J Am Board Fam Med
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Unhealthy drinking is prevalent in the United States, and yet it is underidentified and undertreated. Identifying unhealthy drinkers can be time-consuming and uncomfortable for primary care providers. An automated rule for identification would focus attention on patients most likely to need care and, therefore, increase efficiency and effectiveness. The objective of this study was to build a clinical prediction tool for unhealthy drinking based on routinely available demographic and laboratory data. ⋯ Using commonly available data, a decision tool can identify a subset of patients who seem to warrant clinical attention for unhealthy drinking, potentially increasing the efficiency and reach of screening.
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This study examined the clinical utility of highly efficient subjective and objective screens of cognitive impairment. ⋯ Screening protocols in which cognitive testing is administered subsequent to patient complaint are prone to underdiagnosis. In addition, common dementia screens are insensitive to subjective deficits and healthy cognitive aging. Therefore, they may lead to dismissing valid concerns that deserve preventive attention. Primary care needs efficient screening tools that are sensitive to prodromal decline.
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The objective of this study was to better understand the relationship between panel size, full-time status, and estimated socioeconomic status of a patient panel with types and number of primary care clinician inbox messages. ⋯ These findings contribute to our understanding of primary care workload, specifically as it relates to panel size, full-time status, and patient panel socioeconomic status. Increase in clinical time or panel size needs to come with trained team members or additional time to address inbox messages.
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In this narrative account, the author, a medical student, describes his encounters with several inpatients at a community hospital. He becomes acquainted with a patient's son, who, initially withdrawn, over the course of his mother's hospitalizations transforms into a compassionate volunteer. This change is made especially evident when the author meets another patient who recognizes the volunteer and reveals his very different past.
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Randomized Controlled Trial
Having a Primary Care Provider is the Strongest Predictor of Successful Follow-up of Participants in a Clinical Trial.
Ethnic minorities, women, and those of low socioeconomic status are widely underrepresented in clinical trials. Few studies have explored factors associated with successful follow-up in these historically difficult-to-reach patients. This study's objective was to identify patient characteristics and methods of contact that predict successful contact for follow-up in an urban, predominantly ethnic minority, majority-women, poor population to help devise strategies to improve retention. ⋯ Patients engaged with the health care system by having a PCP are significantly more likely to achieve follow-up. Successful follow-up is also associated with native English speaking. The potential of improving follow-up by facilitating connections with health care providers requires further study.