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4 May 2004 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians, an organization of more than 115,000 internal medicine physicians and medical students. These highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656.

Screening People with Hypertension for Diabetes Is Cost-Effective But Universal Screening for Diabetes Is Not

(Article, p 689; Editorial, p. 756)

U.S. Task Force: Not Enough Evidence to Recommend For or Against Lung Cancer Screening

(Guideline, p. 738; Evidence Paper, p. 740)

Screening Women Over Age 70 with Mammography and Pap Tests Should Be Targeted to Healthy Women, Not Women with Limited Life Expectancies

Three-quarters of women over age 70 in a telephone survey reported having a had recent mammography, Pap test, or both, according to a new study (Article, p. 661) Although it is known that older women whose life expectancy is less than five years are unlikely to benefit from screening mammography or Pap tests, in this study, women who reported worse health were as likely to get the tests as those in better health. An editorial writer says that keeping healthy and mobile are the primary goals for many elderly, not merely extending life (Editorial, p. 754). "Screening can have, at best, only a limited effect on mortality" among the elderly, he says.

Managing Drug Care for Older Adults Needs Improvement

A study examined management of pharmacologic care of 372 vulnerable elderly patients in two managed care organizations against explicit quality indicators. Researchers found failures in educating patients on proper use of medications, monitoring medications appropriately, documenting necessary information, educating patients about their medications and coordinating with the patients' other physicians (Article, p. 714). Researchers also found underuse of potentially beneficial medications but did not find problems with prescriptions for inappropriate medications.

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