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In This Issue of JAMA
August 7, 2018

Highlights

JAMA. 2018;320(5):419-421. doi:10.1001/jama.2017.12482
Research

Obesity often begins in childhood. Barkin and colleagues randomized 610 parent-child pairs from underserved communities and found that a 36-month intervention to promote healthy family behaviors had no effect on body mass index among preschool-age children. In an Editorial, Zylke and Bauchner note that excessive weight gain has been resistant to medical intervention and suggest that interventions for responsive parenting may offer some hope.

Editorial and Related Article

Developmentally appropriate parenting can promote healthy childhood outcomes. In a trial that randomized 291 mother-child pairs, Paul and colleagues found that a responsive parenting intervention initiated in early infancy resulted in a modest reduction in body mass index z scores at age 3 years, but no significant difference in body mass index percentile.

Editorial and Related Article

CME

Testing non–small cell lung cancers for specific genetic mutations can identify patients who are likely to benefit from targeted treatments, but broad-based genomic sequencing has not been shown to improve patient outcomes. Presley and colleagues conducted a retrospective cohort study of 5688 patients with advanced non–small cell lung cancer and found that broad-based genomic sequencing was not associated with better survival. In an Editorial, Bunn and Aisner suggest that broad-based genomic sequencing is likely to be beneficial when it leads to evidence-based targeted therapy.

Editorial

Clinical Review & Education

Atrial fibrillation is a major risk factor for ischemic stroke. This US Preventive Services Task Force statement concludes that current evidence is insufficient to assess the balance of benefits and harms of screening with electrocardiography to identify patients with atrial fibrillation. In an Editorial, Goldberger and Mitrani suggest that atrial myopathy may lead to cardioembolic stroke even in the absence of atrial fibrillation.

Editorial, Related Article, and JAMA Patient Page

Author Audio Interview and CME

In a review of 17 studies with 135 300 participants, Jonas and colleagues found that screening with electrocardiography has not been shown to detect more cases of atrial fibrillation than screening with pulse palpation, nor has treatment of screen-detected asymptomatic older adults been shown to result in better health outcomes than treatment after detection by usual care.

Editorial, Related Article, and JAMA Patient Page

Antibiotic therapy can alter the colonic microbiota and increase the risk of Clostridium difficile infection; probiotics are live microbial preparations that may decrease this risk. In this JAMA Clinical Evidence Synopsis summarizing a Cochrane review of 39 randomized clinical trials, Goldenberg and colleagues discuss the benefits of administering probiotics along with antibiotics in patients at high risk of infection with Clostridium difficile.

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