Lisa Rosenbaum.

Lisa Rosenbaum, M.D.: Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine A decade ago, a primary care physician I admired appeared to come undone . His performance had derived not really from rushing between individuals but from knowing them so well that his charting was effortless and fast. But he became distracted instantly, losing his grasp on the details of his sufferers’ lives.

Data in one efficacy trial32 suggest that the efficacy of an individual dosage of IPV is low, but the trial had limitations. The self-confidence intervals for the efficacy estimates had been wide.32 On the other hand, data from countries when a single dosage of IPV was followed by a dose of OPV, such as Hungary, and analyses from other countries in which a sequential plan was used, claim that a single dose of IPV has been efficacious against vaccine-associated paralytic poliomyelitis induced by Sabin polioviruses.33,34 These data are particularly relevant to the existing policy discussions regarding an eventual global change from trivalent OPV to bivalent OPV for both routine and supplementary immunization. We found that for poliovirus type 2, a single fractional dose produced seroconversion in almost half the infants and a priming response in the vast majority of those who did not undergo seroconversion .