Background:Cardiovascular implantable electronic devices (CIEDs) are associated with procedure-related complications, yet little is known about variation in complication rates among institutions that may suggest disparities in care quality.Objective:To assess institutional variation in risk-standardized complication rates (RSCRs) for CIED.Design:Cohort study.Setting:174 hospitals in Australia and New Zealand, 98 of which implanted at least 25 CIEDs during the study period.Participants:81 304 patients...
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Background:Persons with cerebral palsy (CP) have an increased risk for secondary chronic conditions during childhood, including mental health disorders. However, little is known about how these disorders affect adults with CP.Objective:To determine the prevalence of mental health disorders among adults with CP compared with those without CP.Design:Cross-sectional.Setting:2016 Optum Clinformatics Data Mart.Patients:8.7 million adults (including 7348 adults with CP).Measurements:Other neurodevelopmental...
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Background:Whether statin type influences hepatocellular carcinoma (HCC) incidence or mortality in chronic hepatitis B or C virus infection is unknown.Objective:To assess the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality in a nationwide population with viral hepatitis.Design:Prospective propensity score (PS)–matched cohort.Setting:Swedish registers, 2005 to 2013.Participants:A PS-matched cohort of 16 668 adults (8334 who initiated statin use [6554 lipophilic...
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In November 2017, quinidine gluconate, the only medication approved by the U.S. Food and Drug Administration to treat severe malaria, was discontinued. The authors discuss actions that clinicians, hospitals, federal agencies, and professional societies can take to ensure effective treatment and prevent a catastrophe.
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Description:In May 2019, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved an update to the 2013 joint clinical practice guideline for assessing and managing patients who are at risk for suicide. This guideline provides health care providers with a framework by which to screen for, evaluate, treat, and manage the individual needs and preferences of VA and DoD patients who may be at risk for suicide.Methods:In January 2018, the VA/DoD Evidence-Based Practice...
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Sall and colleagues have presented a synopsis of the 2019 U.S. Department of Veterans Affairs (VA) and Department of Defense (DoD) joint clinical practice guideline on assessing and managing patients at risk for suicide. The editorialist discusses the recommendations and why reducing suicide among veterans depends largely on actions that improve suicide care outside the VA system.
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Alzheimer disease (AD) and other dementia syndromes are becoming more common; an estimated 5.5 million adults aged 65 years or older are living with AD in the United States. It is important for primary care physicians to gain knowledge in this field because most community-dwelling older adults receive their care from them. This article discusses the latest findings in approaches to prevent cognitive decline as well as dementia screening, diagnosis, and treatment. Approaches to address quality of...
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The editorialists discuss the findings of Drake and colleagues' brief research report and recommend strategies to increase telehealth access beyond improving Internet service.
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The editorialists discuss the strengths and limitations of Ranasinghe and colleagues' study, implications for clinical decision making, and potential gaps in the quality of care related to cardiac implantable electronic device implantation.
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Both the United States and New Zealand have experienced tragic mass shootings. This commentary contrasts the responses to these tragedies in the 2 countries in the context of how they each view and regulate firearms.
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