Variation in patient utilities for outcomes of the management of chronic stable angina: implications for clinical practice guidelines

Article Abstract:

Patients with the same degree of chronic chest pain may differ in the amount of distress they experience. Researchers surveyed 211 patients with chronic stable chest pain to assess the amount of distress experienced by the patients. In each progressively severe disease class, the patients experienced increasing distress from their symptoms. Patients with less severe chest pain categorized in treatment classes I or II were bothered significantly less by their symptoms than patients with more severe chest pain in treatment classes III or IV. Within each treatment class, patients were bothered to varying degrees by their symptoms. There was approximately a 33% chance that patients in treatment class II would be bothered by their symptoms more than patients in treatment class III or IV. Clinical practice guidelines for chronic stable chest pain should be based on patient preferences instead of the severity of symptoms alone.

Health aspects, Beliefs, opinions and attitudes, Cardiac patients, Angina pectoris

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Independent Primary Care Practice by Nurse Practitioners

Article Abstract:

More research is needed to determine whether nurse practitioners can deliver the same quality of care as a primary care physician. Although some nurse practitioners must be supervised by a physician, in 22 states, this is not necessary. The Balanced Budget Act of 1997 provided Medicare reimbursement to nurse practitioners and removed the requirement for physician supervision. A 1999 study found that nurse practitioners provided the same quality of care as primary care physicians. However, the study only lasted six months and the patients were not representative of the general population.

Evaluation, Nurse practitioners

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Sponsorship, Authorship, and Accountability

Article Abstract:

The section on publication ethics from the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication" has been revised to require all authors to disclose all conflicts of interest that may affect their research project. In particular, they should state whether they had access to the study data, and to what extent they were involved in the decision to publish the data.

Standards, Medical research, Medical publishing

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