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.
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.
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).
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.
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
Interpreting reported rates of contraceptive failure and counseling
patients when estimates of effectiveness for a specific contraceptive method
Confusion arising from the similarity of many drug names has resulted
in serious prescribing errors, compelling authorities to propose and make
A systematic review of the literature to ascertain why physicians may
not follow clinical practice guidelines.
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.
Strategies to resolve patient-physician disagreements regarding allocation
of resources, access to care, and financial arrangements under managed care.
For your patients: A primer on respiratory illnesses in childhood.
JAMA Theme Issue on Obesity Research
This Week in JAMA. JAMA. 1999;282(15):1401. doi:10.1001/jama.282.15.1401