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JAMA The Journal of the American Medical Association
Journal Prestige (SJR): 8.876
Citation Impact (citeScore): 7
Number of Followers: 2478  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0098-7484 - ISSN (Online) 1538-3598
Published by American Medical Association Homepage  [14 journals]
  • Audio Highlights
    • Abstract: Listen to the JAMA Editor’s Audio Summary for an overview and discussion of the important articles appearing in this week’s issue of JAMA.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.17833
      Issue No: Vol. 325, No. 10 (2021)
       
  • JAMA
    • Pages: 907 - 908
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.17831
      Issue No: Vol. 325, No. 10 (2021)
       
  • Addiction Screening—The A Star Is Born Movie Series and Destigmatization
           of Substance Use Disorders
    • Authors: Oldfield BJ; Tetrault JM, Berland G.
      Pages: 915 - 917
      Abstract: This Arts and Medicine feature uses the A Star is Born movie series to chart trends in popular cultural representations of addiction and to argue for more authentic Hollywood depictions of substance use disorder.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.25256
      Issue No: Vol. 325, No. 10 (2021)
       
  • The Challenge of Conducting Placebo-Controlled Trials as COVID-19 Vaccines
           Become Authorized
    • Authors: Rubin R.
      Pages: 918 - 921
      Abstract: This Medical News feature examines the challenge of continuing or launching placebo-controlled trials of COVID-19 vaccines now that some have been authorized for use in the community.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.0641
      Issue No: Vol. 325, No. 10 (2021)
       
  • Building Health Care Better Means Reining In Costs
    • Authors: Cutler D.
      Pages: 922 - 923
      Abstract: President Biden has promised an economic plan to Build Back Better. After the disaster wrought by the coronavirus disease 2019 (COVID-19) pandemic, that is absolutely necessary. But rebuilding involves more than just repairing the damage from the virus itself. The US economy had glaring weak points before COVID-19, and President Biden will need to address those flaws. Of necessity, this will take the president into the economics of health care.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1578
      Issue No: Vol. 325, No. 10 (2021)
       
  • COVID-19 “Liquid Biopsy” Could Offer Monitoring, Prognostic
           Tool
    • Authors: Abbasi J.
      Pages: 924 - 924
      Abstract: Cornell University researchers are developing a “liquid biopsy” that detects and quantifies injury to internal organs from coronavirus disease 2019 (COVID-19). The test profiles epigenetic changes in circulating cell-free DNA (cfDNA)—small fragments of genetic material from dead cells, including those killed off by infection or immune-related injury. The DNA chemical modifications are specific to different cell, tissue, and organ types, revealing the origin of injury.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.2496
      Issue No: Vol. 325, No. 10 (2021)
       
  • Prolonged SARS-CoV-2 Infection in a CAR T-Cell Therapy Recipient
    • Authors: Abbasi J.
      Pages: 924 - 924
      Abstract: In a recent case report, a team of physicians described an immunosuppressed patient with severe coronavirus disease 2019 (COVID-19) who was contagious for more than 2 months. Infectious virus was present in the patient’s endotracheal aspirate (ETA) 72 days after his COVID-19 diagnosis and 2 days before he died from the massive lung infection. The findings from the 73-year-old man, who had recently undergone chimeric antigen receptor T-cell (CAR-T) therapy, suggest that patients with COVID-19 who are severely immunosuppressed may need isolation for longer than the currently recommended 20 days.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.2493
      Issue No: Vol. 325, No. 10 (2021)
       
  • Saliva Tests Comparable With Nasal Swabs for SARS-CoV-2 Detection
    • Authors: Abbasi J.
      Pages: 924 - 924
      Abstract: During the coronavirus disease 2019 (COVID-19) pandemic, polymerase chain reaction testing with nasopharyngeal swabs has been the standard diagnostic approach, but the method is uncomfortable and requires a trained health professional. Now, 2 meta-analyses have concluded that self-administered saliva tests are on par with nose and throat swabs for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1780
      Issue No: Vol. 325, No. 10 (2021)
       
  • Dramatic Cervical Cancer Screening Decline During Pandemic
    • Authors: Kuehn BM.
      Pages: 925 - 925
      Abstract: During California’s pandemic-related stay-at-home order from mid-March to mid-June 2020, cervical cancer screenings at a large health system in the state declined by about 80% compared with the same timespan a year earlier, recently analyzed data have shown.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1977
      Issue No: Vol. 325, No. 10 (2021)
       
  • More Resources, Community Outreach Needed to Boost Contact Tracing
    • Authors: Kuehn BM.
      Pages: 925 - 925
      Abstract: Contact tracers facing high caseloads and a lack of community cooperation may have stymied US efforts to slow the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), according to a CDC analysis.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1575
      Issue No: Vol. 325, No. 10 (2021)
       
  • Addressing Consolidation in Health Care Markets
    • Authors: Dafny L.
      Pages: 927 - 928
      Abstract: This Viewpoint proposes 3 steps the Biden administration can take to slow consolidation within health care, which has been shown to raise costs without improving service or quality: better fund federal antitrust enforcement agencies; appoint agency heads committed to enforcement; and create an interagency task force devoted to enhancing competition.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.0038
      Issue No: Vol. 325, No. 10 (2021)
       
  • Overcoming the Market Dominance of Hospitals
    • Authors: Kocher RP; Shah S, Navathe AS.
      Pages: 929 - 930
      Abstract: This Viewpoint reviews the conditions which incentivize consolidation of health systems, hospitals, and physician practices into entities that decrease health care quality and increase prices, and in the context of financial pressures wrought by the COVID-19 pandemic proposes policy solutions that could protect patients against potential adverse effects of accelerating trends toward consolidation.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.0079
      Issue No: Vol. 325, No. 10 (2021)
       
  • Rapid Implementation of a Vaccination Superstation
    • Authors: Longhurst CA; Kremer B, Maysent PS.
      Pages: 931 - 932
      Abstract: This Viewpoint details lessons learned from a county-private-university collaboration in San Diego to stand up a coronavirus vaccine superstation to immunize 4500-5000 people daily, detailing optimization of patient throughput and ways to monitor adverse events and document vaccine administration at scale.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.0801
      Issue No: Vol. 325, No. 10 (2021)
       
  • CMS’ Shared Decision-making Requirement for Lung Cancer Screening and
           the USPSTF 2021 Guideline Update
    • Authors: Hoffman RM; Reuland DS, Volk RJ.
      Pages: 933 - 934
      Abstract: This Viewpoint discusses implications of the USPSTF 2021 lung cancer screening recommendation update, which broadens the number of patients eligible for screening, for CMS’ shared decision-making requirement, arguing that to make shared decision-making a reality, CMS should reimburse these visits delivered by nonphysician staff and/or telehealth.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1817
      Issue No: Vol. 325, No. 10 (2021)
       
  • The Triple Aim Applied to Correctional Health Systems
    • Authors: Berwick DM; Beckman AL, Gondi S.
      Pages: 935 - 936
      Abstract: This Viewpoint characterizes correctional health care as a separate health system in the US responsible for the lives of 2 million citizens, but largely neglected by the quality improvement movement, and discusses ways to improve care, outcomes, and health care value for incarcerated individuals and populations.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.0263
      Issue No: Vol. 325, No. 10 (2021)
       
  • Trauma Comes Home
    • Authors: Hoffman M.
      Pages: 937 - 938
      Abstract: In this narrative medicine essay, a surgeon tells of her experience as a caretaker for her partner disabled by chronic sequelae of head trauma, and the challenges it poses as she tries to maintain the professional distance required to do her job as a trauma attending.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.0594
      Issue No: Vol. 325, No. 10 (2021)
       
  • Broadened Eligibility for Lung Cancer Screening
    • Authors: Henderson LM; Rivera M, Basch E.
      Pages: 939 - 941
      Abstract: In 2013, the US Preventive Services Task Force (USPSTF) recommended annual lung cancer screening with low-dose computed tomography (CT) in US adults aged 55 to 80 years who currently smoke or formerly smoked with a 30 pack-year history, and for those who formerly smoked, quitting within the past 15 years (grade “B” recommendation). In this issue of JAMA, the USPSTF updates this recommendation, proposing 2 significant changes, both related to the population recommended to undergo screening. The first change reduces the age at which to initiate annual screening from 55 to 50 years. The second change reduces the smoking intensity from 30 to 20 pack-year history. Thus, the USPSTF now “recommends annual screening for lung cancer with LDCT [low-dose CT] in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. (B recommendation)”
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.26422
      Issue No: Vol. 325, No. 10 (2021)
       
  • Effect of Ventral vs Dorsal Spinal Surgery on Physical Functioning in
           Cervical Spondylotic Myelopathy
    • Authors: Ghogawala Z; Terrin N, Dunbar MR, et al.
      Pages: 942 - 951
      Abstract: This randomized trial compares the effects of ventral surgery (disk removal and fusion) vs dorsal surgery (laminectomy or laminoplasty) on patient-reported physical functioning 1 year after surgery among patients with multilevel cervical spondylotic myelopathy.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1233
      Issue No: Vol. 325, No. 10 (2021)
       
  • Prevalence of Central Nervous System–Active Polypharmacy Among Older
           Adults With Dementia in the US
    • Authors: Maust DT; Strominger J, Kim H, et al.
      Pages: 952 - 961
      Abstract: This pharmacoepidemiology study uses Medicare claims data to describe the prevalence of central nervous system–active polypharmacy among community-dwelling older adults with dementia in the US, including durations of exposure and number of drugs and drug classes.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1195
      Issue No: Vol. 325, No. 10 (2021)
       
  • USPSTF Evidence Report: Screening for Lung Cancer
    • Pages: 962 - 970
      Abstract: This US Preventive Services Task Force Recommendation Statement concludes with moderate certainty that annual screening for lung cancer with low-dose computed tomography has a moderate benefit in persons at high risk of lung cancer based on age, total cumulative exposure to tobacco smoke, and years since quitting smoking (Grade B).
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1117
      Issue No: Vol. 325, No. 10 (2021)
       
  • USPSTF Report: Screening for Lung Cancer With Low-Dose Computed Tomography
    • Authors: Jonas DE; Reuland DS, Reddy SM, et al.
      Pages: 971 - 987
      Abstract: This systematic review to support the 2021 US Preventive Services Task Force Recommendation Statement on screening for lung cancer summarizes published evidence about the relative benefits and harms of low-dose computed tomography to identify lung cancer in persons at high risk.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.0377
      Issue No: Vol. 325, No. 10 (2021)
       
  • USPSTF Modeling Study: Benefits and Harms of Lung Cancer Screening With
           LDCT
    • Authors: Meza R; Jeon J, Toumazis I, et al.
      Pages: 988 - 997
      Abstract: This simluation study models the benefits and harms associated with low-dose computed tomography (LDCT) screening for lung cancer based on a range of starting and stopping ages, screening frequencies, cumulative pack-years, and years since quitting smoking.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1077
      Issue No: Vol. 325, No. 10 (2021)
       
  • Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2
    • Authors: Brooks JT; Butler JC.
      Pages: 998 - 999
      Abstract: This JAMA Insights CDC review summarizes accumulating evidence that mask wearing reduces spread of SARS-CoV-2 infection and that universal mandatory mask wearing policies reduce infections and deaths and emphasizes face masks are one component of pandemic control measures, including physical distancing and handwashing, pending natural or vaccine-induced population immunity.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1505
      Issue No: Vol. 325, No. 10 (2021)
       
  • Prevalence of SARS-CoV-2 in Karnataka, India
    • Authors: Mohanan M; Malani A, Krishnan K, et al.
      Pages: 1001 - 1003
      Abstract: In the context of large numbers of workers moving from urban to rural areas with less strict lockdown policies in low- and middle-income countries, this study describes community-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence in urban vs rural areas of Karnataka state, India.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.0332
      Issue No: Vol. 325, No. 10 (2021)
       
  • Association Between Changes in Social Distancing Policies in Ohio and
           Traffic Volume and Injuries, January Through July 2020
    • Authors: Li L; Neuroth LM, Valachovic E, et al.
      Pages: 1003 - 1006
      Abstract: This study compares traffic volume and motor vehicle crash injuries before, during, and after state-of-emergency and stay-at-home orders in the state of Ohio from January to July 2020 vs the same period in 2019.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.25770
      Issue No: Vol. 325, No. 10 (2021)
       
  • Use of e-Cigarettes for Smoking Cessation—Reply
    • Authors: Eisenberg MJ; Hébert-Losier A, Filion KB.
      Pages: 1006 - 1007
      Abstract: In Reply We agree with Dr Lanspa and colleagues that the role of e-cigarettes in smoking cessation is unclear. However, despite the surprising dearth of randomized clinical trials in this area, many smokers have spontaneously turned to e-cigarettes as a potential method for quitting conventional cigarettes. Therefore, we believe that multiple studies in different settings are required to examine the efficacy and safety of e-cigarettes for smoking cessation. The adverse effects of smoking conventional cigarettes are well known. Although the long-term effects of vaping e-cigarettes are unknown, most experts agree that, while their safety profile remains poorly understood, e-cigarettes are likely to be safer than conventional cigarettes. In our article, we acknowledge that the safety of e-cigarettes is an ongoing concern and recommend that, if adopted for smoking cessation, e-cigarettes should be used for a short period only.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.27210
      Issue No: Vol. 325, No. 10 (2021)
       
  • Use of e-Cigarettes for Smoking Cessation
    • Authors: Lanspa MJ; Blagev DP, Callahan SJ.
      Pages: 1006 - 1006
      Abstract: To the Editor The role of electronic cigarettes (e-cigarettes) in smoking cessation is unclear. We are concerned about the interpretation of the recent trial by Dr Eisenberg and colleagues, which demonstrated an increased rate of smoking cessation that did not persist at 24 weeks. Although this study did not demonstrate harm from e-cigarettes, neither did it demonstrate harm from combustible cigarettes. It is discordant to tout the potential safety of e-cigarettes from examining short-term outcomes in small numbers while acknowledging that harms from combustible cigarettes often take decades to manifest and occur only in a fraction of smokers. More than 50 years elapsed between the mass marketing of cigarettes in the late 19th century and realization of their association with lung cancer in the 1940s. As late as 1960, only one-third of US physicians thought the link between cigarettes and cancer had been established. The mass marketing of e-cigarettes, which have been available for only 15 years, parallels that seen in prior decades with combustible cigarettes. In addition, the unclear messaging from physicians about potential harms of e-cigarettes also seems to parallel that of combustible cigarettes.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.27207
      Issue No: Vol. 325, No. 10 (2021)
       
  • Effect of Emergency Department Care Bundle on Elderly Patients With Acute
           Heart Failure—Reply
    • Authors: Freund Y; Gorlicki J.
      Pages: 1007 - 1008
      Abstract: In Reply The diagnosis of acute heart failure in our trial was based on clinical symptoms and at least 1 other imaging or biological sign of pulmonary congestion. As Dr Liu states, it can be difficult to accurately diagnose acute heart failure in the emergency department; we agree that we may have included patients with a broad differential diagnosis in the ELISABETH trial. We also concur that a more systematic diagnostic workup could have reduced inclusion bias. However, we believe this bias is limited because previous reports have shown good physician performance in diagnosing acute heart failure in French emergency departments, whether clinically or with ultrasonography assessment. Moreover, our goal was to perform a pragmatic trial so the results could be more readily translated in routine clinical practice. We agree that in the future, personalized care and precision medicine may help to better tailor optimal treatment and possibly improve prognosis in acute heart failure. In addition, further research could focus on whether certain patients with acute heart failure may have a better response to the care bundle provided in our trial.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.27294
      Issue No: Vol. 325, No. 10 (2021)
       
  • Effect of Emergency Department Care Bundle on Elderly Patients With Acute
           Heart Failure
    • Authors: Liu K.
      Pages: 1007 - 1007
      Abstract: To the Editor The ELISABETH trial by Dr Freund and colleagues implemented an early guideline-recommended care bundle in the emergency department for older patients to reduce the delay to treatment and to promptly manage precipitating factors of acute heart failure. Although frontline physicians use clinical symptoms, laboratory values, and radiographic findings to make the diagnosis of acute heart failure, accurate judgment about cardiac preload and intravascular volume status remains difficult in patients with obesity, chronic venous stasis, underlying kidney dysfunction, or pulmonary disorders. A common cause for faulty assessment of cardiac preload, particularly in older patients, is discordance between right and left ventricular pressures, or right-to-left mismatch. Integrating quantitative and real-time hemodynamic measurements (eg, bedside Doppler echocardiography) for the titration of volume therapy will likely become a prerequisite in future clinical trials for acute heart failure treatment.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.27291
      Issue No: Vol. 325, No. 10 (2021)
       
  • Minor Clarification
    • Pages: 1008 - 1008
      Abstract: In the A Piece of My Mind article titled “We Are All the Same,” published in the January 22, 2019, and May 5, 2020, issues of JAMA, a minor clarification was added to the third paragraph. Both versions of this article were corrected online.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.2530
      Issue No: Vol. 325, No. 10 (2021)
       
  • Credo
    • Authors: Davis B.
      Pages: 1009 - 1009
      Abstract: He is disappearing from himself. She is learning to spend time
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.24030
      Issue No: Vol. 325, No. 10 (2021)
       
  • Cancer of the Lung
    • Pages: 1010 - 1010
      Abstract: Cancer of the lung seems unmistakably to be steadily increasing in frequency. This increase, both relative and absolute, cannot be explained as being solely due to improvement in diagnostic technic and to more careful postmortem studies. Accurate descriptions may be found in the writings of Rokitansky, Virchow, Laënnec, Graves and many others. Whereas older clinicians regarded it as rare, it has in the past two decades come to occupy a place second in importance only to such common localizations of malignant growths as the stomach, the uterus and the rectum.… The incidence, as cited in recent statistical reports, varies between 5 and 10 per cent of all cancers.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2020.17834
      Issue No: Vol. 325, No. 10 (2021)
       
  • Patient Information: Monoclonal Antibodies for COVID-19
    • Authors: Lloyd EC; Gandhi TN, Petty LA.
      Pages: 1015 - 1015
      Abstract: This JAMA Patient Page describes use of monoclonal antibodies for treatment of nonsevere COVID-19, which may help prevent progression to severe infection.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1225
      Issue No: Vol. 325, No. 10 (2021)
       
  • Patient Information: Screening for Lung Cancer
    • Authors: Jin J.
      Pages: 1016 - 1016
      Abstract: This JAMA Patient Page explains the US Preventive Services Task Force 2021 recommendation to screen for lung cancer in adults aged 50 to 80 years who have a 20-pack-year or greater smoking history and currently smoke or have quit within the past 15 years.
      PubDate: Tue, 09 Mar 2021 00:00:00 GMT
      DOI: 10.1001/jama.2021.1799
      Issue No: Vol. 325, No. 10 (2021)
       
 
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