Annals of internal medicine
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Randomized Controlled Trial Multicenter Study
Adverse events with 4 months of rifampin therapy or 9 months of isoniazid therapy for latent tuberculosis infection: a randomized trial.
Treatment of latent tuberculosis infection with isoniazid for 9 months is complicated by poor patient adherence and the need for close follow-up of side effects, especially hepatotoxicity. Shorter and safer regimens are needed. ⋯ Treatment of latent tuberculosis with 4 months of rifampin leads to fewer serious adverse events and better adherence than 9 months of isoniazid. These findings justify a large-scale trial to compare the efficacy of rifampin with that of isoniazid.
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Review Meta Analysis
Comparative benefits and harms of second-generation antidepressants: background paper for the American College of Physicians.
Second-generation antidepressants dominate the management of major depressive disorder, dysthymia, and subsyndromal depression. Evidence on the comparative benefits and harms is still accruing. ⋯ Current evidence does not warrant the choice of one second-generation antidepressant over another on the basis of differences in efficacy and effectiveness. Other differences with respect to onset of action and adverse events may be relevant for the choice of a medication.
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Randomized Controlled Trial Multicenter Study
Motivational enhancement therapy with and without cognitive behavior therapy to treat type 1 diabetes: a randomized trial.
Although psychological issues can interfere with diabetes care, the effectiveness of psychological treatments in improving diabetes outcomes is uncertain. ⋯ Nurse-delivered motivational enhancement therapy and cognitive behavior therapy is feasible for adults with poorly controlled type 1 diabetes. Combined therapy results in modest 12-month improvement in hemoglobin A(1c) levels compared with usual care, but motivational enhancement therapy alone does not.
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The recent epidemiologic and clinical literature is filled with studies evaluating statistical models for predicting disease or some other adverse event. Risk stratification tables are a new way to evaluate the benefit of adding a new risk marker to a risk prediction model that includes an established set of markers. ⋯ In this article, the authors use examples to show how risk stratification tables can be used to compare 3 important measures of model performance between the models with and those without the new marker: the extent to which the risks calculated from the models reflect the actual fraction of persons in the population with events (calibration); the proportions in which the population is stratified into clinically relevant risk categories (stratification capacity); and the extent to which participants with events are assigned to high-risk categories and those without events are assigned to low-risk categories (classification accuracy). They detail common misinterpretations and misuses of the risk stratification method and conclude that the information that can be extracted from risk stratification tables is an enormous improvement over commonly reported measures of risk prediction model performance (for example, c-statistics and Hosmer-Lemeshow tests) because it describes the value of the models for guiding medical decisions.