David L Schriger

CONTEXT: New criteria for the diagnosis of type 2 diabetes mellitus have recently been introduced that lowered the diagnostic fasting plasma glucose (FPG) concentration from 7.8 to 7.0 mmol/L (140 to 126 mg/dL).

OBJECTIVE: To determine if individuals with diabetes diagnosed by the new FPG concentration criterion would have excessive glycosylation (elevated hemoglobin [HbA1c] levels).

DEFINITIONS: We determined the distribution of HbA1c levels in individuals using 4 classifications: (1) ...

AIMS: To determine if age and race/ethnicity affect HbA1c levels independent of glycemia.

METHODS: We analyzed 2712 individuals from the NHANES III population 40-74 years old without diabetes history.

RESULTS: HbA1c levels increased by 0.10% per decade in people with NGT and 0.07% in those with IFG and/or IGT, independent of fasting and 2-h glucose on OGTT's. Compared to non-Hispanic whites, HbA1c levels increased by 0.12% (NGT) and 0.10% (IFG/IGT) in Mexican-Americans and 0.21% (NGT) ...

STUDY OBJECTIVE: To develop guidelines for the care of infants and children from birth to 36 months of age with fever without source.

PARTICIPANTS AND SETTING: An expert panel of senior academic faculty with expertise in pediatrics and infectious diseases or emergency medicine.

DESIGN AND INTERVENTION: A comprehensive literature search was used to identify all publications pertinent to the management of the febrile child. When appropriate, meta-analysis was used to combine the results of ...

Importance: Most drug epidemics in the United States have disproportionately affected nonwhite communities. Notably, the current opioid epidemic is heavily concentrated among low-income white communities, and the roots of this racial/ethnic phenomenon have not been adequately explained.

Objective: To examine the degree to which differential exposure to opioids via the health care system by race/ethnicity and income could be driving the observed social gradient of the current opioid ...

STUDY OBJECTIVES: We sought to characterize the quantity and quality of graphs in the Journal of American Medicine (JAMA), contrasting articles published in 1999 with those published in 2000 after the addition of a dedicated tables and figures editor. We also sought to compare the quality of graphs in JAMA with the quality of graphs in Annals of Emergency Medicine.

METHODS: Two reviewers independently assessed all graphs in original research articles from 12 randomly chosen issues of ...

OBJECTIVE: Many trauma centers use the pan-computed tomography (CT) scan (head, neck, chest, and abdomen/pelvis) for the evaluation of blunt trauma. This prospective observational study was undertaken to determine whether a more selective approach could be justified.

METHODS: We evaluated injuries in blunt trauma victims receiving a pan-CT scan at a level I trauma center. The primary outcome was injury needing immediate intervention. Secondary outcome was any injury. The perceived need ...

Context. —While clinical guidelines are considered an important mechanism to improve the quality of medical care, problems with implementation may limit their effectiveness. Few empirical data exist about the effect of computer-based systems for application of clinical guidelines on quality of care.Objective. —To determine whether real-time presentation of clinical guidelines using an electronic medical record can increase compliance with guidelines.Design. —Prospective off-on-off, ...

Importance: Since September 2017, standing electric scooters have proliferated rapidly as an inexpensive, easy mode of transportation. Although there are regulations for safe riding established by both electric scooter companies and local governments, public common use practices and the incidence and types of injuries associated with these standing electric scooters are unknown.

Objective: To characterize injuries associated with standing electric scooter use, the clinical outcomes of ...

Objective. —To determine whether a glycosylated hemoglobin level can be used in place of an oral glucose tolerance test (OGTT) to diagnose diabetes.Data Sources/Study Selection. —An augmented MEDLINE search was performed to identify all reports from 1966 through June 1994 in which glycosylated hemoglobin levels were measured concurrently with performance of OGTTs in the same study. The corresponding authors were contacted and asked to provide individual data for all subjects tested. A ...

STUDY OBJECTIVE: Emergency medical services (EMS) may serve as a key source of real-time data about the evolving health of coronavirus disease 2019 (COVID-19)-affected populations, especially in low- and middle-income countries with less rapid and reliable vital statistics registration systems. Although official COVID-19 statistics in Mexico report almost exclusively inhospital mortality events, excess out-of-hospital mortality has been identified in other countries, including 1 EMS ...

CONTEXT: Intracranial hemorrhage must be excluded prior to administration of thrombolytic agents in acute stroke.

OBJECTIVE: To evaluate physician accuracy in cranial computed tomography scan interpretation for determining eligibility for thrombolytic therapy in acute stroke.

DESIGN: Administration of randomly selected, randomly ordered series of 15 computed tomography scans from a pool of 54 scans that demonstrated intracerebral hemorrhage, acute infarction, intracerebral calcifications ...

STUDY OBJECTIVE: We characterize the quantity and quality of data tables and figures in reports of randomized controlled trials (RCTs) submitted to the British Medical Journal (BMJ) and published in peer-reviewed journals. We investigate how the peer review process affected table and figure quality.

METHODS: We reviewed 62 consecutive reports of RCTs submitted to the BMJ in 2001 that were later published in the BMJ (n=12) or elsewhere. We counted and categorized the tables and figures in ...

OBJECTIVE: To assess the cost and cost effectiveness of hydroxymethylglutaryl (HMG)-CoA reductase inhibitor (statin) therapy for the primary prevention of major coronary events in the U.S. population with diabetes and LDL cholesterol levels > or =100 mg/dl, especially in the population with LDL cholesterol levels 100-129 mg/dl.

RESEARCH DESIGN AND METHODS: Analyses were performed using population estimates from National Health and Nutrition Examination Survey (NHANES)-III, cost estimates ...