Journal of general internal medicine
-
To improve pain management, the Veterans Health Administration launched the "Pain as the 5th Vital Sign" initiative in 1999, requiring a pain intensity rating (0 to 10) at all clinical encounters. ⋯ Routinely measuring pain by the 5th vital sign did not increase the quality of pain management. Patients with substantial pain documented by the 5th vital sign often had inadequate pain management.
-
Many scholars have written about the historical underpinnings and likely consequences of African Americans distrust in health care, yet little research has been done to understand if and how this distrust affects African Americans' current views of the trustworthiness of physicians. ⋯ Unique factors contribute to trust and distrust in physicians among African-American patients. These factors should be considered in clinical practice to facilitate trust building and improve health care provided to African Americans.
-
Comparative Study
Correlates of use of antifracture therapy in older women with low bone mineral density.
Guidelines exist for treatment of low bone mineral density (BMD). Little is known about patient characteristics associated with use of treatment. ⋯ Even when physicians of study participants were provided with DXA scan results, 70% of older high-functioning women with an indication for therapy did not start or remain on an antifracture therapy. Substantial room for improvement exists in fracture prevention following a diagnosis of low BMD-especially among women with a history of falls, prior fractures, and among black women.
-
Randomized Controlled Trial
Predictors of quitting among African American light smokers enrolled in a randomized, placebo-controlled trial.
To examine the predictors of quitting among African American (AA) light smokers (<10 cigarettes per day) enrolled in a smoking cessation trial. ⋯ Individual characteristics may decrease the likelihood of quitting; however, the provision of directive, advice-oriented counseling focused on the addictive nature of nicotine, health consequences of smoking, benefits of quitting, and development of a concrete quit plan may be an important and effective facilitator of quitting among AA light smokers.
-
As educators seek confirmation of successful trainee achievement, medical education must move toward a more evidence-based approach to teaching and evaluation. Although medical training often provides physicians with a general background in biostatistics, many are not prepared to apply these skills. ⋯ This paper is intended to be a concise educational tool and guide for choosing and interpreting statistical tests aimed toward medical education assessment. It includes guidelines and examples that clinician-educators can use when analyzing and interpreting studies and when writing methods and results sections of reports.