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Articles 
Gabriel M. Leung, Timothy H. Rainer, Fei-Lung Lau, Irene O.L. Wong, Anna Tong, Tai-Wai Wong, James H.B. Kong, Anthony J. Hedley, Tai-Hing Lam for the Hospital Authority SARS Collaborative Group A simple model uses clinical data at the time of presentation to an emergency department during an acute outbreak of severe acute respiratory syndrome to identify patients with a high likelihood of this infection. For the free electronic version of the decision aid for this article, go to www.annals.org/pda.
Graham Nichol, Padma Kaul, Ella Huszti, and John F.P. Bridges The incremental cost per quality-adjusted life-year for cardiac resynchronization is similar to that of other commonly used interventions but is sensitive to changes in several key variables. Clinicians should not recommend resynchronization therapy for patients with comorbid illness that shortens life expectancy.
Perry J. Pickhardt, Pamela A. Nugent, Pauline A. Mysliwiec, J. Richard Choi, and William R. Schindler Neither optical colonoscopy nor virtual colonoscopy is a perfect test: Each misses 10% to 14% of adenomas that measure 6 mm or greater.
John T. Watson, Peter E. Pertel, Roderick C. Jones, Alicia M. Siston, William S. Paul, Constance C. Austin, and Susan I. Gerber West Nile fever is a more severe illness than has previously been documented. Mandatory reporting of West Nile fever cases in addition to West Nile meningoencephalitis cases could allow more accurate and timely recognition of the geographic distribution of West Nile virus infections and could inform public health interventions.
Improving Patient Care
Sumit R. Majumdar, Brian H. Rowe, Deb Folk, Jeffrey A. Johnson, Brian H. Holroyd, Donald W. Morrish, Walter P. Maksymowych, Ivan P. Steiner, Charles H. Harley, Brian J. Wirzba, David A. Hanley, Sandra Blitz, and Anthony S. Russell In a multifaceted intervention directed at patients and their physicians, the rates of testing and treatment for osteoporosis after emergency department care for a fragility fracture were more than 3 times the rates in controls.
Updates
Norton J. Greenberger and Prateek Sharma This year's Update in Gastroenterology and Hepatology incorporates articles on screening and surveillance for Barrett esophagus, antimicrobial resistance in Helicobacter pylori, treatment for recurrent ulcer bleeding, celiac disease diagnosis, optimal treatment of inflammatory bowel disease, probiotics for antibiotic-associated diarrhea, aspirin for preventing colorectal adenomas, chronic liver disease diagnosis, and the causes of acute liver failure.
Reviews
Finlay A. McAlister, Justin A. Ezekowitz, Natasha Wiebe, Brian Rowe, Carol Spooner, Ellen Crumley, Lisa Hartling, Terry Klassen, and William Abraham In selected patients with heart failure, cardiac resynchronization therapy improves functional and hemodynamic status, reduces heart failure hospitalizations, and may reduce all-cause mortality.
Medicine and Public Issues
Robert B. Doherty This paper explains the policy decisions that shaped the Medicare Modernization Act. It describes the new private health plan options and improvements to traditional Medicare and discusses the impact on beneficiaries in different income and assets categories.
Editorials
John A. Jernigan, Rita F. Helfand, and Umesh D. Parashar If severe acute respiratory syndrome (SARS) recurs, we will need accurate clinical strategies for detecting early cases so that we don't overburden the health care and public health systems with patients who are concerned about SARS but don't have it. In this issue, Leung and colleagues report on a decision rule that may prove helpful as an early case-detection strategy. We hope that other centers will try to validate this decision rule so that we will know if we have a proven strategy for coping with future outbreaks of SARS.
Mark A. Hlatky and Barry M. Massie In this issue, McAlister and associates summarize the evidence on cardiac resynchronization therapy for heart failure, and Nichol and coworkers analyze the cost-effectiveness of this therapy. Cardiac resynchronization therapy may be worth its high cost if it substantially improves patient survival, quality of life, or both. The weight of current evidence suggests that this therapy does improve functional status and quality of life.
David Lieberman Colonoscopy, as a gold standard, has lost some of its glitter. Nevertheless, it remains the preeminent procedure for diagnosing and treating colonic neoplasia. The data on colonoscopy accuracy, such as the findings reported in a study in this issue, are a humbling reminder of the limitations of colonoscopy.
On Being a Patient
Peter A. Beatty I lost my vision when I awoke on the morning of the anniversary of my wife's death from disseminated breast cancer. As a physician, I had rarely given much credence to "stress" as a factor in illness. I am more of a believer now.
Letters Noninvasive Ventilation in Exacerbations of Chronic Obstructive Pulmonary Disease: Implications of Different Meta-Analytic Strategies
Aspirin Use and Risk for Colorectal Adenoma
Malpractice Reform and Medical Injury
New Treatments for Brittle Bones
Low-Molecular-Weight Heparin for Pulmonary Embolism
Alcohol Use and Diabetes Mellitus
Hospice Effect on Medicare Expenditures
Silo-Filler's Disease, the Acute Respiratory Distress Syndrome, and Oxides of Nitrogen
Linda Pinsky
Camille N. Abboud
Nicole Martin
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