This cluster-crossover randomized clinical trial compares the effects of a flexible visitation policy (up to 12 hours per day) vs a standard visitation policy (up to 4.5 hours per day) on delirium incidence among ICU patients.
This randomized clinical trial compared the effects of a diary filled out by clinicians and family members during an intensive care unit (ICU) stay to ground their memory of events after discharge vs usual care on symptoms of posttraumatic stress disorder, anxiety, and depression in patients and family members after discharge.
This cohort study uses hospital discharge data to compare 30-day in-hospital mortality of patients with sepsis in New York State before vs after implementation of regulations mandating rapid administration of antibiotics and fluid resuscitation and compares those data with mortality in 4 comparison states (Florida, Maryland, Massachusetts, and New Jersey) without such a mandate.
This cohort study uses data from the Get With the Guidelines-Stroke registry to report associations between time to treatment and functional outcomes among patients in clinical practice with acute ischemic stroke treated with endovascular recanalization.
This study characterizes price increases exceeding inflation between 2012 and 2017 for protected-class drugs (antineoplastics, antiretrovirals, antidepressants, antipsychotics, anticonvulsants, and immunosuppressants for transplant patients) that would lead to their exclusion from Medicare Part D coverage based on excessive cost under a 2018 CMS rule intended to facilitate more effective price negotiations.
This study uses National Cancer Database data to estimate associations between hurricane disaster declarations, which could disrupt electrical power, and survival of patients undergoing radiotherapy for nonoperative locally advanced non–small cell lung cancer between 2004 and 2014.
This Viewpoint proposes an array of approaches state governments might take to lower health care prices paid by private insurance, including rate setting using reference pricing; scrutiny of hospital mergers; expanding scope-of-practice laws to increase workforce; and investing in alternative payment models.
This Viewpoint discusses the conflict between the role of academic medical centers as providers of complex uncompensated care, and the large profit margins they realize from expensive fee-for-service clinical activity that puts them at odds with attempts to reorganize medicine to provide value-based care.
This Viewpoint reviews evidence about the outcomes and costs of health care at teaching vs nonteaching hospitals in an attempt to answer the question of whether the costs of academic medical centers are defensible and whether they deliver value for their price.
This Viewpoint discusses the rapidly growing threat to public health that the dissemination of medical misinformation enables and the active measures that must be taken to stop it.
This Viewpoint calls out the threat to vaccine policy posed by a very small number of antivaccine (“antivax”) advocates who disrupt attempts to engage vaccine-hesitant persons in public hearings about risks and benefits of vaccination and, acknowledging the concerns of a skeptical public, calls for a renewed commitment to civility in discussing public health policy.
In this narrative medicine essay, an associate director of an internal medicine residency program describes when a student addressed her in an email by her first name but at the same time the student addressed a male colleague as “Doctor” and explains how she decided to handle the discrepancy.
A 39-year-old woman with a history of palmar and axillary hyperhidrosis had anisocoria more pronounced in bright lighting conditions. She appeared well; denied double vision, ptosis, headache, or weakness; had normal visual acuity; and her neurologic examination was unremarkable. What is the diagnosis and what would you do next?
This Medical News article discusses how all physicians who treat seriously ill patients can integrate palliative care into their practices.
In this Medical News article, experts discuss how—or whether—the United States should have a national conversation about death and dying.
This Arts and Medicine essay reviews The Bleeding Edge, a Netflix documentary about the medical device industry and the harms that can come to patients when innovation, regulatory approval, and adoption of devices in practice outpace evidence of their safety and benefit.
This JAMA Patient Page describes use of steroid medications and the side effects that can result.
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