Arch Intern Med
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Randomized Controlled Trial
Cost-effectiveness of B-type natriuretic peptide testing in patients with acute dyspnea.
B-type natriuretic peptide (BNP) is a quantitative marker of heart failure that seems to be helpful in its diagnosis. ⋯ Testing of BNP is cost-effective in patients with acute dyspnea.
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Randomized Controlled Trial
Lowering the threshold for discussions of domestic violence: a randomized controlled trial of computer screening.
Women experiencing domestic violence (DV) frequent health care settings, but DV is rarely identified. ⋯ Computer screening for DV increased but did not guarantee that DV would be addressed during ED encounters. Nonetheless, it is likely that low-cost interventions that allow patients the opportunity to self-disclose can be used to improve detection of DV.
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Randomized Controlled Trial
Effect of weight loss and exercise on frailty in obese older adults.
Obesity exacerbates the age-related decline in physical function and causes frailty in older persons. However, appropriate treatment for obese older persons is unknown. We evaluated the effects of weight loss and exercise therapy on physical function and body composition in obese older persons. ⋯ These findings suggest that weight loss and exercise can ameliorate frailty in obese older adults. Trial Registration clinicaltrials.gov Identifier: NCT00146133.
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Randomized Controlled Trial Multicenter Study
A trial of disclosing physicians' financial incentives to patients.
Concern regarding financial conflict of interest for physicians has led to calls for disclosure of financial incentives to patients. However, limited data on the outcomes of disclosure exist to guide policy. ⋯ Among diverse patient populations, a single mailed disclosure letter from physician groups was associated with improved knowledge of physicians' compensation models. Patients' trust in their physicians was unharmed, and their loyalty to their physician group was strengthened. For physician groups with similar compensation programs, disclosure to patients should be considered an effective method to enhance the patient-physician relationship.
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Randomized Controlled Trial
Role of pharmacist counseling in preventing adverse drug events after hospitalization.
Hospitalization and subsequent discharge home often involve discontinuity of care, multiple changes in medication regimens, and inadequate patient education, which can lead to adverse drug events (ADEs) and avoidable health care utilization. Our objectives were to identify drug-related problems during and after hospitalization and to determine the effect of patient counseling and follow-up by pharmacists on preventable ADEs. ⋯ Pharmacist medication review, patient counseling, and telephone follow-up were associated with a lower rate of preventable ADEs 30 days after hospital discharge. Medication discrepancies before and after discharge were common targets of intervention.