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CONTEXT Few depressed older adults receive effective treatment in primary care settings. OBJECTIVE To determine the effectiveness of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) collaborative care management program for late-life depression. DESIGN Randomized controlled trial with recruitment from July 1999 to August 2001. (More)
CONTEXT Depression and arthritis are disabling and common health problems in late life. Depression is also a risk factor for poor health outcomes among arthritis patients. OBJECTIVE To determine whether enhancing care for depression improves pain and functional outcomes in older adults with depression and arthritis. DESIGN, SETTING, AND PARTICIPANTS(More)
BACKGROUND Late life depression can be successfully treated with antidepressant medications or psychotherapy, but few depressed older adults receive effective treatment. RESEARCH DESIGN A randomized controlled trial of a disease management program for late life depression. SUBJECTS Approximately 1,750 older adults with major depression or dysthymia are(More)
CONTEXT Depression is a leading cause of functional impairment in elderly individuals and is associated with high medical costs, but there are large gaps in quality of treatment in primary care. OBJECTIVE To determine the incremental cost-effectiveness of the Improving Mood Promoting Access to Collaborative Treatment (IMPACT) collaborative care management(More)
OBJECTIVES To examine rates and predictors of lifetime and recent depression treatment in a sample of 1,801 depressed older primary care patients DESIGN Cross sectional survey data collected from 1999 to 2001 as part of a treatment effectiveness trial. SETTING Eighteen primary care clinics belonging to eight organizations in five states. PARTICIPANTS(More)
CONTEXT Headache is a common, disabling disorder that is frequently not well managed in general clinical practice. OBJECTIVE To determine if patients cared for in a coordinated headache management program would achieve reduced headache disability compared with patients in usual care. DESIGN A randomized controlled trial of headache management vs usual(More)
Although it is commonly believed that the innovation of new medicines is of paramount importance for improving the health and quality of life of patients, there is also a keen recognition regarding upward-spiraling costs of innovation, drug discovery, and drug development against a backdrop of dwindling successes in research and development (R&D) efforts.(More)
STUDY OBJECTIVES To determine the test performance characteristics of CT scanning, positron emission tomography (PET) scanning, MRI, and endoscopic ultrasound (EUS) for staging the mediastinum, and to evaluate the accuracy of the clinical evaluation (ie, symptoms, physical findings, or routine blood test results) for predicting metastatic disease in(More)
PURPOSE Our objective was to examine the relative association of depression severity and chronicity, other comorbid psychiatric conditions, and coexisting medical illnesses with multiple domains of health status among primary care patients with clinical depression. METHODS We collected cross-sectional data as part of a treatment effectiveness trial that(More)
STUDY OBJECTIVES To determine the test performance characteristics of transbronchial needle aspiration (TBNA), transthoracic needle aspiration (TTNA), endoscopic ultrasound-guided needle aspiration (EUS-NA), and mediastinoscopy in staging non-small cell lung cancer (NSCLC). DESIGN, SETTING, AND PARTICIPANTS Systematic search of MEDLINE, HealthStar, and(More)