Journal of general internal medicine
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Randomized Controlled Trial Comparative Study
The impact of resident duty hour reform on hospital readmission rates among Medicare beneficiaries.
A key goal of resident duty hour reform by the Accreditation Council for Graduate Medical Education (ACGME) in 2003 was to improve patient outcomes. ⋯ Among Medicare beneficiaries, there were no changes in hospital readmission rates associated with resident duty hour reform.
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Randomized Controlled Trial Comparative Study
Does prevalence matter to physicians in estimating post-test probability of disease? A randomized trial.
The probability of a disease following a diagnostic test depends on the sensitivity and specificity of the test, but also on the prevalence of the disease in the population of interest (or pre-test probability). How physicians use this information is not well known. ⋯ Most physicians do not take into account the prevalence of disease when interpreting a positive test result. This may cause unnecessary testing and diagnostic errors.
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Randomized Controlled Trial Multicenter Study Comparative Study
Presence and correlates of racial disparities in adherence to colorectal cancer screening guidelines.
We examined the presence and correlates of Black/White racial disparities in adherence to guidelines for colorectal cancer screening (CRCS). ⋯ We found that disparities in CRCS are greatly attenuated in the VA system and both Whites and Blacks have substantially higher rates of CRCS than the national average. These results point to the success of the VA at implementing CRCS system-wide. Our findings also suggest additional initiatives may be needed for unmarried low income white men and higher income black men.
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Randomized Controlled Trial Comparative Study
Improving blood pressure control: results of home-based post-acute care interventions.
Blood pressure (BP) control remains elusive for many Americans. Although home health nurses are uniquely positioned to help vulnerable individuals achieve BP control, hypertension (HTN) management has not been a high priority in post-acute care. ⋯ Among stage 2 patients, a nurse-led intervention providing additional HTN medication review and patient self-management support during the 3-month post-acute care period yielded significant improvements in 3-month BP control, plus improvements in secondary BP outcomes.
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Randomized Controlled Trial Multicenter Study Comparative Study
A cluster-randomized trial of a primary care informatics-based system for breast cancer screening.
Information technology offers the promise, as yet unfulfilled, of delivering efficient, evidence-based health care. ⋯ A novel population-based informatics system functioning as part of a non-visit-based care model increased mammography screening rates in intervention practices.