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Heterogeneity in Obesity Prevalence Among Asian American Adults
Nilay S. Shah, MD, MPH , Cecily Luncheon, MD, DrPH , Namratha R. Kandula, MD, MPH , Sadiya S. Khan, MD, MSc , Liping Pan, MD, MPH , Cathleen Gillespie, MS , Fleetwood Loustalot, PhD, FNP , and Jing Fang, MD, MS
doi : 10.7326/M22-0609
November 2022Volume 175, Issue 11
Obesity increases the risk for metabolic and cardiovascular disease, and this risk occurs at lower body mass index (BMI) thresholds in Asian adults than in White adults. The degree to which obesity prevalence varies across heterogeneous Asian American subgroups is unclear because most obesity estimates combine all Asian Americans into a single group.
Characteristics of Persons Screened for Lung Cancer in the United States
Gerard A. Silvestri, MD, MS , Lenka Goldman, MSE , Judy Burleson, MHSA , Michael Gould , Ella A. Kazerooni, MD, MS , Peter J. Mazzone, MD, MPH , M. Patricia Rivera, MD , V. Paul Doria-Rose, DVM, PhD , Lauren S. Rosenthal, MPH , Michael Simanowith, MD , Robert A. Smith, PhD , Nichole T. Tanner, MD, MSCR , and Stacey Fedewa, PhD
doi : 10.7326/M22-1325
Lung cancer screening (LCS) with low-dose computed tomography (LDCT) was recommended by the U.S. Preventive Services Task Force (USPSTF) in 2013, making approximately 8 million Americans eligible for screening. The demographic characteristics and adherence of persons screened in the United States have not been reported at the population level.
Apixaban Versus Rivaroxaban in Patients With Atrial Fibrillation and Valvular Heart Disease
Ghadeer K. Dawwas, MSc, MBA, PhD , Adam Cuker, MD, MS , Geoffrey D. Barnes, MD, MSc , James D. Lewis, MD, MSCE , and Sean Hennessy, PharmD, PhD
doi : 10.7326/M22-0318
Although apixaban and rivaroxaban are commonly used in patients with atrial fibrillation (AF) and valvular heart disease (VHD), there is limited evidence comparing the 2 drugs in these patients.
Comparative Effectiveness and Safety Between Apixaban, Dabigatran, Edoxaban, and Rivaroxaban Among Patients With Atrial Fibrillation
Wallis C.Y. Lau, PhD* , Carmen Olga Torre, MSc* , Kenneth K.C. Man, PhD , Henry Morgan Stewart, PhD , Sarah Seager, BA , Mui Van Zandt, BSc , Christian Reich, MD , Jing Li, MS , Jack Brewster, PhD , Gregory Y.H. Lip, MD , Aroon D. Hingorani, PhD , Li Wei, PhD , and Ian C.K. Wong, PhD
doi : 10.7326/M22-0511
Current guidelines recommend using direct oral anticoagulants (DOACs) over warfarin in patients with atrial fibrillation (AF), but head-to-head trial data do not exist to guide the choice of DOAC.
15-Year Benefits of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality
Frederik E. Juul, MD ,  Amanda J. Cross, PhD ,  Robert E. Schoen, MD, MPH ,  Carlo Senore, MD, MSc ,  Paul Pinsky, PhD ,  Eric Miller, PhD ,  Nereo Segnan, MD, MSc ,  Kate Wooldrage, PhD ,  Paulina Wieszczy-Szczepanik, PhD ,  Paola Armaroli, MD, MSc ,  Kjetil K. Garborg, MD, PhD ,  Hans-Olov Adami, MD, PhD ,  Geir Hoff, MD, PhD, MBChB ,  Mette Kalager, MD, PhD ,  Michael Bretthauer, MD, PhD ,  Magnus Løberg, MD, PhD* ,  and Øyvind Holme, MD, PhD*
doi : 10.7326/M22-0835
The effectiveness of screening for colorectal cancer (CRC) by sex and age in randomized trials is uncertain.
Ticagrelor–Aspirin Versus Clopidogrel–Aspirin Among CYP2C19 Loss-of-Function Carriers With Minor Stroke or Transient Ischemic Attack in Relation to Renal Function: A Post Hoc Analysis of the CHANCE-2 Trial
Anxin Wang, PhD* ,  Xuewei Xie, MD, PhD* ,  Xue Tian, PhD ,  S. Claiborne Johnston, MD, PhD ,  Hao Li, MD, PhD ,  Philip M. Bath, DSc ,  Yingting Zuo, PhD ,  Jing Jing, MD, PhD ,  Jinxi Lin, MD, PhD ,  Yilong Wang, MD, PhD ,  Xingquan Zhao, MD, PhD ,  Zixiao Li, MD, PhD ,  Yong Jiang, MD, PhD ,  Liping Liu, MD, PhD ,  Xia Meng, MD ,  and Yongjun Wang, MD
doi : 10.7326/M22-1667
Evidence on the risk–benefit ratio of dual antiplatelet therapies among patients with stroke and impaired renal function is limited and inconsistent.
Challenged Urine Bicarbonate Excretion as a Measure of Cystic Fibrosis Transmembrane Conductance Regulator Function in Cystic Fibrosis
Peder Berg, MD ,  Mads V. Sorensen, PhD ,  Amalie Quist Rousing, BM ,  Hanne Vebert Olesen, MD ,  Søren Jensen-Fangel, DMSc ,  Majbritt Jeppesen, MD* ,  and Jens Leipziger, DMSc
doi : 10.7326/M22-1741
In cystic fibrosis (CF), renal base excretion is impaired. Accordingly, challenged urine bicarbonate excretion may be an in vivo biomarker of cystic fibrosis transmembrane conductance regulator (CFTR) function.
Vitamin D Deficiency Increases Mortality Risk in the UK Biobank
Joshua P. Sutherland, BHSc Nut Med (Hons) ,  Ang Zhou, PhD ,  and Elina Hyppönen, PhD
doi : 10.7326/M21-3324
Low vitamin D status is associated with increased mortality, but randomized trials on severely deficient participants are lacking.
The Impact of the COVID-19 Pandemic and Associated Control Measures on the Mental Health of the General Population
Georgia Salanti, PhD* ,  Natalie Peter, MD* ,  Thomy Tonia, MSc* ,  Alexander Holloway, MSc* ,  Ian R. White, PhD ,  Leila Darwish, MS ,  Nicola Low, MD ,  Matthias Egger, MD ,  Andreas D. Haas, PhD ,  Seena Fazel, MD ,  Ronald C. Kessler, PhD ,  Helen Herrman, MD ,  Christian Kieling, MD ,  Dominique J.F. De Quervain, MD ,  Simone N. Vigod, MD ,  Vikram Patel, MD ,  Tianjing Li, PhD ,  Pim Cuijpers, PhD ,  Andrea Cipriani, MD ,  Toshi A. Furukawa, MD ,  and Stefan Leucht, MD , and the MHCOVID Crowd Investigators†, Abdulkadir Usman Sambo, MBBS , Akira Onishi, MD , Akira Sato, MD, MScPH , Alessandro Rodolico, MD , Ana Cristina de Oliveira Solis, PhD , Anastasia Antoniou, MSc , Angelika Kapfhammer, MD , Anna Ceraso, MD , Aoife O’Mahony, MSc , Aurélie M. Lasserre, MD, PhD , Aziz Mert Ipekci, MD, MPH , Carmen Concerto, MD, PhD , Caroline Zangani, MD , Chinonso Igwesi-Chidobe, PhD , Christina Diehm, MD , Dicle Dilay Demir, MD , Dongfang Wang, MMed , Edoardo Giuseppe Ostinelli, MD , Ethan Sahker, PhD , Gabriel Henrique Beraldi, MD , Gamze Erzin, MD , Harrison Nelson , Helio Elkis, MD, PhD , Hissei Imai, PhD , Hui Wu, MD , Ilias Kamitsis, PhD , Ioannis Filis, MD , Ioannis Michopoulos, MD, PhD , Irene Bighelli, PhD , James S.W. Hong, MBBS , Javier Ballesteros, PhD , Katharine A. Smith, MD, PhD , Kazufumi Yoshida, MD, MSc , Kenji Omae, MD, DrPH , Marialena Trivella, DPhil , Masafumi Tada, MD , Matthias A. Reinhard, MD , Michael J. Ostacher, MD, MPH, MMSc , Monika Müller, MD, PhD , Nathalia Gonzalez Jaramillo, MD, MSc , Panagiotis P. Ferentinos, PhD , Rie Toyomoto, MHS , Samuele Cortese, MD, PhD , Sanae Kishimoto, MHS, MPH , Sergio A. Covarrubias-Castillo, MD , Spyridon Siafis, MD , Trevor Thompson, PhD , Vasilios Karageorgiou, MD , Virginia Chiocchia, MSc , Yikang Zhu, MD , Yukiko Honda, MPH, DrPH
doi : 10.7326/M22-1507
To what extent the COVID-19 pandemic and its containment measures influenced mental health in the general population is still unclear.
Effectiveness of Opioid Analgesic Medicines Prescribed in or at Discharge From Emergency Departments for Musculoskeletal Pain
Caitlin M.P. Jones, B Occ Thy (Hons) , Chung-Wei Christine Lin, PhD , Masoud Jamshidi, MClinExPhys , Christina Abdel Shaheed, PhD , Christopher G. Maher, DMedSc , Ian A. Harris, PhD , Asad E. Patanwala, PharmD , Michael Dinh, PhD , and Stephanie Mathieson, PhD
doi : 10.7326/M22-2162
The comparative benefits and harms of opioids for musculoskeletal pain in the emergency department (ED) are uncertain.
Evaluation of Harms Reporting in U.S. Cancer Screening Guidelines
Aruna Kamineni, PhD, MPH* , V. Paul Doria-Rose, DVM, PhD* , Jessica Chubak, PhD , John M. Inadomi, MD , Douglas A. Corley, MD, PhD , Jennifer S. Haas, MD, MSc , Sarah C. Kobrin, PhD, MPH , Rachel L. Winer, PhD , Jennifer Elston Lafata, PhD , Elisabeth F. Beaber, PhD, MPH , Joshua S. Yudkin, MPH , Yingye Zheng, PhD , Celette Sugg Skinner, PhD , Joanne E. Schottinger, MD , Debra P. Ritzwoller, PhD , Jennifer M. Croswell, MD, MPH , and Andrea N. Burnett-Hartman, PhD, MPH
doi : 10.7326/M22-1139
Cancer screening should be recommended only when the balance between benefits and harms is favorable. This review evaluated how U.S. cancer screening guidelines reported harms, within and across organ-specific processes to screen for cancer.
Environmental Health: A Position Paper From the American College of Physicians
Ryan Crowley, BSJ , Suja Mathew, MD , and David Hilden, MD, MPH , for the Health and Public Policy Committee of the American College of Physicians
doi : 10.7326/M22-1864
Environmental health refers to the health effects associated with environmental factors, such as air pollution, water contamination, and climate change. Environmental hazards are associated with poor outcomes in common diseases, including diabetes and heart disease.
Supporting the Health and Well-Being of Indigenous Communities: A Position Paper From the American College of Physicians
Josh Serchen, BA , Suja Mathew, MD , David Hilden, MD, MPH , Molly Southworth, MD, MPH , and Omar Atiq, MD
doi : 10.7326/M22-1891
Indigenous peoples in the United States experience many health disparities and barriers to accessing health care services. In addition, Indigenous communities experience poor social drivers of health, including disproportionately high rates of food insecurity, violence, and poverty, among others.
Health Care and Climate Change: Challenges and Pathways to Sustainable Health Care
Sarju Ganatra, MD , Sourbha S. Dani, MD, MSc , Sadeer G. Al-Kindi, MD , and Sanjay Rajagopalan, MD
doi : 10.7326/M22-1241
Lightning: Another Climate Change Threat
Thomas G. DeLoughery, MD Â and Danielle A. Cunningham, MD
doi : 10.7326/M22-1635
In These Uncaring Times, Will Physicians Lead Us Back to Our Better Angels?
Robert B. Doherty, BA
doi : 10.7326/M22-2196
Using Body Mass Index to Identify and Address Obesity in Asian Americans: One Size Does Not Fit All
Christina C. Wee, MD, MPH
doi : 10.7326/M22-2624
Lessons From Implementation of the U.S. Preventive Services Task Force Recommendations for Lung Cancer Screening
Karina W. Davidson, PhD, MASc
doi : 10.7326/M22-2886
Cancer Screening Guidelines Are Not Simple, But They Could Be Less Complex
Russell P. Harris, MD, MPH  and Linda S. Kinsinger, MD, MPH
doi : 10.7326/M22-2599
Environmental Health: Translating Policy Into Action
Emily Senay, MD, MPH Â and Andrew Hantel, MD
doi : 10.7326/M22-2808
How Do Implicit Bias and Stereotype Threat Affect Mental Health Care for a Student of Color?
Chukwuemeka N. Uwakaneme, BA
doi : 10.7326/M22-0934
Effectiveness of a Fourth Dose of COVID-19 mRNA Vaccine Against Omicron Variant Among Elderly People in Singapore
Celine Y. Tan, MBBS , Calvin J. Chiew, MPH , Vernon J. Lee, PhD , Benjamin Ong, MBBS , David Chien Lye, MBBS , Kelvin Bryan Tan, PhD
doi : 10.7326/M22-2042
Prevalence and Correlates of Patient Rationing of Insulin in the United States: A National Survey
Adam Gaffney, MD, MPH , David U. Himmelstein, MD , Steffie Woolhandler, MD, MPH
doi : 10.7326/M22-2477
Monkeypox Virus–Associated Severe Proctitis Treated With Oral Tecovirimat: A Report of Two Cases
Jose Lucar, MD , Afsoon Roberts, MD , Karl M. Saardi, MD , Rebecca Yee, PhD , Marc O. Siegel, MD , Tara N. Palmore, MD
doi : 10.7326/L22-0300
Risks for Anaphylaxis With Intravenous Iron Formulations
Hanny Al-Samkari, MD , John A. Glaspy, MD , Robert T. Means Jr., MD , Glenn M. Chertow, MD, MPH , Michael Auerbach, MD
doi : 10.7326/L22-0282
Risks for Anaphylaxis With Intravenous Iron Formulations
Chintan V. Dave, PharmD, PhD , Gary M. Brittenham, MD , Jeffrey L. Carson, MD , Soko Setoguchi, MD, DrPH
doi : 10.7326/L22-0283
Changes in Health Care Spending, Use, and Clinical Outcomes After Nonfatal Firearm Injuries Among Survivors and Family Members
Alan R. Ertle, MD, MPH, MBA
doi : 10.7326/L22-0266
Affirmative Action Bans and Enrollment of Students From Underrepresented Racial and Ethnic Groups in U.S. Public Medical Schools
Michael Zema, MD
doi : 10.7326/L22-0296
Affirmative Action Bans and Enrollment of Students From Underrepresented Racial and Ethnic Groups in U.S. Public Medical Schools
Dan P. Ly, MD, PhD, MPP , Anupam B. Jena, MD, PhD
doi : 10.7326/L22-0297
Correction: Update Alert 8: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings
doi : 10.7326/L22-0373
Correction: Risk for Recurrent Venous Thromboembolism and Bleeding With Apixaban Compared With Rivaroxaban and Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation
doi : 10.7326/L22-0406
Preoperative Evaluation for Noncardiac Surgery
Kunjam Modha, MD , Christopher Whinney, MD
doi : 10.7326/AITC202211150
The previous In the Clinic that addressed preoperative evaluation for noncardiac surgery was published in December 2016. This update reaffirms much of the information in the previous version and provides new information that has accumulated since then. The goal of preoperative assessment is to identify the risk for postoperative complications so health care teams can more fully understand how to implement strategies to mitigate risks before and after the operation.
Recommendations for pharmacologic management of IBS with constipation
Xavier Calvet, MD
doi : 10.7326/J22-0086
Recommendations for pharmacologic management of IBS with diarrhea
Xavier Calvet, MD
doi : 10.7326/J22-0087
Update of the American Gastroenterological Association (AGA) guideline on the pharmacologic management of adults with irritable bowel syndrome with diarrhea (IBS-D).
In acute ischemic stroke, early IV tenecteplase was noninferior to alteplase for excellent functional outcome
Emma Ferguson, MBBS , Eddy Lang, MD
doi : 10.7326/J22-0090
In adults with acute ischemic stroke causing disabling neurologic deficit, is early IV tenecteplase noninferior to IV alteplase for excellent functional outcome at 90 to 120 days?
In acute ischemic stroke, thrombectomy was not noninferior to alteplase + thrombectomy for 90-d functional independence
Anthony A. Donato, MD, MHPE , Vaibhav Goswami, MD
doi : 10.7326/J22-0088
In acute ischemic stroke, is thrombectomy alone noninferior to IV alteplase plus thrombectomy for functional independence at 90 days?
In ASCVD, moderate-intensity statin + ezetimibe was noninferior to high-intensity statin alone at 3 y
Michelle D. Kelsey, MD , L. Kristin Newby, MD, MHS
doi : 10.7326/J22-0085
In patients with atherosclerotic cardiovascular disease (ASCVD), what are the long-term efficacy and safety of a moderate-intensity statin plus ezetimibe vs. high-intensity statin monotherapy?
In hospitalized adults with fever, fever therapy does not reduce mortality or serious adverse events
Natalia Ovtcharenko, MD , Simon Oczkowski, MD, MSc, MHSc
doi : 10.7326/J22-0081
In adults with fever, does fever therapy reduce mortality and serious adverse events (SAEs)?
In acutely ill inpatients, benefits and harms of anticoagulants for VTE prophylaxis were assessed
Sudeep Shivakumar, MD, MPH
doi : 10.7326/J22-0089
Searched multiple databases to Nov 2021 for randomized controlled trials (RCTs) that compared anticoagulants (low- or intermediate-dose low-molecular-weight heparin [LMWH], low- or intermediate-dose unfractionated heparin [UFH], pentasaccharides, or direct oral anticoagulants [DOACs]) with each other, placebo, or no intervention for preventing VTE in hospitalized adults who were acutely ill.
In adults using oral anticoagulants, PPI use may be associated with lower risk for upper GI bleeding
Daniel J. Stein, MD, MPH , Joseph D. Feuerstein, MD
doi : 10.7326/J22-0084
Multiple databases searched to Apr 2021 for English-language randomized controlled trials (RCTs) and observational studies that compared antisecretory drugs (proton-pump inhibitors [PPIs] or H2-receptor antagonists [H2RAs]) with placebo, no therapy, or each other for reducing overt upper GI bleeding in adults using warfarin or direct oral anticoagulants.
In degenerative meniscal tears, PT was noninferior to arthroscopic partial meniscectomy for knee function at 5 y
David J. Hunter, MBBS, PhD
doi : 10.7326/J22-0083
Treatment allocation concealed; blinded (radiologist and data analysts).*
In asymptomatic adults, a COVID-19 Ag-RDT with combined nasal and throat samples had 82% to 89% positive percent agreement
Thomas Fekete, MD
doi : 10.7326/J22-0082
Blinded comparison of the Abbot Panbio Ag-RDT with reverse transcriptase polymerase chain reaction (RT-PCR) test. Samples were collected over a 7-day period in Jan 2022.
Annals Graphic Medicine - Dr. Mom: The Thrill of Working in the Hospital Where I Was Born
Grace E. Farris, MD
doi : 10.7326/G22-0053
Annals for Hospitalists Inpatient Notes - Managing Alcohol Withdrawal Syndrome in the Hospital Setting�A Call for Research
Tessa L. Steel, MD, MPH
doi : 10.7326/M22-2864
