JAMA : the journal of the American Medical Association
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of a practice-based strategy on test ordering performance of primary care physicians: a randomized trial.
Numbers of diagnostic tests ordered by primary care physicians are growing and many of these tests seem to be unnecessary according to established, evidence-based guidelines. An innovative strategy that focused on clinical problems and associated tests was developed. ⋯ In this study, a practice-based, multifaceted strategy using guidelines, feedback, and social interaction resulted in modest improvements in test ordering by primary care physicians.
-
Physical activity has been related to reduced mortality, but it is not clear whether changes in physical activity affect mortality among older women. ⋯ Increasing and maintaining physical activity levels could lengthen life for older women but appears to provide less benefit for women aged at least 75 years and those with poor health status.
-
Clinicians have observed various patterns of functional decline at the end of life, but few empirical data have tested these patterns in large populations. ⋯ Trajectories of functional decline at the end of life are quite variable. Differentiating among expected trajectories and related needs would help shape tailored strategies and better programs of care prior to death.