Joint letter from physician groups to House leadership expressing opposition to H.R. 4302, the Protecting Access to Medicare Act of 2014

The Coalition for Health Funding’s 64 Urges a Balanced Approach to Deficit Reduction

Joint Response to Healthy Future Task Force Security Request For Information

Joint Principles on Priorities for Coverage, Benefits and Consumer Protections Changes

Joint Physician Letter Opposing H.R. 1

Joint Organizational Letter Thanking Labor, Health and Human Services, and Education (LHHS) Appropriations Subcommittee Clerks for Protecting Vital Programs

Joint Opposition Letter to Equitable Community Access to Pharmacist Services Act

Joint Letter to Senate Appropriation Committee Expressing Support for the CDC Office on Smoking and Health

Multistakeholder Sign-On Letter in Support of Voluntary Advance Care Planning

Joint Letter to Trump Administration Reaffirming Support and Safety of Vaccines

Screening for Major Depressive Disorder in Children and Adolescents: A Systematic Review for the U.S. Preventive Services Task Force

Background: Major depressive disorder (MDD) is common among children and adolescents and is associated with functional impairment and suicide. Purpose: To update the 2009 U.S. Preventive Services Task Force (USPSTF) systematic review on screening for and treatment of MDD in children and adolescents in primary care settings. Data Sources: Several electronic searches (May 2007 to February 2015) and searches of reference lists of published literature. Study Selection: Trials and recent systematic reviews of treatment, test–retest studies of screening, and trials and large cohort studies for harms. Data Extraction: Data were abstracted by 1 investigator and checked by another; 2 investigators independently assessed study quality. Data Synthesis: Limited evidence from 5 studies showed that such tools as the Beck Depression Inventory and Patient Health Questionnaire for Adolescents had reasonable accuracy for identifying MDD among adolescents in primary care settings. Six trials evaluated treatment. Several individual fair- and good-quality studies of fluoxetine, combined fluoxetine and cognitive behavioral therapy, escitalopram, and collaborative care demonstrated benefits of treatment among adolescents, with no associated harms. Limitation: The review included only English-language studies, narrow inclusion criteria focused only on MDD, high thresholds for quality, potential publication bias, limited data on harms, and sparse evidence on long-term outcomes of screening and treatment among children younger than 12 years. Conclusion: No evidence was found of a direct link between screening children and adolescents for MDD in primary care or similar settings and depression or other health-related outcomes. Evidence showed that some screening tools are accurate and some treatments are beneficial among adolescents (but not younger children), with no evidence of associated harms. Primary Funding Source: Agency for Healthcare Research and Quality.

Mechanical Symptoms and Arthroscopic Partial Meniscectomy in Patients With Degenerative Meniscus Tear: A Secondary Analysis of a Randomized Trial: Annals of Internal Medicine: Vol 164, No 7

Background: Recent evidence shows that arthroscopic partial meniscectomy (APM) offers no benefit over conservative treatment of patients with a degenerative meniscus tear. However, patients who report mechanical symptoms (sensations of knee catching or locking) may benefit from APM. Objective: To assess whether APM improves mechanical symptoms better than sham surgery. Design: Randomized, patient- and outcome assessor–blinded, sham surgery–controlled, multicenter trial. (ClinicalTrials.gov: NCT00549172) Setting: 5 orthopedic clinics in Finland. Patients: Adults (aged 35 to 65 years) with a degenerative medial meniscus tear and no knee osteoarthritis. Intervention: APM or sham surgery. Measurements: Patients' self-report of mechanical symptoms before surgery and at 2, 6, and 12 months after surgery. Results: 70 patients were randomly assigned to APM, and 76 were assigned to sham surgery. Thirty-two patients (46%) in the APM group and 37 (49%) in the sham surgery group reported catching or locking before surgery; the corresponding numbers at any follow-up were 34 (49%) and 33 (43%), with a risk difference of 0.03 (95% CI, −0.06 to 0.12). In the subgroup of 69 patients with preoperative catching or locking, the risk difference was 0.07 (CI, −0.08 to 0.22). Limitation: Analyses were post hoc, and the results are only generalizable to knee catching and occasional locking because few patients reported other types of mechanical symptoms. Conclusion: Resection of a torn meniscus has no added benefit over sham surgery to relieve knee catching or occasional locking. These findings question whether mechanical symptoms are caused by a degenerative meniscus tear and prompt caution in using patients' self-report of these symptoms as an indication for APM. Primary Funding Source: Academy of Finland.

Disclosing Pleiotropic Effects During Genetic Risk Assessment for Alzheimer Disease: A Randomized Trial: Annals of Internal Medicine: Vol 164, No 3

Background: Increasing use of genetic testing raises questions about disclosing secondary findings, including pleiotropic information. Objective: To determine the safety and behavioral effect of disclosing modest associations between apolipoprotein E (APOE) genotype and coronary artery disease (CAD) risk during APOE-based genetic risk assessments for Alzheimer disease (AD). Design: Randomized, multicenter equivalence clinical trial. (ClinicalTrials.gov: NCT00462917) Setting: 4 teaching hospitals. Participants: 257 asymptomatic adults were enrolled, 69% of whom had 1 AD-affected first-degree relative. Intervention: Disclosure of genetic risk information about AD and CAD (AD+CAD) or AD only (AD-only). Measurements: Primary outcomes were Beck Anxiety Inventory (BAI) and Center for Epidemiologic Studies Depression Scale (CES-D) scores at 12 months. Secondary outcomes were all measures at 6 weeks and 6 months and test-related distress and health behavior changes at 12 months. Results: At 12 months, mean BAI scores were 3.5 in both the AD-only and AD+CAD groups (difference, 0.0 [95% CI, −1.0 to 1.0]), and mean CES-D scores were 6.4 and 7.1 in the AD-only and AD+CAD groups, respectively (difference, 0.7 [CI, −1.0 to 2.4]). Both confidence bounds fell within the equivalence margin of ±5 points. Among carriers of the APOE ε4 allele, distress was lower in the AD+CAD groups (difference, −4.8 [CI, −8.6 to −1.0]) (P = 0.031 for the interaction between group and APOE genotype). Participants in the AD+CAD groups also reported more health behavior changes, regardless of APOE genotype. Limitations: Outcomes were self-reported by volunteers without severe anxiety, severe depression, or cognitive problems. Analyses omitted 33 randomly assigned participants. Conclusion: Disclosure of pleiotropic information did not increase anxiety or depression and may have decreased distress among persons at increased risk for 2 conditions. Providing risk modification information about CAD improved health behaviors. Findings highlight the potential benefits of disclosure of secondary genetic findings when options exist for decreasing risk. Primary Funding Source: National Human Genome Research Institute.

Population-Wide Screening for Chronic Kidney Disease

Universal Masking in Health Care Settings

Comparison of SARS-CoV-2 Reverse Transcriptase Polymerase Chain Reaction and BinaxNOW Rapid Antigen Tests at a Community Site During an Omicron Surge

Update Alert 4: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings

Prevalence of Asymptomatic SARS-CoV-2 Infection

Residual Shunt After Patent Foramen Ovale Closure and Long-Term Stroke Recurrence

Histopathologic Changes and SARS-CoV-2 Immunostaining in the Lung of a Patient With COVID-19