We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
This Week in JAMA |

This Week in JAMA FREE

JAMA. 2007;298(23):2711. doi:10.1001/jama.298.23.2711.
Text Size: A A A
Published online


Computed tomographic pulmonary angiography (CTPA) is an alternative to ventilation- perfusion (/) lung scanning to evaluate patients with suspected pulmonary embolism, but whether CTPA is as reliable and safe as / scanning for the initial patient evaluation is not clear. To examine this question, Anderson and colleaguesArticle randomly assigned patients with symptoms or signs associated with a high pretest probability of an acute pulmonary embolism to either CTPA or / scanning. Patients in whom pulmonary embolism was excluded by either procedure did not receive antithrombotic therapy, and the patients were followed up for 3 months to assess subsequent development of symptomatic pulmonary embolism or proximal deep vein thrombosis. The authors found that CTPA was not inferior to / scanning in ruling out pulmonary embolism. However, more patients were diagnosed with pulmonary embolism using CTPA. In an editorial, GlassrothArticle discusses clinical implications of the study findings and issues for further investigation.


Rapid activation of the cardiac catheterization laboratory based on an assessment of the initial diagnostic electrocardiogram by the emergency department physician can reduce door-to-balloon times in patients with ST-segment elevation myocardial infarction (STEMI). However, rapid catheterization laboratory activation may result in some patients undergoing angiography who do not need acute reperfusion therapy (“false-positives”). To determine the prevalence of false-positive catheterization laboratory activation—defined as no culprit coronary artery, no significant coronary artery disease, or negative cardiac biomarker results—Larson and colleaguesArticle reviewed regional registry data from 1335 patients with suspected STEMI who had undergone angiography. The authors found that the frequency of false-positive catheterization laboratory activation was common, ranging from 9.2% to 14%, depending on the definition used. In an editorial, MasoudiArticle discusses the need to assess both the positive and negative consequences of quality improvement efforts.


Women with low bone mineral density (BMD) and prevalent vertebral fractures are at increased risk of incident vertebral fractures, but the absolute risk of fractures over the long-term is not known. Cauley and colleagues analyzed data from the longitudinal Study of Osteoporotic Fractures to assess the absolute risk of incident vertebral fracture by BMD and prevalent vertebral fracture status. In their analysis of data from 2680 women who attended the 15th-year visit and who had a mean age at baseline of 68.8 years, the authors found that women with a prevalent vertebral fracture and osteoporosis by BMD had an absolute risk of incident vertebral fracture of 56%. Among women without prevalent vertebral fractures and normal BMD, the absolute risk of incident vertebral fracture was 9%.


Symptoms, pathophysiology, and catheter ablation treatment of supraventricular arrhythmias.


“I have never been particularly close to my father, but the process of sharing an organ with him changed our relationship dramatically.” From “Giving Back.”


Community-based efforts to curb obesity are enlisting schools, businesses, families, restaurants, grocery stores, and local government to play a role in encouraging healthful behaviors.


Lethal injection and physicians

Nonpayment for hospital-acquired harms

Market distortions in health care


Authors are invited to submit manuscripts for an upcoming theme issue.


Exploring the dangerous trades with Dr Alice Hamilton


How would you manage a 39-year-old man with erythema and swelling of a finger? Go to www.jama.com to read the case and submit your response by December 26. Your response may be selected for online publication.


For your patients: Information about atrial fibrillation.



Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.