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In This Issue of JAMA Internal Medicine
June 10, 2013

In This Issue of JAMA Internal Medicine

JAMA Intern Med. 2013;173(11):946. doi:10.1001/jamainternmed.2013.63

The MACE service is a novel model of care designed to deliver specialized interdisciplinary care to hospitalized older adults to improve patient outcomes. To evaluate the impact of the MACE service, Hung et al conducted a prospective, matched cohort study of patients 75 years or older admitted to a tertiary hospital for an acute illness to either the MACE service or medicine service. Admission to the MACE service was associated with lower rates of adverse events (9.5% vs 17.0%), shorter hospital length of stay by 0.8 days, and better satisfaction.

Doshi challenges the basic assumptions of officials and professional societies to treat influenza as a major public health threat for which the annual vaccine offers a safe and effective solution, showing that there is no good evidence that vaccines reduce serious complications of influenza. Promotional messages conflate “influenza” (disease caused by influenza viruses) with “flu” (a syndrome with many causes, of which influenza viruses appear to be a minor contributor). This lack of precision causes physicians and potential vaccine recipients to have unrealistic assumptions about the vaccine's potential benefit and impedes dissemination of the evidence on nonpharmaceutical interventions against respiratory diseases. Also, unexpected and serious adverse effects of influenza vaccines have occurred. The decisions surrounding influenza vaccines need to include a discussion of these risks and benefits.

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