hensive assessment of their needs. Step 4 identifies resources that, when available and accessible, can help patients remain at home and in their communities and relieve some of the significant burden that often falls on family caregivers. Reinhard and Levine identify the most frustrating limitation of these efforts and our tool. As clinicians arrive at the last step of our algorithm, too frequently they will find they cannot secure a needed resource for their patient. Access varies widely by location, insurance type, and financial status, and Medicare itself prioritizes acute and episodic care rather than the chronic care services essential to the health and wellbeing of the very patients the chronic care management benefit targets. If indeed some of the resources we present in step 4 represent a wish list for many clinicians, patients, and caregivers, then we hope our algorithm will prompt an additional step by clinicians: advocacy for expansion and improved coverage of patient and caregiver resources. Christopher A. Bautista, MD Kenneth Covinsky, MD, MPH Louise Aronson, MD, MFA Author Affiliations: Department of Internal Medicine, University of California, Davis (Bautista); Division of Geriatrics, University of California, San Francisco (Covinsky, Aronson). Corresponding Author: Louise Aronson, MD, MFA, Division of Geriatrics, University of California, 3333 California St, San Francisco, CA 94118 ([email protected]). Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. 1. Levine C, Halper D, Peist A, Gould DA. Bridging troubled waters: family caregivers, transitions, and long-term care. Health Aff (Millwood). 2010;29(1): 116-124. 2. Kleinman A. From illness as culture to caregiving as moral experience. N Engl J Med. 2013;368(15):1376-1377. 3. Lynn J. Strategies to ease the burden of family caregivers. JAMA. 2014;311(10): 1021-1022. 4. Ducharme F, Kergoat MJ, Coulombe R, Lévesque L, Antoine P, Pasquier F. Unmet support needs of early-onset dementia family caregivers: a mixed-design study. BMC Nurs. 2014;13(1):49. 5. Black BS, Johnston D, Rabins PV, Morrison A, Lyketsos C, Samus QM. Unmet needs of community-residing persons with dementia and their informal caregivers: findings from the maximizing independence at home study. J Am Geriatr Soc. 2013;61(12):2087-2095. 6. Harris DP, Chodosh J, Vassar SD, Vickrey BG, Shapiro MF. Primary care providers’ views of challenges and rewards of dementia care relative to other conditions. J Am Geriatr Soc. 2009;57(12):2209-2216.

CORRECTION Incorrect Data for Absolute Rates of Adverse Effects: In the JAMA Clinical Evidence Synopsis entitled “Systemic Corticosteroid Therapy for Acute Sinusitis” published in the March 24/31, 2015, issue of JAMA (2015;313[12]1258-1259. doi:10.1001/jama.2014.14418), data were incorrect for the absolute rates of oral

corticosteroids vs control treatment for adverse effects. The correct data for the absolute rates of adverse effects are 147 of 586 patients (25.1%) for oral corticosteroids vs 167 of 577 patients (28.9%) for control treatment; P = .14. This article was corrected online.

Incorrect Outcomes Data: In the Original Investigation entitled “Comparison of 2 Transvaginal Surgical Approaches and Perioperative Behavioral Therapy for Apical Vaginal Prolapse: The OPTIMAL Randomized Trial,” published in the March 12, 2014, issue of JAMA (2014;311[10]:1023-1034. doi:10.1001/jama.2014.1719), surgical success rates and the significance of a group interaction were reported inaccurately because of errors in the data. After the article was published, 1 of the 9 clinical sites discovered via internal quality check that values from several participants’ pelvic organ prolapse quantification (POPQ) examinations were entered as positive when they should have been negative. These data entry errors meant that some cases were reported as surgical failures in the article when in fact they were successes. The discovery prompted the authors to perform a network-wide audit of the POPQ values at all of the clinical sites and a subsequent reanalysis. In all, the primary outcome of surgical failure changed for 16 of 307 participants. None of the study conclusions or major inferences was affected. However, several numerical changes were necessary in the text, the figure, and the tables of the anatomic (POPQ) data. This article was corrected online.

Incorrect Description for Basis of Household Income: In the Original Investigation entitled “Differences in Breast Cancer Stage at Diagnosis and Cancer-Specific Survival by Race and Ethnicity in the United States” published in the January 13, 2015, issue of JAMA (2015;313[2]:165-173. doi:10.1001/jama.2015.17322), the description of the basis of household income as “Census tract (residence)” is incorrect. In the Methods section, Cohort Selection paragraph, the penultimate sentence should have been “The median household income was estimated from the Census 2007-2011 American Community Survey based on the county of residence.” This article was corrected online.

Guidelines for Letters Letters discussing a recent JAMA article should be submitted within 4 weeks of the article's publication in print. Letters received after 4 weeks will rarely be considered. Letters should not exceed 400 words of text and 5 references and may have no more than 3 authors. Letters reporting original research should not exceed 600 words of text and 6 references and may have no more than 7 authors. They may include up to 2 tables or figures but online supplementary material is not allowed. All letters should include a word count. Letters must not duplicate other material published or submitted for publication. Letters not meeting these specifications are generally not considered. Letters being considered for publication ordinarily will be sent to the authors of the JAMA article, who will be given the opportunity to reply. Letters will be published at the discretion of the editors and are subject to abridgement and editing. Further instructions can be found at http://jama.com/public /InstructionsForAuthors.aspx. A signed statement for authorship criteria and responsibility, financial disclosure, copyright transfer, and acknowledgment and the ICMJE Form for Disclosure of Potential Conflicts of Interest are required before publication. Letters should be submitted via the JAMA online submission and review system at http: //manuscripts.jama.com. For technical assistance, please contact [email protected] Section Editor: Jody W. Zylke, MD, Deputy Editor.


(Reprinted) JAMA June 9, 2015 Volume 313, Number 22

Copyright 2015 American Medical Association. All rights reserved.

Downloaded From: http://jama.jamanetwork.com/ by a GAZI UNIVERSITESI User on 01/12/2016


Incorrect outcomes data.

Incorrect outcomes data. - PDF Download Free
45KB Sizes 0 Downloads 4 Views