The New England journal of medicine
-
Randomized Controlled Trial Multicenter Study Comparative Study
Randomized Trial of Four Treatment Approaches for Actinic Keratosis.
Actinic keratosis is the most frequent premalignant skin disease in the white population. In current guidelines, no clear recommendations are made about which treatment is preferred. ⋯ At 12 months after the end of treatment in patients with multiple actinic keratosis lesions on the head, 5% fluorouracil cream was the most effective of four field-directed treatments. (Funded by the Netherlands Organization for Health Research and Development; ClinicalTrials.gov number, NCT02281682.).
-
Randomized Controlled Trial Multicenter Study Comparative Study
Sleep and Alertness in a Duty-Hour Flexibility Trial in Internal Medicine.
A purpose of duty-hour regulations is to reduce sleep deprivation in medical trainees, but their effects on sleep, sleepiness, and alertness are largely unknown. ⋯ This noninferiority trial showed no more chronic sleep loss or sleepiness across trial days among interns in flexible programs than among those in standard programs. Noninferiority of the flexible group for alertness was not established. (Funded by the National Heart, Lung, and Blood Institute and American Council for Graduate Medical Education; ClinicalTrials.gov number, NCT02274818.).
-
Randomized Controlled Trial Multicenter Study Comparative Study
Patient Safety Outcomes under Flexible and Standard Resident Duty-Hour Rules.
Concern persists that extended shifts in medical residency programs may adversely affect patient safety. ⋯ Allowing program directors flexibility in adjusting duty-hour schedules for trainees did not adversely affect 30-day mortality or several other measured outcomes of patient safety. (Funded by the National Heart, Lung, and Blood Institute and Accreditation Council for Graduate Medical Education; iCOMPARE ClinicalTrials.gov number, NCT02274818.).