Information sourced from NEJM Journal Watch:
NEJM Journal Watch General Medicine Year in Review 2014
Allan S. Brett, MD
The most important medical topics of 2014, as chosen by the editors of NEJM Journal Watch General Medicine.
Each year, the editors of NEJM Journal Watch General Medicine choose the year's most important thematic areas in clinical research. We try to strike a balance among relevance to primary care, recognition of landmark studies, and acknowledgment of media publicity and public awareness. Some of our stories emerge from one important study, and others come from several studies on a single topic. The order of these stories is not intended to reflect their relative importance. All citations refer to 2014, unless otherwise noted. Readers might wonder why the Ebola epidemic — arguably the biggest medical story of the year — isn't included among our topics for the 2014 Year-in-Review feature. Our editors decided to pass on an Ebola review for two reasons. First, our reviews usually are built on clinical trials, guidelines, or other medical investigations that are relevant to the daily practice of generalist clinicians; journal coverage of Ebola doesn't really fit that paradigm. And second, the epidemiology and politics of the Ebola epidemic were so well covered by the media that we believe our readers already are well informed about the unfolding Ebola story in 2014.
Our Year in Review topics for 2014:
A New Era Unfolds in HCV Treatment
[Lawitz E et al. Simeprevir plus sofosbuvir, with or without ribavirin, to treat chronic infection with hepatitis C virus genotype 1 in non-responders to pegylated interferon and ribavirin and treatment-naive patients: The COSMOS randomised study. Lancet 2014 Jul 28. PubMed® abstract]
[Afdhal N et al. Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection. N Engl J Med 2014 May 15. Full-text NEJM article PDF | PubMed® abstract]
[Kowdley KV et al. Ledipasvir and sofosbuvir for 8 to 12 weeks for chronic HCV without cirrhosis. N Engl J Med 2014 Apr 11. Full-text NEJM article PDF | PubMed® abstract]
[Feld JJ et al. Treatment of HCV with ABT-450/r–ombitasvir and dasabuvir with ribavirin. N Engl J Med 2014 Apr 24; 370:1594. Full-text NEJM article PDF | PubMed® abstract]
[Zeuzem S et al. Retreatment of HCV with ABT-450/r–ombitasvir and dasabuvir with ribavirin. N Engl J Med 2014 Apr 24; 370:1604. Full-text NEJM article PDF | PubMed® abstract]
[Poordad F et al. ABT-450/r–ombitasvir and dasabuvir with ribavirin for hepatitis C with cirrhosis. N Engl J Med 2014 Apr 12. Full-text NEJM article PDF | PubMed® abstract]
Fecal DNA Testing: Finally Ready for Prime Time?
[Imperiale TF et al. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med 2014 Mar 19. Full-text NEJM article PDF | PubMed® abstract]
Has Risk for Contrast-Induced Nephropathy Been Exaggerated?
[McDonald JS et al. Risk of intravenous contrast material-mediated acute kidney injury: A propensity score-matched study stratified by baseline-estimated glomerular filtration rate. Radiology 2014 Apr; 271:65. PubMed® abstract]
[McDonald RJ et al. Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality. Radiology 2014 Dec;273(3):714-25. Full-text Radiology article PDF | PubMed® abstract]
JNC 8: Raising the Blood Pressure (and Ire) of Many
[James PA et al. 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). JAMA Dec 18. JNC 8 Guideline PDF at JAMA | PubMed® abstract]
What Is an Ounce of Cardiovascular Prevention Worth?
[Ikeda Y et al. Low-dose aspirin for primary prevention of cardiovascular events in Japanese patients 60 years or older with atherosclerotic risk factors: A randomized clinical trial. JAMA 2014 Dec 17. PubMed® abstract]
[Muhlestein JB et al. Effect of screening for coronary artery disease using CT angiography on mortality and cardiac events in high-risk patients with diabetes: The FACTOR-64 randomized clinical trial. JAMA 2014 Dec 3. PubMed® abstract]
Proactive Palliative Care and Hospice Consultation Benefit Patients at the End of Life
[Zimmermann C et al. Early palliative care for patients with advanced cancer: A cluster-randomised controlled trial. Lancet 2014 May 17. PubMed® abstract]
[Seow H et al. Impact of community based, specialist palliative care teams on hospitalisations and emergency department visits late in life and hospital deaths: A pooled analysis. BMJ 2014 Jun 6; 348:g3496. Full-text BMJ article PDF in PubMed® Central | PubMed® abstract]
[Obermeyer Z et al. Association between the Medicare hospice benefit and health care utilization and costs for patients with poor-prognosis cancer. JAMA 2014 Nov 12; 312:1888.
Full-text JAMA article PDF in PubMed® Central | PubMed® abstract]
[Binney ZO et al. Feasibility and economic impact of dedicated hospice inpatient units for terminally ill ICU patients. Crit Care Med 2014 May; 42:1074. PubMed® abstract]
When Is Conservative Treatment Better? Nearly Always, for Some Patients with Chronic Orthopedic Pain
[Sihvonen R et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med 2013 Dec 26; 369:2515. Full-text NEJM article PDF | PubMed® abstract]
[Khan M et al. Arthroscopic surgery for degenerative tears of the meniscus: A systematic review and meta-analysis. CMAJ 2014 Oct 7. Full-text CMAJ article PDF in PubMed® Central | PubMed® abstract]
[Friedly JL et al. A randomized trial of epidural glucocorticoid injections for spinal stenosis. N Engl J Med 2014 Jul 3; 371:11. Full-text NEJM article PDF | PubMed® abstract]
[Cohen SP et al. Epidural steroid injections, conservative treatment, or combination treatment for cervical radicular pain: A multicenter, randomized, comparative-effectiveness study. Anesthesiology 2014 Nov; 121:1045. PubMed® abstract]
Direct Oral Anticoagulants Are Safe and Effective Compared with Warfarin
[Ruff CT et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: A meta-analysis of randomised trials. Lancet 2014 March 15. PubMed® abstract]
[Liew A et al. Comparing mortality in patients with atrial fibrillation who are receiving a direct-acting oral anticoagulant or warfarin: A meta-analysis of randomized trials. J Thromb Haemost 2014 Sep; 12:1419. PubMed® abstract]
[Van Es N et al. Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: Evidence from phase 3 trials. Blood 2014 Sep 18; 124:1968. Full-text Blood article PDF | PubMed® abstract]
[Sardar P et al. New oral anticoagulants in elderly adults: Evidence from a meta-analysis of randomized trials. J Am Geriatr Soc 2014 May; 62:857. PubMed® abstract]
New Developments in Cardiovascular Assessment Before Noncardiac Surgery
[Devereaux PJ et al for the POISE-2 Investigators. Aspirin in patients undergoing noncardiac surgery. N Engl J Med 2014 Apr 17. Full-text NEJM article PDF | PubMed® abstract]
[Devereaux PJ et al for the POISE-2 Investigators. Clonidine in patients undergoing noncardiac surgery. N Engl J Med 2014 Mar 31. Full-text NEJM article PDF | PubMed® abstract]
[Fleisher LA et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014 Dec 9. Full-text ACC/AHA Guideline PDF in Circulation | PubMed® abstract].
Studies Suggest We Should Modify Our Approach to Sepsis Treatment
[The ProCESS Investigators. A randomized trial of protocol-based care for early septic shock. N Engl J Med 2014 Mar 18. Full-text NEJM article PDF in PubMed® Central | PubMed® abstract]
[ARISE Investigators and the ANZICS Clinical Trials Group. Goal-directed resuscitation for patients with early septic shock. N Engl J Med 2014 Oct 16. PubMed® abstract]
[Holst LB et al. Lower versus higher hemoglobin threshold for transfusion in septic shock. N Engl J Med 2014 Oct 9; 371:1381. PubMed® abstract]
Can We Do a Better Job of Keeping Patients Out of the Hospital?
[Dhalla IA et al. Effect of a postdischarge virtual ward on readmission or death for high-risk patients: A randomized clinical trial. JAMA 2014 Oct 1; 312:1305. PubMed® abstract]
[De Jonge KE et al. Effects of home-based primary care on Medicare costs in high-risk elders. J Am Geriatr Soc 2014 Oct; 62:1825. Full-text J Am Geriatr Soc article PDF | PubMed® abstract]
[Edes T et al. Better access, quality, and cost for clinically complex veterans with home-based primary care. J Am Geriatr Soc 2014 Oct; 62:1954. PubMed® abstract]
[Friedberg MW et al. Association between participation in a multipayer medical home intervention and changes in quality, utilization, and costs of care. JAMA 2014 Feb 26; 311:815. Full-text JAMA article PDF | PubMed® abstract]
[Kanaan AO et al. Adverse drug events after hospital discharge in older adults: Types, severity, and involvement of Beers criteria medications. J Am Geriatr Soc 2013 Nov; 61:1894. PubMed® abstract]
[Mixon AS et al. Characteristics associated with postdischarge medication errors. Mayo Clin Proc 2014 Aug; 89:1042. PubMed® abstract]
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