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Journal Cover JAMA Internal Medicine
  [SJR: 5.955]   [H-I: 272]   [224 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 2168-6106 - ISSN (Online) 2168-6114
   Published by American Medical Association Homepage  [13 journals]
  • Consent to Study Purpose in Randomized Clinical Trials of Antibiotics
    • Authors: Doshi P; Hur P, Jones M, et al.
      Pages: 1 - 8
      Abstract: This cross-sectional analysis of trial documents submitted to regulators examines the degree to which the study purpose is explained to potential participants in randomized clinical trials of antibiotics.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3820
      Issue No: Vol. 177, No. 10 (2017)
       
  • October 2017 Issue Highlights
    • Pages: 1405 - 1407
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2016.6169
      Issue No: Vol. 177, No. 10 (2017)
       
  • JAMA Internal Medicine
    • Pages: 1408 - 1408
      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: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2016.6170
      Issue No: Vol. 177, No. 10 (2017)
       
  • The Use of Storytelling in Medicine
    • Authors: Silverman E.
      Pages: 1409 - 1410
      Abstract: This Viewpoint describes an organization created to share stories and experiences of medical professionals.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.2996
      Issue No: Vol. 177, No. 10 (2017)
       
  • Risk Stratification to Reduce Errors in Cervical Cancer Prevention
    • Authors: Perkins RB; Cain JM, Feldman S.
      Pages: 1411 - 1412
      Abstract: This Viewpoint posits that safely and effectively implementing consensus guidelines for Papanicolou and human papillomavirus testing for cervical cancer prevention requires accurate risk stratification of patients.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3999
      Issue No: Vol. 177, No. 10 (2017)
       
  • Making All Lives Matter in Medicine From the Inside Out
    • Authors: Mensah MO.
      Pages: 1413 - 1414
      Abstract: This Viewpoint examines racial bias in the health care workplace.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.1981
      Issue No: Vol. 177, No. 10 (2017)
       
  • Lessons From an Educational Never Event
    • Authors: Lucey CR; Navarro R, King TE, Jr.
      Pages: 1415 - 1416
      Abstract: The event described by Mensah in this issue occurred when he was a student at a school known for its commitment to preparing a workforce capable of meeting the needs of our increasingly diverse communities, with faculty committed to using science to solve complex problems for our most vulnerable communities, in a medical educational program with social justice as a foundational pillar.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3055
      Issue No: Vol. 177, No. 10 (2017)
       
  • Meeting the Needs of Patients for Specialty Care
    • Authors: Katz MH.
      Pages: 1417 - 1417
      Abstract: Timely access to specialists has been a longstanding concern for patients with Medicaid compared with patients who have private insurance. Thus, instituting requirements that Medicaid managed care plans adhere to timeliness and proximity standards seems like an excellent solution to a longstanding problem. However, as with so many things in health care, the issue is more complicated.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3778
      Issue No: Vol. 177, No. 10 (2017)
       
  • A Call for Social Responsibility and Suicide Intervention
    • Authors: O'Brien K; Knight JR, Jr, Harris SK.
      Pages: 1418 - 1419
      Abstract: The national suicide rate has risen steadily in recent decades, making suicide now the second leading cause of death among young people, accounting for more than 1 in 6 deaths. Adolescent reports of suicide ideation and attempts are on the rise. According to national high school Youth Risk Behavior Survey, the percentage of high school respondents who reported that they seriously considered attempting suicide during the 12 months preceding the survey rose from 13.8% in 2009 to 17.7% in 2015; during this same interval, the percentage of high school students making a plan for how they would attempt suicide increased (10.9% to 14.6%), as did the percentage who actually attempted suicide (6.3% to 8.6%).
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3388
      Issue No: Vol. 177, No. 10 (2017)
       
  • Macy’s Fourth of July Fireworks, 2017
    • Pages: 1419 - 1419
      Abstract: Courtesy of: Manfred Hauben, MD, MPH, Pfizer, Worldwide Safety Strategy, 235 E 42nd St, New York, New York 10017.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.5524
      Issue No: Vol. 177, No. 10 (2017)
       
  • Don’t Just Do Something, Stand There!
    • Authors: Sinha P.
      Pages: 1420 - 1421
      Abstract: Penalty kicks in soccer can make fans crumple with anguish or weep with elation. The kicker sends the ball rocketing toward the goal and goalkeepers lunge acrobatically to stop it. Often the fate of the match hangs in the balance. Analyses suggest that goalkeepers may block more goals by staying stolidly in the center of the goal instead of diving to one side. Surprisingly, goalkeepers rarely adopt this strategy. One explanation is that staying in the middle looks deceptively foolish when kickers shoot toward the side. On the contrary, even when their dive is unsuccessful, goalkeepers are seen to have failed while trying. Knowing the ferocity of soccer, this is an understandable decision.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3628
      Issue No: Vol. 177, No. 10 (2017)
       
  • Mistakes Were Made (by Me)
    • Authors: Manesh R.
      Pages: 1422 - 1423
      Abstract: I still remember taking care of a particular patient when I was a medical student. She was a middle-aged woman with cyclic vomiting syndrome who presented with nausea, vomiting, and abdominal pain. The plan was the same as always: nothing by mouth, intravenous fluid, antiemetics, and discharge once she could eat. On hospital day 2 she suddenly developed chest pain. An electrocardiogram (EKG) revealed ST-segment elevations, which prompted emergent cardiac catheterization. I reviewed her admission EKG and realized it had identical ST-segment elevations. I became nauseated myself, because no one from our team had looked at the initial EKG. The angiogram excluded acute coronary syndrome, but the guilt of a potentially tragic mistake remained. I wanted to share this experience with my colleagues so we could learn from it. I asked a colleague for the best forum to discuss our mistake, and my colleague gestured “hush” and said, “There is no need to tell anyone because she didn’t have plaque rupture.” I was confused by that reaction. Was I to be ashamed of my mistake'
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3781
      Issue No: Vol. 177, No. 10 (2017)
       
  • Social Determinants of Health in Managed Care Payment Formulas
    • Authors: Ash AS; Mick EO, Ellis RP, et al.
      Pages: 1424 - 1430
      Abstract: This modeling analysis adds social determinants of health variables to a diagnosis-based payment formula that allocates funds to managed care plans and physician networks.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3317
      Issue No: Vol. 177, No. 10 (2017)
       
  • Social and Behavioral Determinants of Spending
    • Authors: Joynt Maddox KE.
      Pages: 1431 - 1432
      Abstract: A growing proportion of state and federal health care dollars are spent via managed care, in which government pays private companies to administer insurance coverage on its behalf. Recent reports suggest that as many as 77% of Medicaid beneficiaries are enrolled in some type of managed care plan, and Medicare Advantage, which is Medicare’s managed care option, now enrolls nearly a third of Medicare beneficiaries.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3325
      Issue No: Vol. 177, No. 10 (2017)
       
  • Association of a Communication Tool With Docusate Administration
    • Authors: Pasay D; Guirguis M, Shkrobot R, et al.
      Pages: 1433 - 1436
      Abstract: This study assesses the association of dissemination of an educational document about the lack of efficacy of docusate with docusate administration and whether changes in docusate administration were associated with changes in the administration of comparable laxatives.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3605
      Issue No: Vol. 177, No. 10 (2017)
       
  • Group Exercise Program to Improve Mobility in Older Adults
    • Authors: Brach JS; Perera S, Gilmore S, et al.
      Pages: 1437 - 1444
      Abstract: This cluster-randomized trial compares the effectiveness of a group exercise program that focuses on the timing and coordination of movement with a seated strength, endurance, and flexibility program (usual care) on function, disability, and walking ability of older adults.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3609
      Issue No: Vol. 177, No. 10 (2017)
       
  • State Access Standards and Accessibility to Specialists for Medicaid
           Managed Care Enrollees
    • Authors: Ndumele CD; Cohen MS, Cleary PD.
      Pages: 1445 - 1451
      Abstract: This study compares ratings of access to specialists for adult Medicaid and commercial insurance enrollees before and after the implementation of specialty access standards.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3766
      Issue No: Vol. 177, No. 10 (2017)
       
  • What Should Patients Be Told About Noninferiority Studies'
    • Authors: Menikoff J.
      Pages: 1459 - 1460
      Abstract: A noninferiority trial is a study in which a new treatment is compared with an existing, already available treatment, but in which the statistical analysis does not evaluate the possible superiority of the new treatment. Rather, it tests whether the new treatment is not worse than the existing treatment, using a prespecified threshold for the evaluation (the “noninferiority margin”). In this issue of JAMA Internal Medicine, Doshi et al explore both what patients are being told, and what they should be told, about the purpose of the research when being asked to participate in a noninferiority trial designed to test the comparative efficacy and safety of antibiotics.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3825
      Issue No: Vol. 177, No. 10 (2017)
       
  • Identifying Patients at Risk of Hypoglycemia-Related Use
    • Authors: Karter AJ; Warton E, Lipska KJ, et al.
      Pages: 1461 - 1470
      Abstract: This study develops and validates a risk stratification tool to categorize risk of future hypoglycemia-related emergency department or hospital use in patients with type 2 diabetes.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3844
      Issue No: Vol. 177, No. 10 (2017)
       
  • Effects of Oral vs Transdermal Estrogen Therapy on Sexual Function
    • Authors: Taylor HS; Tal A, Pal L, et al.
      Pages: 1471 - 1479
      Abstract: This ancillary study of a randomized clinical trial assesses the effects of oral or transdermal estrogen therapy vs placebo on sexual function in postmenopausal women.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3877
      Issue No: Vol. 177, No. 10 (2017)
       
  • Collaborative Care for Opioid and Alcohol Use Disorders in Primary Care
    • Authors: Watkins KE; Ober AJ, Lamp K, et al.
      Pages: 1480 - 1488
      Abstract: This randomized clinical trial examines whether collaborative care for patients with opioid and/or alcohol use disorders improves the delivery of evidence-based treatments and increases self-reported abstinence compared with usual primary care.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3947
      Issue No: Vol. 177, No. 10 (2017)
       
  • Association of Evidence-Based Care Processes and Mortality in
           Staphylococcus aureus Bacteremia
    • Authors: Goto M; Schweizer ML, Vaughan-Sarrazin MS, et al.
      Pages: 1489 - 1497
      Abstract: This cohort study examines the association of evidence-based care processes in routine care for Staphylococcus aureus bacteremia with mortality at Veterans Health Administration hospitals.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3958
      Issue No: Vol. 177, No. 10 (2017)
       
  • Blood Pressure Lowering and Risk of Mortality in Chronic Kidney Disease
    • Authors: Malhotra R; Nguyen H, Benavente O, et al.
      Pages: 1498 - 1505
      Abstract: This systematic review and meta-analysis of randomized clinical trials investigates if more intensive compared with less intensive blood pressure control is associated with reduced mortality risk in persons with chronic kidney disease stages 3 to 5.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.4377
      Issue No: Vol. 177, No. 10 (2017)
       
  • The Ideal Blood Pressure Target for Patients With Chronic Kidney Disease
    • Authors: Kovesdy CP.
      Pages: 1506 - 1507
      Abstract: Hypertension is the number 1 cardiovascular risk factor, and its treatment prevents major cardiovascular events and lowers mortality. Most patients with chronic kidney disease (CKD) have hypertension, and CKD is characterized by extremely high cardiovascular disease rates. It is thus not surprising that antihypertensive therapy is a universal part of CKD management, and its benefits are broadly accepted. Notwithstanding the general consensus about the pathophysiologic relevance of hypertension, there has been controversy in the medical community regarding the ideal therapeutic blood pressure (BP) target in patients with CKD. Fueling this controversy are concerns about the presence of a J-curve and the paucity of dedicated randomized clinical trials (RCTs) testing the effects of BP lowering to levels that approach physiologic normalcy (ie, <120/80 mm Hg). These uncertainties are further accentuated when assessing the effects of antihypertensive therapy on all-cause mortality, which includes deaths with causes entirely unrelated to hypertension.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.4467
      Issue No: Vol. 177, No. 10 (2017)
       
  • Eliminating Creatine Kinase–Myocardial Band Testing in Suspected ACS
    • Authors: Alvin MD; Jaffe AS, Ziegelstein RC, et al.
      Pages: 1508 - 1512
      Abstract: This Special Communication discusses the benefits of eliminating creatine kinase–myocardial band testing in suspected acute coronary syndrome.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3597
      Issue No: Vol. 177, No. 10 (2017)
       
  • Cardiac Resynchronization Therapy—Does One Size Fit All'
    • Authors: Baker M; Weidendorf D, Swaminathan L.
      Pages: 1513 - 1514
      Abstract: This Teachable Moment illustrates the complexity of determining the appropriateness and timing of cardiac resynchronization therapy in the management of heart failure.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.2778
      Issue No: Vol. 177, No. 10 (2017)
       
  • Toward Improving Patient Safety
    • Authors: Varosy PD.
      Pages: 1514 - 1515
      Abstract: In this issue of JAMA Internal Medicine, Baker and colleagues present the case of a woman in her 90s who experienced fatal complications after implantation of a cardiac resynchronization therapy pacemaker (CRT-P). The authors make educational points in this Teachable Moment about the possible harms of placing a device in a high-risk patient with less than clear indications. There is, however, more we can learn from this story.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.2987
      Issue No: Vol. 177, No. 10 (2017)
       
  • Unnecessary Staging Imaging in Early-Stage Breast Cancer
    • Authors: Wolfe HR; Gupta A, Sadeghi N.
      Pages: 1516 - 1517
      Abstract: This Teachable Moment uses the details of a case report to evaluate the risks and benefits of staging imaging in early-stage breast cancer.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.2785
      Issue No: Vol. 177, No. 10 (2017)
       
  • The Harms of Empirical Bowel Regimens
    • Authors: Gupta A; Agrawal D, Croft C.
      Pages: 1518 - 1519
      Abstract: This Teachable Moment describes a hospitalized patient with nosocomial diarrhea caused by unnecessary prescription of laxatives and discusses the potential harms of this routine practice.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3653
      Issue No: Vol. 177, No. 10 (2017)
       
  • Macroscopic T-Wave Alternans
    • Authors: Moore PK; Raffel KE, Whitman IR.
      Pages: 1520 - 1522
      Abstract: A man in his 40s with a history of alcohol abuse and hepatitis C cirrhosis presented to the emergency department with several weeks of subjective fever, abdominal cramping, and diarrhea. He had no history of cardiovascular disease and was not taking medications or supplements.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3191
      Issue No: Vol. 177, No. 10 (2017)
       
  • Enactment of a “Stand Your Ground” Law and Homicides in
           Florida
    • Authors: Humphreys DK; Gasparrini A, Wiebe DJ.
      Pages: 1523 - 1524
      Abstract: This study analyzes data on homicides to evaluate changes in the number of justifiable and unlawful homicides in Florida following the enactment of a “stand your ground” law.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3433
      Issue No: Vol. 177, No. 10 (2017)
       
  • Hours Worked Among US Dual Physician Couples With Children
    • Authors: Ly DP; Seabury SA, Jena AB.
      Pages: 1524 - 1525
      Abstract: This Research Letter estimates weekly hours worked for married, dual-physician couples.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3437
      Issue No: Vol. 177, No. 10 (2017)
       
  • Smoking Cessation Pharmacotherapy Among Smokers Hospitalized for Coronary
           Heart Disease
    • Authors: Pack QR; Priya A, Lagu TC, et al.
      Pages: 1525 - 1527
      Abstract: This study uses data from the Premier Alliance database to assess factors associated with the use of smoking cessation pharmacotherapy in smokers hospitalized for coronary heart disease.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3489
      Issue No: Vol. 177, No. 10 (2017)
       
  • Internet Searches for Suicide Following the Release of 13 Reasons Why
    • Authors: Ayers JW; Althouse BM, Leas EC, et al.
      Pages: 1527 - 1529
      Abstract: This quasiexperimental examination of internet search results determines that the Netflix series 13 Reasons Why has both increased suicide awareness while unintentionally increasing suicidal ideation.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3333
      Issue No: Vol. 177, No. 10 (2017)
       
  • Association of Frequency of Lipid Testing With Changes in Lipid-Lowering
           Therapy
    • Authors: Stenehjem K; Herren D, Pulver G, et al.
      Pages: 1529 - 1531
      Abstract: This study examines clinician rationale for ordering monitoring lipid panels among patients on statin therapy and the association of treatment changes with testing.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3954
      Issue No: Vol. 177, No. 10 (2017)
       
  • Association of Insurance Gains and Losses With Access to Prescription
           Drugs
    • Authors: Yabroff K; Kirby J, Zodet M.
      Pages: 1531 - 1532
      Abstract: Using longitudinal data from the nationally representative Medical Expenditure Panel Survey, this study examines the association of insurance gains and losses with prescription drug access.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.4011
      Issue No: Vol. 177, No. 10 (2017)
       
  • Distribution of Medical Education Debt by Specialty, 2010-2016
    • Authors: Grischkan J; George BP, Chaiyachati K, et al.
      Pages: 1532 - 1535
      Abstract: This survey study analyzes the trends in the distribution of medical education debt by focusing on the increase in graduates without such debt.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.4023
      Issue No: Vol. 177, No. 10 (2017)
       
  • Consequences of Recent Anti-immigration Policy
    • Authors: Dourgnon P; Das P.
      Pages: 1535 - 1535
      Abstract: To the Editor The recent Original Investigation by Cervantes and colleagues, the Research Letter by Gray and colleagues, and the Invited Commentary by Fernández and Rodriguez accompanying both articles, demonstrate the problems undocumented persons face in obtaining health care in the United States. Policies affecting this group are mostly based on political principles rather than on facts and ethics. These studies demonstrate that managing undocumented immigrants outside the health care system, without provision of any form of primary, coordinated or preventive care, and only allowing access to emergency care, is inefficient, inequitable, and has poor outcomes. It is also more burdensome and more expensive to the larger health care system.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3483
      Issue No: Vol. 177, No. 10 (2017)
       
  • Consequences of Recent Anti-Immigration Policy—Reply
    • Authors: Fernandez A; Rodriguez RA.
      Pages: 1535 - 1536
      Abstract: In Reply We agree with Dr Dourgnon and Mr Das that federal anti-immigrant rhetoric and executive actions combined with widely publicized immigration raids are likely to deter undocumented immigrants from seeking needed health care. Fear among immigrants is currently so widespread that even in San Francisco, a city with a well-known sanctuary policy for health care settings, there appears to be a decrease in immigrants seeking appointments or accepting referrals. Clinicians in other sanctuary cities are reporting similar decreases in immigrant patient visits. This decline is consistent with past experiences of the effects of expansion of immigration enforcement. A 2014 study of the impact of Arizona state law that empowered police to detain individuals who could not prove their legal status upon request (SB 1070) found that among teen mothers and their children, routine preventive health care for the children dropped after the law was implemented. More recently, the Los Angeles police department voiced concern about a 25% drop of reports of sexual assault among Latinos in early 2017 compared with the same period last year. This occurred despite the longstanding police department policy of not sharing routine information with immigration authorities.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3486
      Issue No: Vol. 177, No. 10 (2017)
       
  • Migraines—The Parable of the People Who Were Blind and the Elephant
    • Authors: Rothschild BM.
      Pages: 1536 - 1536
      Abstract: To the Editor The Original Investigation by Zhao et al in a recent issue of JAMA Internal Medicine is mindful of a lesson learned 4 decades ago addressing what superficially appears to be a different disorder. At that time, there were no insights as to effective treatment of fibromyalgia. The physical therapist from our rheumatology treatment team had just returned from a lecture by Janet Travell, MD, on myofascial pain syndrome, noting an overlap of many symptoms with fibromyalgia, and the physical therapist from our team asked if he might apply the treatment, an electrical acupuncture technique. Because I knew of no effective intervention for fibromyalgia at the time and because the safety of the electrical acupuncture technique was well established, we offered it to our patients. Application 4 times per week for several weeks was as effective for fibromyalgia as had been demonstrated for myofascial pain syndrome.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3510
      Issue No: Vol. 177, No. 10 (2017)
       
  • Subgroup Claims Are Hype, Not Hope
    • Authors: Braillon A.
      Pages: 1536 - 1537
      Abstract: To the Editor Wallach et al must be commended for their demanding Original Investigation, a meta-epidemiological survey, examining data sets of trials with subgroup claims. Their conclusions that “…subgroup analyses are often spurious and should be considered hypothesis generating”(p559) and “…when subgroup corroborations are attempted, the initially observed subgroup differences are not demonstrated again”(p559) deserve the strongest support and also repentance.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3721
      Issue No: Vol. 177, No. 10 (2017)
       
  • Consider Quality of Life to Improve Quality of Cancer Guidelines
    • Authors: Schepisi G; Banna G, De Giorgi U.
      Pages: 1537 - 1537
      Abstract: To the Editor In an Original Investigation in a recent issue of JAMA Internal Medicine, Merkow and colleagues focused on the lack of clarity in cancer surveillance recommendations because of the prolongation of survival due to the innovative treatment development. They concluded that recommendations of cancer guidelines should be nonambiguous with the aim of optimizing care quality and resource use.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3694
      Issue No: Vol. 177, No. 10 (2017)
       
  • Consider Quality of Life to Improve Quality of Cancer Guidelines
    • Authors: Nekhlyudov L; Alfano CM, Weller D.
      Pages: 1537 - 1538
      Abstract: To the Editor We read with interest the Original Investigation by Merkow et al in a recent issue of JAMA Internal Medicine that analyzed clinical practice guidelines for cancer survivorship surveillance. The authors identified 41 English-language national guidelines that addressed posttreatment care for survivors of 9 adult-onset cancers. They found that the guidelines included inconsistent and ambiguous recommendations for surveillance testing and advised that more definitive recommendations are needed. They emphasized that clear guidance is particularly important as primary care providers are more often charged with caring for cancer survivors and have limited knowledge of appropriate cancer surveillance strategies.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3697
      Issue No: Vol. 177, No. 10 (2017)
       
  • Consider Quality of Life to Improve Quality of Cancer
           Guidelines—Reply
    • Authors: Merkow RP; Korenstein D, Baxi SS.
      Pages: 1538 - 1539
      Abstract: In Reply We appreciate the letters from Schepisi et al and Nekhlyudov et al, both of which highlight the need for a definition of cancer survivorship care that goes beyond surveillance for recurrent disease. In our study, we reported on the inconsistency and lack of clarity among national guidelines regarding posttreatment surveillance in patients with common adult cancers and recommended a more systematic guideline development process. These letters make an additional point about the appropriate scope of survivorship care.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3700
      Issue No: Vol. 177, No. 10 (2017)
       
  • Current Shortcomings of Camera Screening
    • Authors: Ramchandran RS; Feldon SE, Owsley C.
      Pages: 1539 - 1539
      Abstract: To the Editor In an Original Investigation published in a recent issue of JAMA Internal Medicine, Daskivich et al show that primary care–based digital camera–enabled telemedicine screening for diabetic retinopathy increases the rate and decreases the wait time of such screening for the underserved diabetic population of the largest county public health system in the United States. Camera-based retinal screening in nonophthalmic settings is certainly a powerful disruptive innovation that will alter best practices in the way eye care is delivered across populations.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3833
      Issue No: Vol. 177, No. 10 (2017)
       
  • Current Shortcomings of Camera Screening—Reply
    • Authors: Daskivich LP; Mangione CM.
      Pages: 1539 - 1540
      Abstract: In Reply Our teleretinal diabetic retinopathy screening (TDRS) program was implemented to address the large backlog of persons with diabetes in Los Angeles County waiting for diabetic retinopathy (DR) screening examinations. As stated in our article, our TDRS program is intended solely for DR screening; it is not intended to replace a comprehensive eye examination to rule out the presence of conditions such as glaucoma. However, it is clear that the highest risk of blindness posed to our patient population is from diabetic retinopathy. Although the pre-TDRS mean wait time for screening of 158 days may be acceptable for lower levels of diabetic retinopathy, it is not an acceptable wait time for a screening examination to determine who falls into that category. As evidenced by our historically low screening rate and long wait times for DR screening examinations, many of these patients were not getting adequate eye care, or any eye care at all, prior to the implementation of our TDRS program. This is a major challenge for the US safety net.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3836
      Issue No: Vol. 177, No. 10 (2017)
       
  • Effects of Reminder Devices on Medication Adherence
    • Authors: Schwartz JK; Foster A, Smith RO.
      Pages: 1540 - 1541
      Abstract: To the Editor In an Original Investigation in a recent issue of JAMA Internal Medicine, Dr Choudhry and colleagues evaluated the effectiveness of 3 low-cost reminder devices on medication adherence. While the study is highly rational when viewed from the medical model of disability, at its core this study is about the effectiveness of assistive technology intervention. From this perspective, the study loses its coherence.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.3996
      Issue No: Vol. 177, No. 10 (2017)
       
  • Open VA Data Sets to Non-VA Researchers
    • Authors: Weeks WB; West AN.
      Pages: 1541 - 1541
      Abstract: To the Editor There is debate about whether patient outcomes at Department of Veterans Affairs (VA) facilities are comparable to those at other facilities; such information may inform what role VA should have in US health care.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.4192
      Issue No: Vol. 177, No. 10 (2017)
       
  • Cytomegalovirus in Patients in the Intensive Care Unit
    • Authors: De Vlieger G; Van Wijngaerden E.
      Pages: 1541 - 1542
      Abstract: To the Editor We read with interest the Original Investigation by Cowley and colleagues on antiviral therapy to prevent cytomegalovirus (CMV) reactivation in patients who are immunocompetent and in the intensive care unit (ICU). The strategy to suppress CMV replication has been studied in solid organ transplants, in which both prophylaxis and preemptive treatment is accepted as standard of care. In patients in the ICU, CMV reactivation occurs in 35% of patients who are seropositive and has been associated with worse outcomes: a longer stay in the ICU and/or hospital, longer need for organ support, higher risk for bacterial infections, and increased mortality. Cowley and colleagues mention a direct correlation between CMV viral load and mortality but this association has not been shown. There is a correlation between CMV viral load and a combined end point of mortality and continued hospitalization at day 30, but the correlation between viral load and mortality as such has not been evaluated.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.4395
      Issue No: Vol. 177, No. 10 (2017)
       
  • Cytomegalovirus in Patients in the Intensive Care Unit
    • Authors: Aguilar G; Navarro D.
      Pages: 1542 - 1543
      Abstract: To the Editor We read with interest the Original Investigation by Cowley and colleagues in a recent issue of JAMA Internal Medicine on a randomized clinical trial evaluating the efficacy and safety of antiviral therapy for prevention of cytomegalovirus (CMV) reactivation in patients in the intensive care unit (ICU).
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.4398
      Issue No: Vol. 177, No. 10 (2017)
       
  • Cytomegalovirus in Patients in the Intensive Care Unit—Reply
    • Authors: Cowley NJ; Moss P, Bion JF.
      Pages: 1543 - 1543
      Abstract: In Reply We appreciate the interest shown in our Original Investigation. Drs Navarro and Aguilar are correct to note that the small numbers of patients in whom we could obtain repeat bronchiolar lavage specimens makes conclusions on viral suppression in the lung difficult. We agree that the effective suppression of viremia may not necessarily exclude end organ disease.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.4401
      Issue No: Vol. 177, No. 10 (2017)
       
  • β-Blockers and Diltiazem Combination
    • Authors: Pea F.
      Pages: 1543 - 1544
      Abstract: To the Editor I read with interest the Teachable Moment by Carroll and Hassanin published in a recent issue of JAMA Internal Medicine and concerning the worrisome issue of polypharmacy in the elderly. I fully agree with Carroll and Hassanin about the opportunity of considering medication reconciliation and of containing the number of comedications in the elderly to a minimum. The strategies proposed by Carroll and Hassanin (ie, use of established prescribing tools such as Beers criteria and STOPP criteria and/or discontinuation of medications without a clear indication) are robust and may surely concur in reducing polypharmacy. Likewise, they may be helpful in effectively preventing avoidable drug-drug interactions leading to unintentional hospital admission.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.4765
      Issue No: Vol. 177, No. 10 (2017)
       
  • The Dangers of Polypharmacy in Elderly Patients
    • Authors: Turgeon J; Michaud V, Steffen L.
      Pages: 1544 - 1544
      Abstract: To the Editor In a recent issue of JAMA Internal Medicine, Carroll and Hassanin published a Teachable Moment that embodies the importance for health care practitioners to reduce polypharmacy and prevent adverse drug events. Although we support their conclusions, we provide additional explanation regarding underlying causes of bradycardia and hypotension in patients besides unintentional metoprolol overdose.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.4790
      Issue No: Vol. 177, No. 10 (2017)
       
  • Error in Author’s Address
    • Pages: 1544 - 1544
      Abstract: In the Viewpoint titled “Sharing and Healing Through Storytelling in Medicine,” published online August 21, 2017, an incorrect address was listed for the author. The contact information should have appeared as, “Emily Silverman, MD, Department of Internal Medicine, Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA 94110 (emily.silverman@ucsf.edu).” This article was corrected online.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.6116
      Issue No: Vol. 177, No. 10 (2017)
       
  • Extraneous Sentence in the Abstract
    • Pages: 1544 - 1544
      Abstract: In the Original Investigation titled “Association of Evidence-Based Care Processes With Mortality in Staphylococcus aureus Bacteremia at Veterans Health Administration Hospitals, 2003-2014,” published online September 5, 2017, there was an extraneous sentence in the Results section of the abstract. This article has been corrected online.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.6121
      Issue No: Vol. 177, No. 10 (2017)
       
  • Omission of Conflicts of Interest
    • Pages: 1544 - 1544
      Abstract: In the article titled “Eliminating Creatine Kinase–Myocardial Band Testing in Suspected Acute Coronary Syndrome: A Value-Based Quality Improvement,” conflicts of interest were omitted when the article was published online. The article was corrected online.
      PubDate: Sun, 01 Oct 2017 00:00:00 GMT
      DOI: 10.1001/jamainternmed.2017.5550
      Issue No: Vol. 177, No. 10 (2017)
       
 
 
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