A modeling study estimates that treatments with ICERs above $100,000 to $150,000 per QALY are unlikely to be considered cost-effective for the US healthcare system. The study suggests that spending less on low-effectiveness treatments could allow more funding for treatments with larger health gains.
An agent-based computer model shows that delayed implementation of social distancing measures and low adherence can increase COVID-19 cases in urban areas. Maintaining personal behaviors like face mask use after easing social distancing measures also has a significant impact.
ACP leaders compared the healthcare proposals of President Trump and former Vice-President Joe Biden to their comprehensive framework for improving healthcare in the US. The proposals were evaluated on eight key challenges, including universal coverage, pre-existing conditions, and prescription drug pricing.
Industry, government, and academic researchers propose general clinical endpoints to facilitate evaluation of COVID-19 vaccine candidates. These endpoints include asymptomatic infection as a study endpoint.
Researchers found a 10-fold increased risk of COVID-19-related death in individuals with Down syndrome. Meanwhile, the FDA is reevaluating its REMS program for mifepristone to improve women's health access during the pandemic and post-pandemic
The American College of Physicians (ACP) and Annals of Internal Medicine hosted a virtual forum on October 16, assembling leading health experts to discuss timely information related to COVID-19 vaccines. Panelists offered current evidence-based insights into vaccine science, approval processes, and clinical recommendations.
Linked color imaging (LCI) is more effective than white light imaging (WLI) in detecting tumors in the upper gastrointestinal tract. Researchers found that LCI detected 1.67 more neoplastic lesions during the first examination, and reduced overlooked neoplasms compared to WLI.
Researchers found that 12.1% of cases received out-of-network claims, often due to out-of-network anesthesiologists and pathologists. The study suggests partnering with in-network providers and considering cost-saving strategies to spare patients surprise bills.
A randomized controlled trial found that early referral to physical therapy significantly improved function and reduced symptoms of back pain with sciatica compared to usual care. Patients who received physical therapy immediately after their primary care visit reported less disability than those who took the wait-and-see approach.
For over two decades, the FDA has approved new opioids based on studies lacking critical safety and efficacy data. The agency's regulatory activities have been scrutinized due to the role prescription opioids played in driving the opioid epidemic.
The National Institutes of Health COVID-19 Treatment Guidelines Panel has expressed uncertainty about the efficacy and safety of convalescent plasma for treating COVID-19. The panel's analysis, published in Annals of Internal Medicine, highlights the need for more data before making recommendations on the treatment.
Researchers developed a decision tool called the COVID-19 Inpatient Risk Calculator (CIRC) to predict disease trajectory in patients. Older age and obesity are identified as independent risk factors for progression to severe disease or death, according to findings published in Annals of Internal Medicine.
Researchers found that glucocorticoid therapy, even at low doses (5mg/day or less), significantly increases the risk of serious infections in rheumatoid arthritis (RA) patients. The study used claims data from over 200,000 patients with RA to show a 30% increase in infection risk among those on low-dose glucocorticoids.
Researchers found that COVID-19 is mainly transmitted through respiratory droplets or aerosols, not surfaces. Social distance and proper ventilation are crucial in reducing transmission risk. Novel community isolation quarantine facilities can effectively manage COVID-19 without serious adverse outcomes.
Researchers found that active surveillance and surge testing can prevent COVID-19 spread in homeless shelters. Guidelines developers face challenges due to poorly designed studies, but solutions are proposed through the COVID-NMA Project, which aims to improve evidence synthesis and guideline development.
A randomized, double-blind trial found that turmeric supplements were more effective in reducing knee pain in patients with osteoarthritis compared to a placebo. The study also showed no adverse events and reduced medication usage, but highlighted the need for larger, longer-term trials.
Researchers from Stanford University and Harvard T.H. Chan School of Public Health propose a new method to accurately estimate COVID-19 mortality rates by measuring direct, indirect, and excess deaths. This approach could provide a more accurate picture of the pandemic's impact on human life.
A systematic review of published evidence found that treating hypertension reduces the risk of orthostatic hypotension. Lowering blood pressure targets can mitigate this condition in adults with hypertension, regardless of age or health status.
Researchers found that prophylactic treatment with direct-acting antivirals prevented chronic hepatitis C virus infection in patients receiving kidneys from HCV-positive deceased donors. The approach has potential to shorten waiting times on the organ waitlist.
A new study published in Annals of Internal Medicine found that COVID-19 infection fatality ratios vary significantly by age, race, ethnicity, and sex. The overall noninstitutionalized infection fatality rate was 0.26%, with higher rates among older adults and non-whites, particularly those aged 60 or older, who had an IFR of 1.71%.
Researchers from the University of Hong Kong investigated SARS-CoV-2 transmission via fecal aerosols in a Guangzhou high-rise apartment building. They found evidence suggesting that toilet flushing by infected patients may have caused the outbreak. The study's findings emphasize the importance of adequate hygiene and ventilation to pre...
A large cohort study found no association between maternal H1N1 vaccination during pregnancy and risk for autism spectrum disorder (ASD) in children. Researchers also found that vaccine exposure in the first trimester did not increase ASD or autistic disorder (AD) risks.
Researchers developed a saliva-based diagnostic method for COVID-19, detecting more cases than standard nasopharyngeal swab tests. The new approach has several advantages, including reduced need for PPE and trained staff.
A large population-based study found that acute cardiovascular events are common among adults hospitalized with influenza, with older age and underlying cardiovascular disease significantly increasing the risk. Vaccination is crucial for these patients, particularly those with cardiovascular risk factors, to prevent such complications.
A new analysis from Harvard Medical School and Hunter College found that 2.3 million teachers and 28.6 million adults are at high risk of severe COVID-19 due to age or chronic diseases. The study also highlights the need for comprehensive clinician mental health support in the post-pandemic era.
A new article by Dr. Ahmad Mourad explores how 'remote misses' in COVID-19 can create a false sense of invulnerability and security, potentially leading to increased risk. This phenomenon is linked to population-wide traumatic experiences and adaptive behavior.
The American College of Physicians and the American Academy of Family Physicians recommend treating acute pain from non-low back musculoskeletal injuries with topical NSAIDs, with or without menthol gel, as the first line of treatment. Topical NSAIDs were shown to be effective for pain reduction, physical function, treatment satisfacti...
A new clinical guideline recommends treating acute pain from non-low back musculoskeletal injuries with topical NSAIDs, suggesting against opioid use. The guideline focuses on effective treatments and suggests oral NSAIDs, acetaminophen, acupressure, or transcutaneous nerve stimulation for patients.
Researchers found that household contacts had a 1 in 10 chance of infection, while asymptomatic patients were less likely to infect close contacts. Patients with severe disease were more likely to spread COVID-19 to their close contacts.
A retrospective cohort study found obesity was a significant independent risk factor for death from COVID-19. Patients with high BMI were 4 times more likely to die within 21 days of diagnosis compared to those in the normal weight group.
Researchers found a 30% decrease in outpatient visits during the initial 10 weeks of the COVID-19 pandemic. The shift to virtual visits was partly offset by an increase in telephone and video visits, with over 10 million fewer in-person visits compared to previous years.
A new study published in Annals of Internal Medicine found that a substantial number of overdose deaths were misclassified as sudden cardiac deaths, leading to grossly underestimated national estimates of the opioid overdose burden. Meanwhile, another study provides real-world recommendations for overcoming telemedicine challenges with...
A new analysis of the CANTOS trial found that patients receiving canakinumab had significantly lower rates of total hip or total knee replacements over an average follow-up of 3.7 years. The study's findings are important as no treatments currently exist to prevent or slow osteoarthritis progression.
Researchers found that severe COVID-19 is associated with endotheliitis and microangiopathy, leading to a multisystem inflammatory syndrome similar to Kawasaki disease. Additionally, obesity in adults under 65 years old increases the risk of intubation or death from COVID-19, but not for those over 65.
A team of bioethicists from Johns Hopkins University emphasizes the need for informed consent in public health activities, including those related to COVID-19. The authors suggest that good governance of public health surveillance infrastructure is crucial to maintain public trust and prevent research abuses.
A comprehensive review of vaccine data over 20 years found vaccines to be remarkably safe, with most safety issues identified through existing postmarketing surveillance programs. The study confirms the effectiveness of the vaccine approval system and postmarketing surveillance in ensuring public health benefits while minimizing risks.
Researchers found that over 20% of US homes lack sufficient space and plumbing facilities to isolate or quarantine COVID-19 patients. The study suggests that offering hotel stays with medical supervision at no cost could decrease transmission in minority communities.
A reduced dose of prasugrel was found to be as effective as a standard dose of ticagrelor in reducing the risk of bleeding without increasing it, particularly in elderly or low-weight patients with acute coronary syndrome. This finding is based on a randomized trial that assessed efficacy and safety in nearly 4,000 patients.
A study published in Annals of Internal Medicine found that older patients and those with coexisting diseases were more likely to die from COVID-19. The 30-day cumulative mortality rate was 24.4% among hospitalized patients, with shortness of breath being the most prevalent symptom among those who died.
Researchers found SARS-CoV-2 RNA in a volunteer blood donor 40 days after resolution of COVID-19-like symptoms. This detection raises concerns about the risk to blood supply safety, as current guidelines do not recommend screening for SARS-CoV-2 in allogeneic donors.
A new randomized trial published in Annals of Internal Medicine found that hydroxychloroquine showed no benefit in reducing symptom severity or duration in outpatients with early, mild COVID-19. The study suggests that the treatment may not be effective in populations at higher risk for severe COVID-19.
A surgeon demonstrated telesurgery using robotic technology and a 5G network, performing remote operations on a cadaver patient from 15 km away. This was the first public demonstration of remote surgery over 5G. Researchers also explored albumin-creatinine ratio for CKD screening, staging, and prognosis.
Recent trials of COVID-19 treatments often use time to a positive outcome as a key endpoint, but this may not be suitable when death is a competing risk. The authors propose alternative methods for interpreting treatment effects in COVID-19 studies.
Researchers studied SARS-CoV-2 antibodies in 11,066 patients, finding they associate with clinical severity and provide valuable diagnostic support. Obesity is associated with worse COVID-19 outcomes in NYC cohort of 1,687 persons hospitalized with confirmed cases.
A new study suggests that early initiation of annual breast cancer screening with MRI and mammography may reduce breast cancer mortality by half or more in female childhood cancer survivors previously exposed to chest radiation. The findings highlight the importance of MRI in reducing deaths from breast cancer in this population.
Taiwan's universities share their experience in safely reopening colleges and universities, highlighting effective public health strategies. Immigrant physicians in the US face unique challenges due to visa status, affecting their families' health and safety.
Researchers suggest routine use of N95 respirators for inpatient COVID-19 care, citing existing data as evidence. Worldwide step count decreases have been seen during COVID-19, with regional variability reflecting adherence to social distancing measures.
A systematic review and network meta-analysis suggest metformin-based therapy as a preferred first-line treatment for drug-naive patients with type 2 diabetes at low cardiovascular risk. Insulin regimens and GLP-1 RAs added to metformin-based background therapy produced the greatest reductions in hemoglobin A1c level.
Researchers report a lower incidence of COVID-19 among HIV-positive patients receiving tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) therapy. Further investigation is warranted to understand the findings' implications for HIV preexposure prophylaxis and randomized trials.
A commentary from Beth Israel Deaconess Medical Center reviews basic respiratory physiology and highlights the clinician's role in educating the public against relying on speech as a sign of adequate respiration. Data from studies of war and torture victims show that suffocation is a strong predictor of posttraumatic stress disorder.