JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study
Early Metformin in Gestational Diabetes: A Randomized Clinical Trial.
Gestational diabetes is a common complication of pregnancy and the optimal management is uncertain. ⋯ Early treatment with metformin was not superior to placebo for the composite primary outcome. Prespecified secondary outcome data support further investigation of metformin in larger clinical trials.
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Randomized Controlled Trial Multicenter Study
Effects of the Million Hearts Model on Myocardial Infarctions, Strokes, and Medicare Spending: A Randomized Clinical Trial.
The Million Hearts Model paid health care organizations to assess and reduce cardiovascular disease (CVD) risk. Model effects on long-term outcomes are unknown. ⋯ The Million Hearts Model, which encouraged and paid for CVD risk assessment and reduction, reduced first-time MIs and strokes. Results support guidelines to use risk scores for CVD primary prevention.
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Randomized Controlled Trial Multicenter Study Comparative Study
A Multilevel Primary Care Intervention to Improve Follow-Up of Overdue Abnormal Cancer Screening Test Results: A Cluster Randomized Clinical Trial.
Realizing the benefits of cancer screening requires testing of eligible individuals and processes to ensure follow-up of abnormal results. ⋯ A multilevel primary care intervention that included EHR reminders and patient outreach with or without patient navigation improved timely follow-up of overdue abnormal cancer screening test results for breast, cervical, colorectal, and lung cancer.
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Randomized Controlled Trial Multicenter Study
Remote Ischemic Conditioning for Acute Stroke: The RESIST Randomized Clinical Trial.
Despite some promising preclinical and clinical data, it remains uncertain whether remote ischemic conditioning (RIC) with transient cycles of limb ischemia and reperfusion is an effective treatment for acute stroke. ⋯ RIC initiated in the prehospital setting and continued in the hospital did not significantly improve functional outcome at 90 days in patients with acute stroke.