Although it is possible that most studies were very rigorous in their selection of data, the lack of a clear report in the methods section makes it difficult for readers to identify stronger CDAs from ones that are less evidence-based. Our limitations include the fact that some of these data elements can only be obtained from databases like SEER, but all of these studies included probabilities that were obtained from the medical literature. We believe that the addition of evidence selection and appraisal in CDAs can strengthen these studies and give readers more confidence to evaluate their results. SD 3.8) ; the median number of months with the same counselor was 12. We found a high level of interest in quitting: 81% expressed the desire to quit, and 71% had plans to quit within the next six months. Sixty-nine percent agreed at least somewhat that counseling may aid people with nicotine addiction, and 73% that smoking cessation should be discussed in counseling sessions. However, 56% reported that their counselors had never asked about smoking. Over two-thirds reported that counselors never or rarely 1) discussed the adverse health effects of nicotine (68%), 2) advised them to quit (68%), nor 3) discussed smoking cessation options (72% We collected data on risk factors for coronary artery disease and type of surgery to be performed during the preoperative evaluation. All patients had CBC, routine chemistry, coagulation studies, electrocardiogram, and chest x-ray according to the protocol followed in the ambulatory surgery unit. A chart review conducted at least a month after the surgery was done to assess the incidence of postoperative cardiovascular complications. RESULTS: Average age of patients studied was 57, with a range of 28 ± 86 years. There were 108 men and 173 women. 30% had an abnormal electrocardiogram, 61% had hypertension, 30% had diabetes, 37% patients had at least one other risk factor for coronary disease, and 53% had two or more cardiac risk factors for surgery. The type of surgery included a variety of ambulatory procedure. The most common were eye 21%, breast 15%,cholecystectomies/ laparatomies 10%, hernias 7%, and ENT 5%. Overall outcome There were no patients in this cohort group who had postoperative cardiac complications. CONCLUSION: The incidence of cardiac complications after low-risk ambulatory procedures is low, even in the patients with risk factors. Additional testing is very unlikely to add to the ability to predict risk in this group of patients. À.13 ** À.21 ** À.08 * À.18 ** À.20 ** +.26 ** Fat Intake À.07 À.08 * À.06 À.08 * À.10 ** +.10 * Fr/Veg Intake À.14 * À.13 ** À.11 ** À.16 ** À.12 * +.18 ** Manage Stress À.33 ** À.31 ** À.15 ** À.32 ** À.25 ** +.38 ** Tob(Smokers only) À.23 À.11 À.12 À.03 À.03 +.12 Phys Activity À.19 * À.22 ** À.13 ** À.22 ** À.20 ** +.28 ** * P < .05; ** P < .001 PURPOSE: Diabetes mellitus is associated with abnormal autonomic function. Impaired glucose tolerance and diabetes mellitus are related to increased mortality. Abnormal heart rate recovery (aHRR), a measure of autonomic dysfunction, is also known to be associated with increased mortality. Whether impaired fasting glucose (IFG) is associated with aHRR has not been characterized. METHODS: 5190 healthy adults without medically treated diabetes (mean age 45, 39 % women) enrolled in the Lipid Research Clinics Prevalence study underwent exercise testing. Low physical fitness was defined according to the lowest quartile of peak METs. HRR was defined as the change from peak heart rate to that measured after 2 minutes of recovery, an abnormal value was < 42 BPM. RESULTS: 504 subjects (10%) had IFG and 131 (3%) were diabetics. An aHRR was found in 1699 (33%) adults; 1196 (23%) were unfit. Increasing levels of fasting plasma glucose (FPG) were strongly associated with aHRR (see figure) , even at glucose levels < 110 mg/dl. The association between increasing FPG and poor physical fitness was weaker. FPG remained an independent predictor of aHRR after adjustment for standard risk factors and resting heart rate (RHR) (adjusted OR for increase of glucose of 500/glucose by 1, 1.17, 95% CI 1.05 ± 1.30, chisquare = 9, P = 0.003). There was a strong interaction between FPG and RHR for prediction of aHRR. The association between FPG and aHRR was very strong with RHR 80 BPM (P for interaction = 0.0008); no association was present with RHR < 80 BPM. CONCLUSION: 1. FPG is strongly and independently associated with aHRR, even at nondiabetic levels. 2. The association between FPG and aHRR is substantially affected by resting heart rate. Internists. When practicing physicians are asked about the areas of medical practice where they feel the least prepared by their formal medical education and the most uncomfortable in clinical practice, they frequently cite scenerios around controlled drug prescribing. These include acute / chronic / and malignant pain management, management of anxiety vs. depression, management of insomnia, identification and management of addictive dissorders, and opioid and benzodiazepine pharmacology. Pilot data exist to suggest that the prescribing of controlled drugs in primary care clinic settings bear little if any resemblence to current practice recommendations. As part of a controlled clinical trial of alcohol screening and interventions in a primary care population, we performed a chart review in the Resident and Attending Primary Care Medical Clinic of a large urban teaching hospital. In an effort to assess controlled drug prescribing practices, part of the chart review included assessing whether there was addiction screening information in the patient record when controlled drugs were prescribed. METHODS: A total of eight hundred charts were randomly chosen from the three Internal Medicine Clinic resident firms as well as from the Attending clinic. Charts were categorized based upon 1) whether controlled drugs were prescribed at any time in the 12 months prior to the audit, 2) the type of controlled drug prescribied, 3) wheter there was any evidence of an alcohol or drug abuse histroy documented in the chart, and 4) the result of that history if documented. The charts were abstracted by trained research assistants using a data template and supervised by the Project Director and the Project Administrator. RESULTS: A total of 768 charts were completely reviewed, of which 135 indicated some prescribing of controlled drugs (17.6%). The percentage of patients receiving controlled drug prescriptions was not different based upon the gender of the patient (18%of men and 17%of women), and the type of controlled drugs showed no gender differences. 45%of women and 35%men had no evidence of a substance use history having been taken in their charts, and 3%of women and 13%of men had charts that documented hazardous or harmfull use of alcohol or drugs. Of the 70 male pateints prescribed controlled drugs, they represented 17.6%of those wit hno substance use assessment, 18.8%of those with a low risk substance use assesment, and 17%of those with active substance use problems documented in their charts. For the 65 women patients prescribed controlled drugs, they represented 18.5%of those with no substance use assessment, 14.7%of those assesed as low risk, and 33.3%of those wit hchart documentation of active addictive problems. There were no differences between the controlled drug prescribing patterns of attendings versus residents. CONCLUSION: The rate of prescribing controlled drugs and the appropriateness of prescribing decisions is becomming more and more closely monitored, bot hby regulatory agencies as well as advocay groups. Little is known about the controlled drug prescribing practices of practicing physicians, but they self-report it as an area of great un-ease. Although guidelines are not well established in this area of practice, there is general agreement that ambulatory controlled drug prescribing is relatively contraindicated in the face of active or past substance abuse on the part of the patient. This pilot data contains concerning information to suggest that a lack of any documentation of substance use histroy is common place when prescribing controlled drugs in primary care. Worse, the precentage of patients receiving controlled drug prescriptions who have a documented active substance abuse problem, is as high as those who receive a prescrition without any history taken, and atlease as high as those who both have an apropriate history AND whose hostory indicates that they are a low risk population.