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Despite mortality reductions found in early trials, recent population-based data suggest that breast and prostate cancer screening have not yielded expected benefits. Whereas evidence-based appraisals generally mistrust disease-specific mortality as a primary outcome measure, cancer screening trials have consistently used this endpoint, largely because of the impracticality of studies with enough statistical power to detect all-cause mortality reductions, which would require millions of subjects. The acceptance of disease-specific mortality as a practical surrogate for all-cause mortality may explain the discrepancy between expected and actual impact. Screening may reduce deaths from the target cancer but may increase deaths from other causes, most likely because of overdiagnosis, an increasingly recognized risk of cancer screening. Recognition of the discrepancy between the expected and the actual impact of screening and recognition of overdiagnosis as a source of harm may be critical for understanding and projecting the potential impact of cancer screening programs. J Natl Cancer Inst 2010;102:1008-1011 DOI: 10.1093/jnci/djq190

Byline: David H. Newman, Ian Greenwald, Clifton W. Callaway Abstract: Thrombolytic agents may have clinically significant beneficial effects in cardiac arrest. The application of thrombolytic drugs in the setting of current and antecedent cardiopulmonary resuscitation is well documented; however, it has not been systematically studied nor has it been widely considered. We provide a literature review of thrombolytic agents and cardiopulmonary resuscitation to discuss the need for randomized controlled trials and the possibility of benefits in acute resuscitation. [Newman DH, Greenwald I, Callaway CW. Cardiac arrest and the role of thrombolytic agents. Ann Emerg Med . May 2000;35:472-480.] Author Affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA. Article History: Received 2 July 1999; Revised 8 November 1999; Accepted 5 January 2000 Article Note: (footnote) [star] Address for reprints: Center for Emergency Medicine of Western Pennsylvania, c/o David H. Newman, 230 McKee Place, Suite 500, Pittsburgh, PA 15213;,412-647-8284; E-mail Newman44@pol.net .

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.annemergmed.2010.05.027 Byline: Jarone Lee, Jonathan Kirschner, Sapna Pawa, Dan E. Wiener, David H. Newman, Kaushal Shah Abstract: There is both increasing recognition and growing scrutiny of the increased utilization of computed tomography (CT) in medicine. For our primary objective, we determine and quantify the CT utilization rate in our emergency department (ED) during the last 7 years. As a secondary objective, we compare trends in utilization for various types of CT scans. Author Affiliation: Department of Emergency Medicine, St Luke's Roosevelt Hospital Center, New York, NY Article History: Received 26 February 2010; Revised 7 April 2010; Revised 6 May 2010; Accepted 18 May 2010 Article Note: (footnote) Provide feedback on this article at the journal's Web site, www.annemergmed.com., Please see page 592 for the Editor's Capsule Summary of this article., Supervising editors: William R. Mower, MD, PhD; Donald M. Yealy, MD, Author contributions: DEW, DHN, and KS conceived the study. JL, JK, DEW, DHN, and KS designed the study. JL and JK analyzed the data primarily. DHN and KS provided assistance with data interpretation. JL, JK, and SP wrote the article, and all authors contributed substantially to its revision. KS takes responsibility for the paper as a whole., Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement., Publication dates: Available online July 10, 2010.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.annemergmed.2010.03.036 Byline: Richard Sinert (a), David H. Newman (b), Ethan Brandler (a), Lorenzo Paladino (a) Abstract: The American Heart Association recommends the initiation of [beta]-blockade to all patients with an ST-segment elevation myocardial infarction (STEMI) without contraindications to [beta]-blocking agents. The present study seeks to systematically review the medical literature to determine the efficacy of treating STEMI patients with a [beta]-blocker within the first 24 hours. Author Affiliation: (a) Department of Emergency Medicine, SUNY-Downstate Medical Center, Brooklyn, NY (b) Columbia University, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY Article Note: (footnote) Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement., Reprints not available from the authors.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.annemergmed.2005.12.010 Byline: David H. Newman, Inna Zhitomirsky Abstract: We determine the prevalence of nontherapeutic and coagulopathic international normalized ratios (INRs) among patients receiving warfarin and presenting to an emergency department (ED). As a secondary goal, we aim to determine whether a simple decision aid composed of physical examination and historical features could be predictive of INR greater than 5. Author Affiliation: St. Luke's-Roosevelt Hospital Center, New York, NY. Article History: Received 14 October 2005; Revised 28 November 2005; Accepted 9 December 2005 Article Note: (footnote) Supervising editor: Allan B. Wolfson, MD Author contributions: DHN conceived and designed the study, executed the study design, administrated the study data collection, and wrote the manuscript. IZ aided in study design, designed and administrated the database, collected data, administrated the study data collection, and designed and made the manuscript graphics (). DHN takes responsibility for the paper as a whole. Funding and support: The authors report this study did not receive any outside funding or support. Publication dates: Available online February 10, 2006. Reprints not available from authors.