In a randomized, open-label study that enrolled 399 patients who were hospitalized with an acute pulmonary embolism (PE) and had a high risk of recurrent PE, Mismetti and colleagues assessed the efficacy and safety of retrievable vena cava filter placement plus anticoagulation therapy vs anticoagulation therapy alone for prevention of recurrent PE. The authors report that use of a retrievable inferior vena cava filter plus anticoagulation, compared with anticoagulation alone, did not reduce the risk of symptomatic recurrent PE at 3 months’ follow-up.
Emergency department (ED) screening, brief intervention, and referral for treatment has shown efficacy for some forms of unhealthy substance use. In a randomized, single-center trial that enrolled 329 opioid-dependent patients, D’Onofrio and colleagues assessed the efficacy of 3ED interventions for opioid dependence: screening and referral to treatment; screening, a Brief Negotiation Interview intervention, and facilitated referral to community-based treatment services; or screening with brief intervention, treatment initiation with buprenorphine, primary care follow-up, and addiction treatment referral. The authors found that individuals randomly assigned to receive ED-initiated buprenorphine with primary care follow-up were significantly more likely to engage in formal addiction treatment than were participants receiving the alternative interventions in the ED.
Author Video Interview and Continuing Medical Education
In an analysis of data from 3 prospective cohorts of patients with rheumatoid arthritis—representing a total of 4758 nonoverlapping patients across the 3 cohorts—Viatte and colleagues found that HLA-DRB1 haplotypes that are associated with rheumatoid arthritis (RA) susceptibility are also associated with radiological severity, mortality, and treatment response. In an Editorial, Felson and Klareskog discuss implications of emerging data on the genetics of rheumatoid arthritis.
Systematic review and meta-analysis of individual-level participant data (IPD) from all studies addressing a particular research question is considered a gold standard approach to evidence synthesis. Stewart and colleagues describe the development and key features of an extension to the PRISMA Statement (Preferred Reporting Items for a Systematic Review and Meta-analyses; PRISMA), which provides guidelines for reporting systematic reviews and meta-analyses of IPD. In an Editorial, Golub and Fontanarosa discuss efforts to improve the quality of study design and guidelines for the reporting and interpretation of study results.
The Veterans Health Administration (VHA) established a primary care–based diabetic teleretinal screening program in 2006. An article in JAMA Ophthalmology reported that the teleretinal imaging program at 1 VHA medical center was effective in screening patients for vision-threatening conditions but was associated with an increase in subsequent eye care resource use among screened patients. In this From the JAMA Network article, Kroenke discusses evidence supporting telemedicine to screen for eye diseases—in resource-poor rural settings as well as urban integrated health care systems.
This JAMA Diagnostic Test Interpretation article by Le Gal and colleagues presents the case of an 82-year-old woman with bladder cancer who had a several-day history of fever, cough, limited deep inspiration, and left-sided pleuritic chest pain. Physical examination findings included a temperature of 38.3°C (101°F), reduced air entry at the left lung base, and absent leg swelling or calf pain. A D-dimer assay result was 680 ng/mL (negative <500 ng/mL). How would you interpret this result?
Highlights. JAMA. 2015;313(16):1589-1591. doi:10.1001/jama.2014.11707