject
Has Abstractpub_date
1998-02-01 00:00:00pages
106-10issue
2eissn
0884-8734issn
1525-1497journal_volume
13pub_type
杂志文章abstract：BACKGROUND:Pharmaceutical industry gifts to physicians are common and influence physician behavior. Little is known about patient beliefs about the prevalence of these gifts and how these beliefs may influence trust in physicians and the health care system. OBJECTIVE:To measure patient perceptions about the prevalence...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-011-1760-3
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:Many primary care physicians (PCPs) are ill-equipped to provide screening and counseling for inherited breast cancer. OBJECTIVE:To evaluate the outcomes of an interactive web-based genetics curriculum versus text curriculum for primary care physicians. DESIGN:Randomized two-group design. PARTICIPANTS:121 ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-014-3113-5
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:The risk of adverse events among alcohol-interactive medication users can occur with one standard alcoholic drink. Research on the extent to which this occurs is scant. OBJECTIVE:To examine the prevalence and correlates of concurrent alcohol and alcohol-interactive (AI) medication use across different level...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0639-4
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:Patients with limited literacy skills are routinely encountered in clinical practice, but they are not always identified by clinicians. OBJECTIVE:To evaluate 3 candidate questions to determine their accuracy in identifying patients with limited or marginal health literacy skills. METHODS:We studied 305 Eng...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2006.00532.x
更新日期：2006-08-01 00:00:00
abstract：OBJECTIVE:Determine relationships between age, self-reported health, and satisfaction in a large cohort of hospitalized patients. DESIGN:Cross-sectional survey. SETTING:Thirty-one hospitals in a large Midwestern metropolitan area. PATIENTS/PARTICIPATION: Randomly selected medical and surgical patients (N = 64,900; me...
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
abstract：OBJECTIVE:To determine whether students who take ambulatory rotations in internal medicine are more likely to choose internal medicine careers. DESIGN:National survey. SETTING AND PARTICIPANTS:The intended sample was 1,650 senior U.S. medical students from 16 medical schools, of whom 1,244 (76%) responded. Representa...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/BF02640362
更新日期：1995-10-01 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 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：OBJECTIVES:We examined the presence and correlates of Black/White racial disparities in adherence to guidelines for colorectal cancer screening (CRCS). METHODS:The sample included 328 Black and 1827 White patients age 50-75 from 24 VA medical facilities who responded to a mailed survey with phone follow-up (response r...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1007/s11606-010-1575-7
更新日期：2011-03-01 00:00:00
abstract：:A number of new biological markers are being studied as predictors of disease or adverse medical events among those who already have a disease. Systematic reviews of this growing literature can help determine whether the available evidence supports use of a new biomarker as a prognostic test that can more accurately p...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-011-1899-y
更新日期：2012-06-01 00:00:00
abstract：:The fourth-year medicine clerkship was restructured at one of four sites. Teams consisting of one attending physician and three students cared for eight new patients per week. The overall experience of the restructured clerkship was rated significantly more positively than the experiences at all other sites and the te...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02600292
更新日期：1993-01-01 00:00:00
abstract：BACKGROUND:Many national guidelines recommend the use of patient provider agreements (PPAs) when prescribing opioids for chronic pain. There are no standards for PPA content, readability, or administration processes. OBJECTIVE:Conduct a national survey of providers who use PPAs to describe the process of administering...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06364-2
更新日期：2021-01-08 00:00:00
abstract：OBJECTIVES:1) To describe the prevalence of eight injury-prone behaviors (IPBs) and the associations of these behaviors with ten standard chronic disease and sociodemographic risk factors (CDSRFs) among internal medicine patients and 2) to identify a subset of patients with multiple IPBs who might be at particularly hi...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599194
更新日期：1992-11-01 00:00:00
abstract：BACKGROUND:There are currently roughly 10,000 Germans on the organ waiting list, and that number is over 113,000 in the USA. There is a clear need to increase support for organ donation in general and to increase the number of registered donors in particular. OBJECTIVE:The current study examines the relationship betwe...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05734-0
更新日期：2020-08-01 00:00:00
abstract：OBJECTIVE:To identify the communication factors that are significantly associated with appropriate short-term follow-up of abnormal mammograms. DESIGN:Prospective longitudinal study involving medical record review and patient survey. SETTING:Ten academically affiliated ambulatory medical practices in the Boston metro...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1525-1497.2004.30357.x
更新日期：2004-04-01 00:00:00
abstract：:Multiple factors are driving residency programs to explicitly address practice-based learning and improvement (PBLI), yet few information systems exist to facilitate such training. We developed, implemented, and evaluated a Web-based tool that provides Internal Medicine residents at the University of Virginia Health S...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0467-y
更新日期：2008-04-01 00:00:00
abstract：:A lack of access to critical drugs in the USA, either due to exorbitant prices or shortages, has become a troubling norm that threatens the quality and safety of healthcare. In 2017, there were shortages of 146 commonly used drugs including electrolytes, chemotherapy, cardiovascular, and antibiotic agents. For example...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-018-4548-x
更新日期：2018-11-01 00:00:00
abstract：:Anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis is an immune-mediated syndrome that remains under-recognized despite a growing body of literature. This syndrome has been predominantly described in young females with a constellation of symptoms, including personality changes, autonomic dysfunction and neu...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-011-1641-9
更新日期：2011-07-01 00:00:00
abstract：:Although intimate partner violence (IPV) remains a major public health problem, physicians often fail to screen female patients. Reported IPV training approaches suffer from weak study designs and limited outcome assessments. We hypothesized that an educational experience for residents at a women's safe shelter would ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1111/j.1525-1497.2005.0100.x
更新日期：2005-06-01 00:00:00
abstract：BACKGROUND:Enhancing the cultural competency of students is emerging as a key issue in medical education; however, students may perceive that they are more able to function within cross-cultural situations than their teachers, reducing the effectiveness of cultural competency educational efforts. OBJECTIVE:The purpose...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-009-1245-9
更新日期：2010-05-01 00:00:00
abstract：BACKGROUND:Use of electronic health records (EHRs) is associated with physician stress and burnout. While emergency departments and subspecialists have used scribes to address this issue, little is known about the impact of scribes in academic primary care. OBJECTIVE:Assess the impact of a scribe on physician and pati...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-018-4434-6
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND:Limitations in instrumental activities of daily living (IADL) hinder a person's ability to live independently in the community and self-manage their conditions, but its impact on hospital readmission has not been firmly established. OBJECTIVE:To test the importance of IADL dependency as a predictor of 30-da...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05982-0
更新日期：2020-10-01 00:00:00
abstract：OBJECTIVE:To identify gender differences in social and behavioral factors associated with antiretroviral adherence. DESIGN:Prospective cohort study. SETTING:Methadone maintenance program. PARTICIPANTS:One hundred thirteen HIV-seropositive current or former opioid users. MEASUREMENTS AND MAIN RESULTS:Participants we...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2004.30445.x
更新日期：2004-11-01 00:00:00
abstract：:Sarcoidosis is a multisystem disease of unknown etiology. Renal manifestation is rare and usually caused by hypercalcemia and nephrocalcinosis. Moreover, renal disease can occur as granulomatous interstitial nephritis (GIN), which is a histological diagnosis. We describe a case of sarcoidosis first presenting with mul...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0603-3
更新日期：2008-06-01 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：:In rare cases, pancytopenia results from hormonal deficiencies that arise in the setting of panhypopituitarism. Here we describe the unusual case of a 60-year-old man who presented with progressive fatigue and polyuria, and whose laboratory workup revealed a deficiency of the five hormones associated with the action o...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-014-3161-x
更新日期：2015-05-01 00:00:00
abstract：PURPOSE:Recent reports have emphasized the importance of delivery systems in improving health care quality. However, few prior studies have assessed differences in primary care quality between physician groups that differ in size and organizational configuration. We examined whether larger physician group size and affi...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0234-0
更新日期：2007-10-01 00:00:00
abstract：:Twenty-five to sixty percent of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external pressures. In addition, physicians are predisposed to burnout due to internal traits such as compulsiveness, guilt, and self-denial, and a medical culture tha...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-014-3144-y
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Process measures of healthcare quality are usually formulated as the number of patients who receive evidence-based treatment (numerator) divided by the number of patients in the target population (denominator). When the systems being evaluated can influence which patients are included in the denominator, it ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-015-3558-1
更新日期：2016-04-01 00:00:00
abstract：:Elderly veterans who visit our Veterans Affairs (VA) Medical Center primary care clinic often mention they are enrolled in HMOs. Approximately 20% of patients hospitalized at our facility report health insurance coverage. Of 1,000 hospitalizations during a 6-month period in which veterans reported insurance coverage, ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.1997.012004247.x
更新日期：1997-04-01 00:00:00
