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21 May 2002 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.

New Recommendations: Doctors Should Screen All Adults for Depression

(News release on new U.S. Preventive Services Task Force recommendations.)

Canadian Study Finds No Gender Bias in Heart Procedures

Many studies have shown that women get less aggressive treatment for coronary heart disease than men. A study of all people in Alberta, Canada, who had cardiac catheterizations between 1995 and 1998 found strong evidence that men and women get equal treatment once their doctors know the extent of their disease (Article, p. 723). The authors first analyzed the data the same way that previous researchers have done. They found that women were less likely to have either percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery to treat blocked coronary arteries. However, when the authors adjusted the data so that factors such as the patient's age, previous history of heart disease, and the severity of coronary artery disease were similar in women and men, women were as likely as men to have one of the procedures. In other words, when men and women were similar in all important respects, they got the same treatment for heart disease. The authors say that detailed clinical information is necessary to evaluate possible bias in providing access to heart procedures.

Of Three Treatments, Neck Pain Responds Best to Manual Therapy

A study of 183 people with nonspecific neck pain found that manual therapy was more successful in improving neck mobility and lessening pain than physical therapy or continued care by a physician (Article, p. 713). In the manual therapy group, 68.3 percent of patients felt "much improved" or "completely recovered," compared with 50.8 percent of patients in the physical therapy group and 35.9 percent of doctor-treated patients. In manual therapy, a trained therapist moves a patient's neck, while in physical therapy, the patient performs the exercises. In this study, primary care doctors treated the third group of participants with drugs and advice about hot compresses and home exercises. In the United States, chiropractors, physical therapists, osteopaths and massage therapists practice manual therapy.

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