Journal of general internal medicine
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To develop a sound method to identify patient and physician characteristics that influence specialty referrals. ⋯ Because these methods were not difficult to implement and the results were credible, we believe that other organizations should be able to use them.
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To determine the clinical factors associated with delayed protease inhibitor initiation. ⋯ HIV-infected patients with higher CD4 cell counts or a history of depression or history of injection drug use have significant and lengthy delays of protease inhibitor therapy. Although some delays may be clinically appropriate, enhancement of provider and patient education might prove beneficial. Further research should examine reasons for delays in protease inhibitor initiation and their appropriateness.
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To measure patient preferences for four different screening strategies: annual fecal occult blood testing (FOBT) alone; flexible sigmoidoscopy (FSIG) every 5 years alone; both annual FOBT and FSIG every 5 years; or no screening. ⋯ Patient preferences for colon cancer screening were modestly sensitive to information about test performance and strongly sensitive to out-of-pocket costs. The heterogeneity of patients' preferences for how to be screened supports informed shared decision making as a possible means of improving colon cancer screening.
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We conducted this study to determine if a smoking status stamp would prompt physicians to increase the number of times they ask, advise, assist, and arrange follow-up for African-American patients about smoking-related issues. ⋯ The stamp had a significant effect on increasing rates of asking about cigarette smoking, telling patients to quit, and arranging follow-up for smoking cessation. However, the stamp did not improve the low rate at which physicians offered patients specific advice on how to quit or in setting a quit date.