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Effect of Intravenous Acetaminophen on Postoperative Hypoxemia After Abdominal Surgery: The FACTOR Randomized Clinical Trial
Alparslan Turan, MD; Hani Essber, MD; Wael Saasouh, MD; et al.
doi : 10.1001/jama.2020.10009
JAMA. 2020;324(4):350-358.
This randomized trial compares the effect of intravenous acetaminophen vs placebo on duration of hypoxemia during the initial 48 postoperative hours among patients undergoing colorectal and other abdominal surgeries.
Association of the Healthy, Hunger-Free Kids Act With Dietary Quality Among Children in the US National School Lunch Program
Kelsey Kinderknecht, BS; Cristen Harris, PhD, RDN; Jessica Jones-Smith, PhD, MPH, RD
doi : 10.1001/jama.2020.9517
JAMA. 2020;324(4):359-368.
This national survey study assesses the dietary quality of lunch for students participating in the National School Lunch Program (NSLP) before and after implementation of the Healthy, Hunger-Free Kids Act, which, in 2012, aligned school lunch nutrition standards with the 2010 Dietary Guidelines for Americans.
Association of Menopausal Hormone Therapy With Breast Cancer Incidence and Mortality During Long-term Follow-up of the Women’s Health Initiative Randomized Clinical Trials
Rowan T. Chlebowski, MD, PhD; Garnet L. Anderson, PhD; Aaron K. Aragaki, MS; et al.
doi : 10.1001/jama.2020.9482
JAMA. 2020;324(4):369-380.
This study reports 20-year breast cancer incidence among participants in Women’s Health Initiative (WHI) trials randomized to conjugated equine estrogen (CEE) alone or with medroxyprogesterone acetate vs placebo.
Economic Vulnerability of Households With Essential Workers
Grace McCormack, BA; Christopher Avery, PhD; Ariella Kahn-Lang Spitzer, PhD; et al.
doi : 10.1001/jama.2020.11366
JAMA. 2020;324(4):388-390.
This study uses 2018 national survey data to characterize the proportion of essential workers in the US overall and living in economically vulnerable households, defined as income <$40 000 or at least 1 member uninsured or older than age 65.
Associations Between Built Environment, Neighborhood Socioeconomic Status, and SARS-CoV-2 Infection Among Pregnant Women in New York City
Ukachi N. Emeruwa, MD, MPH; Samsiya Ona, MD; Jeffrey L. Shaman, PhD; et al.
doi : 10.1001/jama.2020.11370
JAMA. 2020;324(4):390-392.
This cross-sectional study investigates associations of residential building characteristics and markers of neighborhood socioeconomic status (SES) with screen-detected SARS-CoV-2 prevalence among pregnant women delivering in 2 New York City hospitals.
SARS-CoV-2 Positivity Rate for Latinos in the Baltimore–Washington, DC Region
Diego A. Martinez, PhD; Jeremiah S. Hinson, MD, PhD; Eili Y. Klein, PhD; et al.
doi : 10.1001/jama.2020.11374
JAMA. 2020;324(4):392-395.
This study characterizes the trends in rates of SARS-CoV-2 positive test results among individuals in the Baltimore–Washington, DC area by self-reported race/ethnicity.
Trends in HIV Preexposure Prophylaxis Prescribing in the United States, 2012-2018
Hyun Jin Song, MPharm, PhD; Patrick Squires, PharmD; Debbie Wilson, PhD; et al.
doi : 10.1001/jama.2020.7312
JAMA. 2020;324(4):395-397.
This study uses national pharmacy claims data to describes trends in prescriptions for HIV preexposure prophylaxis (PrEP) overall and by specialty between 2012 and 2018.
A Proposed Lottery System to Allocate Scarce COVID-19 Medications: Promoting Fairness and Generating Knowledge
Douglas B. White, MD, MAS; Derek C. Angus, MD, MPH
doi : 10.1001/jama.2020.11464
JAMA. 2020;324(4):329-330.
This Viewpoint proposes creation of state-level central lotteries for allocating drugs like remdesivir to hospitalized patients with COVID-19, which, if paired with demographic and outcome registry data, would enable equitable treatment allocation and facilitate actionable intelligence about the drugs’ treatment effectiveness through a natural experiment.
Missed Opportunities on Emergency Remdesivir Use
Ameet Sarpatwari, PhD, JD; Anna Kaltenboeck, MA; Aaron S. Kesselheim, MD, JD, MPH
doi : 10.1001/jama.2020.11932
JAMA. 2020;324(4):331-332.
This Viewpoint argues that the FDA’s Emergency Use Authorization (EUA) of remdesivir missed important opportunities to mandate further study of the drug’s safety and efficacy and to require fair drug pricing, and proposes modifications to create a patient registry with required data entry for any prescription and to allow government negotiations to achieve a reasonable drug price based on shared risk-taking.
The State of Health Care Quality Measurement in the Era of COVID-19: The Importance of Doing Better
J. Matthew Austin, PhD; Allen Kachalia, MD, JD
doi : 10.1001/jama.2020.11461
JAMA. 2020;324(4):333-334.
This Viewpoint discusses deficiencies in existing approaches to measuring health care quality and safety exposed by the coronavirus disease 2019 (COVID-19) pandemic and proposes process improvements, including reducing the need for manual data extraction, reducing delays between measures and reporting, and better standardizing the measures.
The Dual Epidemics of COVID-19 and Influenza: Vaccine Acceptance, Coverage, and Mandates
Lawrence O. Gostin, JD; Daniel A. Salmon, MPH, PhD
doi : 10.1001/jama.2020.10802
JAMA. 2020;324(4):335-336.
This Viewpoint proposes policy responses to boost influenza vaccination uptake and reduce the anticipated morbidity and mortality of an influenza–COVID-19 co-epidemic in fall 2020.
Cognitive Bias and Public Health Policy During the COVID-19 Pandemic
Scott D. Halpern, MD, PhD; Robert D. Truog, MD; Franklin G. Miller, PhD
doi : 10.1001/jama.2020.11623
JAMA. 2020;324(4):337-338.
This Viewpoint reviews common cognitive biases that led health centers and the public to favor patient- over population health–oriented policy responses to the initial COVID-19 pandemic, and proposes messaging to better articulate the rationale for more effective population health responses.
Centralization of High-risk Surgery in the US: Feasible Solution or More Trouble Than It Is Worth?
Kyle H. Sheetz, MD, MSc; Nader N. Massarweh, MD, MPH
doi : 10.1001/jama.2020.2953
JAMA. 2020;324(4):339-340.
This Viewpoint discusses the rationale for centralizing high-risk surgical procedures—referring patients to medical centers with more experienced surgeons to improve outcomes—and considers alternative strategies less likely to inconvenience patients and more likely to improve surgical safety with fewer trade-offs.
Limited Evidence for the Health Effects and Safety of Intermittent Fasting Among Patients With Type 2 Diabetes
Benjamin D. Horne, PhD, MStat, MPH; Martin M. Grajower, MD; Jeffrey L. Anderson, MD
doi : 10.1001/jama.2020.3908
JAMA. 2020;324(4):341-342.
This Viewpoint summarizes evidence about the effects of intermittent fasting on chronic disease markers and considers potential concerns about fasting as a strategy for weight management and glycemic control in people with type 2 diabetes.
The VA MISSION Act and the Future of Veterans’ Access to Quality Health Care
Nader N. Massarweh, MD, MPH; Kamal M. F. Itani, MD; Melanie S. Morris, MD
doi : 10.1001/jama.2020.4505
JAMA. 2020;324(4):343-344.
In the context of loosening criteria allowing veterans cared for within the Veterans Health Administration (VHA) health system to seek and receive nonurgent care in community settings, this Viewpoint discusses comparative access and timeliness, quality, and costs associated with the VHA vs outside facility care, and potential ramifications for the US Department of Veterans Affairs (VA) budget.
A Cruel COVID-19 Irony
Katherine C. McKenzie, MD
doi : 10.1001/jama.2020.11882
JAMA. 2020;324(4):345-346.
In this narrative medicine essay, an internist notes the irony of being able to go to the bedside of her dying mother and lie in her bed holding her through the night to awaken to her recovering mother only to be again banished from her.
Menopausal Hormone Therapy and Long-term Breast Cancer Risk: Further Data From the Women’s Health Initiative Trials
Christina A. Minami, MD, MS; Rachel A. Freedman, MD, MPH
doi : 10.1001/jama.2020.9620
JAMA. 2020;324(4):347-349.
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Regression Discontinuity Design
Matthew L. Maciejewski, PhD; Anirban Basu, PhD
doi : 10.1001/jama.2020.3822
JAMA. 2020;324(4):381-382.
This JAMA Guide to Statistics and Methods explains the use of regression discontinuity analysis on observational data—the difference in effect estimate between regression analyses using an exposure variable above and beneath a threshold of interest—to distinguish changes attributable to an intervention from background ecological or secular changes.
Management of Hepatitis A in 2020-2021
Angel N. Desai, MD, MPH; Arthur Y. Kim, MD
doi : 10.1001/jama.2020.4017
JAMA. 2020;324(4):383-384.
This JAMA Clinical Insights article reviews the epidemiology, diagnosis, treatment, and prevention of hepatitis A infection given an upward trend in the incidence of the disease since 2016 in the US.
Digit Ulcerations in a Young Woman
Bibin Varghese, MD; Erin Chew, MD; Maximilian F. Konig, MD
doi : 10.1001/jama.2020.6084
JAMA. 2020;324(4):385-386.
A 23-year-old woman had pain, color changes, and ischemic ulcerations of the fingertips of both hands. History and examination revealed eye and mouth dryness, mild dysphagia, and dilated nailfold capillaries; antinuclear antibodies were positive (≥1:640) in a composite nuclear and nucleolar fine speckled staining pattern, as were anti-Ro52, anti-Ro60, and anti–Scl-70 antibodies. What is the diagnosis and what would you do next?
COVID-19’s Crushing Effects on Medical Practices, Some of Which Might Not Survive
Rita Rubin, MA
doi : 10.1001/jama.2020.11254
JAMA. 2020;324(4):321-323.
This Medical News article discusses the financial and logistical impact of COVID-19 on medical practices.
Prescribing Paid Sick Leave—An Important Tool for Primary Care During the Pandemic
Benjamin D. Sommers, MD, PhD; Brett E. Coburn, JD
doi : 10.1001/jama.2020.12209
JAMA. 2020;324(4):324-325.
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More Than 1 in 3 US Adults Use Disinfectants Unsafely
Bridget M. Kuehn, MSJ
doi : 10.1001/jama.2020.12600
JAMA. 2020;324(4):328.
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Dramatic Increase in US Congenital Syphilis Cases
Bridget M. Kuehn, MSJ
doi : 10.1001/jama.2020.11652
JAMA. 2020;324(4):328.
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Telehealth Reduces Excess Weight Gain in Pregnancy
Anita Slomski
doi : 10.1001/jama.2020.11670
JAMA. 2020;324(4):327.
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Rivaroxaban Reduces Complications of PAD Revascularization
Anita Slomski
doi : 10.1001/jama.2020.12589
JAMA. 2020;324(4):327.
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Intervention Improves Kids’ Attitudes About Mental Disorders
Anita Slomski
doi : 10.1001/jama.2020.12591
JAMA. 2020;324(4):327.
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Novel Therapy Eradicates H pylori
Anita Slomski
doi : 10.1001/jama.2020.12592
JAMA. 2020;324(4):327.
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Wellness Program Failed to Improve Employee Health
Anita Slomski
doi : 10.1001/jama.2020.12593
JAMA. 2020;324(4):327.
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Better HHS Planning Needed for National Disaster Medical System
Rita Rubin, MA
doi : 10.1001/jama.2020.11957
JAMA. 2020;324(4):326.
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Higher Rate of Opioid-Related Stays in Urban Than Rural Hospitals
Rita Rubin, MA
doi : 10.1001/jama.2020.12645
JAMA. 2020;324(4):326.
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NIH Launches Platform to Serve as Depository for COVID-19 Medical Data
Rita Rubin, MA
doi : 10.1001/jama.2020.12646
JAMA. 2020;324(4):326.
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Rereading Arrowsmith in the COVID-19 Pandemic
David J. Eisenman, MD
doi : 10.1001/jama.2020.11489
JAMA. 2020;324(4):319-320.
This Arts and Medicine feature discusses the ongoing relevance of Sinclair Lewis’ 1925 novel Arrowsmith to unresolved questions of research, treatment, prevention, and mitigation of the 2020 COVID-19 pandemic.
10.1001/jama.2019.13543
Ioana Baiu, MD, MPH; Lisa M. Knowlton, MD, MPH
doi : 10.1001/jama.2020.2580
JAMA. 2020;324(4):406.
This JAMA Patient Page reviews some of the actions bytanders, first responders, and medical personnel can take at the scene of a trauma (eg, car crash, gunshot, drowning) to stabilize a patient for transportation to a trauma center hospital.
Pathogenic Variants in Breast Cancer Susceptibility Genes in Older Women
Florentia Fostira, PhD; Despoina Kalfakakou, MSc; Irene Konstantopoulou, PhD
doi : 10.1001/jama.2020.7986
JAMA. 2020;324(4):397.
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Pathogenic Variants in Breast Cancer Susceptibility Genes in Older Women—Reply
Allison W. Kurian, MD, MSc; Ryan Bernhisel, MStat; Marcia L. Stefanick, PhD
doi : 10.1001/jama.2020.7999
JAMA. 2020;324(4):397-398.
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Drug Prices, Rebates, and Discounts
Anna Anderson-Cook, PhD; Andrea Noda, MPP
doi : 10.1001/jama.2020.7989
JAMA. 2020;324(4):398-399.
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Drug Prices, Rebates, and Discounts
Benjamin N. Rome, MD; William B. Feldman, MD, DPhil; Aaron S. Kesselheim, MD, JD, MPH
doi : 10.1001/jama.2020.7983
JAMA. 2020;324(4):399.
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Drug Prices, Rebates, and Discounts—Reply
Inmaculada Hernandez, PharmD, PhD; Walid F. Gellad, MD, MPH
doi : 10.1001/jama.2020.7996
JAMA. 2020;324(4):399-400.
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