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7 November 2000 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following 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. Full content of the issue is available on the Internet at on November 7, 2000.

Program Successfully Controls Anticoagulant Therapy In Elderly Patients

A rigorous controlled trial of a program to manage long-term warfarin therapy demonstrated that the program reduced frequency of major bleeding and more effectively maintained blood clotting levels in an acceptable range (Article, p. 687). The program consisted of assessing the patients’ risks for bleeding, educating patients to monitor their blood clotting time at home, and managing the anticoagulant drug dosing using guidelines.

Study Proposes Immediate Treatment for Mild Hepatitis C

A cost-effectiveness analysis of treatment for mild chronic hepatitis C virus (HCV) compared immediate therapy with two antiviral drugs to watchful waiting and periodic liver biopsies plus later drug treatment (Article, p. 665). The study found that immediate antiviral therapy would increase survival and reduce costs for people with mild HCV.

Capture, Shock: Clinical Trial Names and the "Branding" of Research

Until the 1970s, clinical trials didn’t have ordinary names. But then came MRFIT, the Multiple Risk Factor Intervention Trial, that became affectionately known as Mr. Fit. A memorable moniker can encapsulate complex, concrete information in a single reference; it can carry soft and fuzzy meanings and associations as well. A physician describes the evolution of clinical trials naming from MRFIT to today’s SCAT and SYMPHONY, MOCHA and COBRA, CAPTURE and SHOCK (Medical Writings, p. 755). He notes that the mnemonic names coincided with the rapid growth in sponsorship of clinical trials by pharmaceutical and biotechnology companies and that the "branding" of study groups and clinical trials may thus be "a manifestation of a marketing strategy that works well, perhaps too well, in other areas of medicine." He asks whose interests this "branding" of research really serves?

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