HARVARD MEDICAL SCHOOL                Department of Continuing EducationPRIMARY CAREINTERNAL MEDICINEPrinciples and Practi...
 
Primary Care Internal Medicine: Principles and Practice                                              October 20- 24, 2008 ...
Therapeutic options for delirium      Theodore A. Stern, M.D. ...............................................................
Primary Care Internal Medicine: Principles and Practice                                    General Information        On b...
10.   Evaluation Forms: This information is an essential component of our program planning      and we not only read and r...
Primary Care Internal Medicine: Principles and Practice                                    Monday, October 20, 2008       ...
Primary Care Internal Medicine: Principles and Practice                                    Monday, October 20, 20083:20 – ...
Primary Care Internal Medicine: Principles and Practice                                    Tuesday, October 21, 2008      ...
Primary Care Internal Medicine: Principles and Practice                                  Tuesday, October 21, 20083:20 – 4...
Primary Care Internal Medicine: Principles and Practice                                   Wednesday, October 22, 2008     ...
Primary Care Internal Medicine: Principles and Practice                                  Wednesday, October 22, 20083:45 –...
Primary Care Internal Medicine: Principles and Practice                                     Thursday, October 23, 2008    ...
Primary Care Internal Medicine: Principles and Practice                                    Thursday, October 23, 20083:45 ...
Primary Care Internal Medicine: Principles and Practice                                   Friday, October 24, 2008        ...
 
ALIREZA ATRI, M.D. Ph.D., Clinical Instructor in Neurology, Harvard Medical School;     Assistant in Neurology, Massachuse...
TRACY L. BROOKS, M.D., Instructor in Pediatrics, Harvard Medical School; Director of     Adolescent Medical Services, Camb...
SUKRAN ERGIN, M.D., Instructor in Medicine, Harvard Medical School; Staff Physician,     Division of Rheumatology, Beth Is...
THOMAS J. GILL, M.D., Associate Professor of Orthopedic Surgery, Harvard Medical    School; Chief, Sports Medicine, Depart...
JAMES J. HEFFERNAN, M.D., M.P.H., Associate Professor of Medicine, Harvard Medical     School; Director of Healthcare Asso...
LEE M. KAPLAN, M.D., Ph.D., Associate Professor of Medicine, Harvard Medical School;      Director, MGH Weight Center, Mas...
AARON LAZARE, M.D., Professor of Psychiatry, Harvard Medical School; Celia and Issac Haidak    Distinguished Professor of ...
MARGARET A. MILLER, M.D., Assistant Professor of Obstetrics and Gynecology, Brown    Medical School; Director of Ambulator...
RICHARD J. PELS, M.D., Assistant Professor of Medicine, Harvard Medical School; Associate Chief of     Medicine, Director,...
MARTIN A. SAMUELS, M.D., Professor of Neurology, Harvard Medical School;     Neurologist-in-Chief, Brigham and Womens Hosp...
GERALD W. SMETANA, M.D., Associate Professor of Medicine, Harvard Medical     School; Physician, Division of General Medic...
LISA WEISSMANN, M.D., Clinical Instructor in Medicine, Harvard Medical School; Chief of      Hematology/Oncology at Cambri...
Primary Care Internal Medicine: Principles and Practice                                     Faculty DisclosuresHarvard Med...
The following speakers, spouses and planners, have reported receiving something of value*from a company whose product may ...
Johnson & Johnson               Scientific advisor                        C. R. Bard                      ConsultCiarán P....
CV Therapeutics                  Consultant                              Medtronic                        Consultant      ...
Primary Care Internal Medicine: Principles and Practice                                 Monday, October 20, 2008          ...
Medical headlines 2008: Evaluatingrecent “evidence” for clinical practice       John D. Goodson, M.D.
John D. Goodson, M.D.                                                             Primary Care Internal Medicine:         ...
2007 – 2008 Medical Headlines     1.     Generalist physicians now responsible for patients with life            threateni...
AF: Rhythm vs. rate                                   Interventions+                                           Rhythm     ...
AF: Rhythm vs. rate                                             Outcomes                                          Composit...
Key terms Sampling: The selection of clinical material for study. A sample may or may not represent      the entire popula...
RCT of arthroscopic surgery for knee OA                                     Patient characteristics                       ...
HBGM in Type II DM                     Baseline patient characteristics                                (N=453)            ...
Example 4: How generalizable are RCT results?In 2008 Dhruva and Redberg reported a comparison of the patient characteristi...
II.   Meta-analysis      Example 1: Calcium reduces osteoporosis.      In 2007 Tang, et al. reported a meta-analysis of 29...
Meta-analysis: The pooling of results from studies to achieve a more accurate estimate of effect.The process involves thre...
Heterogeneity                                  Control                         (Ann Intern Med 1987;107:227)Example 2: Are...
Example 3: Do antioxidant vitamin supplements increase mortality?          1.     Meta Analysis: In 2007 Bjelakovic, et al...
Swedish obese patient cohort            Baseline patient characteristics                    Surgery             Convention...
Cohort studies                                                                  Disease                                   ...
High dose (over 175% average dose), long term (over 1 year)                      PPI use associated with hip fracture risk...
2.      Do the cases adequately represent the disease spectrum? Did the case selection process                choose only ...
40 mg/day, and half atorvostatin, 80 mg/day. Patients were followed for an average of 24months. LDL levels fell to 95 mg/d...
Disease                      Lethal disease                                 65                      Stroke                ...
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
General Session
Upcoming SlideShare
Loading in …5
×