IMPORTANCE Colorectal cancer (CRC) remains a significant cause of morbidity and mortality in the United States.OBJECTIVE To systematically review the effectiveness, diagnostic accuracy, and harms of screening for CRC.

There are insufficient adequately powered clinical trials evaluating the incremental effect of the ABI, hsCRP level, or CAC score in risk assessment and initiation of preventive therapy. Furthermore, the clinical meaning of improvements in measures of calibration, discrimination, and reclassification risk prediction studies is uncertain.

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BACKGROUND AND OBJECTIVES: After the 1996 introduction of routine varicella vaccination in the United States, most studies evaluating pediatric herpes zoster (HZ) incidence reported lower incidence over time, with varying degrees of decline. Using the combined databases of 6 integrated health care organizations, we examined HZ incidence in children over a 12-year period in the varicella vaccine era.METHODS: This study included children aged 0 through 17 years from 2003 through 2014. Using electronic medical records, we identified HZ cases through International Classification of Diseases, Ninth Revision diagnosis code 053. We calculated HZ incidence rates per 100 000 person years of health plan membership for all children and among children who were vaccinated versus unvaccinated. We calculated rates for the 12-year period and examined temporal trends. Among children who were vaccinated, we compared HZ rates by month and year of age at vaccination. RESULTS:The study included 6 372 067 children with $1 month of health plan membership. For the 12-year period, the crude HZ incidence rate for all subjects was 74 per 100 000 person years, and the rate among children who were vaccinated was 38 per 100 000 person years, which was 78% lower than that among children who were unvaccinated (170 per 100 000 person years; P , .0001). Overall HZ incidence declined by 72% (P , .0001) from 2003 through 2014. Annual rates in children who were vaccinated were consistently lower than in children who were unvaccinated. CONCLUSIONS:With this population-based study, we confirm the decline in pediatric HZ incidence and the significantly lower incidence among children who are vaccinated, reinforcing the benefit of routine varicella vaccination to prevent pediatric HZ.

Some prior research has examined pain-related variables based on prescription opioid dose, but data from studies involving patient-reported outcomes have been limited. This study examined the relationships between prescription opioid dose and self-reported pain intensity, function, quality of life, and mental health. Participants were recruited from two large integrated health systems, Kaiser Permanente Northwest (n=331) and VA Portland Health Care System (n=186). To be included, participants had to have musculoskeletal pain diagnoses and be receiving stable doses of long-term opioid therapy (LTOT). We divided participants into three groups based on current prescription opioid dose in daily morphine equivalent doses (MED): Low Dose (5 – 20 mg MED), Moderate Dose (20.1 – 50 mg MED), and Higher Dose (50.1 – 120 mg MED) groups. A statistically significant trend emerged where higher prescription opioid dose was associated with moderately-sized effects including greater pain intensity, more impairments in functioning and quality of life, poorer self-efficacy for managing pain, greater fear avoidance, and more healthcare utilization. Rates of potential alcohol and substance use disorders also differed among groups. Findings from this evaluation reveal significant differences in pain-related and substance-related factors based on prescription opioid dose.