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Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-22 Chintan V. Dave, Yongmei Li, Michael A. Steinman, Sei J. Lee, Xiaojuan Liu, Bocheng Jing, Laura A. Graham, Zachary A. Marcum, Kathy Z. Fung, Michelle C. Odden
ImportanceLimited evidence exists on the association between initiation of antihypertensive medication and risk of fractures in older long-term nursing home residents.ObjectiveTo assess the association between antihypertensive medication initiation and risk of fracture.Design, Setting, and ParticipantsThis was a retrospective cohort study using target trial emulation for data derived from 29 648 older
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Sodium-Glucose Cotransporter-2 Inhibitors vs Sulfonylureas for Gout Prevention Among Patients With Type 2 Diabetes Receiving Metformin JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-15 Natalie McCormick, Chio Yokose, Na Lu, Deborah J. Wexler, J. Antonio Aviña-Zubieta, Mary A. De Vera, Rozalina G. McCoy, Hyon K. Choi
ImportanceSodium-glucose cotransporter type 2 inhibitors (SGLT2i) are a revolutionary treatment for type 2 diabetes (T2D) with cardiovascular, kidney, and serum urate-lowering benefits.ObjectiveTo compare risk of incident gout and rate of recurrent flares between patients with T2D initiating SGLT2i vs sulfonylurea, most common second-line glucose-lowering therapy, when added to metformin monotherapy
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Electronic Health Record Population Health Management for Chronic Kidney Disease Care JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-15 Manisha Jhamb, Melanie R. Weltman, Susan M. Devaraj, Linda-Marie Ustaris Lavenburg, Zhuoheng Han, Alaa A. Alghwiri, Gary S. Fischer, Bruce L. Rollman, Thomas D. Nolin, Jonathan G. Yabes
ImportanceLarge gaps in clinical care in patients with chronic kidney disease (CKD) lead to poor outcomes.ObjectiveTo compare the effectiveness of an electronic health record–based population health management intervention vs usual care for reducing CKD progression and improving evidence-based care in high-risk CKD.Design, Setting, and ParticipantsThe Kidney Coordinated Health Management Partnership
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Stigmatizing Language, Patient Demographics, and Errors in the Diagnostic Process JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-15 Katherine C. Brooks, Katie E. Raffel, David Chia, Abhishek Karwa, Colin C. Hubbard, Andrew D. Auerbach, Sumant R. Ranji
This cohort study assesses the association between stigmatizing language, demographic characteristics, and errors in the diagnostic process among hospitalized adults.
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Adverse Pregnancy Outcomes and Long-Term Mortality in Women JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-15 Casey Crump, Jan Sundquist, Kristina Sundquist
ImportanceWomen with adverse pregnancy outcomes, such as preterm delivery or preeclampsia, have higher future risks of cardiometabolic disorders; however, little is known about their long-term mortality risks. A better understanding of such risks is needed to facilitate early identification of high-risk women and preventive actions.ObjectiveTo determine long-term mortality risks associated with 5 major
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I Read Health Information Online—Can I Trust It? JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-08 Kelly Johnson-Arbor
This JAMA Internal Medicine Patient Page describes what health misinformation is and how to find more reliable health information online.
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Strengthening the Role of the NIH in the Firearm Violence Epidemic JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-08 Therese S. Richmond, Stephen W. Hargarten, Frederick P. Rivara
This Viewpoint discusses the potential for the National Institutes of Health (NIH), the premier research entity in the world, to significantly strengthen its investment in preventing and reducing firearm-related harms.
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d-Mannose for Prevention of Recurrent Urinary Tract Infection Among Women JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-08 Gail Hayward, Sam Mort, Alastair D. Hay, Michael Moore, Nicholas P. B. Thomas, Johanna Cook, Jared Robinson, Nicola Williams, Nicola Maeder, Rebecca Edeson, Marloes Franssen, Jenna Grabey, Margaret Glogowska, Yaling Yang, Julie Allen, Christopher C. Butler
ImportanceRecurrent urinary tract infection (UTI) is a common debilitating condition in women, with limited prophylactic options. d-Mannose has shown promise in trials based in secondary care, but effectiveness in placebo-controlled studies and community settings has not been established.ObjectiveTo determine whether d-mannose taken for 6 months reduces the proportion of women with recurrent UTI experiencing
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A Brief Intervention With Instant Messaging or Regular Text Messaging Support in Reducing Alcohol Use JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-08 Siu Long Chau, Tzu Tsun Luk, Benney Yiu Cheong Wong, Yongda Socrates Wu, Yee Tak Derek Cheung, Sai Yin Ho, Jean H. Kim, Herman Hay Ming Lo, Tai Hing Lam, Man Ping Wang
ImportanceAlcohol use is prevalent among university students. Mobile instant messaging apps could enhance the effectiveness of an alcohol brief intervention (ABI), but the evidence is scarce.ObjectiveTo evaluate the effectiveness of an ABI plus 3 months of mobile chat-based instant messaging support for alcohol reduction in university students at risk of alcohol use disorder.Design, Setting, and ParticipantsIn
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Telephone-Based Guideline-Directed Medical Therapy Optimization in Navajo Nation JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-07 Lauren A. Eberly, Ada Tennison, Daniel Mays, Chih-Yuan Hsu, Chih-Ting Yang, Ernest Benally, Harriett Beyuka, Benjamin Feliciano, C. Jane Norman, Maria Ynes Brueckner, Clybert Bowannie, Daniel R. Schwartz, Erica Lindsey, Stephen Friedman, Elizabeth Ketner, Pamela Detsoi-Smiley, Yu Shyr, Sonya Shin, Maricruz Merino
ImportanceUnderutilization of guideline-directed medical therapy for heart failure with reduced ejection fraction is a major cause of poor outcomes. For many American Indian patients receiving care through the Indian Health Service, access to care, especially cardiology care, is limited, contributing to poor uptake of recommended therapy.ObjectiveTo examine whether a telehealth model in which guideline-directed
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Clinical Reasoning of a Generative Artificial Intelligence Model Compared With Physicians JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-01 Stephanie Cabral, Daniel Restrepo, Zahir Kanjee, Philip Wilson, Byron Crowe, Raja-Elie Abdulnour, Adam Rodman
This cross-sectional study assesses the ability of a large language model to process medical data and display clinical reasoning compared with the ability of attending physicians and residents.
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Interrupted Time Series Analysis of Bar/Tavern Closing Hours and Violent Crime JAMA Intern. Med. (IF 39.0) Pub Date : 2024-04-01 Erika M. Rosen, Pamela J. Trangenstein, Patrick L. Fullem, Jih-Cheng Yeh, David H. Jernigan, Ziming Xuan
ImportanceIt is well established that alcohol outlets (ie, places that sell alcohol) attract crime, particularly during late-night hours.ObjectiveTo evaluate the association of Maryland Senate Bill 571 (SB571), which reduced the hours of sale for bars/taverns in 1 Baltimore neighborhood from 6 am to 2 am to 9 am to 10 pm, with violent crime within that neighborhood.Design, Setting, and ParticipantsThis
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Effectiveness of an Artificial Intelligence–Enabled Intervention for Detecting Clinical Deterioration JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-25 Robert J. Gallo, Lisa Shieh, Margaret Smith, Ben J. Marafino, Pascal Geldsetzer, Steven M. Asch, Kenny Shum, Steven Lin, Jerri Westphal, Grace Hong, Ron Chen Li
ImportanceInpatient clinical deterioration is associated with substantial morbidity and mortality but may be easily missed by clinicians. Early warning scores have been developed to alert clinicians to patients at high risk of clinical deterioration, but there is limited evidence for their effectiveness.ObjectiveTo evaluate the effectiveness of an artificial intelligence deterioration model–enabled
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Inappropriate Diagnosis of Pneumonia Among Hospitalized Adults JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-25 Ashwin B. Gupta, Scott A. Flanders, Lindsay A. Petty, Tejal N. Gandhi, Michael S. Pulia, Jennifer K. Horowitz, David Ratz, Steven J. Bernstein, Anurag N. Malani, Payal K. Patel, Timothy P. Hofer, Tanima Basu, Vineet Chopra, Valerie M. Vaughn
ImportanceLittle is known about incidence of, risk factors for, and harms associated with inappropriate diagnosis of community-acquired pneumonia (CAP).ObjectiveTo characterize inappropriate diagnosis of CAP in hospitalized patients.Design, Setting, and ParticipantsThis prospective cohort study, including medical record review and patient telephone calls, took place across 48 Michigan hospitals. Trained
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Practice Facilitation and Peer Coaching for Uncontrolled Hypertension Among Black Individuals JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-18 Monika M. Safford, Doyle M. Cummings, Jacqueline R. Halladay, James M. Shikany, Joshua Richman, Suzanne Oparil, James Hollenberg, Alyssa Adams, Muna Anabtawi, Lynn Andreae, Elizabeth Baquero, Joanna Bryan, Debra Sanders-Clark, Ethel Johnson, Erica Richman, Orysya Soroka, Jimmy Tillman, Andrea L. Cherrington
ImportanceRural Black participants need effective intervention to achieve better blood pressure (BP) control.ObjectiveAmong Black rural adults with persistently uncontrolled hypertension attending primary care clinics, to determine whether peer coaching (PC), practice facilitation (PF), or both (PCPF) are superior to enhanced usual care (EUC) in improving BP control.Design, Setting, and ParticipantsA
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Understanding and Improving Women’s Health—From Cells to Society JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-18 Karen DeSalvo, Victor J. Dzau
This Viewpoint discusses highlights from the National Academy of Medicine 2023 Annual Meeting Scientific Symposium that are representative of key gaps, trends, and opportunities in women’s health.
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Text vs Patient Portal Messaging to Improve Influenza Vaccination Coverage JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-18 Peter G. Szilagyi, O. Kenrik Duru, Alejandra Casillas, Michael K. Ong, Sitaram Vangala, Chi-Hong Tseng, Christina Albertin, Sharon G. Humiston, Emma Clark, Mindy K. Ross, Sharon A. Evans, Michael Sloyan, Craig R. Fox, Carlos Lerner
ImportanceIncreasing influenza vaccination rates is a public health priority. One method recommended by the US Centers for Disease Control and Prevention and others is for health systems to send reminders nudging patients to be vaccinated.ObjectiveTo evaluate and compare the effect of electronic health record (EHR)–based patient portal reminders vs text message reminders on influenza vaccination rates
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Pragmatic Implementation of Online Obesity Treatment and Maintenance Interventions in Primary Care JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-11 J. Graham Thomas, Emily Panza, Carly M. Goldstein, Jacqueline F. Hayes, Noah Benedict, Kevin O’Leary, Rena R. Wing
ImportanceBehavioral weight loss interventions have achieved success in primary care; however, to our knowledge, pragmatic implementation of a fully automated treatment that requires little researcher oversight has not been tested. Moreover, weight loss maintenance remains a challenge.ObjectiveTo evaluate the long-term effectiveness of an automated, online, behavioral obesity treatment program (Rx
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Episode-Based Cost Sharing to Prospectively Guarantee Patients’ Out-of-Pocket Costs JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-11 Michal Horný, David M. Anderson, A. Mark Fendrick
This Viewpoint proposes episode-based cost sharing as a way to prospectively guarantee out-of-pocket costs for patients while also preventing insurers from absorbing cost differentials created by unexpected complications of care.
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Opioid Prescribing and Outcomes in Patients With Sickle Cell Disease Post–2016 CDC Guideline JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-11 Hyeun Ah Kang, Bofei Wang, Jamie C. Barner, Kenneth I. Ataga, Robert C. Mignacca, Alicia Chang, Yahan Zhang
ImportanceAlthough the intention of the 2016 US Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain was not to limit pain treatment for patients with sickle cell disease (SCD), clinicians and patients have recognized the possibility that the guideline may have altered outcomes for this population. However, the outcomes of the 2016 guideline for this patient
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What Should I Know About Injectable Weight-Loss Medications? JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-11 Andrew Kraftson, Dina Griauzde
This JAMA Internal Medicine Patient Page describes how to use injectable weight-loss medications as well as their risks and benefits.
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Approach to Obesity Treatment in Primary Care JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-11 Susan Z. Yanovski, Jack A. Yanovski
ImportanceMore than 40% of US adults have obesity, which increases the risks for multiple chronic diseases and premature mortality. Historically, nonsurgical interventions often have not led to sufficient weight loss and maintenance to improve health, but highly effective antiobesity medications (AOMs) have recently become available, and additional effective therapeutics are under development. Given
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Clinical Decision Support for Hypertension Management in Chronic Kidney Disease JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-11 Lipika Samal, John L. Kilgallon, Stuart Lipsitz, Heather J. Baer, Allison McCoy, Michael Gannon, Sarah Noonan, Ryan Dunk, Sarah W. Chen, Weng Ian Chay, Richard Fay, Pamela M. Garabedian, Edward Wu, Matthew Wien, Saul Blecker, Hojjat Salmasian, Joseph V. Bonventre, Gearoid M. McMahon, David W. Bates, Sushrut S. Waikar, Jeffrey A. Linder, Adam Wright, Patricia Dykes
ImportanceChronic kidney disease (CKD) affects 37 million adults in the United States, and for patients with CKD, hypertension is a key risk factor for adverse outcomes, such as kidney failure, cardiovascular events, and death.ObjectiveTo evaluate a computerized clinical decision support (CDS) system for the management of uncontrolled hypertension in patients with CKD.Design, Setting, and ParticipantsThis
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Catholic Hospital Affiliation and Postpartum Contraceptive Care and Subsequent Deliveries JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-04 Giacomo Meille, Jessica N. Monnet
ImportanceIn recent years, the number of Catholic hospitals has grown, raising concerns about access to contraception. The association between living in an area in which the closest hospital is Catholic and the probability of postpartum contraception and subsequent deliveries is unknown.ObjectiveTo assess whether living in an area in which the closest hospital was Catholic was associated with the probability
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Primary Care Physician Network Overlap Between Medicaid and the Patient Protection and Affordable Care Act Marketplace JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-04 Hannah L. Crook, John A. Graves, Carrie E. Fry
This cross-sectional study quantifies Medicaid and the Patient Protection and Affordable Care Act (ACA) Marketplace overlap among primary care physicians.
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Clinical Outcomes of Rapid Respiratory Virus Testing in Emergency Departments JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-04 Tilmann Schober, Kimberly Wong, Gaëlle DeLisle, Chelsea Caya, Nathan J. Brendish, Tristan W. Clark, Nandini Dendukuri, Quynh Doan, Patricia S. Fontela, Genevieve C. Gore, Patricia Li, Allison J. McGeer, Kim Chloe Noël, Joan L. Robinson, Eva Suarthana, Jesse Papenburg
ImportanceRapid tests for respiratory viruses, including multiplex panels, are increasingly available in emergency departments (EDs). Their association with patient outcomes remains unclear.ObjectiveTo determine if ED rapid respiratory virus testing in patients with suspected acute respiratory infection (ARI) was associated with decreased antibiotic use, ancillary tests, ED length of stay, and ED return
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Dementia Prevention and Treatment JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-04 David B. Reuben, Sarah Kremen, Donovan T. Maust
ImportanceDementia affects 10% of those 65 years or older and 35% of those 90 years or older, often with profound cognitive, behavioral, and functional consequences. As the baby boomers and subsequent generations age, effective preventive and treatment strategies will assume increasing importance.ObservationsPreventive measures are aimed at modifiable risk factors, many of which have been identified
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Longitudinal Management of Dementia in Primary Care JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-04 Lauren R. Moo
This Viewpoint describes the positive role that primary care teams can play in the lives of patients with dementia and the families that care for them.
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Complication Rates of Central Venous Catheters JAMA Intern. Med. (IF 39.0) Pub Date : 2024-03-04 Bijan Teja, Nicholas A. Bosch, Calvin Diep, Tiago V. Pereira, Paolo Mauricio, Michael C. Sklar, Ashwin Sankar, Harindra C. Wijeysundera, Refik Saskin, Allan Walkey, Duminda N. Wijeysundera, Hannah Wunsch
ImportanceCentral venous catheters (CVCs) are commonly used but are associated with complications. Quantifying complication rates is essential for guiding CVC utilization decisions.ObjectiveTo summarize current rates of CVC-associated complications.Data SourcesMEDLINE, Embase, CINAHL, and CENTRAL databases were searched for observational studies and randomized clinical trials published between 2015
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COVID-19−Associated Acute Kidney Injury and Longitudinal Kidney Outcomes JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-26 Abinet M. Aklilu, Sanchit Kumar, James Nugent, Yu Yamamoto, Claudia Coronel-Moreno, Bashar Kadhim, Sophia C. Faulkner, Kyle D. O’Connor, Farah Yasmin, Jason H. Greenberg, Dennis G. Moledina, Jeffrey M. Testani, F. Perry Wilson
ImportanceCOVID-19 infection is associated with a high incidence of acute kidney injury (AKI). Although rapid kidney function decline has been reported in the first few months after COVID-19−associated AKI (COVID-AKI), the longer-term association of COVID-AKI with kidney function remains unknown.ObjectiveTo assess long-term kidney outcomes of patients who had COVID-19−associated AKI.Design, Setting
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Unusual Tachycardia in a Patient With Chest Pain and Bradycardia JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-26 Zhaolong Xu, Qinghua Chang, Renguang Liu
This case report describes a patient in their 50s who presented with squeezing chest pain for 4 hours and an initial electrocardiogram showing acute inferior wall and right ventricular infarction with third-degree atrioventricular block.
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Racial Differences in Shared Decision-Making About Critical Illness JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-26 Deepshikha C. Ashana, Whitney Welsh, Doreet Preiss, Jessica Sperling, HyunBin You, Karissa Tu, Shannon S. Carson, Catherine Hough, Douglas B. White, Meeta Kerlin, Sharron Docherty, Kimberly S. Johnson, Christopher E. Cox
ImportanceShared decision-making is the preferred method for evaluating complex tradeoffs in the care of patients with critical illness. However, it remains unknown whether critical care clinicians engage diverse patients and caregivers equitably in shared decision-making.ObjectiveTo compare critical care clinicians' approaches to shared decision-making in recorded conversations with Black and White
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Age-Related Risk of Serious Fall Events and Opioid Analgesic Use JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-19 Ria E. Hopkins, Chrianna Bharat, Luke Buizen, Jacqueline Close, Rebecca Ivers, Brian Draper, Sallie-Anne Pearson, Louisa Degenhardt, Natasa Gisev
ImportanceOpioid analgesics may be associated with increased risk of falls, particularly among older adults.ObjectiveTo quantify the age-related risk of serious fall events among adults prescribed opioids by opioid exposure, time from initiation, and daily dose.Design, Setting, and ParticipantsThis population-based cohort study conducted in New South Wales, Australia, used data linking national pharmaceutical
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Management of Resistant Hypertension—An Update JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-19 John M. Giacona, Weerapat Kositanurit, Wanpen Vongpatanasin
This JAMA Internal Medicine Clinical Insights review provides an update on the current recommendations for resistant hypertension management.
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Association of a Medicare Mandate for Shared Decision-Making With Cardiac Device Utilization JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-19 Joshua B. Rager, Hechuan Hou, Tanner Caverly, Michael P. Thompson
This cohort study evaluates the association between a Medicare shared decision-making mandate for use of implantable cardioverter defibrillators with the rate of use for this device.
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Body Composition in Anti-Obesity Medication Trials—Beyond Scales JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-19 Ank A. Agarwal, Aditya Narayan, Fatima Cody Stanford
This Viewpoint contends that focusing only on weight loss as the primary weight medication end point is an inaccurate measure of medication efficacy for both patients and clinicians.
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Why Wonder Why? JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-19 Jayshil J. Patel
This essay describes how a physician’s encounter with a patient with repeated intensive care unit admissions illuminated the value of wonder in clinical care and medical education.
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Neighborhood Segregation and Access to Live Donor Kidney Transplantation JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-19 Yiting Li, Gayathri Menon, Byoungjun Kim, Sunjae Bae, Evelien E. Quint, Maya N. Clark-Cutaia, Wenbo Wu, Valerie L. Thompson, Deidra C. Crews, Tanjala S. Purnell, Roland J. Thorpe, Sarah L. Szanton, Dorry L. Segev, Mara A. McAdams DeMarco
ImportanceIdentifying the mechanisms of structural racism, such as racial and ethnic segregation, is a crucial first step in addressing the persistent disparities in access to live donor kidney transplantation (LDKT).ObjectiveTo assess whether segregation at the candidate’s residential neighborhood and transplant center neighborhood is associated with access to LDKT.Design, Setting, and ParticipantsIn
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When the Boards Fail Us—Structural Bias in Certification Examinations JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-12 Pramita Kuruvilla
This essay shines a light on structural bias inherent to the board certification examination process, sharing the author's experience preparing and sitting for the examination while contending with co-occurring challenging life events.
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Outcomes of Various Classes of Oral Antidiabetic Drugs on Nonalcoholic Fatty Liver Disease JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-12 Heejoon Jang, Yeonjin Kim, Dong Hyeon Lee, Sae Kyung Joo, Bo Kyung Koo, Soo Lim, Woojoo Lee, Won Kim
ImportanceSeveral oral antidiabetic drug (OAD) classes can potentially improve patient outcomes in nonalcoholic fatty liver disease (NAFLD) to varying degrees, but clinical data on which class is favored are lacking.ObjectiveTo investigate which OAD is associated with the best patient outcomes in NAFLD and type 2 diabetes (T2D).Design, Setting, and ParticipantsThis retrospective nonrandomized interventional
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Patient Navigator Intervention to Improve Palliative Care Outcomes for Hispanic Patients With Serious Noncancer Illness JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-12 Stacy M. Fischer, Sung-Joon Min, Danielle M. Kline, Kathleen Lester, Wendolyn Gozansky, Christopher Schifeling, John Himberger, Joseph Lopez, Regina M. Fink
ImportanceDisparities persist across the trajectory of serious illness, including at the end of life. Patient navigation has been shown to reduce disparities and improve outcomes for underserved populations.ObjectiveTo determine the effectiveness of a lay patient navigator intervention, Apoyo con Cariño, in improving palliative care outcomes among Hispanic patients.Design, Setting, and ParticipantsThis
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Effect of Testosterone on Progression From Prediabetes to Diabetes in Men With Hypogonadism JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-05 Shalender Bhasin, A. Michael Lincoff, Steven E. Nissen, Kathleen Wannemuehler, Marie E. McDonnell, Anne L. Peters, Nader Khan, Michael C. Snabes, Xue Li, Geng Li, Kevin Buhr, Karol M. Pencina, Thomas G. Travison
ImportanceThe effect of testosterone replacement therapy (TRT) in men with hypogonadism on the risk of progression from prediabetes to diabetes or of inducing glycemic remission in those with diabetes is unknown.ObjectiveTo evaluate the efficacy of TRT in preventing progression from prediabetes to diabetes in men with hypogonadism who had prediabetes and in inducing glycemic remission in those with
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Possible Digoxin-Related Toxic Effects in a Patient JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-05 Chan-Hee Lee, Melvin M. Scheinman
This case report describes a patient in their 70s with hypertension and heart failure presenting to the emergency department with chest discomfort, nausea, anorexia, and weakness.
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Transforming Value-Based Dementia Care—Implications for the GUIDE Model JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-05 Tarun Ramesh, Kushal Kadakia, Lidia Moura
This Viewpoint reviews the Guiding an Improved Dementia Experience (GUIDE) Model to assess its suitability in providing equitable and cost-effective dementia care and to compare it with previously introduced specialty care payment models to identify opportunities for refining payment innovation in dementia care.
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Officer-Involved Killings of Unarmed Black People and Racial Disparities in Sleep Health JAMA Intern. Med. (IF 39.0) Pub Date : 2024-02-05 Atheendar S. Venkataramani, Elizabeth F. Bair, Jacob Bor, Chandra L. Jackson, Ichiro Kawachi, Jooyung Lee, Andrew Papachristos, Alexander C. Tsai
ImportanceRacial disparities in sleep health may mediate the broader health outcomes of structural racism.ObjectiveTo assess changes in sleep duration in the Black population after officer-involved killings of unarmed Black people, a cardinal manifestation of structural racism.Design, Setting, and ParticipantsTwo distinct difference-in-differences analyses examined the changes in sleep duration for
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Availability and Coverage of New Drugs in 6 High-Income Countries With Health Technology Assessment Bodies JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-29 Olivier J. Wouters, Huseyin Naci, Irene Papanicolas
This cohort study analyzes review times and approval outcomes of health technology assessments conducted in 6 high-income countries for novel therapeutic agents approved by the US Food and Drug Administration.
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Efficacy of Electronic Cigarettes vs Varenicline and Nicotine Chewing Gum as an Aid to Stop Smoking JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-29 Hao-Xiang Lin, Zhao Liu, Peter Hajek, Wan-Tong Zhang, Yuan Wu, Bao-Chen Zhu, Hai-Hua Liu, Qiu Xiang, Yan Zhang, Shu-Bin Li, Francesca Pesola, Ying-Ying Wang
ImportanceElectronic cigarettes (ECs) are often used by smokers as an aid to stopping smoking, but evidence is limited regarding their efficacy compared with nicotine replacement therapy (NRT), and no evidence is available on how their efficacy compares with that of varenicline.ObjectiveTo evaluate whether ECs are superior to NRT and noninferior to varenicline in helping smokers quit.Design, Setting
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Sodium-Glucose Cotransporter 2 Inhibitors and Nephrolithiasis Risk in Patients With Type 2 Diabetes JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-29 Julie M. Paik, Helen Tesfaye, Gary C. Curhan, Heidi Zakoul, Deborah J. Wexler, Elisabetta Patorno
ImportanceType 2 diabetes (T2D) is associated with an increased risk of kidney stones. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) might lower the risk of nephrolithiasis by altering urine composition. However, no studies have investigated the association between SGLT2i use and nephrolithiasis risk in patients receiving routine care in the US.ObjectiveTo investigate the association between
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Care Fragmentation, Care Continuity, and Care Coordination—How They Differ and Why It Matters JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-29 Lisa M. Kern, Julie P. W. Bynum, Harold Alan Pincus
This Viewpoint considers why fragmentation occurs and suggests a potential path forward for developing evidenced-based strategies that can reduce the occurrence of fragmentation and its associated harms.
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Using Behavioral Economics to Reduce Low-Value Care Among Older Adults JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-29 Jeffrey T. Kullgren, H. Myra Kim, Megan Slowey, Joseph Colbert, Barbara Soyster, Stuart A. Winston, Kerry Ryan, Jane H. Forman, Melissa Riba, Erin Krupka, Eve A. Kerr
ImportanceUse of low-value care is common among older adults. It is unclear how to best engage clinicians and older patients to decrease use of low-value services.ObjectiveTo test whether the Committing to Choose Wisely behavioral economic intervention could engage primary care clinicians and older patients to reduce low-value care.Design, Setting, and ParticipantsStepped-wedge cluster randomized clinical
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Wealth Redistribution to Extend Longevity in the US JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-29 Kathryn E. W. Himmelstein, Alexander C. Tsai, Atheendar S. Venkataramani
ImportanceThe US is unique among wealthy countries in its degree of wealth inequality and its poor health outcomes. Wealth is known to be positively associated with longevity, but little is known about whether wealth redistribution might extend longevity.ObjectiveTo examine the association between wealth and longevity and estimate the changes in longevity that could occur with simulated wealth distributions
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Food Insecurity and Premature Mortality and Life Expectancy in the US JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-29 Hao Ma, Xuan Wang, Xiang Li, Yoriko Heianza, Peter T. Katzmarzyk, Oscar H. Franco, Lu Qi
ImportanceFood insecurity has been linked to multiple causes of disease and premature mortality; however, its association with mortality by sex and across racial and ethnic groups remains unknown in the US.ObjectiveTo investigate the associations of the entire range of food security with all-cause premature mortality and life expectancy across racial and ethnic and sex groups in US adults.Design, Setting
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First Trimester Use of Buprenorphine or Methadone and the Risk of Congenital Malformations JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-22 Elizabeth A. Suarez, Brian T. Bateman, Loreen Straub, Sonia Hernández-Díaz, Hendrée E. Jones, Kathryn J. Gray, Hilary S. Connery, Jonathan M. Davis, Barry Lester, Mishka Terplan, Yanmin Zhu, Seanna M. Vine, Helen Mogun, Krista F. Huybrechts
ImportanceUse of buprenorphine or methadone to treat opioid use disorder is recommended in pregnancy; however, their teratogenic potential is largely unknown.ObjectiveTo compare the risk of congenital malformations following in utero exposure to buprenorphine vs methadone.Design, Setting, and ParticipantsThis population-based cohort study used health care utilization data from publicly insured Medicaid
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British Columbia’s Safer Opioid Supply Policy and Opioid Outcomes JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-16 Hai V. Nguyen, Shweta Mital, Shawn Bugden, Emma E. McGinty
ImportanceIn March 2020, British Columbia, Canada, became the first jurisdiction globally to launch a large-scale provincewide safer supply policy. The policy allowed individuals with opioid use disorder at high risk of overdose or poisoning to receive pharmaceutical-grade opioids prescribed by a physician or nurse practitioner, but to date, opioid-related outcomes after policy implementation have
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Evaluation of a Best-Practice Advisory for Primary Aldosteronism Screening JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-08 Suranut Charoensri, Linda Bashaw, Cheryl Dehmlow, Tammy Ellies, Jennifer Wyckoff, Adina F. Turcu
ImportancePrimary aldosteronism (PA) is a common cause of secondary hypertension and an independent risk factor for cardiovascular morbidity and mortality. Fewer than 2% to 4% of patients at risk are evaluated for PA.ObjectiveTo develop and evaluate an electronic health record best-practice advisory (BPA) that assists with PA screening.Design, Setting, and ParticipantsThis prospective quality improvement
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Primary Care Patients’ Perspectives on Health Care Screening for Firearms in a Diverse, Urban Area JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-08 Madison R. Wilson, Nichole A. Smith, Monica E. Peek, Elizabeth L. Tung
ImportanceFirearm violence is increasingly recognized as a public health issue, but whether physicians should intervene remains politically contested.ObjectiveTo explore self-described patient perspectives about the appropriateness and acceptability of health care screening for firearms.Design, Setting, and ParticipantsThis qualitative study recruited 50 adult patients from a primary care clinic in
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Early Tecovirimat Treatment for Mpox Disease Among People With HIV JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-08 Bruce Aldred, Robert H. Lyles, Jane Y. Scott, Daniel J. Gromer, Amalia Aldredge, Kimberly A. Workowski, Zanthia Wiley, Boghuma K. Titanji, Brittany Szabo, Anandi N. Sheth, Paulina A. Rebolledo, Minh Ly Nguyen, Vincent C. Marconi, Colleen F. Kelley, Sheetal Kandiah, Aley Kalapila, Jesse T. Jacob, Betsy Hall, Jonathan A. Colasanti, Emily J. Cartwright, Valeria D. Cantos
ImportanceDespite a lack of effectiveness data in humans, tecovirimat was widely prescribed to people with HIV (PWH) with mpox during the 2022 mpox epidemic, particularly PWH with low CD4+ T-cell counts or severe mpox clinical manifestations.ObjectiveTo evaluate if PWH with mpox who were treated with tecovirimat within 7 days of symptom onset were less likely to have mpox disease progression.Design
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Population-Based Trends in Complexity of Hospital Inpatients JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-08 Hiten Naik, Tyler M. Murray, Mayesha Khan, Daniel Daly-Grafstein, Guiping Liu, Barry O. Kassen, Jake Onrot, Jason M. Sutherland, John A. Staples
ImportanceClinical experience suggests that hospital inpatients have become more complex over time, but few studies have evaluated this impression.ObjectiveTo assess whether there has been an increase in measures of hospital inpatient complexity over a 15-year period.Design, Setting and ParticipantsThis cohort study used population-based administrative health data from nonelective hospitalizations
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COVID-19 and Patient Safety—Lessons From 2 Efforts to Keep People Safe JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-08 Robert M. Wachter
This Viewpoint examines the similarities between medical errors and COVID-19 and discusses lessons applicable to ongoing and emerging health challenges.
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Unraveling Wavy ST Segments—An Unusual Case of Syncope JAMA Intern. Med. (IF 39.0) Pub Date : 2024-01-08 Kimberly L. Yan, Robert T. Short, Nora F. Goldschlager
This case report describes a patient in their 60s with gastroesophageal reflex disease who presented to the emergency department after loss of consciousness during dinner and daily intermittent chest discomfort.