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American College of Physicians


Breast cancer overdiagnosis may not happen as frequently as previously thought

A modeling study suggests that breast cancer overdiagnosis may occur in about 15% of screen-detected cases, rather than the estimated 30%. This could spare around 25,000 women unnecessary treatment. Researchers used data from the Breast Cancer Surveillance Consortium to estimate the rate of overdiagnosis.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeComputational simulation/modeling·DateFeb 28, 2022

COVID-19 patients’ ZIP codes may affect hospitalization outcomes

A study found that COVID-19 patients from high-vulnerability neighborhoods presented with more severe illness and required intensive care, but did not experience higher mortality rates. Researchers suggest policies targeting socially vulnerable neighborhoods to improve access to testing, treatment, and vaccination.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateFeb 21, 2022

NOACs associated with lower risk for diabetic complications and mortality compared with warfarin

A retrospective cohort study of patients with atrial fibrillation and diabetes found that non-vitamin K antagonist oral anticoagulants (NOAC) were associated with a lower risk of diabetes complications and mortality than warfarin. The study suggests that NOAC may be a better therapeutic choice for this patient population.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeData/statistical analysis·DateFeb 14, 2022

ACP releases two new clinical guidelines on the diagnosis and management of diverticulitis

The American College of Physicians (ACP) has released two new clinical guidelines for the diagnosis and management of diverticulitis. The guidelines recommend that clinicians manage most patients with uncomplicated disease in outpatient settings without antibiotics, while patients with complicated disease should be referred for colonos...

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateJan 17, 2022

Mild autonomous cortisol secretion predominantly affects women, associated with risk for hypertension, diabetes

A cross-sectional study found that mild autonomous cortisol secretion (MACS) predominantly affects women, increasing the frequency and severity of hypertension and type 2 diabetes compared to nonfunctioning adrenal tumors. Patients with MACS carried an increased cardiometabolic burden similar to Cushing Syndrome, even without typical f...

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeObservational study·DateJan 3, 2022

mRNA vaccines highly effective at preventing death from COVID-19, less effective at preventing infection

Researchers found that mRNA vaccines were highly effective (86%) in preventing SARS-CoV-2-related deaths among vaccinated individuals, especially in the elderly population. However, vaccine effectiveness against infection was lower (69%) and decreased with increasing age and comorbidity burden.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeRandomized controlled/clinical trial·DateDec 20, 2021

Telehealth-delivered diet and exercise programs led to significant improvements in knee osteoarthritis symptoms and quality of life

Researchers found that video-based, telehealth-delivered exercise and weight loss programs improved pain and function in people with knee osteoarthritis and overweight or obesity. The intervention with dietary component led to substantial weight loss and additional benefits.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeRandomized controlled/clinical trial·DateNov 29, 2021

Using short-acting opioids in the hospital could improve care for patients experiencing opioid withdrawal without pain

Experts suggest expanding treatment options for hospital patients with opioid withdrawal symptoms, potentially allowing more individualized and patient-centered care. Randomized controlled trials are needed to determine the efficacy of short-acting opioids in this context.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeCommentary/editorial·DateNov 22, 2021

Model suggests extending annual mammography screening past age 75 may be cost-effective for some healthy older women

A modeling study found that annual mammography screening beyond age 75 may provide little to no benefit in terms of lives saved, while increasing costs and potential harms from overdiagnosis. Biennial screening up to age 80 is more cost-effective but yields a small number of deaths averted.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeComputational simulation/modeling·DateNov 22, 2021

Flexible sigmoidoscopy screening associated with long-term reduction in colorectal cancer incidence and mortality

Flexible sigmoidoscopy screening significantly reduces colorectal cancer incidence and mortality, with a substantial protective effect maintained up to 19 years. The study's findings confirm the safety and effectiveness of flexible sigmoidoscopy as a preventive measure.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeRandomized controlled/clinical trial·DateNov 8, 2021

CBT intervention with yoga and education components improved pain management for patients on long-term opioids better than usual care

A randomized controlled trial found that CBT with yoga and education components significantly reduced pain impact and disability in patients on long-term opioid therapy. Patients receiving CBT also reported greater reductions in pain compared to those receiving usual care.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeRandomized controlled/clinical trial·DateNov 1, 2021

Addition of genotypic resistance testing did not improve virologic response in patients with HIV virologic failure sub-Saharan Africa

A randomized controlled trial found that adding genotypic resistance testing to routine care didn't improve virologic suppression among HIV patients with first-line antiretroviral therapy failure in public-sector clinics in Uganda and South Africa. The findings highlight the need for effective interventions for persons with virologic f...

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·TypeRandomized controlled/clinical trial·DateOct 25, 2021

Excess deaths disproportionally occurred among Black, American Indian/Alaskan Native, and Latino males and females during the 2020 COVID-19 pandemic

A large study found that excess deaths during the 2020 COVID-19 pandemic were significantly higher among Black, American Indian/Alaskan Native, and Latino males and females. The disparities were attributed to structural and social determinants of health with deep roots in racism.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateOct 4, 2021

COVID-19 vaccination elicits antibody response in vast majority of immunocompromised patients receiving immunosuppressive therapy

A prospective cohort study found that nearly 90% of immunocompromised patients developed an antibody response to SARS-CoV-2 vaccination, suggesting potential protection against severe illness. The response was weaker than in healthy participants but still encouraging for immunocompromised individuals.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateAug 30, 2021

Shorter weekly course of rifapentine-isoniazid associated with much higher treatment completion rates compared to longer daily course

A randomized trial found that a shorter course of rifapentine-isoniazid therapy resulted in significantly higher treatment completion rates compared to a longer daily course. The findings suggest that this regimens can be more effective for preventing tuberculosis disease in individuals with HIV, particularly in high-transmission areas.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateAug 23, 2021

COVID-19 News from Annals of Internal Medicine

Rates of COVID-19 hospitalizations, ICU admissions, and in-hospital deaths peaked in December 2020 among adults aged 65+, males, and Hispanic or non-Hispanic Black persons. Effective therapeutics use increased while invasive interventions waned, suggesting clinical practice evolved based on increasing knowledge.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateAug 9, 2021

Quitting smoking after lung cancer diagnosis may extend life without cancer recurrence

A prospective cohort study found that quitting smoking after being diagnosed with early-stage non-small cell lung cancer can slow disease progression and decrease mortality. Patients who quit smoking lived longer overall, had a longer time to death from lung cancer, and experienced improved survival without cancer recurrence.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateJul 26, 2021

COVID-19 news from Annals of Internal Medicine

Researchers found that COVID-19 vaccines are more than 95% effective in preventing confirmed infection. The study also revealed significant disparities among different age groups and comorbidities, with higher risks observed among older adults and those with underlying health conditions. Additionally, a separate cohort study showed tha...

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateJul 20, 2021

COVID-19 News from Annals of Internal Medicine

A recent study in Annals of Internal Medicine suggests that mandatory COVID-19 vaccination for healthcare workers is strongly justified due to the higher mortality rate of SARS-CoV-2 compared to influenza. The authors propose strategies to increase employee acceptance and overcome vaccine hesitancy, emphasizing the importance of protec...

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateJul 12, 2021

Infusion centers associated with substantially better outcomes than the ER for patients with acute pain events and sickle cell disease

A prospective cohort study found that treatment at an infusion center is associated with substantially better outcomes than treatment in the emergency department for patients with sickle cell disease. Patients treated in ICs received parenteral pain medication faster and were more likely to have their pain reassessed within 30 minutes.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateJul 5, 2021

Tai chi about equal to conventional exercise for reducing belly fat in middle aged and older adults

A randomized controlled trial found that tai chi is as effective as conventional exercise in reducing waist circumference and improving HDL cholesterol levels among middle-aged and older adults with central obesity. The study's findings are good news for those who may prefer tai chi due to limited mobility or preference.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateMay 31, 2021

Autonomous cortisol secretion associated with 2- to 3-fold increase in mortality risk

A retrospective cohort study found that autonomous cortisol secretion is associated with a 2- to 3-fold increased risk of death and cardiovascular disease in patients with adrenal incidentalomas. Researchers recommend treating known cardiovascular risk factors and incorporating findings into treatment decisions, including surgery.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateMay 24, 2021

Increased use of minimally invasive non-endoscopic tests for Barrett's esophagus screening

A new commentary suggests that more extensive use of minimally invasive non-endoscopic tests for Barrett's esophagus (BE) screening could lead to better early detection and prevention of esophageal adenocarcinoma, a deadly form of cancer. BE is often asymptomatic, but endoscopic treatment can reduce the risk of progression to cancer.

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateMay 3, 2021

COVID-19 News from Annals of Internal Medicine

A liver transplant recipient was reinfected with SARS-CoV-2 111 days after initial diagnosis, using genomic sequencing to distinguish relapse from reinfection. Additionally, a study found people of color have substantially higher risks for hospitalization and intensive-level care for COVID-19 compared to White persons

SourceAmerican College of Physicians·JournalAnnals of Internal Medicine·DateApr 19, 2021