JAMA internal medicine
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JAMA internal medicine · Oct 2013
Randomized Controlled Trial Multicenter Study Comparative StudyDecision making in prostate cancer screening using decision aids vs usual care: a randomized clinical trial.
The conflicting recommendations for prostate cancer (PCa) screening and the mixed messages communicated to the public about screening effectiveness make it critical to assist men in making informed decisions. ⋯ Both decision aids improved participants’ informed decision making about PCa screening up to 13 months later but did not affect actual screening rates. Dissemination of these decision aids may be a valuable public health tool.
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JAMA internal medicine · Oct 2013
Randomized Controlled Trial Multicenter StudyCholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial.
Observational data link low 25-hydroxyvitamin D levels to both prevalent blood pressure and incident hypertension. No clinical trial has yet examined the effect of vitamin D supplementation in isolated systolic hypertension, the most common pattern of hypertension in older people. ⋯ Vitamin D supplementation did not improve blood pressure or markers of vascular health in older patients with isolated systolic hypertension.
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JAMA internal medicine · Oct 2013
Multicenter Study Comparative StudyPatient-centered medical home intervention at an internal medicine resident safety-net clinic.
The patient-centered medical home (PCMH) model holds promise for improving primary care delivery, but it has not been adequately tested in teaching settings. ⋯ Our PCMH-guided intervention, which represented a modest but substantive step toward the PCMH vision, had favorable effects on patient and resident satisfaction at a safety-net teaching clinic but did not reduce emergency department or hospital utilization in the first year. Our experience may provide lessons for other teaching clinics in safety-net settings hoping to implement PCMH-guided reforms.