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JAMA The Journal of the American Medical Association
Journal Prestige (SJR): 8.876
Citation Impact (citeScore): 7
Number of Followers: 1960  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0098-7484 - ISSN (Online) 1538-3598
Published by American Medical Association Homepage  [14 journals]
  • Highlights for April 16, 2019
    • Pages: 1429 - 1431
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2018.15289
      Issue No: Vol. 321, No. 15 (2019)
       
  • JAMA
    • Pages: 1433 - 1434
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2018.15290
      Issue No: Vol. 321, No. 15 (2019)
       
  • Dr Schrier Goes to Congress as Second Woman Physician
    • Authors: Rubin R.
      Pages: 1443 - 1445
      Abstract: This Medical News article is an interview with the first pediatrician and second woman physician to serve in Congress.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.1704
      Issue No: Vol. 321, No. 15 (2019)
       
  • Childhood Lead Exposure May Affect Personality, Mental Health in Adulthood
    • Authors: Sancar F.
      Pages: 1445 - 1446
      Abstract: This Medical News feature summarizes a recent study exploring the link between childhood lead exposure and mental health and personality in adulthood.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.1116
      Issue No: Vol. 321, No. 15 (2019)
       
  • Making Amends for the Opioid Epidemic
    • Authors: Sharfstein JM; Olsen Y.
      Pages: 1446 - 1447
      Abstract: With the opioid epidemic now claiming nearly 2000 lives from overdose in the United States each month, the medical profession is increasingly accepting the assessment of noted surgeon and writer Atul Gawande, MD: “We started it.” Specialty societies such as the American Academy of Family Physicians and American College of Physicians are offering tools to reduce the unnecessary use of opioids for pain and the risk of addiction. The Federation of State Medical Boards has released guidelines for the treatment of chronic pain, and many state medical boards have adopted their own policies. Physicians are responding. Since peaking in 2012, opioid prescriptions have declined by more than one-fourth.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3505
      Issue No: Vol. 321, No. 15 (2019)
       
  • Antimicrobial Resistance on the Rise in Zoonotic Bacteria in Europe
    • Authors: Friedrich MJ.
      Pages: 1448 - 1448
      Abstract: Experts continue to find zoonotic bacteria with high levels of antimicrobial resistance in humans, animals, and food, according to a new report from the European Food Safety Authority and the European Centre for Disease Prevention and Control.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3829
      Issue No: Vol. 321, No. 15 (2019)
       
  • Cancer Goes Undiagnosed in Almost Half the World’s Children
    • Authors: Friedrich MJ.
      Pages: 1448 - 1448
      Abstract: Almost half of all children around the world with cancer—the vast majority of whom live in low- and middle-income countries—are not diagnosed or treated, US researchers have reported.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3827
      Issue No: Vol. 321, No. 15 (2019)
       
  • Monster 2015-2016 El Niño Event Triggered Infectious Diseases
    • Authors: Friedrich MJ.
      Pages: 1448 - 1448
      Abstract: An intense El Niño event in 2015-2016 fueled outbreaks of chikungunya, hantavirus, Rift Valley fever, cholera, and plague around the world, according to a new report from US investigators. The National Oceanic and Atmospheric Administration ranked this El Niño among the top 3 strongest events in nearly 70 years.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3155
      Issue No: Vol. 321, No. 15 (2019)
       
  • Robotically Assisted Surgical Devices Raise Caution
    • Authors: Sancar F.
      Pages: 1449 - 1449
      Abstract: The FDA has warned that robotically assisted surgical devices haven’t been established as safe and effective to treat or prevent breast or cervical cancers.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3834
      Issue No: Vol. 321, No. 15 (2019)
       
  • Agreement to Regulate Cell-Based Meat Products
    • Authors: Sancar F.
      Pages: 1449 - 1449
      Abstract: As lab-to-table beef and poultry products inch closer to reality, the FDA announced a formal agreement to jointly regulate them.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3831
      Issue No: Vol. 321, No. 15 (2019)
       
  • New Therapy for Treatment-Resistant Depression
    • Authors: Sancar F.
      Pages: 1449 - 1449
      Abstract: The FDA has approved esketamine nasal spray as an adjunctive therapy for adults with treatment-resistant depression (TRD), which affects approximately 30% of patients with major depressive disorder. It’s the first regulatory approval of esketamine, the s-enantiomer of ketamine, for any psychiatric condition worldwide.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3596
      Issue No: Vol. 321, No. 15 (2019)
       
  • The Uncertain Effect of Financial Incentives to Improve Health Behaviors
    • Authors: Thirumurthy H; Asch DA, Volpp KG.
      Pages: 1451 - 1452
      Abstract: Given considerable empirical support for using financial incentives to motivate desired behaviors, this Viewpoint reviews behavioral economics principles and methodological reasons that might explain the absence of an effect of financial rewards on medication adherence and health outcomes in several recent randomized trials.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.2560
      Issue No: Vol. 321, No. 15 (2019)
       
  • A Model for Public Access to Trustworthy and Comprehensive Reporting of
           Research
    • Authors: Broitman M; Sox HC, Slutsky J.
      Pages: 1453 - 1454
      Abstract: This Viewpoint describes the peer review processes of the Patient-Centered Outcomes Research Institute, the yield since 2010 of publicly posted final reports of funded comparative effectiveness studies, and speculates that the benefits of the legislatively mandated process may someday outweigh its many current procedural challenges.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.2807
      Issue No: Vol. 321, No. 15 (2019)
       
  • Central Casting: The Hospital Team as Grey’s Anatomy Characters
    • Authors: Colaianni C.
      Pages: 1455 - 1456
      Abstract: In this narrative medicine essay an otolaryngologist remembers a patient who identifies her physicians as characters in the television show Grey’s Anatomy, a playful reference that makes her advanced cancer hospitalizations bearable and disarms her physicians through diversion and humor.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3954
      Issue No: Vol. 321, No. 15 (2019)
       
  • The Future of the GLP-1 Receptor Agonists
    • Authors: Hirsch IB.
      Pages: 1457 - 1458
      Abstract: The discovery of the enteric hormone glucagon-like peptide 1 (GLP-1), and subsequent demonstration that its physiologic actions to lower blood glucose levels can be extended to the treatment of type 2 diabetes, have been important therapeutic advances. The approval of exenatide for clinical use in the United States and Europe in 2005 was the first of several GLP-1 receptor agonists (GLP-1RAs) to advance the clinical use of the dual effects of these drugs to lower glycated hemoglobin (HbA1c) and reduce body weight. This introduced a new and needed option to treat patients with diabetes. The actions of the currently available GLP-1RAs are specific for the endogenous GLP-1 receptor signaling system and thus share many pharmacodynamic characteristics. However, these agents differ in properties that alter pharmacokinetics, with dosing schedules that vary from daily to weekly injections among the various agents.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.2941
      Issue No: Vol. 321, No. 15 (2019)
       
  • The Search for an Effective Therapy and Pain Relief for Oral Mucositis
    • Authors: Elad S; Yarom N.
      Pages: 1459 - 1461
      Abstract: Oral mucositis is a significant complication of cancer therapy because of the associated pain and negative effects on the ability to eat, drink, and swallow and on the quality of life. Furthermore, oral mucositis increases the risk of systemic infection, and may interrupt cancer therapy. Oral mucositis manifests as erosions or ulcerations of the nonkeratinized oral mucosa, and its course depends on the form of cancer therapy. Oral mucositis affects an estimated 14% to 81% of patients undergoing some forms of chemotherapy, begins within days of initiating treatment, and lasts for up to 2 weeks depending on the dose, intensity of myeloablation, and stomatotoxicity of the chemotherapy drugs. Among patients undergoing myeloablative hematopoietic stem cell transplantation, oral mucositis affects an estimated 83%, and the course is similar to chemotherapy-associated oral mucositis; however, it is often more severe and develops faster. Among patients receiving radiotherapy to the head and neck, oral mucositis occurs in 59% to 100% of patients, and signs of it develop within about 2 weeks of treatment initiation and the condition worsens during the radiotherapy course. In a minority of cases (approximately 6%), radiotherapy-associated oral mucositis becomes chronic and can continue for years. Therefore, there has been significant interest in the prevention and treatment of oral mucositis.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3269
      Issue No: Vol. 321, No. 15 (2019)
       
  • Employer Wellness Programs—A Work in Progress
    • Authors: Abraham J.
      Pages: 1462 - 1463
      Abstract: Approximately 4 of 5 large US employers offer a wellness program as part of their employees’ health benefits. Workplace wellness programs include a coordinated set of activities that support employees in making changes to health behaviors that may reduce their risk for certain chronic conditions and enable employees with existing diagnoses to manage them more effectively. Comprehensive, multicomponent programs typically include health assessments and biometric screening to quantify risk factors; education and coaching for lifestyle behavior modification (eg, tobacco cessation, physical activity promotion, stress reduction, and weight management); and in some cases, chronic disease management.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3376
      Issue No: Vol. 321, No. 15 (2019)
       
  • Screening for Elevated Blood Lead Levels in Children and Pregnant Women
    • Authors: Spanier AJ; McLaine P, Gilden RC.
      Pages: 1464 - 1465
      Abstract: In this issue of JAMA, the US Preventive Services Task Force (USPSTF) presents its recommendation on screening for elevated blood lead levels in children and pregnant women, along with the evidence summary supporting this recommendation—a reevaluation of the 2006 recommendations. Lead exposure in children is associated with significant neurologic effects, including deficits in IQ and increased risk of hyperactivity. Elevated lead levels in pregnant women are associated with gestational hypertension and spontaneous abortion. While changes in public policy have led to substantial declines in prevalence of lead poisoning and elevated lead levels in children, prevention of lead exposure and its consequences remains of paramount importance.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.2594
      Issue No: Vol. 321, No. 15 (2019)
       
  • Effect of Add-on Oral Semaglutide vs Sitagliptin on HbA 1c in Type 2
           Diabetes Uncontrolled With Metformin
    • Authors: Rosenstock J; Allison D, Birkenfeld AL, et al.
      Pages: 1466 - 1480
      Abstract: This randomized clinical trial compares the effects of 3-, 7-, and 14-mg/d of oral semaglutide vs sitagliptin on glycated hemoglobin in patients with type 2 diabetes uncontrolled with metformin alone or with sulfonylurea.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.2942
      Issue No: Vol. 321, No. 15 (2019)
       
  • Doxepin Mouthwash or Diphenhydramine-Lidocaine-Antacid Mouthwash vs
           Placebo for Oral Mucositis Pain
    • Authors: Sio TT; Le-Rademacher JG, Leenstra JL, et al.
      Pages: 1481 - 1490
      Abstract: This phase 3 randomized trial compares the effect of doxepin mouthwash or diphenhydramine-lidocaine-antacid mouthwash on oral mucositis–related pain among patients who underwent definitive head and neck radiotherapy.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3504
      Issue No: Vol. 321, No. 15 (2019)
       
  • Effect of a Workplace Wellness Program on Employee Health and Economic
           Outcomes
    • Authors: Song Z; Baicker K.
      Pages: 1491 - 1501
      Abstract: This cluster randomized clinical trial evaluates the effects of a workplace wellness program comprising nutrition, physical activity, and stress reduction modules on self-reported lifestyle outcomes (exercise, diet, smoking, alcohol use), clinical measures (eg, cholesterol, blood pressure, body mass index [BMI]), spending and utilization measures, and employment outcomes (absenteeism job tenure, job performance).
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3307
      Issue No: Vol. 321, No. 15 (2019)
       
  • USPSTF Recommendation: Screening for Elevated Blood Lead Levels in
           Children and Pregnancy
    • Pages: 1502 - 1509
      Abstract: This 2019 Recommendation Statement from the US Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic children (I statement) and asymptomatic pregnant persons (I statement).
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3326
      Issue No: Vol. 321, No. 15 (2019)
       
  • USPSTF Evidence Report: Screening for Elevated Blood Lead Levels in
           Childhood and Pregnancy
    • Authors: Cantor AG; Hendrickson R, Blazina I, et al.
      Pages: 1510 - 1526
      Abstract: This systematic review to support the 2019 US Preventive Services Task Force Recommendation Statement on screening for elevated blood lead levels in childhood and pregnancy summarizes published evidence on the benefits and harms of screening and intervention for elevated blood lead levels in pregnant women and children 5 years and younger in the primary care setting.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.1004
      Issue No: Vol. 321, No. 15 (2019)
       
  • Management of Patients With Severe Aortic Stenosis With Transcatheter
           Valve Replacement
    • Authors: Dia A; Cifu AS, Shah AP.
      Pages: 1527 - 1528
      Abstract: This JAMA Clinical Guidelines Synopsis summarizes the 2017 focused update of the American College of Cardiology/American Heart Association (AHA/ACC) guideline on management of patients with severe aortic stenosis focusing on surgical vs transcatheter valve replacement (TAVR).
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.1336
      Issue No: Vol. 321, No. 15 (2019)
       
  • App-Based Decision Support and Alerts for Blood Glucose Self-management in
           Type 2 Diabetes
    • Authors: Lum E; Jimenez G, Huang Z, et al.
      Pages: 1530 - 1532
      Abstract: This study characterizes the proportion of apps available in 2018 for self-management of type 2 diabetes that included goal-setting features, reminders to measure blood glucose, hypoglycemia and hyperglycemia alerts, and action prompts.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.1644
      Issue No: Vol. 321, No. 15 (2019)
       
  • Lowering the P Value Threshold
    • Authors: Adibi A; Sin D, Sadatsafavi M.
      Pages: 1532 - 1533
      Abstract: To the Editor Mr Wayant and colleagues evaluated the effect of lowering the significance threshold from .05 to .005 on major randomized clinical trials (RCTs) published in 2017. The authors reported that 70.7% of primary end points remained significant and suggested that lowering the threshold might address statistical issues such as P-hacking.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.0566
      Issue No: Vol. 321, No. 15 (2019)
       
  • Lowering the P Value Threshold—Reply
    • Authors: Wayant C; Scott J, Vassar M.
      Pages: 1533 - 1533
      Abstract: In Reply Mr Adibi and colleagues raise salient points about the prior probability of replication of late-phase RCTs and the increased sample size requirements necessary for a P value threshold of .005. Although we agree that the .005 threshold would require adjustments to funding strategies and trial design, we remain unconvinced that the .005 threshold would come with “little added benefit.” Ultimately, we remain supportive of the new .005 threshold, for this proposal was meant to serve as a temporizing measure while improved statistical frameworks are developed.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.0574
      Issue No: Vol. 321, No. 15 (2019)
       
  • Evaluation for Fibrosis After Cure of Hepatitis C
    • Authors: Kahal D.
      Pages: 1534 - 1535
      Abstract: To the Editor Dr Wilder et al described a patient treated and cured of HCV who subsequently underwent VCTE to restage his liver disease. Vibration-controlled transient elastography or routine monitoring of fibrosis regression is not currently recommended after HCV cure.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.0869
      Issue No: Vol. 321, No. 15 (2019)
       
  • Evaluation for Fibrosis After Cure of Hepatitis C
    • Authors: Fischer BG; Baduashvili A, Evans AT.
      Pages: 1534 - 1534
      Abstract: To the Editor We are concerned about 2 comments that Dr Wilder and colleagues made in their discussion of a patient with cured chronic hepatitis C virus (HCV) infection who underwent vibration-controlled transient elastography (VCTE) testing.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.0865
      Issue No: Vol. 321, No. 15 (2019)
       
  • Evaluation for Fibrosis After Cure of Hepatitis C—Reply
    • Authors: Wilder J; Choi SS, Moylan CA.
      Pages: 1535 - 1535
      Abstract: In Reply Dr Fischer and colleagues highlight 2 important points regarding the decision to perform VCTE. We agree that specificity describes the accuracy of a test in the absence of disease and defines the ability of a test to correctly classify an individual as disease free. We obtained our information regarding 94% specificity of VCTE to rule out cirrhosis from the study by Cardoso et al. Accuracy of VCTE was evaluated in patients with hepatitis B and HCV in whom the presence of cirrhosis was unknown. In their analysis, VCTE was 94% specific in individuals without cirrhosis and an LSM less than 12.5 kPa. The intent of our sentence was to indicate the accuracy of the test and probably should not have used the word specific given the interpretation that this would mean specificity. We have asked that the article be corrected online to the following: “VCTE is 93% accurate for cirrhosis when LSM is greater than the threshold . . . .” We apologize for any confusion.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.0873
      Issue No: Vol. 321, No. 15 (2019)
       
  • Incorrect Numeric Value
    • Pages: 1535 - 1535
      Abstract: In the Diagnostic Test Interpretation entitled “Vibration-Controlled Transient Elastography for Diagnosing Cirrhosis and Staging Hepatic Fibrosis,” published in the November 20, 2018, issue of JAMA, a value reported in the Application to This Patient section was incorrect. The third sentence should have read “VCTE is 93% specific for cirrhosis when LSM is greater than the threshold and consistent with other findings of cirrhosis (ie, thrombocytopenia).” This article was corrected online.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.4034
      Issue No: Vol. 321, No. 15 (2019)
       
  • Error in JAMA Forum Article on Pelvic Examination Under Anesthesia
    • Pages: 1535 - 1535
      Abstract: In the JAMA Forum article titled “Teaching Pelvic Examination Under Anesthesia Without Patient Consent,” published in the February 26, 2019, issue of JAMA, there was an error in the sentence “The Association of American Medical Colleges, reversing its prior policy position, offered that ‘performing pelvic examinations on women under anesthesia, without their knowledge or approval…is unethical and unacceptable.’” The Association of American Medical Colleges did not reverse its prior policy position; the organization has been on record in opposing the practice since 2003. This article has been corrected online.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.3638
      Issue No: Vol. 321, No. 15 (2019)
       
  • The MRI
    • Authors: Skillman J.
      Pages: 1536 - 1536
      Abstract: You take off your jewels and your watch,lie down head first, prepare to enter the cavern.A nurse, kind and young, arranges youwith a pillow and warm blanket.She asks are you comfortable'
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2018.22127
      Issue No: Vol. 321, No. 15 (2019)
       
  • The Foxhall Fossil Human Jawbone
    • Pages: 1537 - 1537
      Abstract: In our Correspondence Department this week we publish a letter from J. Reid Moir of Ipswich, England, in regard to a fossil human jawbone found at Foxhall. As will be noticed, the object of Mr. Moir’s communication to The Journal is to secure, if possible, some trace of the jawbone, which Mr. Moir believes to be in the United States. While not strictly medical, the subject of the antiquity of man, as revealed by fossil fragments such as this, is of special interest to most physicians. Prof. Frederick Starr of the Department of Anthropology of the University of Chicago is inclined to believe that this fragment probably is not of the Pliocene period.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2018.15297
      Issue No: Vol. 321, No. 15 (2019)
       
  • Screening for High Blood Lead Levels in Children and Pregnant Women
    • Authors: Jin J.
      Pages: 1542 - 1542
      Abstract: This JAMA Patient Page describes the US Preventive Services Task Force’s recent recommendations on screening for high blood lead levels in children and pregnant women.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1001/jama.2019.2944
      Issue No: Vol. 321, No. 15 (2019)
       
 
 
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