Journal Cover
JAMA Internal Medicine
Journal Prestige (SJR): 8.032
Citation Impact (citeScore): 4
Number of Followers: 306  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 2168-6106 - ISSN (Online) 2168-6114
Published by American Medical Association Homepage  [14 journals]
  • June 2019 Issue Highlights
    • Pages: 737 - 739
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.5496
      Issue No: Vol. 179, No. 6 (2019)
       
  • JAMA Internal Medicine
    • Pages: 740 - 740
      Abstract: Mission Statement: To promote the art and science of medicine and the betterment of human health by publishing manuscripts of interest and relevance to internists practicing as generalists or as medical subspecialists.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.5497
      Issue No: Vol. 179, No. 6 (2019)
       
  • Cardiovascular Outcomes of Calcium-Free vs Calcium-Based Phosphate Binders
           in End-stage Renal Disease
    • Authors: Spoendlin J; Paik JM, Tsacogianis TT, et al.
      Pages: 741 - 749
      Abstract: This observational study examines the use of sevelamer vs calcium acetate for treatment of hyperphosphatemia in patients 65 years or older with end-stage renal disease who are undergoing hemodialysis.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0045
      Issue No: Vol. 179, No. 6 (2019)
       
  • Comparative Safety of Phosphate Binders Without Proven Efficacy
    • Authors: Kestenbaum BR; de Boer IH.
      Pages: 749 - 750
      Abstract: The association of phosphate and survival among persons with end-stage renal disease (ESRD) was first reported in 1998, when Block et al demonstrated associations of progressively higher serum phosphate concentrations with all-cause mortality among patients receiving in-center hemodialysis. Similar findings were subsequently reported from dozens of observational studies in dialysis and nondialysis populations. In parallel, the results of cell culture and animal model studies suggested that inorganic phosphate can initiate biological pathways of vascular and soft-tissue calcification, providing a possible physiological mechanism to explain the observed associations.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0043
      Issue No: Vol. 179, No. 6 (2019)
       
  • Effect of the Serious Illness Care Program in Outpatient Oncology
    • Authors: Bernacki R; Paladino J, Neville BA, et al.
      Pages: 751 - 759
      Abstract: This cluster randomized clinical trial evaluates the effect of a communication quality-improvement intervention on a goal-concordant care and peacefulness at the end of life among oncology clinicians and patients with advanced cancer.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0077
      Issue No: Vol. 179, No. 6 (2019)
       
  • Allocation of Inpatient Time Among First-Year Internal Medicine Residents
    • Authors: Chaiyachati KH; Shea JA, Asch DA, et al.
      Pages: 760 - 767
      Abstract: This secondary analysis of time-motion data from participants in a cluster-randomized trial assesses how first-year internal medicine residents allocate time spent working on general medicine inpatient services.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0095
      Issue No: Vol. 179, No. 6 (2019)
       
  • A Modern Snapshot of the Daily Work of Medical Interns
    • Authors: Moriates C; Hudson F.
      Pages: 767 - 768
      Abstract: The daily work of a medical trainee has changed. This much is as clear as it is predictable. During our residency training less than a decade ago, we heard stories about the “good old days” when residents would trek to the medical library to make photocopies of articles to bring to rounds the next day to inform their clinical care. We were told about hunting for physical radiology films and collecting laboratory results on carbon paper printouts. Back then, a time-motion study following interns would almost certainly include much more time and motion in the hospital than it would today. Although these stories are suffused with the sepia tones of nostalgia, few would argue that these activities were better for medical care or education than instantaneously available up-to-date medical information, high-definition computerized films, and real-time laboratory results.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0092
      Issue No: Vol. 179, No. 6 (2019)
       
  • Dual Enrollment Status and Financial Penalties in the Hospital
           Readmissions Reduction Program
    • Authors: Joynt Maddox KE; Reidhead M, Qi AC, et al.
      Pages: 769 - 776
      Abstract: This cross-sectional study examines changes in performance and penalties after stratification of hospitals by the Hospital Readmissions Reduction Program into groups based on the proportion of each hospital’s Medicare patient population that is enrolled in both Medicare and Medicaid.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0117
      Issue No: Vol. 179, No. 6 (2019)
       
  • Association of Cumulative Disadvantage With Disparities in Smoking
           Prevalence in the US, 2008-2017
    • Authors: Leventhal AM; Bello MS, Galstyan E, et al.
      Pages: 777 - 785
      Abstract: This study of a nationally representative cross-sectional annual household-based probability sample of noninstitutionalized residents estimates disparities in smoking prevalence associated with the number of socioeconomic and health-related disadvantages faced by US adults from 2008 to 2017.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0192
      Issue No: Vol. 179, No. 6 (2019)
       
  • Association Between Receipt of a Medically Tailored Meal Program and
           Health Care Use
    • Authors: Berkowitz SA; Terranova J, Randall L, et al.
      Pages: 786 - 793
      Abstract: This cohort study looks at the incidence of inpatient and skilled nursing facility admissions, as well as health care costs, for recipients of home-delivered medically tailored meals.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0198
      Issue No: Vol. 179, No. 6 (2019)
       
  • Food Is Medicine: The Promise and Challenges of Integrating Food and
           Nutrition Into Health Care
    • Authors: Mozaffarian D; Mande J, Micha R.
      Pages: 793 - 795
      Abstract: Diet-related diseases produce crushing health and economic burdens. The estimated US costs of diabetes, cardiovascular diseases, obesity-related cancers, and other obesity-related conditions are approximately $1.72 trillion per year, or 9.3% of the gross domestic product. This burden creates tremendous stress on government budgets, private businesses, and families. Marginalized groups often suffer most, with significant disparities in both diet and health leading to illness, suboptimal school and work performance, increased health costs, and lower productivity and wages.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0184
      Issue No: Vol. 179, No. 6 (2019)
       
  • Diagnostic Performance of Creatinine-Based Equations for Estimating
           Glomerular Filtration Rate in Older Adults
    • Authors: da Silva Selistre L; Rech DL, de Souza V, et al.
      Pages: 796 - 804
      Abstract: This cross-sectional study compares 4 equations used to estimate glomerular filtration rate against measurement of inulin 2247 older French adults with varying degrees of kidney health.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0223
      Issue No: Vol. 179, No. 6 (2019)
       
  • Association Between State Laws Facilitating Distribution of Naloxone and
           Risk of Fatal Overdose
    • Authors: Abouk R; Pacula R, Powell D.
      Pages: 805 - 811
      Abstract: This population-based study examines fatal opioid overdose rates in states with policies allowing pharmacy distribution of naloxone.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0272
      Issue No: Vol. 179, No. 6 (2019)
       
  • 5α-Reductase Inhibitors and Time to Diagnosis and Mortality in
           Prostate Cancer
    • Authors: Sarkar RR; Parsons J, Bryant AK, et al.
      Pages: 812 - 819
      Abstract: This population-based cohort study examines medical records of 80 875 men who were treated at Veterans Affairs hospitals for prostate cancer to compare the time to diagnosis and mortality in men previously treated with 5α-reductase inhibitors for benign prostatic hyperplasia with those of men who received different or no treatment.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0280
      Issue No: Vol. 179, No. 6 (2019)
       
  • Prognosis Reconsidered in Light of Ancient Insights
    • Authors: Thomas JM; Cooney LM, Jr, Fried TR.
      Pages: 820 - 823
      Abstract: This article discusses the ways that the meaning of prognosis has evolved over time and its implications for practice in modern medicine.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0302
      Issue No: Vol. 179, No. 6 (2019)
       
  • Pseudo-Arrhythmia in Parkinson Disease
    • Authors: Osman W; Hanson M, Baranchuk A.
      Pages: 824 - 826
      Abstract: This case report describes pseudo–ventricular tachycardia, pseudo–atrial fibrillation, and pseudo–atrial flutter in a patient with Parkinson disease.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0746
      Issue No: Vol. 179, No. 6 (2019)
       
  • Assessment of First-Year Use of Medicare’s Advance Care Planning
           Billing Codes
    • Authors: Pelland K; Morphis B, Harris D, et al.
      Pages: 827 - 829
      Abstract: This observational analysis characterizes the first year of use of the Medicare code for advance care planning and describes beneficiaries most likely to receive advance care planning.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.8107
      Issue No: Vol. 179, No. 6 (2019)
       
  • Early Utilization Patterns of the New Medicare Procedure Codes for Advance
           Care Planning
    • Authors: Belanger E; Loomer L, Teno JM, et al.
      Pages: 829 - 830
      Abstract: This study of Medicare claims analyzes utilization patterns for new Current Procedural Terminology codes for advance care planning visits.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.8615
      Issue No: Vol. 179, No. 6 (2019)
       
  • Advance Care Planning Codes—Getting Paid for Quality Care
    • Authors: Mehta A; Kelley AS.
      Pages: 830 - 831
      Abstract: In 2017, Sudore et al(p14) developed a consensus definition of advance care planning (ACP) as “a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. The goal of ACP is to help ensure that people receive medical care that is consistent with their values, goals, and preferences during serious and chronic illness.” The discussion around ACP has evolved for decades. Originally, efforts focused on documenting advance directives or surrogate decision makers, interventions that alone were not effective. Now defined as a process, ACP discussions focus on eliciting patient values based on personal experiences, choosing a proxy that understands their role, and communicating their decisions to family members. More than 70% of patients are unable to participate in their own end-of-life care decisions, and values and preferences are known to change over time, so ongoing discussions with patients about their wishes are imperative.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.8105
      Issue No: Vol. 179, No. 6 (2019)
       
  • Formulary Placement of Branded Drugs in Medicare Prescription Drug Plans
           When Generics Are Available
    • Authors: Socal MP; Bai G, Anderson GF.
      Pages: 832 - 833
      Abstract: This study examines Medicare Part D prescription drug plans to assess how often branded products were given more favorable formulary placement than generic products.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.7824
      Issue No: Vol. 179, No. 6 (2019)
       
  • Factors Associated With Receipt of Training Among Caregivers of Older
           Adults
    • Authors: Burgdorf J; Roth DL, Riffin C, et al.
      Pages: 833 - 835
      Abstract: This study uses data from the 2015 National Health and Aging Trends Survey to investigate whether family and unpaid caregiver characteristics are associated with the receipt of caregiver training.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.8694
      Issue No: Vol. 179, No. 6 (2019)
       
  • Family Caregivers Needed—No Training Provided
    • Authors: Berg KM; Fortinsky RH, Robison J.
      Pages: 835 - 836
      Abstract: Each year, millions of people in the United States provide care for an older family member with physical or cognitive limitations. As the population ages, the demand for family caregivers will continue to increase. Often overlooked by the health care system, family caregivers support older adults’ health and provide enormous financial and societal value by allowing the deferral or avoidance of institutional care.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.8689
      Issue No: Vol. 179, No. 6 (2019)
       
  • Automatically Charting Symptoms From Patient-Physician Conversations Using
           Machine Learning
    • Authors: Rajkomar A; Kannan A, Chen K, et al.
      Pages: 836 - 838
      Abstract: This study assesses the feasibility of using machine learning to automatically populate a review of systems of all symptoms discussed in an encounter between a patient and a clinician.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.8558
      Issue No: Vol. 179, No. 6 (2019)
       
  • Characteristics of Digital Health Studies Registered in ClinicalTrials.gov
    • Authors: Chen CE; Harrington RA, Desai SA, et al.
      Pages: 838 - 840
      Abstract: This analysis of digital health studies in ClinicalTrials.gov examines the clinical evidence underlying digital health interventions.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.7235
      Issue No: Vol. 179, No. 6 (2019)
       
  • Evaluating Digital Health Tools
    • Authors: Auerbach AD.
      Pages: 840 - 841
      Abstract: Digital health software tools (DHSTs) are becoming increasingly available to patients, health care systems, and other key stakeholders seeking to enhance patient-centered care with innovative apps, sensors, algorithms, and data visualization approaches. Broadly speaking, DHSTs seek to improve care by providing more informed treatment recommendations, clarifying and refining diagnoses, optimizing workflows and efficiency, and facilitating access to and use of complex health care data. However, even as these tools increase in use and popularity, real challenges exist to identify which DHSTs are appropriate for which patients or which clinical settings, how to integrate them into clinical and other care, and which DHSTs are safe and effective in practice.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.7229
      Issue No: Vol. 179, No. 6 (2019)
       
  • Association of Health Status With Receipt of Supplemental Security Income
    • Authors: Sonik RA; Parish SL, Mitra M.
      Pages: 842 - 843
      Abstract: This study assesses the association of health status with receipt of Supplemental Security Income by comparing the health patterns among individuals before vs after entry into the program.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2018.8609
      Issue No: Vol. 179, No. 6 (2019)
       
  • Supplemental Security Income and the Health of Low-Income Adults
    • Authors: DeJong C; Katz MH.
      Pages: 843 - 844
      Abstract: “America has always cared for its aged poor, the blind, and the disabled…This legislation once again provides dramatic and heart-warming evidence that America is the country that cares….” These were the words of President Richard Nixon on October 30, 1972, as he signed H.R. 1 into law, which expanded Medicare and Social Security and created a federal program of Supplemental Security Income (SSI).
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0058
      Issue No: Vol. 179, No. 6 (2019)
       
  • Effectiveness of a Best Practice Alert to Reduce Telemetry
           Orders—Reply
    • Authors: Najafi N; Cucina R, Khanna R.
      Pages: 844 - 845
      Abstract: Less is More
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0705
      Issue No: Vol. 179, No. 6 (2019)
       
  • Effectiveness of a Best Practice Alert to Reduce Telemetry Orders
    • Authors: Garneau WM; Knight AM, Pahwa AK.
      Pages: 844 - 844
      Abstract: To the Editor It was with great interest that we read the study by Najafi and colleagues reporting the results of a best practice alert (BPA) intervention to reduce telemetry orders. The authors demonstrated that a BPA can be effective on its own, whereas previous studies have employed multimodal approaches to telemetry discontinuation.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0708
      Issue No: Vol. 179, No. 6 (2019)
       
  • Future Directions for Corticosteroids in Treatment of Sepsis—Reply
    • Authors: Zhang Y; Xu J, Fang F.
      Pages: 845 - 845
      Abstract: In Reply We are thankful for the interest shown by Spencer-Segal in our meta-analysis of corticosteroid use for treatment of sepsis. We welcome her thoughtful comments regarding additional directions for future trials.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0856
      Issue No: Vol. 179, No. 6 (2019)
       
  • Providing Prescriptions to the Patient Who Is Leaving Against Medical
           Advice
    • Authors: Prakash S; Naguib M.
      Pages: 845 - 846
      Abstract: To the Editor In their Teachable Moment recently published in JAMA Internal Medicine, Drs Rudofker and Gottenborg highlight the key issues that health care providers and patients face when patients leave the hospital against medical advice (AMA). The authors suggest that postdischarge and transitional clinics are useful means to shorten the time to follow-up for patients who are not established with a primary care provider or who otherwise face long wait times to see their physicians.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0878
      Issue No: Vol. 179, No. 6 (2019)
       
  • Future Directions for Corticosteroids in Treatment of Sepsis
    • Authors: Spencer-Segal JL.
      Pages: 845 - 845
      Abstract: To the Editor In their systematic review and meta-analysis of corticosteroids for treatment of sepsis, Fang and colleagues suggest that future studies should address the identification of patients who will derive the most benefit from corticosteroid use to enable a personalized medicine approach. I suggest additional directions for this field.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0859
      Issue No: Vol. 179, No. 6 (2019)
       
  • Complication Rates in a Study of Invasive Diagnostic Procedures for Lung
           Abnormalities
    • Authors: Halliday SJ; Aboudara MC, Maldonado F.
      Pages: 846 - 847
      Abstract: To the Editor The study by Huo and colleagues reported high complication rates and associated costs from procedures likely to be encountered by patients undergoing lung cancer screening using computed tomography (CT). This has been a topic of concern among clinicians and policymakers initiating such screening programs given the high false-positive rate of CT scans, the concern that real-world patients will have more comorbidities than reported in the National Lung Screening Trial, and the possibility of higher complication rates at centers less experienced with such screening programs. For these reasons, the study by Huo et al addresses important issues. However, we believe that the complication rates are overstated, which may lead to delays in implementation of screening programs.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0960
      Issue No: Vol. 179, No. 6 (2019)
       
  • Complication Rates in a Study of Invasive Diagnostic Procedures for Lung
           Abnormalities—In Reply
    • Authors: Huo J; Shih Y.
      Pages: 847 - 847
      Abstract: In Reply We appreciate the comments by Halliday et al regarding our article. Concerns of overestimated complication rates were raised, citing the following 4 reasons: representativeness of our study population, unmeasured confounders, relevant time frame for postprocedural complications, and not differentiating between complications with vs without direct association with the invasive diagnostic procedures. Herein, we have summarized our point-by-point response.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0954
      Issue No: Vol. 179, No. 6 (2019)
       
  • Lack of Standardized Terminology in Ultrasound Reports for Ovarian Cysts
    • Authors: Suh-Burgmann E; Herrinton L.
      Pages: 847 - 848
      Abstract: To the Editor In the article “Risk of Malignant Ovarian Cancer Based on Ultrasonography Findings in a Large Unselected Population,” Smith-Bindman and coauthors reviewed ultrasounds from 1043 women (142 ovarian cancer cases with 7 controls per case) and extrapolated the findings to a larger retrospective cohort, concluding that simple cysts are common and rarely associated with cancer—a finding that has been shown by several previous studies. While lack of awareness of the evidence supporting the benign nature of simple cysts may contribute to excessive follow-up, in our opinion, the bigger driver of overdiagnosis and overtreatment of benign adnexal masses is lack of standardization of ultrasound reports. Without standardization, a simple cyst may be reported as “simple cyst,” “cyst,” “anechoic cyst,” “hypoechoic mass,” “cystic lesion,” or any number of other descriptions, not infrequently attached to phrases such as “cannot rule out neoplasm” or “worrisome for ovarian neoplasm,” or “follow-up recommended.” Similarly, the word “complex” is used to describe both small functional cysts and large cystic and solid tumors and thus has no consistent correlation with risk.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0970
      Issue No: Vol. 179, No. 6 (2019)
       
  • Lack of Standardized Terminology in Ultrasound Reports for Ovarian
           Cysts—Reply
    • Authors: Smith-Bindman R; Miglioretti D.
      Pages: 848 - 849
      Abstract: In Reply We commend Drs Suh-Burgmann and Herrinton for their important article quantifying the risks of ovarian cancer associated with specific mass characteristics seen on pelvic ultrasound. Although we did not report these results in our article owing to space limitations, we also characterized variations in cancer risk by the presence of specific imaging findings. We found that the presence of specific findings (eg, papillary projections, thick septations, mural nodules, and vascular flow) increased risks, and the risks increased with the severity of findings. We classified masses with any of these findings as complex cysts, because all would require close clinical surveillance to ensure that they were not malignant. We primarily highlighted simple cysts in our article, because these have no increased risk of being cancerous in our cohort, similar to normal ovaries. Thus, Drs Suh-Burgmann and Herrinton’s results and our report are concordant: Simple cysts do not represent cancer. The presence of simple cysts on ultrasound does not convey an increased risk of ovarian cancer and does not require surveillance.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0976
      Issue No: Vol. 179, No. 6 (2019)
       
  • Power Calculations, Effect Sizes, and 30-Day Mortality in
           Enterobacteriaceae Bacteremia
    • Authors: Timbrook TT; Burnham JP.
      Pages: 849 - 850
      Abstract: To the Editor In an Original Investigation recently published in JAMA Internal Medicine, Tamma and colleagues reported on the association of 30-day mortality with oral step-down therapy vs intravenous therapy for patients with Enterobacteriaceae bacteremia. This study demonstrates similar mortality among exposure groups in a large propensity matched cohort while highlighting the advantage of a decreased length of stay among patients on oral step-down therapy. The authors also evaluated mortality among those on oral-step down therapy with high vs low bioavailability, reflecting similar rates, but concluding their study was underpowered to evaluate this comparison. This point merits further discussion on the goal of power calculations, the article’s power calculation, and the importance of accurate and transparent reporting of statistical analyses.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.1190
      Issue No: Vol. 179, No. 6 (2019)
       
  • Insulin Cost and Underuse in Patients with Diabetes
    • Authors: Bhatia K; Chang EY, Bilal M.
      Pages: 849 - 849
      Abstract: To the Editor In a recent issue of JAMA Internal Medicine, we read with great interest an article by Herkert and colleagues regarding insulin underuse in relation to cost. The prevalence of cost-related insulin underuse reported was 1 in 4 at an urban diabetes center, which highlights the central issue of the affordability of insulin.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0973
      Issue No: Vol. 179, No. 6 (2019)
       
  • Methodological Issues in Determining the Accuracy of Automated Office
           Blood Pressure Readings—Reply
    • Authors: Roerecke M; Kaczorowski J, Myers MG.
      Pages: 850 - 851
      Abstract: In Reply We agree with Etyang’s assertion that the accurate assessment of blood pressure (BP) is an important step in determining cardiovascular risk and that efforts to improve the accuracy of BP measurement should be encouraged. This accuracy is equally important for screening, diagnosis, and ongoing management of patients because the consequences of inaccurate readings often lead to misdiagnosis and inappropriate treatment. However, Etyang also seems to imply that patients cannot be identified as having hypertension if they already have a diagnosis of hypertension. If correct, this belief would preclude a diagnosis of resistant hypertension, which currently describes many patients with high BP readings who are already receiving antihypertensive therapy.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.1221
      Issue No: Vol. 179, No. 6 (2019)
       
  • Methodological Issues in Determining the Accuracy of Automated Office
           Blood Pressure Readings
    • Authors: Etyang AO.
      Pages: 850 - 850
      Abstract: To the Editor I read with interest the recently published Original Investigation by Roerecke and colleagues. The accurate assessment of blood pressure (BP) is an important step in determining cardiovascular risk; therefore, efforts to improve the accuracy of measurement should be encouraged. The article, while adding to the evidence in favor of using automated office BP (AOBP) measurement, had several limitations that I would like to highlight so that they can be addressed in future research.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.1224
      Issue No: Vol. 179, No. 6 (2019)
       
  • Deciding That a Patient Is Not a Candidate
    • Authors: Blythe JA; Batten JN, Magnus DC.
      Pages: 851 - 852
      Abstract: To the Editor In their Original Investigation published in a recent issue of JAMA Internal Medicine, Wong and colleagues reported that decisions to forgo maintenance dialysis for patients with advanced kidney disease were sometimes based on a physician’s view that the patient was not a candidate for dialysis. Although the study concludes by noting that such decisions often omit consideration of the patient’s values and goals, this conclusion sidesteps an important aspect of medical decision making.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.1227
      Issue No: Vol. 179, No. 6 (2019)
       
  • Deciding That a Patient Is Not a Candidate—Reply
    • Authors: Wong SY; O’Hare AM.
      Pages: 852 - 852
      Abstract: In Reply As Blythe and colleagues outline, the “best interest” approach to decision making gives clinicians discretion to unilaterally carry out or withhold treatments without soliciting input from or collaborating with patients when they believe that this is in patients’ best interest. This approach assumes that clinicians know what interventions will be most beneficial and least harmful for individual patients. The difficulty with this approach, however, is that it is impossible to know how patients might weigh the benefits and harms of treatment without knowing their values and goals. Furthermore, clinicians often do not agree with their patients on what is most important near the end of life and cannot always accurately predict prognosis or the effects of treatment in individual patients.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.1237
      Issue No: Vol. 179, No. 6 (2019)
       
  • Digital Breast Tomosynthesis for Women Older Than 70 Years—Reply
    • Authors: Richman IB; Gross CP.
      Pages: 853 - 854
      Abstract: In Reply In their letter regarding our Viewpoint, Philpotts and Durand call attention to 3 studies. First, they take issue with the reference in our article to the study by Sharpe et al, an observational study that evaluated changes in recall among women undergoing breast cancer screening after the introduction of digital breast tomosynthesis. The study did not find a significantly lower recall rate with digital breast tomosynthesis among women 70 years and older compared with 2-dimensional mammography. Philpotts and Durand cite a critique of that study, but the critique expressed concern that the analysis had overestimated effectiveness of digital breast tomosynthesis, not underestimated it. In addition, the critique likely reflected a misunderstanding of the analysis rather than an actual error in the original publication.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0957
      Issue No: Vol. 179, No. 6 (2019)
       
  • Digital Breast Tomosynthesis for Women Older Than 70 Years
    • Authors: Durand MA; Philpotts L.
      Pages: 853 - 853
      Abstract: To the Editor In a Viewpoint article, Richman and Gross discussed the use of new breast cancer screening technologies in older women. Citing a study by Sharpe et al, they state “we are aware of only 1 study of digital breast tomosynthesis that has reported outcomes in women older than 70 years.” There have, however, been several studies on the use of digital breast tomosynthesis in older women. In the cited study, only 923 patients 70 years or older from 1 institution were screened with digital breast tomosynthesis. Thus, it is not surprising that significant differences in recall rates between digital breast tomosynthesis and digital mammography were not seen. Moreover, the study by Sharpe et al and cited by Richman and Gross has been criticized for errors in data analysis. For example, the authors excluded a cohort of about 9000 examinations read by lower-volume general radiologists from their analysis. However, cancer detection rate was calculated including this lower-volume cohort.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.1234
      Issue No: Vol. 179, No. 6 (2019)
       
  • Limpkin, Sweetwater Preserve, Gainesville, Florida
    • Pages: 854 - 854
      Abstract: Courtesy of: David E. Winchester, MD, MS, University of Florida College of Medicine, 1600 SW Archer Rd, PO Box 100277, Gainesville, FL 32610-0277.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.0419
      Issue No: Vol. 179, No. 6 (2019)
       
  • Error in Key Points
    • Pages: 854 - 854
      Abstract: In the Original Investigation titled “Quality and Experience of Outpatient Care in the United States for Adults With or Without Primary Care,” which was published March 4, 2019, in the print issue of JAMA Internal Medicine, there was an error in the the Findings paragraph of the Key Points. The slightly more low-value care is more interpretable as 1 of 4 composites, not 3 of 4 composites. This article was corrected online.
      PubDate: Sat, 01 Jun 2019 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2019.1010
      Issue No: Vol. 179, No. 6 (2019)
       
 
 
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