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JAMA wants campaign on clinical alerts

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7120.1397e (Published 29 November 1997) Cite this as: BMJ 1997;315:1397
  1. Deborah Josefson
  1. San Francisco

    The American Medical Association's journal, JAMA, is spearheading a campaign of “clinical alerts” to ensure that patients benefit quickly from medical breakthroughs.

    The campaign will use established medical journals and the lay press to get the message across. The proposal was outlined by Dr George Lundberg, editor of JAMA, and Dr John Wennberg of the Department of Family Medicine at Dartmouth Medical Center in New Hampshire (JAMA 1997;278:1615-6).

    Many proved medical treatments that are reported in the literature are slow to trickle down into clinical practice. For instance, several recent studies have shown that up to 75% of elderly patients with heart problems who are candidates for treatment with a ß blocker fail to be prescribed the drug. Similarly, aspirin, which has proved to be of benefit in preventing heart attacks, is also underprescribed.

    The article in JAMA suggests that the current response system is too slow. The authors call for a panel of medical experts to review the leading medical journals and identify clinically relevant findings of sufficient magnitude to demand urgent attention and for which solutions exist that could be readily implemented and translated into practice. An individual would be made responsible for each identified problem and accountable for implementing the changes. The clinically relevant breakthroughs would be referred to a medical organisation, which might choose to initiate further research or validate the problems. Consensus teams, consisting of doctors, researchers, government agencies, academic institutes, insurers, and managed care organisations would take part.

    Dr William Jessee, vice president for quality and managed care at the American Medical Association, said that the association expected to start the educational process shortly and that the first alert would be about ß blockers.

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