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16 March 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.

Task Force Recommends Against Routine Screening for Hepatitis C

People who aren't at high risk for hepatitis C infection do not need to be screened for the disease, according to a new recommendation from the U.S. Preventive Services Task Force (Clinical Guidelines, p. 462 and p. 465). In addition, the Task Force concluded that the scientific evidence that screening improves health is not strong enough to screen people who are at high risk for contracting hepatitis C (including current or former intravenous drug users, those who received blood transfusions before 1990, or those whose mothers are infected with the virus).

Study: Jury Still Out on Best Form of Nicotine Replacement Therapy

A study of 299 smokers found that after six months, those who used a nicotine nasal spray and those who used a skin patch quit at about the same rate (12 percent of those using the spray and 15 percent of those using the patch) (Article, p. 426). However, smokers who were highly dependent on nicotine, obese, and nonwhite achieved higher abstinence rates with the spray, while low to moderately nicotine dependent, nonobese, and white smokers achieved higher abstinence rates with the patch. Thus, ethnicity, weight, and level of nicotine dependence may help identify smokers who will do well with one form of nicotine replacement therapy or another. These findings require confirmation in larger studies.

Disclosing Medical Errors Has Varying Effects on Patients

A study of how people react to descriptions of a patient and a medical mistake found that full disclosure of the error improved patients' trust and satisfaction with their physicians but did not necessarily affect their feelings about seeking legal advice (Article, p. 409; Editorial, p. 482). Researchers studied responses of 958 adults who returned a survey containing a scenario that described a medical error and asked the subject to state whether they would seek legal advice. Each participant received one of eight scenarios, which differed in the type of error, its severity and the completeness of error disclosure. Full disclosure neither increased nor decreased the likelihood that a patient would agree that they would seek legal advice

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