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September 10, 2019, Vol 322, No. 10, Pages 903-1022

In This Issue of JAMA

Highlights

Abstract Full Text
free access has audio
JAMA. 2019;322(10):903-905. doi:10.1001/jama.2018.15498
  • Audio Summary: Mycophenolate vs Methotrexate for Uveitis, Home-Based Physical Therapy After Hip Fracture, Dialysis Facility Ownership Profit Status and Kidney Transplantation, and more
Original Investigation

Effect of Corticosteroid-Sparing Treatment With Mycophenolate Mofetil vs Methotrexate on Inflammation in Patients With Uveitis: A Randomized Clinical Trial

S. R. Rathinam, MD, PhD; John A. Gonzales, MD; Radhika Thundikandy, MD; et al.
Abstract Full Text
has active quiz
JAMA. 2019;322(10):936-945. doi:10.1001/jama.2019.12618

This randomized trial compares the effects of oral methotrexate, 25 mg weekly vs oral mycophenolate mofetil, 3 g daily, on measures of inflammation in patients with noninfectious uveitis.

Effect of a Multicomponent Home-Based Physical Therapy Intervention on Ambulation After Hip Fracture in Older Adults: The CAP Randomized Clinical Trial

Jay Magaziner, PhD, MSHyg; Kathleen K. Mangione, PT, PhD; Denise Orwig, PhD; et al.
Abstract Full Text
JAMA. 2019;322(10):946-956. doi:10.1001/jama.2019.12964

This randomized clinical trial compares a multicomponent home-based physical therapy intervention with an active control on ability to walk in daily life among adults aged 60 years and older who had experienced a nonpathologic, minimal trauma hip fracture.

Association Between Dialysis Facility Ownership and Access to Kidney Transplantation

Jennifer C. Gander, PhD; Xingyu Zhang, PhD; Katherine Ross, MPH; et al.
Abstract Full Text
has active quiz
JAMA. 2019;322(10):957-973. doi:10.1001/jama.2019.12803

This cohort study characterizes the association of for-profit vs nonprofit dialysis facility ownership with placement on the deceased donor kidney transplantation waiting list or receipt of a living donor or a deceased donor kidney transplant.

Research Letter

Prevalence of Oral HPV Infection in Unvaccinated Men and Women in the United States, 2009-2016

Anil K. Chaturvedi, PhD; Barry I. Graubard, PhD; Tatevik Broutian, PhD; et al.
Abstract Full Text
JAMA. 2019;322(10):977-979. doi:10.1001/jama.2019.10508

To estimate changes in oral human papillomavirus (HPV) prevalence attributable to vaccination vs herd immunity, this national survey study uses National Health and Nutrition Examination Survey data to compare oral HPV prevalence for 4 types targeted by HPV vaccine and 33 nonvaccine types in unvaccinated US adults aged 18 to 59 years from 2009 to 2016.

Viewpoint

Scientific Discovery and the Future of Medicine

Accelerating the Science of SCD Therapies—Is a Cure Possible?

Edward J. Benz Jr, MD; Traci Heath Mondoro, PhD; Gary H. Gibbons, MD
Abstract Full Text
has audio
JAMA. 2019;322(10):921-922. doi:10.1001/jama.2019.11419

This Viewpoint reviews the molecular basis of sickle cell disease (SCD), the history of treatments for the disease, and recent progress toward curative therapies including HSCT and gene therapy and editing, emphasizing that research and innovation needs to take into account patient priorities and perspectives given the history of research mistreatment of minority groups most affected by SCD.

  • Audio Interview: Accelerating the Science of Sickle Cell Disease Therapies—Is a Cure Possible?

CAR T-Cell Therapy: A Microcosm for the Challenges Ahead in Medicare

Caron Jacobson, MD; Amy Emmert, MScPH; Meredith B. Rosenthal, PhD
Abstract Full Text
JAMA. 2019;322(10):923-924. doi:10.1001/jama.2019.10194

This Viewpoint discusses existing mechanisms of Medicare reimbursement for chimeric antigen receptor (CAR) T-cell therapy, which at US $375 000 to $475 000 per treatment is prohibitively expensive, and proposes ways to mitigate the challenges of covering the therapy appropriately and equitably for those who need it while realistically managing cost constraints.

Prescriptions on Demand: The Growth of Direct-to-Consumer Telemedicine Companies

Tara Jain, BA; Richard J. Lu, MBA; Ateev Mehrotra, MD, MPH
Abstract Full Text
JAMA. 2019;322(10):925-926. doi:10.1001/jama.2019.9889

This Viewpoint discusses advantages and theoretical harms of direct-to-consumer drug telemedicine, whereby patients obtain prescription drugs through online visits, and calls for monitoring of for-profit DTC direct-to-consumer telemedicine ventures (eg, Curology, Hims, Nurx, and The Pill Club) to ensure that quality and safety are not being sacrificed for convenience of care.

Moving From Substantial Equivalence to Substantial Improvement for 510(k) Devices

Rita F. Redberg, MD, MSc; Sanket S. Dhruva, MD, MHS
Abstract Full Text
JAMA. 2019;322(10):927-928. doi:10.1001/jama.2019.10191

This Viewpoint reviews the FDA’s 510(k) premarket review pathway through which many medical devices are brought into the US market based on “substantial equivalence” to a currently available device and the FDA’s 2019 guidance for an alternative “Safety and Performance Based Pathway,” and proposes additional strategies and policies to reduce harms from 510(k) approval mechanism and improve the safety and effectiveness of medical devices.

A Piece of My Mind

Don’t Fear the Reaper

Jules B. Lipoff, MD
Abstract Full Text
free access
JAMA. 2019;322(10):929-930. doi:10.1001/jama.2019.12602

In this narrative medicine essay, a dermatologist recalls his moments with his grandmother a fierce educator and administrator in the New York City Schools who taught him about life and death with advice and by example and whom he helped guide through her transition at 96 years—proud to be her medical advocate, sad to let her go.

Editorial

Improving Access to Kidney Transplantation: Business as Usual or New Ways of Doing Business?

L. Ebony Boulware, MD, MPH; Virginia Wang, PhD; Neil R. Powe, MD, MPH, MBA
Abstract Full Text
JAMA. 2019;322(10):931-933. doi:10.1001/jama.2019.12784

Medical Education 2020—Charting a Path Forward

Marianne Green, MD; Diane B. Wayne, MD; Eric G. Neilson, MD
Abstract Full Text
JAMA. 2019;322(10):934-935. doi:10.1001/jama.2019.12661
JAMA Insights

Medical Use of Cannabis in 2019

Kevin P. Hill, MD, MHS
Abstract Full Text
JAMA. 2019;322(10):974-975. doi:10.1001/jama.2019.11868

This JAMA Insights Clinical Update reviews what is known and not known about the efficacy and safety of cannabis and cannabinoids for managing medical conditions, distinguishing between FDA-approved indications, nonapproved indications supported by high-quality emerging evidence, and current claims and uses for which there is inadequate evidence.

Medical News & Perspectives

Type 1 Diabetes Advances Could Pave Way for Prevention

Jennifer Abbasi
Abstract Full Text
free access has audio
JAMA. 2019;322(10):912-914. doi:10.1001/jama.2019.10432

This Medical News article discusses a clinical trial to delay the onset of type 1 diabetes in high-risk relatives of people with the disease.

  • Audio: Type 1 Diabetes Advances Pave the Way for Prevention

Debate Sparks Over LATE, a Recently Recognized Dementia

Jennifer Abbasi
Abstract Full Text
free access
JAMA. 2019;322(10):914-916. doi:10.1001/jama.2019.12232

This Medical News article discusses a controversy around limbic-predominant age-related TDP-43 encephalopathy, or LATE, a recently recognized dementia that mimics Alzheimer disease.

The JAMA Forum

Federal Government Increases Focus on Price Transparency

Gail Wilensky, PhD
Abstract Full Text
free access
JAMA. 2019;322(10):916-917. doi:10.1001/jama.2019.12912
News From the Centers for Disease Control and Prevention

Norovirus Outbreak

Bridget Kuehn, MSJ
Abstract Full Text
free access
JAMA. 2019;322(10):919. doi:10.1001/jama.2019.12274

Declining US Fertility

Bridget Kuehn, MSJ
Abstract Full Text
free access
JAMA. 2019;322(10):919. doi:10.1001/jama.2019.13200
Biotech Innovations

Better Sensation and Dexterity for Artificial Hands

Jennifer Abbasi
Abstract Full Text
free access
JAMA. 2019;322(10):918. doi:10.1001/jama.2019.13202

Advances in Fluid Assessment and Kidney Injury Prediction

Jennifer Abbasi
Abstract Full Text
free access
JAMA. 2019;322(10):918. doi:10.1001/jama.2019.13930
Poetry and Medicine

Mistakes

Michelle Kittleson, MD
Abstract Full Text
free access
JAMA. 2019;322(10):984. doi:10.1001/jama.2019.5696
JAMA Revisited

Correspondence: Cancer Said to Be Caused by a Single Injury

Abstract Full Text
free access
JAMA. 2019;322(10):985. doi:10.1001/jama.2018.15506
Appendix

Medical Schools in the United States, 2018-2019

Barbara Barzansky, PhD; Sylvia I. Etzel
Abstract Full Text
JAMA. 2019;322(10):986-995. doi:10.1001/jama.2019.10154

This Appendix presents data from the 2018-2019 Liaison Committee on Medical Education (LCME) annual questionnaire detailing information on the number of students, student demographics, curriculum content, and enrollment at US medical schools.

Graduate Medical Education, 2018-2019

Sarah E. Brotherton, PhD; Sylvia I. Etzel
Abstract Full Text
JAMA. 2019;322(10):996-1016. doi:10.1001/jama.2019.10155

This Appendix presents 2018 National GME Census data detailing the numbers and types of ACGME-accredited training programs and the residents and fellows in them.

JAMA Patient Page

Mumps

Dara Grennan, MD
Abstract Full Text
free access
JAMA. 2019;322(10):1022. doi:10.1001/jama.2019.10982

This JAMA Patient Page describes the symptoms, diagnosis, treatment, and prevention of mumps.

Comment & Response

Trends in Alcoholic Fatty Liver Disease

Jinxiang Zhang, MD, PhD; Yong Lin, PhD; Lanjing Zhang, MD
Abstract Full Text
JAMA. 2019;322(10):979-980. doi:10.1001/jama.2019.10347

Trends in Alcoholic Fatty Liver Disease—Reply

Katherine Dang, MAS; Robert J. Wong, MD, MS
Abstract Full Text
JAMA. 2019;322(10):980-981. doi:10.1001/jama.2019.10351

Flourishing as a Definition of Health

Alan J. Card, PhD, MPH
Abstract Full Text
JAMA. 2019;322(10):981. doi:10.1001/jama.2019.10343

Flourishing as a Definition of Health—Reply

Tyler J. VanderWeele, PhD; Eileen McNeely, PhD, NP; Howard K. Koh, MD, MPH
Abstract Full Text
JAMA. 2019;322(10):981-982. doi:10.1001/jama.2019.10355

Proposals to Lower Medication Costs

Ron Cohen, MD; Jeremy M. Levin, DPhil, MB, BChir; John M. Maraganore, PhD
Abstract Full Text
JAMA. 2019;322(10):982. doi:10.1001/jama.2019.10391

Proposals to Lower Medication Costs—Reply

Robert M. Califf, MD; Andrew Slavitt, MBA
Abstract Full Text
JAMA. 2019;322(10):982-983. doi:10.1001/jama.2019.10395
Correction

Data, Language, and Author Contribution Errors

Abstract Full Text
free access
JAMA. 2019;322(10):983. doi:10.1001/jama.2019.7450
JAMA Masthead

JAMA

Abstract Full Text
free access
JAMA. 2019;322(10):907-908. doi:10.1001/jama.2018.15499

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