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Effective Clinical Practice

January/February 2000

ORIGINAL ARTICLES

Radiologic Tests after a New Diagnosis of Breast Cancer
Robert O. Dillman and Sherri Chico

Radiologic staging of breast cancer is unnecessary in women with a primary tumor less than 5 cm in diameter, clinically negative axillary nodes, and no signs or symptoms of metastatic disease.
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How Patients with Diabetes Perceive Their Risk for Major Complications
David Meltzer and Brian Egleston

Patients with diabetes significantly overestimate their risk for lower-leg amputation, blindness, and end-stage renal disease.
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Improving General Practice Care of Patients with Asthma or Chronic Obstructive Pulmonary Disease: Evaluation of a Quality System
Marielle P. Jans, François G. Schellevis, Wouter van Hensbergen, and Jacques Th. M. van Eijk

Practices implementing a quality system were more likely than control practices to comply with some guidelines for patients with asthma or chronic obstructive pulmonary disease. The quality system, however, required a considerable investment of time.
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CASE REPORT

Alternative Explanations for Poor Report Card Performance
Rachel Sorokin

Partial-year enrollment of patients interfered with the accuracy of four of five report cards in this group practice. Other recurring problems included diagnostic errors, missing laboratory data, and inadequate sample sizes—all of which may unnecessarily impugn good care.
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PATTERNS OF PRACTICE

Medication Review and Documentation in Physician Office Practice
Marjorie E. Jaski, Joanne G. Schwartzberg, Rosalie A. Guttman, and Maqsood Noorani

Although physicians report that they routinely document prescription medications, they much less frequently record the use of over-the-counter medications, nutritional supplements, and herbal medicines.
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Is Hospitalism New? An Analysis of Medicare Data from Washington State in 1994
Sanjay Saint, Dimitri A. Christakis, Laura-Mae Baldwin, and Roger Rosenblatt

Even before the term hospitalist was coined, a considerable number of physicians performed most of their work in the hospital.
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EDITORIALS

Improving Quality Improvement Research
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Risky Business
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Primer on Absolute vs. Relative Differences
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ETHICS MATTERS

Informed Consent for Screening by Community Sampling
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LETTER TO THE EDITOR

An Orthopedist Questions the Utility of Surgery for Back
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THANK YOU TO REVIEWERS

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