Highlights of this issue

Patient decision aids

Patient decision aids help to supplement counselling by physicians on treatment options and outcomes, so that patients can make specific, informed decisions about their care. Holbrook and coauthors report on their study of whether patients' treatment choices are influenced by certain features of decision aids (their format and their graphic presentation of data on treatment benefits and harms) and the names of the treatments themselves. In a related commentary, O'Connor emphasizes how important decision aids are in helping patients navigate the “grey zone” of medical decision-making, where the best choice differs depending on how patients weigh the benefits and risks.

See pages 1583 and 1597

Tighter anticoagulation control decreases adverse events

In a meta-analysis of studies involving more than 71 000 people taking anticoagulants orally, Oake and colleagues found that almost half of all hemorrhages and thromboemboli occurred when patients' international normalized ratios were over or under their therapeutic range. The investigators suggest that improved anticoagulation control could decrease the likelihood of such events, and they encourage the evaluation of interventions such as anticoagulation clinics and patient self-management for implementation.

See page 1589

Teenage pregnancy

Donald Langille comments on the trends and contributing factors of unplanned pregnancy in teenagers. He also discusses the role physicians should play in providing appropriate sexual health information and services to teenagers in their practice.

See page 1601

Diagnosing septic arthritis

Septic arthritis in patients with rheumatoid arthritis is a serious concern. Kherani and Shojania describe the epidemiology and pathophysiology of this condition and review the steps necessary to make an accurate diagnosis.

See page 1605

Practice

Abdominal “crunches,” a common element in exercise programs, factor into this teaching case report about an unusual cause of empyema (page 1577).

Dermatomyositis: Rafailidis and colleagues describe the case of a woman with dermatomyositis who presented with fever, myalgia and facial edema (page 1580).