 |
 |
|
Home |
Current Issue |
Past Issues |
Audio/Video |
CME |
Collections |
In the Clinic |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
|
Articles 
Frederick A. Spencer, Jeanna Allegrone, Robert J. Goldberg, Joel M. Gore, Keith A.A. Fox, Christopher B. Granger, Rajendra H. Mehta, David Brieger the GRACE Investigators* Statin therapy can modulate early pathophysiologic processes in patients with acute coronary syndromes. In this observational study, patients taking statins before admission for acute coronary syndromes and patients who started taking statins after admission had better outcomes than patients who did not take statins.
Harry R. Büller, Bruce L. Davidson, Hervé Decousus, Alexander Gallus, Michael Gent, Franco Piovella, Martin H. Prins, Gary Raskob, Annelise E.M. Segers, Roger Cariou, Oscar Leeuwenkamp, Anthonie W.A. Lensing The Matisse Investigators* Once-daily subcutaneous fondaparinux was at least as effective and safe as twice-daily, body weight–adjusted enoxaparin in the initial treatment of symptomatic deep venous thrombosis.
Eric S. Holmboe, Richard E. Hawkins, and Stephen J. Huot The authors studied direct observation of competence, a new approach to improving faculty skills in evaluating trainees' clinical ability. The new method appeared to make faculty more critical observers of trainee performance.
Michael Hummel, Ezio Bonifacio, Sandra Schmid, Markus Walter, Annette Knopff, and Anette-G Ziegler Childhood autoimmune diabetes is associated with autoimmunity that starts before 2 years of age. Autoimmunity that starts after 2 years is much less likely to lead to diabetes.
Improving Patient Care
Bruce E. Landon, Ira B. Wilson, Keith McInnes, Mary Beth Landrum, Lisa Hirschhorn, Peter V. Marsden, David Gustafson, and Paul D. Cleary This prospective, controlled study of almost 10 000 patients found that a quality improvement collaborative did not significantly affect the quality of care. We need additional research to improve methods of implementing quality improvement programs in order to achieve better results.
Brian S. Mittman Many of the intensive efforts to improve health care quality and safety use the quality improvement collaborative method, an approach emphasizing collaborative learning and exchange of insights and support among a set of health care organizations. Unfortunately, the widespread use of this method is based not on solid evidence but on shared beliefs and anecdotal experience that may overstate its actual effectiveness.
Academia and Clinic
Allan H. Goroll, Carl Sirio, F. Daniel Duffy, Richard F. LeBlond, Patrick Alguire, Thomas A. Blackwell, William E. Rodak, Thomas Nasca the Residency Review Committee for Internal Medicine The Residency Review Committee for Internal Medicine of the Accreditation Council for Graduate Medical Education proposes a new outcomes-based accreditation strategy for residency training programs in internal medicine. It shifts residency program accreditation from external audit of educational process to continuous assessment and improvement of trainee clinical competence.
Reviews
Dena M. Bravata, Kathryn M. McDonald, Wendy M. Smith, Chara Rydzak, Herbert Szeto, David L. Buckeridge, Corinna Haberland, and Douglas K. Owens Few surveillance systems have been specifically designed for collecting and analyzing data for the early detection of a bioterrorist event. Past studies of surveillance systems for detecting bioterrorism are insufficient to characterize the timeliness of detection or its sensitivity and specificity. As a result, they may compromise clinical and public health decision making.
Editorials
Andreas Laupacis and Muhammad Mamdani The current evidence leaves us uncertain about whether starting statin therapy at the time of admission for an acute coronary syndrome is more effective than starting this therapy later. While we wait for the results of large randomized trials, we can reflect on the many reasons for caution in drawing firm conclusions from observational studies of treatment effectiveness.
Paolo Prandoni After almost 50 years without any substantial progress, antithrombotic treatment of patients with venous thromboembolism has finally evolved. Factor Xa or thrombin inhibitors will probably allow antithrombotic treatment that is effective, safe, and simple enough for all physicians to use in most outpatients.
Christine K. Cassel Two papers in this issue indicate the dramatic and important movement of outcomes-based thinking into the world of medical education and training.
On Being a Doctor
Faith T. Fitzgerald Two patients, two doctor visits, two widely different experiences.
Letters Successful Treatment of Sarcoidosis
Yousaf Ali and Elliot Perlman Clinical Implications of Genetic Polymorphism of CYP2D6 in Mexican Americans
Deborah L. Flores, Israel Alvarado, Ma-Li Wong, Julio Licinio, and David Flockhart Risk Factors for Helicobacter pylori Resistance
Use of Angiotensin-Converting Enzyme Inhibitors in Heart Failure and Renal Insufficiency
Patient Safety and Medical Malpractice
Practice Guidelines for Chronic Kidney Disease
Andrew S. Levey for the Kidney Disease Outcomes Quality Initiatives Work Group on Chronic Kidney Disease—RESPONSE To Butterfly or To Needle: The Pilot Phase
A Novel Diagnostic Method for Acute Pulmonary Embolism: Technetium-99m Apcitide Scintigraphy
Jonathan M. Davison, Robert Bridwell, Jamie L. Montilla, Edward Jackson, and Lisa K. Moores Correction: Update in Infectious Diseases
Barbara Starfield
Donald C. Harrison
Frank Vinicor and Leonard Jack, Jr.
Michael M. Engelgau, Linda S. Geiss, Jinan B. Saaddine, James P. Boyle, Stephanie M. Benjamin, Edward W. Gregg, Edward F. Tierney, Nilka Rios-Burrows, Ali H. Mokdad, Earl S. Ford, Giuseppina Imperatore, and K. M. Venkat Narayan
Centers for Disease Control and Prevention Primary Prevention Working Group*
K. M. Venkat Narayan, Evan Benjamin, Edward W. Gregg, Susan L. Norris, and Michael M. Engelgau
Leonard Jack, Jr., Leandris Liburd, Tirzah Spencer, and Collins O. Airhihenbuwa
Ping Zhang, Michael M. Engelgau, Susan L. Norris, Edward W. Gregg, and K. M. Venkat Narayan
Dara Murphy, Tom Chapel, and Cynthia Clark
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
In this Issue
Articles
Previous Issue
