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JAMA Internal Medicine
Journal Prestige (SJR): 8.032  Citation Impact (citeScore): 4 Number of Followers: 196  Subscription journalISSN (Print) 2168-6106 - ISSN (Online) 2168-6114 Published by American Medical Association  [14 journals]
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- JAMA Internal Medicine Peer Reviewers in 2021
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PubDate: Mon, 02 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0153
Issue No: Vol. 182, No. 5 (2022)
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- Error in Quiz Answer Choice Caused by Error in Related Article
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Pages: 1 - 1
Abstract: In the Continuing Medical Education Quiz, “Association of Self-reported COVID-19 Infection and SARS-CoV-2 Serology Test Results With Persistent Physical Symptoms Among French Adults During the COVID-19 Pandemic,” published online January 4, 2022, in JAMA Internal Medicine, answer option 3A has been changed to “Breathing difficulties” to reflect a correction in the related article. Both articles have been corrected online.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0451
Issue No: Vol. 182, No. 5 (2022)
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- JAMA Internal Medicine
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Pages: 467 - 467
Abstract: Mission Statement: To promote the art and science of medicine and the betterment of public health by publishing manuscripts of interest and relevance to internists practicing as generalists or as medical subspecialists.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2021.6077
Issue No: Vol. 182, No. 5 (2022)
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- JAMA Internal Medicine—Year in Review, 2021
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Authors: Redberg RF.
Pages: 469 - 470
Abstract: We start another year with the continuing COVID-19 pandemic and much coverage in the news and medical journals, as well as progress. Thankfully, we now have widespread vaccinations and effective public health measures. The latest highly contagious Omicron variant, which has slowed the highly anticipated recovery, finally appears to be subsiding. We remain optimistic that we will learn how best to live with this “new normal,” and we can get back to the hard work of promoting high-value health care that is accessible to all.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0464
Issue No: Vol. 182, No. 5 (2022)
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- New US Preventive Services Task Force Recommendations on Screening for
Eating Disorders-
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Authors: Nagata JM; Golden NH.
Pages: 471 - 473
Abstract: Eating disorders are conditions characterized by disturbances in eating behaviors that impair physical and psychosocial functioning and include, but are not limited to, anorexia nervosa, binge eating disorder, bulimia nervosa, avoidant/restrictive food intake disorder, and other specific feeding and eating disorders, including atypical anorexia nervosa (Table). Lifetime prevalence estimates for eating disorders range from 0.5% to 3.5% in women and 0.1% to 2.0% in men, although these may be underestimations, particularly because the prevalence of eating disorders has risen during the COVID-19 pandemic. Eating disorders have considerable short- and long-term consequences for mental and physical health.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0121
Issue No: Vol. 182, No. 5 (2022)
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- Association Between Low-Density Lipoprotein Cholesterol Reduction and
Relative and Absolute Effects of Statin Treatment-
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Authors: Byrne P; Demasi M, Jones M, et al.
Pages: 474 - 481
Abstract: This systematic review and meta-analysis examines the association between absolute reductions in low-density lipoprotein cholesterol levels with treatment with statin therapy and all-cause mortality, myocardial infarction, and stroke.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0134
Issue No: Vol. 182, No. 5 (2022)
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- Outcomes and Safety of History-Based Screening for Medication Abortion
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Authors: Upadhyay UD; Raymond EG, Koenig LR, et al.
Pages: 482 - 491
Abstract: This cohort study evaluates the outcomes and safety of a history-based screening, no-test approach to medication abortion care.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0217
Issue No: Vol. 182, No. 5 (2022)
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- It Is Time to Change the Standard of Medication Abortion
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Authors: Karlin J; Perritt J.
Pages: 491 - 493
Abstract: Before prescribing medication abortion, clinicians have been compelled to perform a pelvic examination or ultrasonography for gestational dating to adhere to the requirements of the US Food and Drug Administration (FDA) Risk Evaluation and Mitigation System (REMS) program for dispensing mifepristone. These examinations require an in-person clinic visit, which can be logistically burdensome and limit access to care. In this issue of JAMA Internal Medicine, Upadhyay et al provide evidence that medication abortion using mifepristone and misoprostol is safe and effective for pregnancy termination without requiring an in-person clinical evaluation. These data should reassure clinicians and FDA evaluators that allowing history-based screening in lieu of in-person examinations is appropriate and evidence based.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0216
Issue No: Vol. 182, No. 5 (2022)
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- Accessible Hepatitis C Care for People Who Inject Drugs
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Authors: Eckhardt B; Mateu-Gelabert P, Aponte-Melendez Y, et al.
Pages: 494 - 502
Abstract: This randomized clinical trial examines the efficacy of an accessible care model for treating hepatitis C virus in people who inject drugs.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0170
Issue No: Vol. 182, No. 5 (2022)
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- Curing Hepatitis C—Requires More Than a Prescription
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Authors: Choudhury A; Katz MH.
Pages: 502 - 502
Abstract: Treatment for hepatitis C has improved substantially with the availability of direct antigen antiviral therapy, which results in eradication of the virus in approximately 90% of persons in 8 to 12 weeks of treatment. However, it can be particularly challenging to provide treatment for persons who inject drugs because the US health care system is not oriented around the needs of this population.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0181
Issue No: Vol. 182, No. 5 (2022)
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- Perinatal Complications in Individuals With or Without SARS-CoV-2
Infection During Pregnancy-
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Authors: Ferrara A; Hedderson MM, Zhu Y, et al.
Pages: 503 - 512
Abstract: This cohort study examines the risk for perinatal complications in pregnant individuals with SARS-CoV-2 infection.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0330
Issue No: Vol. 182, No. 5 (2022)
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- Glucagon-Like Peptide-1 Receptor Agonist Use and Risk of Gallbladder and
Biliary Diseases-
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Authors: He L; Wang J, Ping F, et al.
Pages: 513 - 519
Abstract: This systematic review and meta-analysis of 76 randomized clinical trials examines the effects of glucagon-like peptide-1 receptor agonist use on the risk of gallbladder and biliary diseases.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0338
Issue No: Vol. 182, No. 5 (2022)
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- Safety of Glucagon-Like Peptide-1 Receptor Agonists
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Authors: Haider S; Lipska KJ.
Pages: 520 - 521
Abstract: A 64-year-old patient with long-standing type 2 diabetes and a history of myocardial infarction expressed frustration with his elevated blood glucose level and inability to lose weight. He was taking metformin but wondered if he needed another medication. We discussed treatment options and he became interested in starting treatment with a glucagon-like peptide-1 receptor agonist (GLP-1 RA), but he wanted to make sure it had a good track record of safety.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0335
Issue No: Vol. 182, No. 5 (2022)
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- Antipsychotic Drug Exposure in Pregnancy and Risk of Neurodevelopmental
Disorders-
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Authors: Straub L; Hernández-Díaz S, Bateman BT, et al.
Pages: 522 - 533
Abstract: This nationwide birth cohort study of 3.4 million children nested in nationwide health care utilization data with up to 14 years of follow-up evaluates the risk of specific neurodevelopment disorders associated with in utero exposure to antipsychotic medications.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0375
Issue No: Vol. 182, No. 5 (2022)
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- Deprescribing Education vs Usual Care for Patients With Cognitive
Impairment and Primary Care Clinicians-
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Authors: Bayliss EA; Shetterly SM, Drace ML, et al.
Pages: 534 - 542
Abstract: This cluster randomized clinical trial examines the effectiveness of educating patients and clinicians about the potential to deprescribe unnecessary or risky medications among patients with dementia or mild cognitive impairment.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0502
Issue No: Vol. 182, No. 5 (2022)
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- Inpatient Management of Type 2 Diabetes
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Authors: Warnock S; Latifi N.
Pages: 543 - 544
Abstract: This Teachable Moment describes treatment plans that reduce the frequency of finger stick blood glucose checks for patients with type 2 diabetes.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0410
Issue No: Vol. 182, No. 5 (2022)
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- The Harms of Postoperative Antibiotic Prophylaxis
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Authors: Halani S; McIntyre M, Vaisman A.
Pages: 545 - 546
Abstract: This Teachable Moment describes a man in his 70s with coronary artery disease who presented to the emergency department with fever and chills and was diagnosed with Clostridium difficile infection.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0413
Issue No: Vol. 182, No. 5 (2022)
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- Where Is the Culprit Lesion in the New Electrocardiogram Pattern'
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Authors: Zhang C Xu Z.
Pages: 547 - 548
Abstract: This case report presents the electrocardiogram findings of a patient in their 60s with paroxysmal chest pain.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0011
Issue No: Vol. 182, No. 5 (2022)
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- Acute Myocardial Infarction With Wide Complex Rhythm
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Authors: Chang Q; Jin Y.
Pages: 549 - 550
Abstract: This case report presents the electrocardiographic findings of a man in his 70s who presented to the emergency department with sudden-onset chest pain and profuse sweating.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0122
Issue No: Vol. 182, No. 5 (2022)
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- Diagnostic Dilemma of Pericarditis Concurrent With ST-Elevation Myocardial
Infarction-
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Authors: Alsagaff M; Oktaviono Y, Lusida T.
Pages: 551 - 552
Abstract: This case report presents the electrocardiogram findings of a 57-year-old man with persistent diffuse ST elevation after failed treatment with streptokinase therapy.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0318
Issue No: Vol. 182, No. 5 (2022)
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- Tachycardiomyopathy—The Eye Cannot See What the Mind Does Not Know
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Authors: Divani G; Gupta A, Jain A.
Pages: 553 - 554
Abstract: This case report describes a patient in his 20s with no comordities who presented with recurrent heart palpitations and progressive heart failure for 6 months.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0515
Issue No: Vol. 182, No. 5 (2022)
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- Cancer Center Recommendations for Prostate Cancer Screening Compared With
Evidence-Based Guidelines-
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Authors: Koh ES; Lee AJ, Ehdaie B, et al.
Pages: 555 - 556
Abstract: This cross-sectional study examines prostate cancer recommendations among US cancer centers to identify differences from clinical practice guidelines.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0091
Issue No: Vol. 182, No. 5 (2022)
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- FDA-Mandated Postmarketing Studies for High-risk Cardiovascular Devices
Approved 2015-2019-
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Authors: Hidano D; Dhruva SS, Redberg RF.
Pages: 556 - 558
Abstract: This qualitative study assesses the availability and strength of evidence of postapproval studies for high-risk cardiovascular devices subsequent to the 21st Century Cures Act.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0184
Issue No: Vol. 182, No. 5 (2022)
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- Workforce Providing Abortion Care and Management of Pregnancy Loss in the
US-
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Authors: Strasser J; Schenk E, Das K, et al.
Pages: 558 - 559
Abstract: This cross-sectional study uses national medical claims data set to examine the workforce providing abortion care and management of pregnancy loss.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0223
Issue No: Vol. 182, No. 5 (2022)
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- Dual Antiplatelet Therapy in Patients With Acute Ischemic Stroke
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Authors: Xian Y; Xu H, Smith EE, et al.
Pages: 559 - 564
Abstract: This cohort study examines patterns in prescriptions of dual antiplatelet therapy after publication of important trials and release of updated guidelines.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0323
Issue No: Vol. 182, No. 5 (2022)
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- Medical Documentation Burden Among US Office-Based Physicians
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Authors: Gaffney A; Woolhandler S, Cai C, et al.
Pages: 564 - 566
Abstract: This cross-sectional study uses data from the 2019 National Electronic Health Records Survey to assess the burden and time spent on medical documentation outside office hours among US physicians.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0372
Issue No: Vol. 182, No. 5 (2022)
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- Follow-up Duration and Gender Differences in Older Adults
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Authors: He M; Luo M, Huang J.
Pages: 566 - 566
Abstract: To the Editor We read with great enthusiasm the original investigation by Dr Shah and colleagues, who reported that identifiable social support was associated with a lower likelihood of prolonged nursing home stay among older adults living alone in the presence of a health shock. Recent estimates indicate that as many as 43.6 million older adults worldwide had no spouse or children, and 4.4 million older adults had no spouse, children, or siblings. Given the world’s aging population and the rising number of older adults living alone, we believe that the conclusions of Dr Shah and colleagues are critical and of enormous public health importance. These findings on the association of social support and nursing home stays will help draw attention to this growing, vulnerable, and underserved segment of older adults, as well as lay the groundwork for future research and policy development on aging.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0058
Issue No: Vol. 182, No. 5 (2022)
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- Follow-up Duration and Gender Differences in Older Adults—Reply
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Authors: Shah SJ; Covinsky KE.
Pages: 566 - 567
Abstract: In Reply We agree with Dr He and colleagues that understanding the health effects of social support in older adults who live alone is essential as the global population ages. Discerning what types of social resources support healthy aging and when social supports most affect health is important for patients, clinicians, and policy makers.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0061
Issue No: Vol. 182, No. 5 (2022)
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- Point-of-Care Ultrasonography
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Authors: Shokoohi H; Liteplo AS, Ma IY.
Pages: 567 - 567
Abstract: To the Editor In their recent editorial, Drs Bernstein and Wang discussed the shortcomings of point-of-care ultrasonography (POCUS), portraying it as practiced by untrained clinicians who use it for inappropriate indications (eg, ruling out nephrolithiasis despite its low sensitivity) and who do not archive images or perform quality assurance. The problem that the authors described is not POCUS itself, but POCUS done improperly and not meeting practice standards. Adequate documentation and quality assurance are essential, allowing subsequent review for image adequacy.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0067
Issue No: Vol. 182, No. 5 (2022)
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- Point-of-Care Ultrasonography
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Authors: Wilt TJ; Crandall CJ, Qaseem A.
Pages: 567 - 568
Abstract: To the Editor The editorial by Drs Bernstein and Wang titled “Point-of-Care Ultrasonography: Visually Satisfying Medicine or Evidence-Based Medicine'” raises concerns around the limitations of emerging evidence on point-of-care ultrasonography (POCUS), similar to the concerns we noted in the American College of Physicians’ (ACP) clinical guideline. However, we would like to clarify several key items mentioned in the editorial that do not represent the ACP guideline correctly.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0070
Issue No: Vol. 182, No. 5 (2022)
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- Point-of-Care Ultrasonography—Reply
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Authors: Bernstein E; Wang TY.
Pages: 568 - 568
Abstract: In Reply We agree with Dr Shokoohi and colleagues’ comments on our editorial that point-of-care ultrasonography (POCUS), when performed by properly trained clinicians in a health system with a quality assurance infrastructure and a dedicated POCUS director, is ideal and likely offers clinical benefit in certain scenarios. It is worth noting that many hospitals do not possess a quality assurance infrastructure and that not all clinicians who use POCUS are formally trained or are required to be trained. Although the position statement by the Journal of Hospital Medicine does allude to privileging requirements and training pathways, it also refers to heterogeneity among specialties, professional organizations, and hospitals; there is no universal minimum requirement for using POCUS. Decisions about what constitutes “POCUS done improperly” should be guided by evidence demonstrating meaningful clinical outcomes or adverse events. Ultimately, as with other aspects of medical practice, we need to learn more about how these outcomes (including the potential for unnecessary downstream testing) relate to the various examinations and clinical indications as well as to the level of clinician training.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0073
Issue No: Vol. 182, No. 5 (2022)
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- Japanese Framework for Access to High-risk Medical Devices
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Authors: Yamamoto H; Kusakabe T, Takahashi M.
Pages: 569 - 570
Abstract: To the Editor Dr Kadakia and colleagues recently called for reforms to medical device safety in the US by pointing out the numerous serious adverse events (SAEs) reported in association with the Penumbra JET 7 Reperfusion Catheter with Xtra Flex Technology (JET 7). Similar SAEs have also occurred in Japan; however, public injuries from JET 7 have been minimized by important postmarketing safety measures for medical devices.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0102
Issue No: Vol. 182, No. 5 (2022)
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- Maybe Not an Acute Inferior Myocardial Infarction
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Authors: Cao Y Wu H.
Pages: 569 - 569
Abstract: To the Editor This letter is in response to the Challenges in Clinical Electrocardiography report by Jay and colleagues who described an interesting case of sodium-glucose cotransporter-2 inhibitor–associated euglycemic diabetic ketoacidosis and its effect on the electrocardiogram (ECG). We would like to commend the authors for sharing their observations and discussing ST-segment elevation mimicking acute myocardial infarction during euglycemic diabetic ketoacidosis. The case report is excellent; however, 3 points need further discussion.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0096
Issue No: Vol. 182, No. 5 (2022)
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- Maybe Not an Acute Inferior Myocardial Infarction—Reply
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Authors: Jay DB; Henry TD, Sharkey SW.
Pages: 569 - 569
Abstract: In Reply We appreciate the opportunity to respond to the insightful comments from Drs Cao and Wu regarding our recent report. We agree with the authors that there is a possibility that acidosis-induced paroxysmal atrioventricular block caused the patient’s prehospital symptoms. The patient had continuous electrocardiographic monitoring during a 4-day hospitalization, without evidence of heart block beyond that of mild first-degree AV block (PR interval, 216 milliseconds).
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0099
Issue No: Vol. 182, No. 5 (2022)
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- Japanese Framework for Access to High-Risk Medical Devices—Reply
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Authors: Kadakia KT; Ross JS, Krumholz HM.
Pages: 570 - 571
Abstract: In Reply We appreciate the letter from officials at Japan’s Pharmaceuticals and Medical Devices Agency (PMDA) regarding our recent case study of the recalled Penumbra JET 7 Reperfusion Catheter with Xtra Flex Technology (JET 7) device. In contrast to the US Food and Drug Administration (FDA), the PMDA authorized the device later (January 2020 vs June 2019), and Japanese manufacturers withdrew it from distribution sooner (June 2020 vs December 2020). However, the divergent regulatory experiences extend beyond timelines, with Dr Yamamoto and colleagues noting differences in each country’s approach to the premarket classification of device risk, systems for adverse event reporting, and expectations for postmarket surveillance.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0105
Issue No: Vol. 182, No. 5 (2022)
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- Inhaled Ciclesonide for Patients Asthma or COPD and COVID-19
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Authors: Chen C; Wang C, Lai C.
Pages: 571 - 572
Abstract: To the Editor We read with great interest the recent article by Dr Clemency and colleagues who investigated the efficacy of inhaled ciclesonide for patients with symptomatic COVID-19 in an outpatient setting. This randomized clinical trial observed no significant differences between the ciclesonide intervention and placebo arms regarding time to alleviation of all COVID-19−related symptoms nor resolution of all symptoms by day 30. In contrast, the ciclesonide treatment arm had fewer COVID-19-related emergency department visits and hospitalization than the control. However, we have 2 substantial concerns with these findings.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0207
Issue No: Vol. 182, No. 5 (2022)
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- Missed Signs of Acute Pulmonary Embolism
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Authors: Zhao Y; Wang L.
Pages: 572 - 573
Abstract: To the Editor We read with great interest the case presented by Drs Belyavskaya and deSouza—massive pulmonary embolism mimicking acute ST-segment−elevation myocardial infarction. However, we found that the authors did not understand that electrocardiograms (ECGs) can provide important clues in the diagnosis of pulmonary embolism, although most of these ECG markers are nonspecific and should be read in the context of the clinical picture.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0384
Issue No: Vol. 182, No. 5 (2022)
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- Inhaled Ciclesonide for Patients With Asthma or Chronic Obstructive
Pulmonary Disease and COVID-19—Reply-
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Authors: Clemency BM; Koster DJ, Blaiss MS.
Pages: 572 - 572
Abstract: In Reply We appreciate the thoughtful inquiry by Dr Chen and colleagues on our randomized clinical trial. COVID-19 is primarily a respiratory illness, so it is logical that its effects among patients with chronic respiratory comorbidities would be of special interest to clinicians. However, published meta-analyses have suggested that asthma is not an independent risk factor for severe COVID-19 disease progression.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0210
Issue No: Vol. 182, No. 5 (2022)
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- Missed Signs of Acute Pulmonary Embolism
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Authors: Li T; Chen X.
Pages: 573 - 573
Abstract: To the Editor We read with interest the article by Drs Belyavskaya and deSouza who reported a case with ST-segment elevation in leads I, II, III, aVF, and V2 to V6 caused by acute pulmonary embolism (PE). The case is excellently presented; however, some points raised in the article require further discussion.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0387
Issue No: Vol. 182, No. 5 (2022)
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- Missed Signs of Acute Pulmonary Embolism−Reply
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Authors: deSouza IS; Belyavskaya J.
Pages: 573 - 574
Abstract: In Reply We appreciate the interest in our case report and the letters submitted by Drs Li and Chen and Drs Zhao and Wang. Our report primarily focused on the limited accuracy of postarrest electrocardiogram (ECG) ST-segment elevations in the diagnosis of acute coronary occlusion and the potential and immediate implications for clinical management. However, we would like to acknowledge and further discuss the interesting points made in the letters.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0390
Issue No: Vol. 182, No. 5 (2022)
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- Breaking the Silence of Clinically Undetectable Heart Sounds
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Authors: Maidens J; Chorba JS, Thomas JD.
Pages: 574 - 575
Abstract: To the Editor In a recent research letter, Jariwala and colleagues highlight the need to evaluate the limitations of auscultation for heart sounds. Despite the ubiquity of the stethoscope, there is still a paucity of data on the clinical interpretation of heart sounds in real-world contexts, making this work an important contribution. The findings presented demonstrate the challenge of interpreting the acoustic signatures of valvular heart disease using a particular model of electronic stethoscope. However, far from demonstrating that this integral part of the physical examination is outdated, we believe that their work emphasizes the importance of improving the tools and digital enhancements required to maintain the value of the stethoscope in modern practice.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0399
Issue No: Vol. 182, No. 5 (2022)
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- Breaking the Silence of Clinically Undetectable Heart Sounds
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Authors: Jolobe OP.
Pages: 575 - 575
Abstract: To the Editor Jariwala and colleagues published a comparison between auscultation and echocardiography for detection of heart sound and murmurs. What they omitted was whether additional maneuvers, such as postural change and breath-holding (in expiration), were used to elicit elusive murmurs. Heart sound and murmurs can be elusive in 3 disorders: torrential aortic regurgitation, critical aortic stenosis, and critical mitral stenosis.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0402
Issue No: Vol. 182, No. 5 (2022)
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- Breaking the Silence of Clinically Undetectable Heart Sounds—Reply
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Authors: Jariwala N; Klapman S, McBride J.
Pages: 575 - 576
Abstract: In Reply We thank Dr Jolobe and Dr Maidens and colleagues for their responses to our research letter investigating the prevalence of clinically undetectable heart sounds during traditional bedside cardiovascular examination. We acknowledged in the study’s eMethods and Discussion sections that we did not use additional physical examination maneuvers, and we agree with Dr Jolobe that this was an important limitation.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0405
Issue No: Vol. 182, No. 5 (2022)
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- Serology Test Results and Other Important Characteristics of Patients With
Persistent COVID-19 Symptoms-
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Authors: Re’em Y; Symeonides M, McCorkell L.
Pages: 576 - 577
Abstract: To the Editor Dr Matta and colleagues importantly recommend that those with persistent COVID-19 symptoms be adequately evaluated for conditions that may mimic post-acute sequelae of COVID-19. In arriving at this conclusion, they present results that replicate ours: the only long-term symptom correlated with positive SARS-CoV-2 serology is anosmia. However, the evidence suggests that anosmia may be more helpful in assessing one’s likelihood of positive serology results than one’s history of COVID-19 infection. We have previously shown that those reporting persistent COVID-19 who are untested or who have tested negative have symptom time courses—with exception of change in smell and/or taste—that overlap with those who have had a positive result on reverse transcriptase–polymerase chain reaction (RT-PCR), antigen, or antibody test. We interpret this to mean that the clinical syndrome in people reporting persistent COVID-19 with positive, negative, or untested status, is the same. The authors make a key error in assuming that serology has good sensitivity for history of SARS-CoV-2 infection in all populations. Indeed, male sex and hospitalization were found to be predictors of greater antibody titers. Additionally, though participants were asked to indicate whether they thought they had been infected since March 2020, the serology results were obtained between May and November of 2020, suggesting that the time from the RT-PCR positive finding was significantly greater than the mean of 44 days in the study assessing sensitivity of the antibody assay. As mentioned by the authors, antibodies wane with time and are less likely to be found in those with persistent symptoms. There is additionally no mention of statistical methods used to account for extremely large differences in between-group number of patients in the cohort, which can invalidate the results of the logistic regression analysis. Crucially, nonseroconversion after SARS-CoV-2 infection (that is, failure to test positive for antibodies at any time after a positive RT-PCR test result) occurs in an estimated 24% of cases. Clearly, a negative serology finding is insufficient to rule out prior COVID-19 illness. Rigor must be applied to competing differential diagnoses, particularly those that are impossible to objectively disprove, such as some psychiatric conditions. In the absence of sufficient objective measures of prior infection, the patient’s clinical presentation should be the deciding factor when determining likelihood of prior infection. Further, a more important clinical question is why those with clinical syndromes consistent with persistent COVID-19 appear less likely to have sustained antibody responses.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0418
Issue No: Vol. 182, No. 5 (2022)
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- Serology Test Results and Other Important Characteristics of Patients With
Persistent COVID-19 Symptoms-
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Authors: Tack M.
Pages: 577 - 577
Abstract: To the Editor Matta et al studied 26 823 individuals from the French CONSTANCES cohort. Participants were asked if they believed they had a COVID-19 infection and whether they experienced physical symptoms during the previous 4 weeks that had persisted for at least 8 weeks. Anti-SARS-CoV-2 antibodies were detected with an enzyme-linked immunosorbent assay. In the abstract, Matta and colleagues report that “a serology test result positive for SARS-COV-2 was positively associated only with persistent anosmia.”
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0421
Issue No: Vol. 182, No. 5 (2022)
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- Serology Test Results and Other Important Characteristics of Patients With
Persistent COVID-19 Symptoms—Reply-
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Authors: Lemogne C; Matta J, Robineau O.
Pages: 577 - 578
Abstract: In Reply We agree with Dr Re’em and colleagues that serology findings may not be a robust marker of SARS-CoV-2 infection at the individual patient level. Samples with indeterminate results (ie, optical density ratio ≥0.8 and <1.1) were discarded, thereby reducing the risk of false-negative results but not false-positive results. Since the sensitivity and specificity of the test in our study were assessed in another setting, we acknowledge that we cannot properly estimate the prevalence of past infection in our study population. However, whatever the prevalence one may assume in our population, participants with positive (vs negative) results would be more likely to have had COVID-19. Serology testing is thus a useful tool to study the correlates of SARS-CoV-2 infection at the population level. This conclusion holds even assuming a sensitivity of 61.2%, encompassing non-seroconversion, antibodies waning, and non-detection as reported by Perez-Saez et al. Moreover, introducing the date of serology testing (ie, May or June 2020 [n = 5698] vs after June 2020 [n = 21 125]) in model 2, we found no interaction between serology results and the date of serology testing.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0424
Issue No: Vol. 182, No. 5 (2022)
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- Error in Figure 3
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Pages: 579 - 579
Abstract: In the Original Investigation titled “Evaluating the Association Between Low-Density Lipoprotein Cholesterol Reduction and Relative and Absolute Effects of Statin Treatment: a Systematic Review and Meta-analysis,” the y-axis title of Figure 3 was “Percentage relative reduction” but should be “Percentage absolute reduction.” This article was corrected online.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.1671
Issue No: Vol. 182, No. 5 (2022)
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- Error in Abstract and Results
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Pages: 579 - 579
Abstract: In the Original Investigation titled “Association of ‘Weekend Warrior’ and Other Leisure Time Physical Activity Patterns With Risks for All-Cause, Cardiovascular Disease, and Cancer Mortality,” published in the March 2017 issue of JAMA Internal Medicine, the percentage of adult female survey respondents should have been given as 54.1% instead of 44.1%. The percentage appears in the first sentence of the Results sections of the Abstract and main text. This article was corrected online.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0668
Issue No: Vol. 182, No. 5 (2022)
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- Numerical Errors and Clarification of Study Participants With Undefined
Responses, Missing Data, and Complete Data-
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Pages: 579 - 579
Abstract: In the Original Investigation, “Association of Self-reported COVID-19 Infection and SARS-CoV-2 Serology Test Results With Persistent Physical Symptoms Among French Adults During the COVID-19 Pandemic,” published online November 8, 2021, and in the January 2022 issue of JAMA Internal Medicine, there were errors and omissions that required correction and clarification. Participants with undefined responses for income and educational level were excluded from the multivariable analysis, leading to minimal changes in the odds ratios in the Abstract, in Table 3, and in eTables 6 and 7 in Supplement 1. In addition, it is now stated that only participants with complete data for model 3 were included in models 1 and 2. Descriptive and missing data regarding depressive symptoms and the numbers of event and numbers of participants for each symptom (accounting for 1%-2% of missing data for each symptom) have been added to the Tables and eTables. eTable 5 in Supplement 1 now includes only participants with complete data for serology results and acknowledges that some participants gave more than 1 response. In eTable 4 in Supplement 1, the Belief+/Serology− and the Belief+/Serology+ columns were reversed. Finally, lack of information on false positives and false negatives has been added as a limitation, and the sentence regarding estimate of the prevalence of past SARS-CoV-2 infection in the population study has been removed from the Discussion. This article has been corrected.
PubDate: Sun, 01 May 2022 00:00:00 GMT
DOI: 10.1001/jamainternmed.2022.0450
Issue No: Vol. 182, No. 5 (2022)
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