JAMA internal medicine
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JAMA internal medicine · Feb 2014
Randomized Controlled Trial Multicenter Study Comparative StudyOverdiagnosis in low-dose computed tomography screening for lung cancer.
Screening for lung cancer has the potential to reduce mortality, but in addition to detecting aggressive tumors, screening will also detect indolent tumors that otherwise may not cause clinical symptoms. These overdiagnosis cases represent an important potential harm of screening because they incur additional cost, anxiety, and morbidity associated with cancer treatment. ⋯ More than 18% of all lung cancers detected by LDCT in the NLST seem to be indolent, and overdiagnosis should be considered when describing the risks of LDCT screening for lung cancer.
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JAMA internal medicine · Feb 2014
Randomized Controlled Trial Multicenter StudyMultifaceted intervention to improve medication adherence and secondary prevention measures after acute coronary syndrome hospital discharge: a randomized clinical trial.
Adherence to cardioprotective medication regimens in the year after hospitalization for acute coronary syndrome (ACS) is poor. ⋯ A multifaceted intervention comprising pharmacist-led medication reconciliation and tailoring, patient education, collaborative care between pharmacist and patients' primary care clinician and/or cardiologist, and voice messaging increased adherence to medication regimens in the year after ACS hospital discharge without improving BP and LDL-C levels. Understanding the impact of such improvement in adherence on clinical outcomes is needed prior to broader dissemination of the program.