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The Diagnosis and Treatment of Gastroesophageal Reflux Disease in a Managed Care Environment: Suggested Disease Management Guidelines

The Diagnosis and Treatment of Gastroesophageal Reflux Disease in a Managed Care Environment:... Abstract A group of experts from gastroenterology, internal medicine, health economics, medical outcomes, and managed care met in San Francisco, Calif, on September 27, 1994, in an effort to develop clinically and economically effective disease management guidelines to assist physicians in their treatment of gastroesophageal reflux disease in a managed care environment. This article represents a consensus opinion based on the evidence and expert interpretation at the time of that meeting. (Arch Intern Med. 1996;156:477-484) References 1. Hillman AL, Bloom BS, Fendrick AM, Schwartz JJ. Cost and quality effects of alternative treatments for persistent gastroesophageal reflux disease . Arch Intern Med. 1992;152:1467-1472.Crossref 2. Patrick DL, Erickson E. Health Status and Health Policy: Quality of Life in Health Care Evaluation and Resource Allocation . New York, NY: Oxford University Press Inc; 1993. 3. Pope CE. The quality of life following antireflux surgery . World J Surg. 1992;16:355-358.Crossref 4. Stewart AL, Greenfield S, Hays RD, et al. Functional status and well-being of patients with chronic conditions: results from the Medical Outcomes Study . JAMA. 1989;262:907-913.Crossref 5. Dimenas E. Methodological aspects of evaluation of quality of life in upper gastrointestinal diseases . Scand J Gastroenterol. 1993;28:18-21.Crossref 6. Dimenas E, Glise H, Hallerback B, et al. Quality of life in patients with upper gastrointestinal symptoms: an improved evaluation of treatment regimens? Scand J Gastroenterol. 1993;28:681-687.Crossref 7. Brand DL, Eastwood IR, Martin D, Carter WB, Pope CE. Esophageal symptoms, manometry, and histology before and after antireflux surgery . Gastroenterology. 1979;76:1393-1397. 8. Gallup Organization National Survey. Heartburn Across America . Princeton, NJ: Gallup Organization Inc; 1988. 9. Nebel OT, Fornes MF, Castell DO. Symptomatic gastroesophageal reflux: incidence and precipitating factors . Am J Dig Dis. 1976;21:953-956.Crossref 10. Richter JE, Bradley LA, Castel DO. Esophageal chest pain: current controversies in pathogenesis, diagnosis and therapy . Ann Intern Med. 1989; 110:66-78.Crossref 11. Irwin RS, Corrao WM, Pratter MR. Chronic persistent cough in the adult: the frequency and spectrum of causes and successful outcome of specific therapy . Am Rev Respir Dis. 1981;123:413-417. 12. Hewson EG, Sinclair JW, Dalton CB, Richter JE. Twenty-four-hour esophageal pH monitoring: the most useful test for evaluating noncardiac chest pain . Am J Med. 1991;90:576-583.Crossref 13. Sontag SJ, O'Connell S, Khandelwal S, et al. Most asthmatics have gastroesophageal reflux with or without bronchodilator therapy . Gastroenterology. 1990;99:613-620. 14. Dakkak M, Hoare RC, Maslin SC, Bennett GR. Oesophagitis is as important as oesophageal stricture diameter in determining dysphagia . Gut. 1993; 34:152-155.Crossref 15. Winters C, Spurling TJ, Chobanian SJ, et al. Barrett's esophagus: a prevalent occult complication of gastroesophageal reflux disease . Gastroenterology. 1987;92:118-124. 16. Dent J, Dodds WJ, Friedman RH, et al. Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects . J Clin Invest. 1980; 65:256-267.Crossref 17. Wyman JB, Dent J, Heddle R, Dodds WJ, Toouli J, Downton J. Control of belching by the lower esophageal sphincter . Gut. 1990;31:639-646.Crossref 18. Mittal RK, Rochester DF, McCallum RW. Electrical and mechanical activity in the human lower esophageal sphincter during diaphragmatic contraction . J Clin Invest. 1988;81:1182-1189.Crossref 19. Sloan S, Rademaker AW, Kahrilas PJ. Determinants of gastroesophageal junction incompetence: hiatus hernia, lower esophageal sphincter, or both? Ann Intern Med. 1992:117:977-982.Crossref 20. Johnson LF. 24-hour pH monitoring in the study of gastroesophageal reflux . J Clin Gastroenterol. 1980;2:387-399.Crossref 21. Kahrilas PJ, Dodds WJ, Hogan WJ, Kern M, Arndorfer RC, Reece A. Esophageal peristaltic dysfunction in peptic esophagitis . Gastroenterology. 1986;91:897-904. 22. Mittal RK, Lange RC, McCallum RW. Identification and mechanism of delayed esophageal acid clearance in subjects with hiatus hernia . Gastroenterology. 1987;92:130-135. 23. Sloan S, Kahrilas PJ. Impairment of esophageal emptying with hiatal hernia . Gastroenterology. 1991;100:596-605. 24. Orr WC, Robinson MG, Johnson LF. Acid clearance during sleep in the pathogenesis of reflux esophagitis . Dig Dis Sci. 1981;26:423-427.Crossref 25. Powell DW. Barrier function of epithelia . Am J Physiol. 1981;241:G275-G288. 26. Cameron AJ, Zinsmeister AR, Ballard DJ, Carney JA. Prevalence of columnar-lined (Barrett's) esophagus: comparison of population-based clinical and autopsy findings . Gastroenterology. 1990;99:918-922. 27. Sampliner RF, Hixson LJ, Fennerty MB, Garewal HS. Regression of Barrett's esophagus by laser ablation in an antacid environment . Dig Dis Sci. 1993;38:365-368.Crossref 28. Sampliner RE, Garewal HS, Fennerty MB, Aickin M. Lack of impact of therapy on extent of Barrett's esophagus in 67 patients . Dig Dis Sci. 1990; 35:93-96.Crossref 29. Sampliner RE. Effect of up to 3 years of high-dose lansoprazole in Barrett's esophagus . Am J Gastroenterol. 1994;89:1844-1848. 30. Smith PM, Kerr GD, Cockel R, et al. A comparison of omeprazole and ranitidine in the prevention and recurrence of benign oesophageal stricture . Gastroenterology. 1994;107:1312-1318.Crossref 31. Katzka DA, Castell DO. Successful elimination of reflux symptoms does not insure adequate control of acid reflux in patients with Barrett's esophagus . Am J Gastroenterol. 1994;89:989-991. 32. Hacker JF, Chobanian SJ, Johnson DA, Winters C, Cattau EL. Patient acceptability of upper GI radiography versus endoscopy . South J Med. 1987;80:1091-1093.Crossref 33. Waring JP, Hunter JG, Oddsdottir M, Wo J, Katz E. The preoperative evaluation of patients considered for laparoscopic antireflux surgery . Am J Gastroenterol. 1995;90:35-38. 34. Shindlebeck NE, Klauser AG, Berghammer G, Londong W, Muller-Lissner SA. Three-year follow-up with patients with gastroesophageal reflux disease . Gut. 1992;33:1016-1019.Crossref 35. McDougall NI, Johnston BT, Kee F, et al. Three-year follow-up of reflux oesophagitis: do patients still require acid suppression therapy? Gut. 1994;35( (suppl 4) ):A175. Abstract. 36. Hetzel DJ, Dent J, Reed WD, et al. Healing and relapse of severe peptic esophagitis after treatment with omeprazole . Gastroenterology. 1988; 95:903-912. 37. Johnson DA. Medical therapy of gastroesophageal reflux disease . Am J Med. 1992;92( (suppl 5A) ):88-97.Crossref 38. Thomson ABR, Babiuk L, Kirdeikis P, et al. A dose ranging study of ranitidine in its effect on intragastric and intra-oesophageal acidity in subjects with gastro-oesophageal reflux disease . Aliment Pharmacol Ther. 1994;8:443-451.Crossref 39. Johnson NJ, Boyd EJS, Mills JG, Wood JR. A key treatment of reflux oesophagitis: a multi-centered trial to compare 150 mgs ranitidine b.d. with 300 mgs. ranitidine q.d.s . Aliment Pharmacol Ther. 1989;3:259-266.Crossref 40. Bate CM, Keeling PW, O'Morain C, et al. Comparison of omeprazole and cimetidine in reflux oesophagitis: symptomatic endoscopic and histologic evaluations . Gut. 1990;31:968-972.Crossref 41. Bardhaan, KD, Morris P, Tompson M, et al. Omeprazole in the treatment of erosive oesophagitis refractory to high dose of cimetidine and ranitidine . Gut. 1990;31:745-759.Crossref 42. Lundell L, Backkman L, Ekstrom P, et al. Omeprazole or high-dose ranitidine in the treatment of patients with reflux oesophagitis not responding to 'standard doses' of H2 receptor antagonists . Aliment Pharmacol Ther. 1990;4:145-156.Crossref 43. Rianchai, Porro G, Pace F, Peracchia A. Short-term treatment of refractory reflux oesophagitis with different doses of omeprazole or ranitidine . J Clin Gastroenterol. 1992;15:192-198.Crossref 44. Havelund T, Laursen LS, Lauritsen K. Efficacy of omeprazole in lower grades of gastrooesophageal reflux disease . Scand J Gastroenterol. 1994;29( (suppl 201) ):69-73.Crossref 45. Spencer CM, Faulds D. Lansoprazole: a reappraisal of its pharmacodynamic and pharmacokinetic properties, and its therapeutic efficacy in acid related disease . Drugs. 1994; 48:404-430.Crossref 46. Klinkenberg-Krol EC, Festen HP, Jansen JB, et al. Efficacy and safety of long-term treatment with omeprazole for refractory reflux esophagitis . Ann Intern Med. 1994;121:161-167.Crossref 47. Maton PN. Omeprazole . N Engl J Med. 1991; 324:965-975.Crossref 48. Ramirez B, Richter JE. Review article: promotility drugs and the treatment of gastrooesophageal reflux disease . Aliment Pharmacol Ther. 1993;7:5-20.Crossref 49. Geldof H, Hazelhoff B, Otten MH. Two different dose regimens of cisapride in the treatment of reflux oesophagitis: a double-blind comparison with ranitidine . Aliment Pharmacol Ther. 1993; 7:409-415.Crossref 50. Robinson M, Deckator DL, Maton PN, et al. Omeprazole is superior to ranitidine plus metoclopramide in the short-term treatment of erosive oesophagitis . Aliment Pharmacol Ther. 1993; 7:67-73.Crossref 51. Mundo F, Felix R, Aguilar J, et al. Omeprazole vs ranitidine plus cisapride in the treatment of reflux oesophagitis: comparative endoscopic study . Am J Gastroenterol. 1992;87:1254. 52. Swarbrick ET, Gough AL, Christian J, et al. Prevention of recurrence of oesophageal stricture: a comparative study of lansoprazole and high-dose ranitidine . Gut. 1994;35( (suppl 4) ):A175. Abstract. 53. Dent K, Yeomans ND, Mackinoon M, et al. Omeprazole vs ranitidine for prevention of relapse in reflux oesophagitis: a double-blind trial of their efficacy and safety . Gut. 1994;35:590-598.Crossref 54. Hallerback B, Unge P, Carling L, et al. Omeprazole and ranitidine in long-term treatment of reflux oesophagitis . Gastroenterology. 1994;107:1305-1311.Crossref 55. Lundell L. Long-term treatment of gastrooesophageal reflux disease with omeprazole . Scand J Gastroenterol. 1994;29( (suppl 201) ):74-78.Crossref 56. Marks R, Richter JE, Rizzo J, et al. Omeprazole vs. H2 receptor antagonists in treating patients with peptic stricture and oesophagitis . Gastroenterology. 1994;106:907-915. 57. Lieberman DA. Medical therapy for chronic reflux esophagitis . Arch Intern Med. 1987;147:1717-1720.Crossref 58. Just R, Katzka DA, Castell DO. Omeprazole failure in a patient with gastroesophageal reflux disease . Ann Intern Med. 1994;121:899.Crossref 59. Kasapidis P, Xynos E, Mantides A, et al. Differences in manometry in 24-hour ambulatory pH-metry between patients with and without endoscopic or histologic esophagitis and gastroesophageal reflux disease . Am J Gastroenterol. 1993;88:1893-1899. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

The Diagnosis and Treatment of Gastroesophageal Reflux Disease in a Managed Care Environment: Suggested Disease Management Guidelines

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References (59)

Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1996.00440050019003
Publisher site
See Article on Publisher Site

Abstract

Abstract A group of experts from gastroenterology, internal medicine, health economics, medical outcomes, and managed care met in San Francisco, Calif, on September 27, 1994, in an effort to develop clinically and economically effective disease management guidelines to assist physicians in their treatment of gastroesophageal reflux disease in a managed care environment. This article represents a consensus opinion based on the evidence and expert interpretation at the time of that meeting. (Arch Intern Med. 1996;156:477-484) References 1. Hillman AL, Bloom BS, Fendrick AM, Schwartz JJ. Cost and quality effects of alternative treatments for persistent gastroesophageal reflux disease . Arch Intern Med. 1992;152:1467-1472.Crossref 2. Patrick DL, Erickson E. Health Status and Health Policy: Quality of Life in Health Care Evaluation and Resource Allocation . New York, NY: Oxford University Press Inc; 1993. 3. Pope CE. The quality of life following antireflux surgery . World J Surg. 1992;16:355-358.Crossref 4. Stewart AL, Greenfield S, Hays RD, et al. Functional status and well-being of patients with chronic conditions: results from the Medical Outcomes Study . JAMA. 1989;262:907-913.Crossref 5. Dimenas E. Methodological aspects of evaluation of quality of life in upper gastrointestinal diseases . Scand J Gastroenterol. 1993;28:18-21.Crossref 6. Dimenas E, Glise H, Hallerback B, et al. Quality of life in patients with upper gastrointestinal symptoms: an improved evaluation of treatment regimens? Scand J Gastroenterol. 1993;28:681-687.Crossref 7. Brand DL, Eastwood IR, Martin D, Carter WB, Pope CE. Esophageal symptoms, manometry, and histology before and after antireflux surgery . Gastroenterology. 1979;76:1393-1397. 8. Gallup Organization National Survey. Heartburn Across America . Princeton, NJ: Gallup Organization Inc; 1988. 9. Nebel OT, Fornes MF, Castell DO. Symptomatic gastroesophageal reflux: incidence and precipitating factors . Am J Dig Dis. 1976;21:953-956.Crossref 10. Richter JE, Bradley LA, Castel DO. Esophageal chest pain: current controversies in pathogenesis, diagnosis and therapy . Ann Intern Med. 1989; 110:66-78.Crossref 11. Irwin RS, Corrao WM, Pratter MR. Chronic persistent cough in the adult: the frequency and spectrum of causes and successful outcome of specific therapy . Am Rev Respir Dis. 1981;123:413-417. 12. Hewson EG, Sinclair JW, Dalton CB, Richter JE. Twenty-four-hour esophageal pH monitoring: the most useful test for evaluating noncardiac chest pain . Am J Med. 1991;90:576-583.Crossref 13. Sontag SJ, O'Connell S, Khandelwal S, et al. Most asthmatics have gastroesophageal reflux with or without bronchodilator therapy . Gastroenterology. 1990;99:613-620. 14. Dakkak M, Hoare RC, Maslin SC, Bennett GR. Oesophagitis is as important as oesophageal stricture diameter in determining dysphagia . Gut. 1993; 34:152-155.Crossref 15. Winters C, Spurling TJ, Chobanian SJ, et al. Barrett's esophagus: a prevalent occult complication of gastroesophageal reflux disease . Gastroenterology. 1987;92:118-124. 16. Dent J, Dodds WJ, Friedman RH, et al. Mechanism of gastroesophageal reflux in recumbent asymptomatic human subjects . J Clin Invest. 1980; 65:256-267.Crossref 17. Wyman JB, Dent J, Heddle R, Dodds WJ, Toouli J, Downton J. Control of belching by the lower esophageal sphincter . Gut. 1990;31:639-646.Crossref 18. Mittal RK, Rochester DF, McCallum RW. Electrical and mechanical activity in the human lower esophageal sphincter during diaphragmatic contraction . J Clin Invest. 1988;81:1182-1189.Crossref 19. Sloan S, Rademaker AW, Kahrilas PJ. Determinants of gastroesophageal junction incompetence: hiatus hernia, lower esophageal sphincter, or both? Ann Intern Med. 1992:117:977-982.Crossref 20. Johnson LF. 24-hour pH monitoring in the study of gastroesophageal reflux . J Clin Gastroenterol. 1980;2:387-399.Crossref 21. Kahrilas PJ, Dodds WJ, Hogan WJ, Kern M, Arndorfer RC, Reece A. Esophageal peristaltic dysfunction in peptic esophagitis . Gastroenterology. 1986;91:897-904. 22. Mittal RK, Lange RC, McCallum RW. Identification and mechanism of delayed esophageal acid clearance in subjects with hiatus hernia . Gastroenterology. 1987;92:130-135. 23. Sloan S, Kahrilas PJ. Impairment of esophageal emptying with hiatal hernia . Gastroenterology. 1991;100:596-605. 24. Orr WC, Robinson MG, Johnson LF. Acid clearance during sleep in the pathogenesis of reflux esophagitis . Dig Dis Sci. 1981;26:423-427.Crossref 25. Powell DW. Barrier function of epithelia . Am J Physiol. 1981;241:G275-G288. 26. Cameron AJ, Zinsmeister AR, Ballard DJ, Carney JA. Prevalence of columnar-lined (Barrett's) esophagus: comparison of population-based clinical and autopsy findings . Gastroenterology. 1990;99:918-922. 27. Sampliner RF, Hixson LJ, Fennerty MB, Garewal HS. Regression of Barrett's esophagus by laser ablation in an antacid environment . Dig Dis Sci. 1993;38:365-368.Crossref 28. Sampliner RE, Garewal HS, Fennerty MB, Aickin M. Lack of impact of therapy on extent of Barrett's esophagus in 67 patients . Dig Dis Sci. 1990; 35:93-96.Crossref 29. Sampliner RE. Effect of up to 3 years of high-dose lansoprazole in Barrett's esophagus . Am J Gastroenterol. 1994;89:1844-1848. 30. Smith PM, Kerr GD, Cockel R, et al. A comparison of omeprazole and ranitidine in the prevention and recurrence of benign oesophageal stricture . Gastroenterology. 1994;107:1312-1318.Crossref 31. Katzka DA, Castell DO. Successful elimination of reflux symptoms does not insure adequate control of acid reflux in patients with Barrett's esophagus . Am J Gastroenterol. 1994;89:989-991. 32. Hacker JF, Chobanian SJ, Johnson DA, Winters C, Cattau EL. Patient acceptability of upper GI radiography versus endoscopy . South J Med. 1987;80:1091-1093.Crossref 33. Waring JP, Hunter JG, Oddsdottir M, Wo J, Katz E. The preoperative evaluation of patients considered for laparoscopic antireflux surgery . Am J Gastroenterol. 1995;90:35-38. 34. Shindlebeck NE, Klauser AG, Berghammer G, Londong W, Muller-Lissner SA. Three-year follow-up with patients with gastroesophageal reflux disease . Gut. 1992;33:1016-1019.Crossref 35. McDougall NI, Johnston BT, Kee F, et al. Three-year follow-up of reflux oesophagitis: do patients still require acid suppression therapy? Gut. 1994;35( (suppl 4) ):A175. Abstract. 36. Hetzel DJ, Dent J, Reed WD, et al. Healing and relapse of severe peptic esophagitis after treatment with omeprazole . Gastroenterology. 1988; 95:903-912. 37. Johnson DA. Medical therapy of gastroesophageal reflux disease . Am J Med. 1992;92( (suppl 5A) ):88-97.Crossref 38. Thomson ABR, Babiuk L, Kirdeikis P, et al. A dose ranging study of ranitidine in its effect on intragastric and intra-oesophageal acidity in subjects with gastro-oesophageal reflux disease . Aliment Pharmacol Ther. 1994;8:443-451.Crossref 39. Johnson NJ, Boyd EJS, Mills JG, Wood JR. A key treatment of reflux oesophagitis: a multi-centered trial to compare 150 mgs ranitidine b.d. with 300 mgs. ranitidine q.d.s . Aliment Pharmacol Ther. 1989;3:259-266.Crossref 40. Bate CM, Keeling PW, O'Morain C, et al. Comparison of omeprazole and cimetidine in reflux oesophagitis: symptomatic endoscopic and histologic evaluations . Gut. 1990;31:968-972.Crossref 41. Bardhaan, KD, Morris P, Tompson M, et al. Omeprazole in the treatment of erosive oesophagitis refractory to high dose of cimetidine and ranitidine . Gut. 1990;31:745-759.Crossref 42. Lundell L, Backkman L, Ekstrom P, et al. Omeprazole or high-dose ranitidine in the treatment of patients with reflux oesophagitis not responding to 'standard doses' of H2 receptor antagonists . Aliment Pharmacol Ther. 1990;4:145-156.Crossref 43. Rianchai, Porro G, Pace F, Peracchia A. Short-term treatment of refractory reflux oesophagitis with different doses of omeprazole or ranitidine . J Clin Gastroenterol. 1992;15:192-198.Crossref 44. Havelund T, Laursen LS, Lauritsen K. Efficacy of omeprazole in lower grades of gastrooesophageal reflux disease . Scand J Gastroenterol. 1994;29( (suppl 201) ):69-73.Crossref 45. Spencer CM, Faulds D. Lansoprazole: a reappraisal of its pharmacodynamic and pharmacokinetic properties, and its therapeutic efficacy in acid related disease . Drugs. 1994; 48:404-430.Crossref 46. Klinkenberg-Krol EC, Festen HP, Jansen JB, et al. Efficacy and safety of long-term treatment with omeprazole for refractory reflux esophagitis . Ann Intern Med. 1994;121:161-167.Crossref 47. Maton PN. Omeprazole . N Engl J Med. 1991; 324:965-975.Crossref 48. Ramirez B, Richter JE. Review article: promotility drugs and the treatment of gastrooesophageal reflux disease . Aliment Pharmacol Ther. 1993;7:5-20.Crossref 49. Geldof H, Hazelhoff B, Otten MH. Two different dose regimens of cisapride in the treatment of reflux oesophagitis: a double-blind comparison with ranitidine . Aliment Pharmacol Ther. 1993; 7:409-415.Crossref 50. Robinson M, Deckator DL, Maton PN, et al. Omeprazole is superior to ranitidine plus metoclopramide in the short-term treatment of erosive oesophagitis . Aliment Pharmacol Ther. 1993; 7:67-73.Crossref 51. Mundo F, Felix R, Aguilar J, et al. Omeprazole vs ranitidine plus cisapride in the treatment of reflux oesophagitis: comparative endoscopic study . Am J Gastroenterol. 1992;87:1254. 52. Swarbrick ET, Gough AL, Christian J, et al. Prevention of recurrence of oesophageal stricture: a comparative study of lansoprazole and high-dose ranitidine . Gut. 1994;35( (suppl 4) ):A175. Abstract. 53. Dent K, Yeomans ND, Mackinoon M, et al. Omeprazole vs ranitidine for prevention of relapse in reflux oesophagitis: a double-blind trial of their efficacy and safety . Gut. 1994;35:590-598.Crossref 54. Hallerback B, Unge P, Carling L, et al. Omeprazole and ranitidine in long-term treatment of reflux oesophagitis . Gastroenterology. 1994;107:1305-1311.Crossref 55. Lundell L. Long-term treatment of gastrooesophageal reflux disease with omeprazole . Scand J Gastroenterol. 1994;29( (suppl 201) ):74-78.Crossref 56. Marks R, Richter JE, Rizzo J, et al. Omeprazole vs. H2 receptor antagonists in treating patients with peptic stricture and oesophagitis . Gastroenterology. 1994;106:907-915. 57. Lieberman DA. Medical therapy for chronic reflux esophagitis . Arch Intern Med. 1987;147:1717-1720.Crossref 58. Just R, Katzka DA, Castell DO. Omeprazole failure in a patient with gastroesophageal reflux disease . Ann Intern Med. 1994;121:899.Crossref 59. Kasapidis P, Xynos E, Mantides A, et al. Differences in manometry in 24-hour ambulatory pH-metry between patients with and without endoscopic or histologic esophagitis and gastroesophageal reflux disease . Am J Gastroenterol. 1993;88:1893-1899.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 11, 1996

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