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In This Issue of JAMA
June 21, 2016

Highlights

JAMA. 2016;315(23):2493-2495. doi:10.1001/jama.2015.14318
Research

Ganz and colleagues found that a 9-protein risk score—derived from the results of large-scale analysis of 1130 circulating proteins in a cohort of 938 patients with stable coronary artery disease and validated in an independent cohort of 971 patients—performed better than the Framingham secondary event risk score in predicting incident cardiovascular events. In an Editorial, Sabatine discusses the aptamer-based technology used in the study and relevance of the findings for patient care.

Editorial

Rehm and colleagues examined trends in dietary intake and diet quality in an analysis of cross-sectional dietary recall data from 33 932 adults participating in the 1999-2012 National Health and Nutrition Examination Surveys. Among the findings were disparities in diet quality by race/ethnicity, education, and income. In an Editorial, Denke discusses the challenge to improve dietary habits in the United States.

Editorial

CME

In a meta-analysis of data from 62 randomized trials (6653 women), Franco and colleagues found that phytoestrogen supplementation was associated with a modest reduction in some menopausal symptoms, including the number of hot flashes and vaginal dryness, but no reduction in night sweats. Several herbal remedies were associated with decreased frequency of vasomotor symptoms.

Clinical Review & Education

This US Preventive Services Task Force (USPSTF) Recommendation Statement addresses screening for colorectal cancer. Based on a review of the evidence and the results of a comparative modeling study examining optimal starting and stopping ages and screening intervals, the USPSTF recommends that asymptomatic adults begin screening at age 50 years and continue until age 75 years. The USPSTF concluded with high certainty that screening for colorectal cancer in average-risk, asymptomatic adults aged 50 to 75 years is associated with substantial net benefit. In an Editorial, Ransohoff and Sox discuss implications of the screening recommendations.

Editorial, Related Articles 1, 2, and 3, and JAMA Patient Page 1 and 2

Author Audio Interview and Author Video Interview and CME

Lin and colleagues summarize findings from the US Preventive Services Task Force evidence review of the effectiveness, diagnostic accuracy, and harms of colorectal cancer screening using stool-based tests, endoscopy, and imaging in adults at average-risk. The authors report that colonoscopy, flexible sigmoidoscopy, computed tomographic colonography, and stool-based tests have differing levels of evidence to support their use, differing ability to detect cancer and precursor lesions, and vary in the risk of serious adverse events.

Related Articles 1 and 2

CME

To inform the US Preventive Services Task Force Recommendations for colorectal cancer (CRC) screening, Knudsen and colleagues performed a microsimulation modeling study of a hypothetical screening-naive population undergoing CRC screening with 100% adherence. The authors found that 4 strategies (performed from ages 50 to 75 years) resulted in similar life-years gained and a comparable balance of benefit and screening burden: colonoscopy every 10 years, sigmoidoscopy every 10 years with annual fecal immunochemical testing (FIT), computed tomographic colonography every 5 years, and annual FIT.

Related Articles 1 and 2

An article in JAMA Pediatrics reported that interventions delivered by health care professionals during routine child health care visits may be effective in preventing maternal postpartum smoking relapse. In this From The JAMA Network article, Ebbert and Jacobson discuss the limited effectiveness of parental smoking cessation interventions to reduce child exposure to tobacco smoke.

This JAMA Clinical Evidence Synopsis article by Ainsworth and McGuire summarizes a Cochrane review of 6 randomized trials (549 total patients) comparing peripherally inserted central catheters (PICCs) with short peripheral cannulas for delivering parenteral nutrition to neonates. The review found that parenteral nutrition via PICCs is associated with better nutrient delivery. Associations with mortality or invasive infection did not differ between the 2 catheter types.

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