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17 June 2003 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.

Pneumococcal Vaccine May Be Cost-Effective for People 50 to 64

Infection with a type of bacteria called Streptococcus pneumoniae is common and serious. Vaccination against the pneumococcus is effective. Current guidelines recommend a one-time vaccination for pneumococcal disease for all adults over 65 and for younger adults with chronic health conditions. A new study reports that pneumococcal vaccination may be cost-effective for those 50 to 64 (Article, p. 960). Vaccination would save medical costs for blacks in this age group when they are at high-risk for pneumococcal disease ($27.55 savings per vaccinee) and for other high-risk people ($5.92 per vaccinee). Even for low-risk adults, the cost-effectiveness of vaccination is in the range of other preventive services used for this age group. An accompanying editorial says that the study "provides strong impetus for lowering the recommended age for universal immunization with pneumococcal vaccine to 50" (Editorial, p. 999). This article is the subject of a video news release. Call for coordinates.

New Annals Section Explores Quality Improvement and Patient Safety

"Improving Patient Care," a new section in Annals of Internal Medicine, will explore ways to organize health care to improve quality and reduce medical errors, according to Annals editor Harold Sox, MD (Editorial, p. 996). The section, published with support from the Agency for Healthcare Research and Quality, will cover topics such as the patient safety movement, malpractice reform, effective incident reporting systems, and research on the effectiveness of methods to improve care (Editorial, p. 997). The new section debuts with an article on error, blame and the law in health care (Improving Patient Care, p. 974). Victims of medical error deserve fair and timely support, rehabilitation, and compensation without necessarily affixing blame, authors say. "Injury is an inevitable, intrinsic component of health care, and whoever pays for health care should also pay for the things that go wrong."

New Insulin Drug in the Morning Reduced Risk of Drop in Blood Sugar Levels at Night

(Article, p. 898)

Inhaled Steroids Don't Decrease or Prevent Lung Decline in COPD

(Brief Communication, p. 969; Editorial, p. 1001)

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