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  • ACE Inhibitors of Little Benefit to Kidney Transplant Patients

    Abstract Full Text
    JAMA. 2015; 314(24):2608-2608. doi: 10.1001/jama.2015.17189
  • JAMA July 28, 2015

    Figure 1: Publicly Reported Process-of-Care and Outcome Measures by Hospital Quality Summary Score

    A, Process-of-care measures were defined as follows: AMI-10: patient with acute myocardial infarction (AMI) prescribed statin at discharge; HF-1: patient with heart failure (HF) received discharge instructions; HF-3: patient with heart failure with left ventricular systolic dysfunction received an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker; PN-6: patient with pneumonia given appropriate initial antibiotic; SCIP-CARD-2: preoperative β-blocker continued perioperatively; SCIP-INF-3: prophylactic antibiotics discontinued within 24 hours after surgery; and SCIP-INF-9: urinary catheter removed in surgical patients within 2 days postoperatively. B, Mortality measures included 30-day mortality from AMI, heart failure, and pneumonia. P < .001 for all examined measures using the Cuzick extension of Wilcoxon rank-sum test for trend across ordered hospital quality summary score categories with the following exceptions: HF-3 (P = .01) and SCIP-INF-3 (P = .36). Sensitivity analyses with 6 alternative hospital quality summary scores were also performed using the composites shown in eTable 4 in the Supplement. For all 10 measures examined, P < .05 using the Cuzick extension of Wilcoxon rank-sum test for trend with the following exceptions: SCIP-INF-9, composite score C = .06; and SCIP-INF-3, composite score B = .34; composite score C = .47; composite score D = .08; composite score E = .72; and composite score F = .06. Please see the Methods for details about the hospital quality summary score. Means and standard deviations for each measure for every hospital quality summary score category are in eTable 3 in the Supplement.
  • Association Between Physician Time-Unlimited vs Time-Limited Internal Medicine Board Certification and Ambulatory Patient Care Quality

    Abstract Full Text
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    JAMA. 2014; 312(22):2358-2363. doi: 10.1001/jama.2014.13992

    This retrospective analysis reports that there were no significant differences between physicians with time-limited vs time-unlimited board certification on 10 primary care performance measures.

  • JAMA June 4, 2014

    Figure: Unadjusted Kaplan-Meier Estimates of Mortality, and Cox Model-Derived Adjusted Mortality Rates, for Patients With an LVEF Between 30% and 35% With and Without an Implantable Cardioverter-Defibrillator (ICD)

    Adjusted rates, hazard ratios, and P values are from Cox models that include age, sex, race, left ventricular ejection fraction, ischemic heart disease, prior atrial arrhythmia, systolic blood pressure, diabetes, hypertension, and baseline use of angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blocker, digoxin, diuretic, or statin.
  • 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)

    Abstract Full Text
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    JAMA. 2014; 311(5):507-520. doi: 10.1001/jama.2013.284427

    In the report from the panel members appointed to the Eighth Joint National Committee (JNC 8), the guideline authors provide evidence-based recommendations for the management of hypertension including specific goals by age, race, and comorbidities.

  • JAMA February 5, 2014

    Figure: 2014 Hypertension Guideline Management Algorithm

    SBP indicates systolic blood pressure; DBP, diastolic blood pressure; ACEI, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; and CCB, calcium channel blocker.aACEIs and ARBs should not be used in combination.bIf blood pressure fails to be maintained at goal, reenter the algorithm where appropriate based on the current individual therapeutic plan.
  • JAMA August 21, 2013

    Figure: HRs of Incident CHD by Race and ACR

    White participants with an albumin-to-creatinine ratio (ACR) of less than 10 mg/g are the reference standard. Error bars indicate 95% CIs for hazard ratios (HRs) of incident coronary heart disease (CHD). The multivariable model was adjusted for age, sex, geographic region of residence, income, education, health insurance coverage, waist circumference, systolic blood pressure, total and high-density lipoprotein cholesterol, triglycerides, estimated glomerular filtration rate, C-reactive protein, diabetes, smoking status, physical activity, regular aspirin use, use of statins, and use of any antihypertensive medications, angiotensin II receptor blockers, or angiotensin-converting enzyme inhibitors.
  • JAMA June 15, 2011

    Figure 1: Multivariable-Adjusted Hazard Function for Death According to Measured (Untransformed) Levels of Fibroblast Growth Factor 23

    The median fibroblast growth factor 23 (FGF-23) level within the lowest FGF-23 quartile (74 RU/mL) served as the referent value (hazard = 1.0). The model was stratified by center and adjusted for age; sex; race; ethnicity; estimated glomerular filtration rate; natural log-transformed urine albumin-to-creatinine ratio; hemoglobin; serum albumin; systolic blood pressure; body mass index; diabetes; smoking status; low-density lipoprotein; history of coronary artery disease, congestive heart failure, stroke, and peripheral vascular disease; use of aspirin, β-blockers, statins, and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers; and serum calcium, phosphate, and natural log-transformed parathyroid hormone. Tick marks on the x-axis indicate individual observations at corresponding levels of FGF-23. The solid black line represents the multivariable-adjusted hazard of mortality as a function of the measured (nontransformed) FGF-23 level. The dashed lines indicate the 95% confidence intervals.
  • JAMA December 1, 2010

    Figure 3: Analyses of Primary End Point in Paroxysmal Atrial Fibrillation Subgroup

    Analyses were performed using a Cox proportional hazards model fitting separate model for each subgroup. ACEI, indicates angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; CI, confidence interval; and HR, hazard ratio.
  • Nephrology Visits and Health Care Resource Use Before and After Reporting Estimated Glomerular Filtration Rate

    Abstract Full Text
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    JAMA. 2010; 303(12):1151-1158. doi: 10.1001/jama.2010.303
  • The Importance of Biodiversity to Medicine

    Abstract Full Text
    JAMA. 2008; 300(19):2297-2299. doi: 10.1001/jama.2008.655
  • JAMA May 21, 2008

    Figure: CCB/ACE Inhibitor Dual Therapy for Hypertension Lowers Cardiovascular Risk

    A low-cost combination therapy that includes a calcium-channel blocker and an angiotensin-converting enzyme inhibitor may provide the best control of stage 2 hypertension while reducing risk for cardiovascular events.
  • CCB/ACE Inhibitor Dual Therapy for Hypertension Lowers Cardiovascular Risk

    Abstract Full Text
    JAMA. 2008; 299(19):2263-2264. doi: 10.1001/jama.299.19.2263
  • Decline in Rates of Death and Heart Failure in Acute Coronary Syndromes, 1999-2006

    Abstract Full Text
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    JAMA. 2007; 297(17):1892-1900. doi: 10.1001/jama.297.17.1892
  • JAMA May 2, 2007

    Figure 1: Temporal Trends in Patients With ST-Segment Elevation Myocardial Infarction or Left Bundle-Branch Block, July 1999-December 2005

    The sample size of the ST-segment elevation myocardial infarction cohort varied over time. Percentages are based on eligible patients for respective treatments in each period, shown in Table 2 for the first and last periods. ACEI indicates angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; CABG, coronary artery bypass graft; Gp, glycoprotein; LMWH, low-molecular-weight heparin; PCI, percutaneous coronary intervention; UFH, unfractionated heparin.
  • JAMA May 2, 2007

    Figure 3: Temporal Trends in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes, July 1999-December 2005

    The sample size of the ST-segment elevation myocardial infarction cohort varied over time. Percentages are based on eligible patients for respective treatments in each period, shown in Table 2 for the first and last periods. ACEI indicates angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; CABG, coronary artery bypass graft; GP, glycoprotein; LMWH, low-molecular-weight heparin; PCI, percutaneous coronary intervention; UFH, unfractionated heparin.
  • JAMA March 14, 2007

    Figure 2: Financial Barriers to Health Care Services and Health Outcomes at 1-Year Follow-up, With Incremental Risk Adjustment Models

    Error bars indicate confidence intervals (CIs). Demographics: age, sex, and race; clinical: diabetes mellitus, hypertension, tobacco smoking, coronary artery disease (prior acute myocardial infarction [AMI], coronary artery bypass graft surgery, or percutaneous coronary intervention), ST-elevation MI vs non–ST-elevation MI, a prognostic risk score from the Cooperative Cardiovascular Project that included cardiac arrest, anterior or lateral location of AMI, systolic blood pressure, white blood cell count, creatinine level, and heart failure; inpatient care: coronary angiography, coronary revascularization, number of eligible quality-of-care indicators received (aspirin at arrival/discharge, angiotensin-converting enzyme inhibitor for left ventricular systolic dysfunction at discharge, smoking cessation instructions, β-blocker at arrival/discharge), and percentage of eligible indicators received. SAQ indicates Seattle Angina Questionnaire; SF, Short Form; PCS, physical component score; MCS, mental component score.*Baseline health status (included).
  • JAMA March 14, 2007

    Figure 3: Financial Barriers to Medication and Health Outcomes at 1-Year Follow-up, With Incremental Risk Adjustment Models

    Error bars indicate confidence intervals (CIs). Demographics: age, sex, and race; clinical: diabetes mellitus, hypertension, tobacco smoking, coronary artery disease (prior acute myocardial infarction [AMI], coronary artery bypass graft surgery, or percutaneous coronary intervention), ST-elevation MI vs non–ST-elevation MI, a prognostic risk score from the Cooperative Cardiovascular Project that included cardiac arrest, anterior or lateral location of AMI, systolic blood pressure, white blood cell count, creatinine level, and heart failure; inpatient care: coronary angiography, coronary revascularization, number of eligible quality-of-care indicators received (aspirin at arrival/discharge, angiotensin-converting enzyme inhibitor for left ventricular systolic dysfunction at discharge, smoking cessation instructions, β-blocker at arrival/discharge), and percentage of eligible indicators received. SAQ indicates Seattle Angina Questionnaire; SF, Short Form; PCS, physical component score; MCS, mental component score.*Baseline health status (included).
  • Association Between Performance Measures and Clinical Outcomes for Patients Hospitalized With Heart Failure

    Abstract Full Text
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    JAMA. 2007; 297(1):61-70. doi: 10.1001/jama.297.1.61