Taking Our Vital Signs: The Year in Review

The daily work of an internist varies: Diseases take dif-ferent forms, and every patient is a distinct individual. The work of the medical journal editor—at least those of us who do it full time—is much more stereotyped. Every day has its repetitive tasks, and every week its rhythms. We take this occasion to look up from our routines to reflect on the journal’s progress and to scan the horizon for storm clouds and for opportunity. In an editorial that focuses on change, we begin by noting several signature Annals features: methodologically sound, original research articles that advance the content of internal medicine practice; high-quality clinical guidelines produced by the American College of Physicians (ACP) and the U.S. Preventive Services Task Force; rigorous sys-tematic reviews and meta-analyses (including the new com-parative effectiveness reviews commissioned by the Agenc