1637 lines
133 KiB
HTML
Vendored
1637 lines
133 KiB
HTML
Vendored
<!DOCTYPE html>
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<html lang="en" class="pb-page" data-request-id="3f5579dd-8391-41f9-94ee-412b380d213b"
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><head data-pb-dropzone="head"><meta name="pbContext" content=";issue:issue:10.7326/aim.2020.172.issue-7;page:string:Article/Chapter View;ctype:string:Journal Content;article:article:10.7326/M19-3075;subPage:string:Abstract;website:website:annals;requestedJournal:journal:aim;journal:journal:aim;wgroup:string:Publication Websites;pageGroup:string:Publication Pages"/>
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<link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="citation_journal_title" content="Annals of Internal Medicine" /><meta name="dc.Title" content="The Effect of Influenza Vaccination for the Elderly on Hospitalization and Mortality" /><meta name="dc.Creator" content=" Michael L. Anderson " /><meta name="dc.Creator" content=" Carlos Dobkin " /><meta name="dc.Creator" content=" Devon Gorry " /><meta name="dc.Subject" content="Epidemiology; Information storage and retrieval; Elderly; Age groups; Observational studies; Birth; Death rates; Hospitalizations; Statistical data; Seasons; Morbidity; General practitioners; Pneumonia; Surveys; Vaccines; Immune response; Pulmonary diseases; Medical services; Research design; Sexual identity" /><meta name="dc.Description" content="When vaccinating against influenza, some countries focus on elderly persons because observational studies indicate that this practice decreases both population mortality and the frequency of hospit..." /><meta name="Description" content="When vaccinating against influenza, some countries focus on elderly persons because observational studies indicate that this practice decreases both population mortality and the frequency of hospit..." /><meta name="dc.Description" content="Visual Abstract.Influenza Vaccination for the Elderly When vaccinating against influenza, some countries focus on elderly persons because observational studies indicate that this practice decreases..." /><meta name="Description" content="Visual Abstract.Influenza Vaccination for the Elderly When vaccinating against influenza, some countries focus on elderly persons because observational studies indicate that this practice decreases..." /><meta name="dc.Description" content="Background: Observational studies using traditional research designs suggest that influenza vaccination reduces hospitalizations and mortality among elderly persons. Accordingly, health authorities..." /><meta name="Description" content="Background: Observational studies using traditional research designs suggest that influenza vaccination reduces hospitalizations and mortality among elderly persons. Accordingly, health authorities..." /><meta name="dc.Publisher" content=" American College of Physicians " /><meta name="dc.Date" scheme="WTN8601" content="2020-03-03" /><meta name="dc.Type" content="research-article" /><meta name="dc.Format" content="text/HTML" /><meta name="dc.Identifier" scheme="publisher-id" content="AIME202004070-M193075" /><meta name="dc.Language" content="en" /><meta name="dc.Coverage" content="world" /><meta name="keywords" content="Epidemiology,Information storage and retrieval,Elderly,Age groups,Observational studies,Birth,Death rates,Hospitalizations,Statistical data,Seasons,Morbidity,General practitioners,Pneumonia,Surveys,Vaccines,Immune response,Pulmonary diseases,Medical services,Research design,Sexual identity" />
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<title>The Effect of Influenza Vaccination for the Elderly on Hospitalization and Mortality: An Observational Study With a Regression Discontinuity Design: Annals of Internal Medicine: Vol 172, No 7</title>
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<meta charset="UTF-8">
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<meta property="og:url" content="https://www.acpjournals.org/doi/abs/10.7326/M19-3075"/>
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<meta name="viewport" content="width=device-width,initial-scale=1,maximum-scale=1, user-scalable=0"/>
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<link rel="stylesheet" type="text/css" href="/wro/je86~product.css">
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<link rel="stylesheet" href="/products/acp/releasedAssets/css/build-68bce19c818c293f19a8.css" media="all" id="build-style-sheet">
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<script>
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function isIE() { //won't check for edge browser
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var ua = navigator.userAgent;
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/* MSIE used to detect old browsers and Trident used to newer ones*/
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var is_ie = ua.indexOf("MSIE ") > -1 || ua.indexOf("Trident/") > -1;
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return is_ie;
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}
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if(isIE()) {
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buildCss.parentNode.removeChild(buildCss);
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<link rel="stylesheet" href="/products/acp/releasedAssets/css/print-68bce19c818c293f19a8.css"media="print">
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<meta http-equiv="X-UA-Compatible" content="IE=edge">
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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<!-- Google Tag Manager -->
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<script>
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if ("aim") {
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switch("aim") {
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// Annals
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case "aim":
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(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
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new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
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j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
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'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
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})(window,document,'script','dataLayer','GTM-MV3QTJ');
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break;
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// ACP Journal Club
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case "ajc":
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(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
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new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
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j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
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'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
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})(window,document,'script','dataLayer','GTM-TGVBSH9');
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break;
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// Clinical Cases
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case "acc":
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(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
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new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
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j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
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})(window,document,'script','dataLayer','GTM-5NLXHQ5');
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};
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};
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</script>
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<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
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})(window,document,'script','dataLayer','GTM-MK448RX');</script>
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<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
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'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
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})(window,document,'script','dataLayer','GTM-K6XTMPF');</script>
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<!-- End Google Tag Manager -->
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<!-- BEGIN AD SCRIPTS (ACP-24) -->
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<script>
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(function(w,d,s,m,n,t){
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w[m]=w[m]||{init:function(){(w[m].q=w[m].q||[]).push(arguments);},ready:function(c){if('function'!=typeof c){return;}(w[m].c=w[m].c||[]).push(c);c=w[m].c;
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n.onload=n.onreadystatechange=function(){if(!n.readyState||/loaded|complete/.test(n.readyState)){n.onload=n.onreadystatechange=null;
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if(t.parentNode&&n.parentNode){t.parentNode.removeChild(n);}while(c.length){(c.shift())();}}};}},w[m].d=1*new Date();n=d.createElement(s);t=d.getElementsByTagName(s)[0];
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n.async=1;n.src='//www.medtargetsystem.com/javascript/beacon.js?'+(Date.now().toString()).substring(0,5);n.setAttribute("data-aim",m);t.parentNode.insertBefore(n,t);
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})(window,document,'script','AIM');
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AIM.init('97-570-7F9EEAD7');
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</script>
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<!-- Start GPT Tag -->
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<script async='async' src='https://www.googletagservices.com/tag/js/gpt.js'></script>
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<script>
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var gptadslots = [];
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var googletag = googletag || {cmd:[]};
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</script>
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<script>
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googletag.cmd.push(function() {
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var leadermap = googletag.sizeMapping().addSize([0, 0], []).addSize([1000, 200], [[728, 90], [970, 60], [970, 66], [970, 90]]).build();
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var boxmap = googletag.sizeMapping().addSize([0, 0], [300, 250]).addSize([1000, 200], [300, 250]).build();
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var skymap = googletag.sizeMapping().addSize([0, 0], []).addSize([1000, 200], [330, 500]).build();
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var intmap = googletag.sizeMapping().addSize([0, 0], []).addSize([1000, 200], [1, 1]).build();
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//Adslot 1 declaration
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gptadslots.push(googletag.defineSlot('/11548178/annals/Annals_160x600_ROS', [[330,500]], 'div-gpt-ad-1455138856867-1').defineSizeMapping(skymap).addService(googletag.pubads()));
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|
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//Adslot 2 declaration
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gptadslots.push(googletag.defineSlot('/11548178/annals/Annals_1x1_Int_ROS', [[1,1]], 'div-gpt-ad-1455138856867-3').defineSizeMapping(intmap).addService(googletag.pubads()));
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|
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//Adslot 3 declaration
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gptadslots.push(googletag.defineSlot('/11548178/annals/Annals_300xFlex_ROS', [[300,250]], 'div-gpt-ad-1455138856867-5').defineSizeMapping(boxmap).addService(googletag.pubads()));
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|
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//Adslot 4 declaration
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gptadslots.push(googletag.defineSlot('/11548178/annals/Annals_728xFlex_ROS', [[970, 60], [970, 90], [728, 90], [970, 66], [320, 50], [300, 50]], 'div-gpt-ad-1455138856867-7').defineSizeMapping(leadermap).addService(googletag.pubads()));
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googletag.pubads().collapseEmptyDivs();
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||
|
||
switch("") {
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||
case "2101": //Cardiology
|
||
case "9403": //Endocrinology
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||
case "9579": //Gastroenterology/Hepatology
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||
case "8019": //Geriatrics
|
||
case "9271": //Hematology/Oncology
|
||
case "1541395": //Hospital Medicine
|
||
case "3282": //Infectious Diseases
|
||
case "1541397": //Psychiatry and Mental Health
|
||
case "9551": //Nephrology
|
||
case "3006": //Prevention
|
||
case "10515": //Pulmonary Critical Care
|
||
case "5147": //Rheumatology
|
||
googletag.pubads().setTargeting('t', []).setTargeting('loggedin', ['n']).setTargeting('Collection', ['']).setTargeting('Selfserve', []);
|
||
break;
|
||
default:
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||
googletag.pubads().setTargeting('t', []).setTargeting('loggedin', []).setTargeting('Collection', []).setTargeting('Selfserve', []);
|
||
};
|
||
|
||
AIM.ready(function(){
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||
AIM.ondetect(function(json){
|
||
if(!!json.dmd_specialty_code){ googletag.pubads().setTargeting('Specialty', [json.dmd_specialty_code]); }
|
||
if(!!json.npi_number){ googletag.pubads().setTargeting('NPI', [json.npi_number+'']); }
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||
if(!!json.errors){ console.warn(json.errors); }
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||
});
|
||
});
|
||
|
||
googletag.enableServices();
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||
});
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||
</script>
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||
<!-- End GPT Tag -->
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<!-- END AD SCRIPTS -->
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||
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||
|
||
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<script src="//scholar.google.com/scholar_js/casa.js" async></script>
|
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|
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|
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|
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</head>
|
||
<body class="pb-ui">
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<script type="text/javascript">
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if(false) {
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document.getElementById("skipNavigationLink").onclick =function skipElement () {
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var element = document.getElementById('');
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if(element == null || element == undefined) {
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element = document.getElementsByClassName('').item(0);
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}
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element.setAttribute('tabindex','0');
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element.focus();
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}
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}
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</script>
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<div id="pb-page-content" data-ng-non-bindable>
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<div data-pb-dropzone="main" data-pb-dropzone-name="Main">
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<!-- Google Tag Manager (noscript) -->
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<noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-MV3QTJ"
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height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
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<noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-MK448RX"
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height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
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<noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-K6XTMPF"
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height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
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<!-- End Google Tag Manager (noscript) -->
|
||
|
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|
||
|
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|
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|
||
<!-- temporary css -->
|
||
<style>
|
||
/* link styles for custom pages */
|
||
.custom-page-content a {
|
||
color: var(--journal-color);
|
||
}
|
||
.custom-page-content a:hover {
|
||
text-decoration: underline;
|
||
}
|
||
|
||
.ad-banner .leader>div:first-of-type {
|
||
margin: 1em 0;
|
||
}
|
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|
||
/* putting margin on left of orcid icon */
|
||
.orcid__wrapper i.icon-orcid {
|
||
margin: 0 0 0 4px;
|
||
}
|
||
|
||
/* tightening up the featured ad on the journal homepage */
|
||
.card--featured.advertisment {
|
||
padding: 0 24px;
|
||
}
|
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.card--featured .advertisment {
|
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margin-bottom: 0;
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margin-top: 0;
|
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}
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||
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/* layout of images in card list on journal homepage */
|
||
.card__list .card {
|
||
padding: 20px;
|
||
}
|
||
.card__list .card-img {
|
||
flex: none;
|
||
}
|
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.card__list .card-img img {
|
||
max-width: 50px;
|
||
max-height: 50px;
|
||
margin-right: 15px;
|
||
border: 1px solid #f0f0f0;
|
||
box-shadow: 4px 4px 4px rgba(0,0,0,.1);
|
||
}
|
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/* institution logo sizing */
|
||
.header .institution img {
|
||
max-width: 200px;
|
||
max-height: 54px;
|
||
height: auto;
|
||
width: auto;
|
||
}
|
||
/* undoing p styles in comments */
|
||
.comment__description p {
|
||
font-size: 14px;
|
||
font-size: .875rem;
|
||
line-height: 24px;
|
||
font-family: Montserrat,sans-serif;
|
||
}
|
||
/* remove page range, current issue label, and tighten up loi */
|
||
.loi__issue .current,
|
||
.loi__issue .page-range {
|
||
display: none;
|
||
}
|
||
.loi__issue {
|
||
margin-bottom: 0;
|
||
}
|
||
/* remove preview and format links from search results */
|
||
.search__item .issue-item__footer {
|
||
display: none;
|
||
}
|
||
|
||
/* styles for video and audio digital objects on article pages */
|
||
.relatedDo .teaser__item {
|
||
border-bottom: none;
|
||
background: #f0f0f0;
|
||
padding: 1em;
|
||
}
|
||
.relatedDo iframe.inline-video {
|
||
width: 100%;
|
||
height: 180px;
|
||
}
|
||
|
||
@media (max-width: 1023px) {
|
||
.relatedDo iframe.inline-video {
|
||
height: calc(100vw * .51);
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||
}
|
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}
|
||
|
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hr.section__separator {
|
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display: none;
|
||
}
|
||
.relatedDo .audio-player {
|
||
background: #fafafa;
|
||
}
|
||
|
||
/* styles for headings within abstracts */
|
||
.hlFld-Abstract .section__title:not(.to-section) {
|
||
color: black;
|
||
border-top: none;
|
||
margin-top: 0;
|
||
padding-top: 0;
|
||
font-size: 1.3em;
|
||
}
|
||
|
||
/* remove italics from sub-titles */
|
||
.citation__subtitle {
|
||
font-style: normal;
|
||
}
|
||
|
||
/* h3 within a comment */
|
||
.comment__description h3 {
|
||
font-size: 1rem;
|
||
font-weight: normal;
|
||
}
|
||
|
||
/* color of links in a popup */
|
||
.ux-modal-container .modal a.ext-link {
|
||
color: var(--journal-color);
|
||
}
|
||
|
||
/* style free icons on toc and search results */
|
||
span.icon-lock_free {
|
||
padding: 4px;
|
||
border-radius: 2px;
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||
border: 1px solid #d9d9d9;
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text-transform: uppercase;
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||
font-size: 10px;
|
||
font-size: .625rem;
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font-weight: 700;
|
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/* institution admin activation form inputs */
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|
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margin: 10px 0;
|
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}
|
||
|
||
/* ACP-646 */
|
||
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|
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flex-direction: column;
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|
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/* LIT-344553 */
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display: inline;
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|
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|
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|
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|
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|
||
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|
||
|
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|
||
content: "The following ZIP file contains a complete set of COUNTER reports from the old Annals of Internal Medicine website.";
|
||
display: block;
|
||
margin: 15px 0;
|
||
}
|
||
|
||
/* ACP-714 */
|
||
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|
||
min-height: unset;
|
||
}
|
||
|
||
@media (min-width: 768px) {
|
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|
||
margin-right: 0;
|
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}
|
||
}
|
||
|
||
/* ACP-241 */
|
||
article .quote {
|
||
padding: 0 2rem;
|
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|
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|
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article .quote p {
|
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font-size: 1.2em;
|
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|
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/* ACP-719 */
|
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border-top: 1px solid #d9d9d9;
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margin-top: 24px;
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<link rel="stylesheet" type="text/css" href="/pb-assets/styles/branding-aim-1581563343567.css">
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||
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||
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||
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||
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||
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||
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<div class="popup login-popup hidden">
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<h5 class="login-popup-title">LOGIN TO YOUR ACCOUNT</h5>
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<a href="/action/showLogin?redirectUri=%2Fdoi%2F10.7326%2FM19-3075" class="intro-link btn">
|
||
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||
INDIVIDUAL LOGIN | REGISTER
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||
</a>
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<span class="intro-sep">or</span>
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||
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<div class="institution-login">
|
||
INSTITUTIONAL LOGIN
|
||
</div>
|
||
</a>
|
||
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|
||
<div>
|
||
<br/>
|
||
<a href="/action/showLogin?redirectUri=%2Fdoi%2F10.7326%2FM19-3075" class="intro-link btn">
|
||
|
||
INSTITUTIONAL ADMIN LOGIN
|
||
</a>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
|
||
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||
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||
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||
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||
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||
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||
<div class="popup registration-popup hidden">
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<a href="#" class="close"><i class="icon-close_thin"></i></a>
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||
<div class="submit">
|
||
<input class="button submit primary" type="submit" value="Register" />
|
||
</div></form>
|
||
<div class="center">
|
||
<a href="/action/showLogin" class="show-login">
|
||
|
||
Returning user
|
||
</a>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
<div class="popup top-drawer request-reset-password-drawer hidden">
|
||
<div class="content">
|
||
<div class="form">
|
||
|
||
|
||
|
||
|
||
|
||
|
||
<p>Can't sign in? Forgot your password?</p>
|
||
<p class="sub">Enter your email address below and we will send you the reset instructions</p>
|
||
<div class="message error"></div>
|
||
<form action="/action/requestResetPassword" class="request-reset-password-form" method="post"><input type="hidden" name="requestResetPassword" value="true" />
|
||
|
||
<div class="input-group">
|
||
<div class="label">
|
||
<label for="05ce2409-fa0e-494a-9739-291434d86e80.email">Email*</label>
|
||
</div>
|
||
<input id="05ce2409-fa0e-494a-9739-291434d86e80.email" class="email" type="text" name="email" value="" size="15" />
|
||
</div>
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
<input class="button primary submit" type="submit" name="submit" value="Submit" disabled="disabled" /></form>
|
||
|
||
<div class="center">
|
||
<a href="#" class="cancel">Cancel</a>
|
||
</div>
|
||
</div>
|
||
<div class="success-template hidden">
|
||
<p>If the address matches an existing account you will receive an email with instructions to reset your password.</p>
|
||
<div class="center">
|
||
<a href="#" class="cancel">Close</a>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
<div class="popup top-drawer request-username-drawer username-popup hidden">
|
||
<a href="#" class="close"><i class="icon-close_thin"></i></a>
|
||
<div class="content">
|
||
<h2>Request Username</h2>
|
||
<div class="form">
|
||
<p>Can't sign in? Forgot your username?</p>
|
||
<p class="sub">Enter your email address below and we will send you your username</p>
|
||
<div class="message error"></div>
|
||
<form action="/action/requestUsername" method="post"><input type="hidden" name="requestUsername" value="requestUsername" />
|
||
<div class="input-group">
|
||
<div class="label">
|
||
<label for="4063045c-0f73-47d9-b7d4-bf4dc0ae83ee.email">Email*</label>
|
||
</div>
|
||
<input id="4063045c-0f73-47d9-b7d4-bf4dc0ae83ee.email" class="email" type="text" name="email" value="" size="15" />
|
||
</div>
|
||
|
||
<div class="username-recaptcha-ajax"></div>
|
||
|
||
<input class="button primary submit" type="submit" name="submit" value="Submit" disabled="disabled" />
|
||
<div class="center">
|
||
<a href="#" class="cancel">Close</a>
|
||
</div></form>
|
||
</div>
|
||
<div class="success-template hidden note">
|
||
<p>If the address matches an existing account you will receive an email with instructions to retrieve your username</p>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
<div class="popup change-password-drawer hidden">
|
||
<div class="content">
|
||
<a href="#" class="close cancel"><i class="icon-close_thin"></i></a>
|
||
<div class="form legacy-form">
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
<h2>Change Password </h2>
|
||
<form action="/action/changePassword" method="post"><div class="message error"></div>
|
||
<input type="hidden" name="submit" value="submit" />
|
||
<div class="input-group">
|
||
<div class="label">
|
||
<label for="dcfee248-106c-4d03-bc8c-4b501a338baf-old">Old Password</label>
|
||
</div>
|
||
<input id="dcfee248-106c-4d03-bc8c-4b501a338baf-old" class="old" type="password" name="old" value="" autocomplete="off" />
|
||
<span class="password-eye-icon icon-eye hidden"></span>
|
||
</div>
|
||
<div class="input-group">
|
||
<div class="label">
|
||
<label for="dcfee248-106c-4d03-bc8c-4b501a338baf-new">New Password</label>
|
||
</div>
|
||
<input id="dcfee248-106c-4d03-bc8c-4b501a338baf-new" class="pass-hint new" type="password" name="new" value="" autocomplete="off" />
|
||
<span class="password-eye-icon icon-eye hidden"></span>
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
<div class="password-strength-indicator" data-min="8" data-max="20" data-strength="3">
|
||
<span class="text too-short">Too Short</span>
|
||
<span class="text weak">Weak</span>
|
||
<span class="text medium">Medium</span>
|
||
<span class="text strong">Strong</span>
|
||
<span class="text very-strong">Very Strong</span>
|
||
<span class="text too-long">Too Long</span>
|
||
</div>
|
||
|
||
</div>
|
||
<input class="button primary submit" type="submit" value="Submit" disabled="disabled" /></form>
|
||
</div>
|
||
<div class="success-template hidden">
|
||
<h2>Password Changed Successfully</h2>
|
||
<p>Your password has been changed</p>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
<div class="top-drawer verify-phone-drawer hidden">
|
||
<div class="content">
|
||
<div class="form">
|
||
<h2>Verify Phone</h2>
|
||
<form action="/action/verifyPhoneNumber" method="post"><input type="hidden" name="submit" value="submit" />
|
||
<div class="message error"></div>
|
||
<div class="input-group">
|
||
<div class="label">
|
||
<label for="95a06d66-fddf-4302-ae04-87ea1f28e557-code">Enter the verification code</label>
|
||
</div>
|
||
<input id="95a06d66-fddf-4302-ae04-87ea1f28e557-code" class="verificationCode" type="text" name="verificationCode" value="" size="15" />
|
||
</div>
|
||
<input class="button primary submit" type="submit" value="Submit" disabled="disabled" /></form>
|
||
<div class="center">
|
||
<a href="#" class="cancel">Cancel</a>
|
||
</div>
|
||
</div>
|
||
<div class="success-template hidden">
|
||
<h2>Congrats!</h2>
|
||
<p>Your Phone has been verified</p>
|
||
<div class="center">
|
||
<a href="/action/showPreferences" class="button primary submit">close</a>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
<div class="ad-banner advertisement-wrap">
|
||
<div id="BodyContent_Header_ucAdvertisingBlocks_advertisingBlocksLeaderboard" contentplaceholderid="Leaderboard">
|
||
<!-- Ad Block 3 advertisingBlocksLeaderboard -->
|
||
<div style="margin: 0px auto 0px auto; text-align: center;">
|
||
<div id="BodyContent_Header_ucAdvertisingBlocks_regularLeaderBoardAdROS">
|
||
<!-- Ad Block 5 /11548178/annals/Annals_728xFlex_ROS -->
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||
<div class="leader" id='div-gpt-ad-1455138856867-7'>
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||
<script type='text/javascript'>
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googletag.cmd.push(function() {
|
||
googletag.display('div-gpt-ad-1455138856867-7');
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});
|
||
</script>
|
||
</div>
|
||
</div>
|
||
<div id="BodyContent_Header_ucAdvertisingBlocks_regularInterstitialAdROS">
|
||
<!-- /11548178/annals/Annals_1x1_Int_ROS -->
|
||
<div id='div-gpt-ad-1455138856867-3'>
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||
<script type='text/javascript'>
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||
googletag.cmd.push(function() {
|
||
googletag.display('div-gpt-ad-1455138856867-3');
|
||
});
|
||
</script>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
<div data-widget-def="UX3HTMLWidget" data-widget-id="a2c521e6-4cad-4539-996a-794752be350f" class="header fixed journal-branding aim">
|
||
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||
|
||
|
||
|
||
|
||
<header class="header fixed"><div class="journal-menu"><div class="journal-menu__left">
|
||
|
||
|
||
|
||
|
||
<div class="site__logo">
|
||
<a href="https://www.acponline.org/">
|
||
<img src="/specs/products/acp/releasedAssets/images/site-logo.png" alt="ACP Online"/>
|
||
</a>
|
||
</div>
|
||
<div class="journal-menu__journals">
|
||
<div class="dropBlock__holder journal-menu__dropblock">
|
||
<div class="dropBlock">
|
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<ul role="tablist" data-db-target-of="dbTab-0" aria-hidden="true" class="rlist tab__nav dropblock--tab">
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|
||
<li><a id="#pane-1-con" href="/journal/aim" aria-controls="#pane-1" role="tab" data-toggle="tab" title="Annals of Internal Medicine" aria-expanded="false">Annals of Internal Medicine</a></li>
|
||
<!-- li><a id="#pane-2-con" href="/journal/acc" aria-controls="#pane-2" role="tab" data-toggle="tab" title="Clinical Cases" aria-expanded="false">Clinical Cases</a></li -->
|
||
<li><a id="#pane-2-con" href="/loi/ajc" aria-controls="#pane-2" role="tab" data-toggle="tab" title="ACP Journal Club Archives" aria-expanded="false">ACP Journal Club Archives</a></li>
|
||
</ul>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</div><div class="journal-menu__right"></div></div><div class="secondary-container"><div class="header--first-row"><div class="header--first-col">
|
||
|
||
|
||
|
||
|
||
<a href="/journal/aim" class="header__logo">
|
||
<img src="/specs/products/acp/releasedAssets/images/aim-logo.svg" alt="Annals of Internal Medicine" class="hidden-sm hidden-xs">
|
||
<img src="/specs/products/acp/releasedAssets/images/aim-logo--sm.svg" alt="Annals of Internal Medicine" class="hidden-md hidden-lg">
|
||
</a>
|
||
</div><div class="header--second-col">
|
||
|
||
|
||
|
||
|
||
<div class="quick-search menu-qs quick-search--advanced"><a href="#" title="Search" data-db-target-for="headerQuickSearch" class="quick-menu__item quick-search__toggler"><i aria-hidden="true" class="block-icon icon-search"></i></a><div data-db-target-of="headerQuickSearch" class="dropBlock__holder quick-search__dropBlock md-opened quickSearchFormContainer"><div class="tab"><div class="quick-search__searchbox no-flex no-dropdown"><ul class="rlist quick-search__search-items"><li id="pane-0401e5e8-29cd-4223-aa12-9c461e8e807c0" aria-labelledby="pane-0401e5e8-29cd-4223-aa12-9c461e8e807c0-con" role="tabpanel" class="tab__pane quick-search-pane__anywhere"><form action="/action/doSearch" name="defaultQuickSearch" method="get" class="quick-search__form"><div class="quick-search__input input-group option-0 "><label for="AllField0401e5e8-29cd-4223-aa12-9c461e8e807c0" class="sr-only"></label><input autocomplete="off" type="search" id="AllField0401e5e8-29cd-4223-aa12-9c461e8e807c0" name="AllField" aria-label="" placeholder="Search Anywhere" data-auto-complete-max-words="7" data-auto-complete-max-chars="32" data-contributors-conf="3" data-topics-conf="3" data-publication-titles-conf="3" data-history-items-conf="3" value="" class="autocomplete"/></div><button type="submit" title="Search" class="btn quick-search__button"><span class="sr-only">Search</span><i aria-hidden="true" class="icon-search hvr-grow"></i></button></form></li><li class="advanced-and-citation-block">
|
||
|
||
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||
|
||
|
||
<div class="quick-search__links-wrapper">
|
||
<a href="/search/advanced" class="quick-search__advanced-search">Advanced search</a><a href="/search/advanced#citation" class="quick-search__citation-search">Citation search</a>
|
||
</div>
|
||
</li></ul></div></div><input type="hidden" value="https://www.acpjournals.org/search/advanced" class="quick-search__redirect-field"/></div></div>
|
||
<div class="header__quick-menu"><ul class="rlist--inline"><li>
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||
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|
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|
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|
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|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
||
|
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||
|
||
|
||
|
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|
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|
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|
||
<div class="loginBar login-open user-login-bar" title="Sign in">
|
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<a href="/action/showLogin?uri=%2Fdoi%2F10.7326%2FM19-3075&aria-label=Login" class="show-login loginBar__username" uri="/doi/10.7326/M19-3075" aria-label="Login">
|
||
<i class="icon-account_circle" aria-hidden="true"></i>
|
||
<span class="sign-in">Sign in</span>
|
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</a>
|
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</div>
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|
||
</li></ul></div></div></div><div class="header--second-row"><div class="generic-menu">
|
||
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<article data-uri="10.7326/M19-3075" data-view-fewer-author="View fewer authors" data-view-all-author="View all authors" data-figures="https://www.acpjournals.org/action/ajaxShowFigures?doi=10.7326%2FM19-3075&ajax=true" data-references="https://www.acpjournals.org/action/ajaxShowEnhancedAbstract?doi=10.7326%2FM19-3075&ajax=true" class="container"><div class="row"><div class="col-sm-12 col-md-8 article__content"><div class="citation"><div class="citation__top"><span class="citation__top__item">Original Research</span><span class="citation__top__item">7 April 2020</span></div><div class="citation__title__wrapper"><h1 class="citation__title"><a href="/doi/full/10.7326/M19-3075" title="The Effect of Influenza Vaccination for the Elderly on Hospitalization and Mortality">The Effect of Influenza Vaccination for the Elderly on Hospitalization and Mortality</a></h1></div><div class="citation__subtitle">An Observational Study With a Regression Discontinuity Design</div><ul class="rlist--inline article__corrections corrections-articles"></ul><ul title="list of authors" class="meta__authors rlist--inline loa mobile-authors visible-xs"><li><a href="#" title="" data-slide-target="#sb-1" class="w-slide__btn"><span>Michael L. Anderson, PhD</span>, </a></li><li><a href="#" title="" data-slide-target="#sb-1" class="w-slide__btn"><span>Carlos Dobkin, PhD</span>, </a></li><li><a href="#" title="" data-slide-target="#sb-1" class="w-slide__btn"><span>Devon Gorry, PhD</span></a></li></ul><div class="loa-wrapper hidden-xs"><div id="sb-1" class="accordion"><div class="accordion-tabbed loa-accordion"><div class="accordion-tabbed__tab accordion__closed "><a href="#" data-id="a1" data-db-target-for="a1" title="Michael L. Anderson, PhD" class="author-name accordion-tabbed__control visible-x"><span>Michael L. Anderson, PhD</span><i aria-hidden="true" class="icon-mail"></i><i aria-hidden="true" class="icon-arrow_d_n"></i></a><div data-db-target-of="a1" class="author-info accordion-tabbed__content"><p class="author-type"></p><p></p><p>University of California, Berkeley, Berkeley, California, and National Bureau of Economic Research, Cambridge, Massachusetts (M.L.A.)</p><div class="bottom-info"><p><a href="/author/Anderson%2C+Michael+L">Search for more papers by this author</a></p></div></div></div>, <div class="accordion-tabbed__tab "><a href="#" data-id="a2" data-db-target-for="a2" title="Carlos Dobkin, PhD" class="author-name accordion-tabbed__control visible-x"><span>Carlos Dobkin, PhD</span><i aria-hidden="true" class="icon-arrow_d_n"></i></a><div data-db-target-of="a2" class="author-info accordion-tabbed__content"><p class="author-type"></p><p></p><p>University of California, Santa Cruz, Santa Cruz, California, and National Bureau of Economic Research, Cambridge, Massachusetts (C.D.)</p><div class="bottom-info"><p><a href="/author/Dobkin%2C+Carlos">Search for more papers by this author</a></p></div></div></div>, <div class="accordion-tabbed__tab "><a href="#" data-id="a3" data-db-target-for="a3" title="Devon Gorry, PhD" class="author-name accordion-tabbed__control visible-x"><span>Devon Gorry, PhD</span><i aria-hidden="true" class="icon-arrow_d_n"></i></a><div data-db-target-of="a3" class="author-info accordion-tabbed__content"><p class="author-type"></p><p></p><p>Clemson University, Clemson, South Carolina (D.G.)</p><div class="bottom-info"><p><a href="/author/Gorry%2C+Devon">Search for more papers by this author</a></p></div></div></div></div></div></div><a href="#" data-toggle="modal" data-target="#disclosures-modal" class="disclosures-modal-toggle">Author, Article and Disclosure Information</a></div><div class="citation__doi__wrapper"><div class="citation__doi"><a href="https://doi.org/10.7326/M19-3075" class="citation__doi__link">https://doi.org/10.7326/M19-3075</a></div>
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</div></div></div><div class="article__body "><!--abstract content--><div class="hlFld-Abstract"><a name="abstract" class="scroll-offset"></a><div class="accordion visual-abstract__figure"><div class="accordion__content"><figure id="fva1-M193075" class="article__inlineFigure"><div class="figure__image__wrapper"><img class="figure__image" src="/na101/home/literatum/publisher/acp/journals/content/aim/2020/aim.2020.172.issue-7/m19-3075/20200425/images/medium/aime202004070-m193075_visual-abstract.png" data-lg-src="/na101/home/literatum/publisher/acp/journals/content/aim/2020/aim.2020.172.issue-7/m19-3075/20200425/images/large/aime202004070-m193075_visual-abstract.jpeg" alt="" /></div><figcaption><strong class="figure__title">Visual Abstract. Influenza Vaccination for the Elderly</strong><span class="figure__caption"><p></p><p>When vaccinating against influenza, some countries focus on elderly persons because observational studies indicate that this practice decreases both population mortality and the frequency of hospitalization. This new study finds different results with a different research design that reduces the bias and confounding that might have affected other studies.</p></span></figcaption><div class="figure-links"><ul class="rlist--inline"><li><a download="" href="/na101/home/literatum/publisher/acp/journals/content/aim/2020/aim.2020.172.issue-7/m19-3075/20200425/images/large/aime202004070-m193075_visual-abstract.jpeg" target="_blank">
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</a></li></ul></div></figure></div></div><div id="ac_i3" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i3">Background:</h2><p>Observational studies using traditional research designs suggest that influenza vaccination reduces hospitalizations and mortality among elderly persons. Accordingly, health authorities in some countries prioritize vaccination of this population. Nevertheless, questions remain about this policy's effectiveness given the potential for bias and confounding in observational data.</p><div id="ac_i4" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i4">Objective:</h2><p>To determine the effectiveness of the influenza vaccine in reducing hospitalizations and mortality among elderly persons by using an observational research design that reduces the possibility of bias and confounding.</p><div id="ac_i5" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i5">Design:</h2><p>A regression discontinuity design was applied to the sharp change in vaccination rate at age 65 years that resulted from an age-based vaccination policy in the United Kingdom. In this design, comparisons were limited to individuals who were near the age-65 threshold and were thus plausibly similar along most dimensions except vaccination rate.</p><div id="ac_i6" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i6">Setting:</h2><p>England and Wales.</p><div id="ac_i7" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i7">Participants:</h2><p>Adults aged 55 to 75 years residing in the study area during 2000 to 2014.</p><div id="ac_i8" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i8">Intervention:</h2><p>Seasonal influenza vaccine.</p><div id="ac_i9" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i9">Measurements:</h2><p>Hospitalization and mortality rates by month of age.</p><div id="ac_i10" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i10">Results:</h2><p>The data included 170 million episodes of care and 7.6 million deaths. Turning 65 was associated with a statistically and clinically significant increase in rate of seasonal influenza vaccination. However, no evidence indicated that vaccination reduced hospitalizations or mortality among elderly persons. The estimates were precise enough to rule out results from many previous studies.</p><div id="ac_i11" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i11">Limitation:</h2><p>The study relied on observational data, and its focus was limited to individuals near age 65 years.</p><div id="ac_i12" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i12">Conclusion:</h2><p>Current vaccination strategies prioritizing elderly persons may be less effective than believed at reducing serious morbidity and mortality in this population, which suggests that supplementary strategies may be necessary.</p><div id="ac_i13" class="anchor-spacer"></div><h2 class="article-section__title section__title" id="_i13">Primary Funding Source:</h2><p>National Institute on Aging.</p></div><!--/abstract content--><div class="article__references"><p class="explanation__text"></p><h2>References</h2><ul class="rlist separator"><li id="r1-M193075" class="
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</div><div class="ux-modal-container journal-branding"><div id="disclosures-modal" class="modal disclosures-modal"><div class="modal__dialog"><div class="modal__header"><button type="button" data-dismiss="modal" class="close"><i aria-hidden="true" class="icon-close"></i></button><h4 class="modal__header__title">Author, Article and Disclosure Information</h4></div><div class="modal__body"><p><b>Disclaimer:</b> The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the U.S. Department of Agriculture.</p><p><b>Acknowledgment:</b> The authors thank seminar participants at ASHEcon; Brigham Young University; Clemson University; University of California, Irvine; University of Connecticut; University of Illinois at Urbana-Champaign; and University of South Carolina.</p><p><b>Grant Support:</b> By award R01AG044796 from the National Institute on Aging of the National Institutes of Health and by Hatch project 233535 from the National Institute of Food and Agriculture of the U.S. Department of Agriculture. Eighty percent of the project was funded by federal sources, and none was funded by nongovernmental sources.</p><span class="NLM_fn" id="coi01"><p><b>Disclosures:</b> Drs. Anderson, Dobkin, and Gorry report grants from the National Institute on Aging of the National Institutes of Health during the conduct of the study. Disclosures can also be viewed at <a class="ext-link" href="http://www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3075" target="_blank">www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3075</a>.</p></span><p><b>Editors' Disclosures:</b> Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.</p><p><b>Reproducible Research Statement: </b><i>Study protocol:</i> Not available. <i>Statistical code:</i> Available at <a class="ext-link" href="https://doi.org/10.6078/D1Q11H" target="_blank">https://doi.org/10.6078/D1Q11H</a>. <i>Data set:</i> Available for purchase from the Royal College of General Practitioners Research and Surveillance Centre, the U.K. Office for National Statistics, the U.K. National Health Service Hospital Episode Statistics, the U.K. Data Archive, and Picker Institute Europe. The code archive provides details.</p><p><b>Corresponding Author:</b> Michael L. Anderson, PhD, 714 University Hall, MC3310, University of California, Berkeley, Berkeley, CA 94720; e-mail, <a class="ext-link" href="http://mlanderson@berkeley.edu" target="_blank"><span class="__cf_email__" data-cfemail="86ebeae7e8e2e3f4f5e9e8c6e4e3f4ede3eae3ffa8e3e2f3">[email protected]</span></a>.</p><p><b>Current Author Addresses:</b> Dr. Anderson: 714 University Hall, MC3310, University of California, Berkeley, Berkeley, CA 94720.</p><p>Dr. Dobkin: 441 Engineering 2, University of California, Santa Cruz, 1156 High Street, Santa Cruz, CA 95064.</p><p>Dr. Gorry: John E. Walker Department of Economics, 228 Sirrine Hall, Clemson, SC 29634.</p><p><b>Author Contributions:</b> Conception and design: M.L. Anderson, C. Dobkin, D. Gorry.</p><p>Analysis and interpretation of the data: M.L. Anderson, C. Dobkin, D. Gorry.</p><p>Drafting of the article: M.L. Anderson, C. Dobkin, D. Gorry.</p><p>Critical revision of the article for important intellectual content: M.L. Anderson, C. Dobkin, D. Gorry.</p><p>Final approval of the article: M.L. Anderson, C. Dobkin, D. Gorry.</p><p>Provision of study materials or patients: C. Dobkin.</p><p>Statistical expertise: M.L. Anderson, C. Dobkin, D. Gorry.</p><p>Obtaining of funding: M.L. Anderson, C. Dobkin, D. Gorry.</p><p>Administrative, technical, or logistic support: C. Dobkin.</p><p>Collection and assembly of data: C. Dobkin, D. Gorry.</p></div></div></div></div>
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<div class="cover-details"><div class="current-issue"><div class="current-issue__cover"><div class="cover-image"><div class="cover-image__image"><img src="/na101/home/literatum/publisher/acp/journals/content/aim/2020/aim.2020.172.issue-7/aim.2020.172.issue-7/20200410-01/aim.2020.172.issue-7.cover.png" alt="undefined cover image"></div></div></div><div class="current-issue__info"><div class="current-issue__details"><div class="current-issue__specifics"><a href="/toc/aim/172/7"><span>7 April 2020</span><span>Volume 172, Issue 7</span></a></div><div class="current-issue__description"><p>Page: 445-452</p></div></div></div></div></div><section class="section article__keyword"><strong class="section__title">Keywords</strong><div class="section__body my-3"><ul class="rlist rlist--inline"><li><a href="/topic/acpthes/1541398" class="badge-type">Pulmonary diseases</a></li><li><a href="/topic/acpthes/8910" class="badge-type">Epidemiology</a></li><li><a href="/topic/acpthes/3915" class="badge-type">Pneumonia</a></li><li><a href="/topic/acpthes/4073" class="badge-type">Vaccines</a></li><li><a href="/topic/acpthes/4296" class="badge-type">Research design</a></li><li><a href="/topic/acpthes/1092" class="badge-type">Morbidity</a></li><li><a href="/topic/acpthes/4270" class="badge-type">Information storage and retrieval</a></li><li><a href="/topic/acpthes/9036" class="badge-type">Birth</a></li><li><a href="/topic/acpthes/691" class="badge-type">Medical services</a></li><li><a href="/topic/acpthes/9231" class="badge-type">Elderly</a></li><li><a href="/topic/acpthes/649" class="badge-type">Observational studies</a></li><li><a href="/topic/acpthes/7658" class="badge-type">Statistical data</a></li><li><a href="/topic/acpthes/362" class="badge-type">Hospitalizations</a></li><li><a href="/topic/acpthes/7113" class="badge-type">Sexual identity</a></li><li><a href="/topic/acpthes/7861" class="badge-type">Immune response</a></li><li><a href="/topic/acpthes/5684" class="badge-type">Death rates</a></li><li><a href="/topic/acpthes/6498" class="badge-type">Age groups</a></li></ul></div></section><section class="section article__metrics"><strong class="section__title">Metrics</strong><div class="section__body my-3">
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<div>ePublished: 3 March 2020</div>
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<div>Issue Published: 7 April 2020</div>
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