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Articles 
Brian M. Berman, Lixing Lao, Patricia Langenberg, Wen Lin Lee, Adele M.K. Gilpin, and Marc C. Hochberg Acupuncture as adjunctive therapy for osteoarthritis of the knee seems to improve function and relieve pain when compared with control groups receiving either credible sham acupuncture or patient education.
Peter White, George Lewith, Phil Prescott, and Joy Conway Acupuncture reduced chronic neck pain by a statistically, but not clinically, significant effect compared with placebo. The beneficial effects of acupuncture for pain may be due to both nonspecific and specific effects.
John D. Childs, Julie M. Fritz, Timothy W. Flynn, James J. Irrgang, Kevin K. Johnson, Guy R. Majkowski, and Anthony Delitto Patients with low back pain were most likely to benefit from spinal manipulation if they met at least 4 of the following criteria: symptom duration less than 16 days, no symptoms distal to the knee, score less than 19 on a fear-avoidance measure, at least 1 hypermobile lumbar segment, and at least 1 hip with more than 35 degrees of internal rotation.
Andrew D. Rule, Timothy S. Larson, Erik J. Bergstralh, Jeff M. Slezak, Steven J. Jacobsen, and Fernando G. Cosio The Modification of Diet in Renal Disease equation for glomerular filtration rate (GFR) substantially underestimates GFR in healthy persons. A new equation developed with patients with chronic kidney disease and healthy persons may be a step toward accurately estimating GFR when renal function is unknown.
Improving Patient Care
Steven M. Asch, Elizabeth A. McGlynn, Mary M. Hogan, Rodney A. Hayward, Paul Shekelle, Lisa Rubenstein, Joan Keesey, John Adams, and Eve A. Kerr This study used a comprehensive quality-of-care measure to compare the quality of care in the Veterans Health Administration (VHA) and in a national sample. Patients from the VHA received higher-quality care. Differences were greatest in areas where the VHA has established performance measures and actively monitors performance.
Reviews
Keith G. Tolman, Vivian Fonseca, Meng H. Tan, and Anthony Dalpiaz The authors discuss liver disease in type 2 diabetes, including nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, hepatitis C, acute liver failure, and cholelithiasis. They also review the metabolic effects of type 2 diabetes on the liver, the hepatotoxicity of antihyperglycemic medications, and the treatment of diabetes in patients with liver disease.
Editorials
Richard A. Deyo Two articles in this issue address "alternative" treatments for spinal disorders: manipulation for acute low back pain and acupuncture for chronic neck pain. Both studies suggest that the patient's expectations of treatment affect the outcomes of treatment. Therefore, we should try to learn patient expectations and think about how they should affect our treatment recommendations.
Lesley A. Stevens and Andrew S. Levey Estimating equations that accurately calculate glomerular filtration rate (GFR) in patients with chronic kidney disease and normal renal function are potentially important for early detection of disease. Until we are confident that they accurately calculate GFR in several independent populations, we should use current estimating equations, which are well-tested in several different populations of patients with kidney disease.
On Being a Doctor
Richard G. Druss After an extensive evaluation, my father would usher the patient into his consulting room. He would then offer 2 sequential proclamations: This is what you have, and this is what you must do about it. He was not there for discussion. He believed in the authoritarian, not the collaborative, school of medicine. But patients ate it up. When Moses delivered the Ten Commandments to the Children of Israel at Mount Sinai, it was not to start a debate on the merits of "Thou shalt not bear false witness."
Cynthia X. Pan, Jennifer Kales, and Sandra Sanchez-Reilly After hearing the risks and benefits of treatment options, Mrs. V. decided she did not want to be treated. She told us that she wanted to focus on getting home. Two problems arose: Home was in the Philippines, and Mrs. V. had no health insurance and therefore could not receive home hospice benefits.
Letters Terminal Sedation in the Netherlands
Age and Routine Invasive Management of Acute Coronary Syndromes
Gatifloxacin-Induced Hyperglycemia
Hypoglycemia, Hyperglycemia, and Gatifloxacin
Jennifer Fisher Wilson
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