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This Week in JAMA
October 20, 1999

This Week in JAMA

JAMA. 1999;282(15):1401. doi:10.1001/jama.282.15.1401
School-Based Scoliosis Screens May Not Be Effective

School-based screening programs for adolescent idiopathic scoliosis are mandated in 26 US states and are supported by state or local agencies in other areas, even though evidence of effectiveness is lacking. In this evaluation of a community-wide school-based scoliosis screening program, Yawn and colleagues foundArticle that among 2242 children screened in grades 5 through 9 and followed up until age 19 years, the screening program identified 5 of 9 children who were treated for scoliosis and referred 87 others who were not treated. The sensitivity of the screening program for the identification of treated scoliosis was 0.56, the positive predictive value was 0.05, and the number needed to screen to identify a child with treated scoliosis was 448. In an editorialArticle, Higginson details the steps involved in a reevaluation of state-funded or -mandated scoliosis screening programs.

Physical Activity and Risk of Type 2 Diabetes Mellitus

Using data from 70,102 women aged 40 to 65 years enrolled in the Nurses' Health Study and followed prospectively for 8 years, Hu and coworkers found that the risk of developing type 2 diabetes decreased as the level of weekly energy expenditure in metabolic equivalent task–hours (MET score) for 8 common physical activities increased. Among women who did not perform vigorous activity, the risk of developing type 2 diabetes decreased as the MET score for walking increased, and the risk reductions associated with walking and vigorous activity of equivalent energy expenditures were comparable.

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Rate of Hospitalization for Bronchiolitis Increasing

In this analysis of data from the US National Hospital Discharge Survey, Shay and colleagues foundArticle that more than half of the estimated 1.65 million hospitalizations for bronchiolitis from 1980 through 1996 occurred among infants younger than 6 months and 81% occurred among children younger than 1 year. Among children younger than 1 year, the estimated annual rate of bronchiolitis-associated hospitalizations increased from 12.9 per 1000 in 1980 (22.2% of all hospitalizations for lower respiratory tract illnesses) to 31.2 per 1000 in 1996 (47.4% of all hospitalizations for lower respiratory tract illnesses).

White Coat Hypertension and Pregnancy Outcomes

To determine maternal and newborn outcomes of white coat hypertension (elevated blood pressure in the office with normal blood pressure outside the medical setting) during pregnancy, Bellomo and coworkers used 24-hour noninvasive blood pressure monitoring to evaluate 144 women in their third trimester of pregnancy with office hypertension and 103 matched normotensive pregnant women and followed them through 1 month after delivery. Duration of pregnancy, incidence of preeclampsia, and newborn weight were comparable in the group of 42 women identified with white coat hypertension and the normotensive group and differed significantly from the group with sustained hypertension, but the incidence of cesarean delivery was higher in the white coat hypertension group compared with the normotensive group.

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Funding Source and Drug Cost-effectiveness Studies

In this evaluation of 44 articles published between 1988 and 1998 on the cost-effectiveness of 6 new drugs in oncology, Friedberg and colleagues foundArticle that 1 (5%) of 20 pharmaceutical company–sponsored studies reported unfavorable qualitative conclusions compared with 9 (38%) of 24 nonprofit-sponsored studies. Thirty percent of the pharmaceutical company–sponsored studies reported a qualitatively favorable conclusion when quantitative results were neutral or unfavorable or a neutral conclusion when quantitative results were unfavorable compared with 13% of the nonprofit-sponsored studies. In an editorialArticle, Krimsky emphasizes the importance of developing standardized methods of pharmacoeconomic analysis.

From the

Interpreting reported rates of contraceptive failure and counseling patients when estimates of effectiveness for a specific contraceptive method vary.

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Medical News & Perspectives

Confusion arising from the similarity of many drug names has resulted in serious prescribing errors, compelling authorities to propose and make name changes.

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Adherence to Practice Guidelines

A systematic review of the literature to ascertain why physicians may not follow clinical practice guidelines.

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Privacy and Electronic Health Information

An analysis of new legal challenges presented by computerization and electronic transmission of health data, and recommendations for reform of national health information privacy legislation.

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Disagreements Under Managed Care

Strategies to resolve patient-physician disagreements regarding allocation of resources, access to care, and financial arrangements under managed care.

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JAMA Patient Page

For your patients: A primer on respiratory illnesses in childhood.

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JAMA Theme Issue on Obesity Research