This randomized clinical trial compares the effect of vasopressors guided by a mean arterial pressure (MAP) target of 60 to 65 mm Hg with a MAP level determined by the treating physician on 90-day mortality among critically ill older patients with vasodilatory hypotension.
This cohort study uses electronic health record (EHR) data to evaluate the association between Physician Orders for Life-Sustaining Treatment (POLST) and intensive care unit (ICU) admission and the incidence of and risk factors for POLST-discordant intensive care among adult patients hospitalized 6 months or less before death.
This population epidemiology study compares annual changes in all-cause mortality, hospitalization rates, and hospitalization-related mortality among beneficiaries aged 65 years or older dually enrolled in Medicare fee-for-service and Medicaid vs those nondually enrolled (Medicare only).
This study uses Women’s Health Initiative data to compare the prevalence of pathogenic variants (PVs) in breast cancer susceptibility genes in postmenopausal women with vs without breast cancer to guide decisions about who should undergo PV testing.
This 2020 Recommendation Statement from the US Preventive Services Task Force recommends screening for hepatitis C virus infection in adults aged 18 to 79 years (B recommendation).
This systematic review to support the 2020 US Preventive Services Task Force Recommendation Statement on screening for hepatitis C virus (HCV) infection summarizes published evidence on the benefits and harms of HCV screening and treatment in adolescents and adults.
This Viewpoint discusses the potential harms that can emerge from changing disease classifications, generally to broaden criteria for diagnosing greater numbers of patients, and calls for a balanced and systematic evaluation of the benefits and risks of shifting illness thresholds before formalizing changes.
This Viewpoint argues that moral dilemma, moral distress, and moral injury more accurately and etiologically characterize what most people refer to as physician burnout, and proposes that this reconception can lead to more effective prevention strategies and targeted solutions to address physician stress, frustration, dissatisfaction, and depression.
This Viewpoint discusses concern that current risk adjustment models used by CMS to tie payment to performance do not account for dementia, frailty, and social risk, and proposes ways to add reliable measures of each to the agency’s CMS-HCC model to more equitably reimburse clinicians and facilities caring for patients with challenging conditions.
This Viewpoint proposes the creation of a homelessness-focused special needs plan, a Medicare Advantage insurance plan aimed at meeting the unique care needs of specific populations, to help offer the intensive case management and care coordination necessary for providing health care to homeless individuals.
In this narrative medicine essay a psychiatrist finds parallels between his attempts to locate the source of a patient’s psychological trauma and those of trauma surgeons opening up patients to reveal their injuries and shares how a successful connection heals both doctor and patient.
An 18-year-old man who recently emigrated from India presented with fever, malaise, and anorexia for 4 days. He was afebrile with scleral icterus and a palpable liver edge; had a white blood cell count of 3.9 × 103/μL with elevations in total and direct bilirubin, alkaline phosphatase, and liver enzymes; and laboratory test results were positive for HBsAg and HBV core IgG. What is the cause of his hepatitis, and what would you do next?
In this Medical News article, Tom Inglesby, MD, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, speaks about natural and deliberate biological threats to US national security.
This JAMA Patient Page describes the recent USPSTF recommendations on screening for hepatitis C virus infection in adults.
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