In 2003, the U.S. Preventive Services Task Force concluded that evidence was insufficient to advise for or against routinely screening all pregnant women for gestational diabetes mellitus.

Update of 2003 U.S. Preventive Services Task Force (USPSTF) recommendation about screening for gestational diabetes.

Persons who are HIV-infected may be at higher risk for certain types of cancer than the general population.

Factors underlying failure to intensify therapy in response to elevated blood pressure have not been systematically studied.

Data on the association between subclinical thyroid dysfunction and coronary heart disease (CHD) and mortality are conflicting.

Standard proton-pump inhibitor-based therapy for Helicobacter pylori infection fails in up to one quarter of patients. Sequential therapy may be more efficacious.

The American College of Physicians recently highlighted the need to provide increased information comparing the effectiveness of health care interventions to ensure the rational and effective practice of medicine. Comparative effectiveness refers to the evaluation of the relative clinical effectiveness, safety, and cost of 2 or more medical services, drugs, devices, therapies, or procedures used to treat the same condition. The College further recommended the establishment of an adequately funded, trusted national entity that should prioritize, sponsor, or produce both comparative clinical and cost-effectiveness data. This article addresses the need for the proposed entity to develop cost-effectiveness information. It examines the current reluctance to develop and use cost-effectiveness in the United States; it argues for the importance of this information for all health care stakeholders; and it makes specific recommendations regarding how this information can best be made available and used for the good of the public and our patients.

Screening for low bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA) is the primary way to identify asymptomatic men who might benefit from osteoporosis treatment. Identifying men at risk for low BMD and fracture can help clinicians determine which men should be tested.

The American College of Physicians developed this guideline to present the available evidence on risk factors and screening tests for osteoporosis in men.

The profile of opioid dependence in the United States is changing. Abuse of prescription opioids is more common than that of illicit opioids: Recent data indicate that approximately 1.6 million persons abuse or are dependent on prescription opioids, whereas 323,000 abuse or are dependent on heroin. Despite this prevalence, nearly 80% of opioid-dependent persons remain untreated. One option for expanding treatment is the use of buprenorphine and the buprenorphine-naloxone combination. Buprenorphine is a partial opioid agonist that can be prescribed by trained physicians and dispensed at pharmacies. This article addresses the clinical presentation of a patient with opioid dependence and describes the relatively new practice of office-based treatment with buprenorphine-naloxone. The different components of treatment; the role of the physician who provides this treatment; and the logistics of treating this growing, multifaceted patient population are also examined.

Little information is available on the comparative effectiveness of osteoporosis pharmacotherapies.