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November 12, 2019, Vol 322, No. 18, Pages 1731-1836

In This Issue of JAMA

Highlights

Abstract Full Text
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JAMA. 2019;322(18):1731-1733. doi:10.1001/jama.2018.15586
Original Investigation

Effect of Bempedoic Acid vs Placebo Added to Maximally Tolerated Statins on Low-Density Lipoprotein Cholesterol in Patients at High Risk for Cardiovascular Disease: The CLEAR Wisdom Randomized Clinical Trial

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JAMA. 2019;322(18):1780-1788. doi:10.1001/jama.2019.16585

This randomized clinical trial compares the efficacy of bempedoic acid, an experimental drug that inhibits an enzyme upstream of HMG-CoA reductase, vs placebo for lowering levels of low-density lipoprotein cholesterol (LDL-C) in patients at high cardiovascular risk with ongoing hypercholesterolemia receiving maximally tolerated lipid-lowering therapy.

Association of Transplant Center With Survival Benefit Among Adults Undergoing Heart Transplant in the United States

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JAMA. 2019;322(18):1789-1798. doi:10.1001/jama.2019.15686

This study uses data from the Scientific Registry of Transplant Recipients to investigate the association between transplant center and survival benefit among adult candidates for heart transplant adjusting for case mix and mortality estimates.

Preliminary Communication

Association of Cardiac Resynchronization Therapy With Change in Left Ventricular Ejection Fraction in Patients With Chemotherapy-Induced Cardiomyopathy

Abstract Full Text
JAMA. 2019;322(18):1799-1805. doi:10.1001/jama.2019.16658

This cohort study examines the association of cardiac resynchronization therapy with change in left ventricular ejection fraction (LVEF)among patients with chemotherapy-induced cardiomyopathy.

Research Letter

Immunization Status at the Time of Liver Transplant in Children and Adolescents

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JAMA. 2019;322(18):1822-1824. doi:10.1001/jama.2019.14386

This study characterizes the percentage of pediatric patients undergoing liver transplant who were up to date for their age on immunizations at the time of transplant and risk factors for underimmunization.

Prevalence of e-Cigarette Use Among Adults in the United States, 2014-2018

Abstract Full Text
JAMA. 2019;322(18):1824-1827. doi:10.1001/jama.2019.15331

This population epidemiology study uses 2014-2018 data from National Health Interview Surveys to assess trends in prevalence of current and daily e-cigarette use by US adults and to characterize trends by sociodemographic and smoking status among young adults (18-24 years).

Viewpoint

The Risk and Cost of Limited Clinician and Patient Accountability in Health Care

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JAMA. 2019;322(18):1759-1760. doi:10.1001/jama.2019.14832

This Viewpoint discusses the importance of expanding accountability in quality-based payment reform from clinicians alone to include health systems and patients to align financial incentives for improving health outcomes among all the elements that contribute to the cost and enjoy the benefits of achieving them.

Redefining Heart Failure With a Reduced Ejection Fraction

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JAMA. 2019;322(18):1761-1762. doi:10.1001/jama.2019.15600

In this Viewpoint, Milton Packer and colleagues argue that reliance on a threshold of LVEF ≤40% to define heart failure with reduced ejection fraction (HFrEF) may exclude patients with impaired systolic function and subnormal LVEF from evidence-based treatments that reduce morbidity and mortality, and the authors propose that the LVEF threshold for HFrEF treatment be increased to ≤50%.

Integrating Social Care Into the Delivery of Health Care

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JAMA. 2019;322(18):1763-1764. doi:10.1001/jama.2019.15603

This Viewpoint summarizes a 2019 National Academies of Sciences, Engineering, and Medicine consensus committee report defining 5 priority development areas for the US health care system to integrate social care into health care delivery: designing delivery systems and building workforce, developing digital infrastructure interoperable between health and social care organizations, and funding the integration and research into the effectiveness and implementation of social care practices in health care settings.

Potential Liability for Physicians Using Artificial Intelligence

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JAMA. 2019;322(18):1765-1766. doi:10.1001/jama.2019.15064

This Viewpoint proposes a template for thinking about physician malpractice liability arising from use of artificial intelligence (AI) in clinical practice, and identifies scenarios with and without injury and liability vs based on alignment of AI recommendations with standards of care, AI accuracy, and physician decisions in response.

A Piece of My Mind

These Things Happen

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JAMA. 2019;322(18):1767-1768. doi:10.1001/jama.2019.16539

In this narrative medicine essay, a pediatric ophthalmologist recalls his trip back to his parents’ house to help his father die and contrasts his death with the energetic, robust life his father lived.

Editorial

Bempedoic Acid for Lowering LDL Cholesterol

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JAMA. 2019;322(18):1769-1771. doi:10.1001/jama.2019.16598

Optimizing the Use of Heart Transplant in the United States

Abstract Full Text
JAMA. 2019;322(18):1772-1774. doi:10.1001/jama.2019.16002

Need for Multidisciplinary Research and Data-Driven Guidelines for the Cardiovascular Care of Patients With Cancer

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JAMA. 2019;322(18):1775-1776. doi:10.1001/jama.2019.17415

Evaluating Machine Learning Articles

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JAMA. 2019;322(18):1777-1779. doi:10.1001/jama.2019.17304
Users' Guides to the Medical Literature

How to Read Articles That Use Machine Learning: Users’ Guides to the Medical Literature

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JAMA. 2019;322(18):1806-1816. doi:10.1001/jama.2019.16489

This Users’ Guide to the Medical Literature discusses the use of machine learning models as a diagnostic tool, and it explains the important steps needed for making these models and the outcomes they derive clinically effective.

JAMA Clinical Guidelines Synopsis

Primary Prevention of Cardiovascular Disease

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JAMA. 2019;322(18):1817-1818. doi:10.1001/jama.2019.15915

This JAMA Clinical Guidelines Synopsis summarizes the 2019 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on primary prevention of cardiovascular disease.

From The Medical Letter on Drugs and Therapeutics

Drugs for Atrial Fibrillation

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JAMA. 2019;322(18):1819-1820. doi:10.1001/jama.2019.15892

This Medical Letter review summarizes drugs available for anticoagulation and rate and rhythm control for use in patients with atrial fibrillation.

Medical News & Perspectives

Older Patients (Still) Left Out of Cancer Clinical Trials

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JAMA. 2019;322(18):1751-1753. doi:10.1001/jama.2019.17016

This Medical News article discusses how the continuing lack of older adults in oncology studies can affect their treatment outcomes.

How Certain Foods Affect Cognition, Seizures, and Cardiometabolic Disease: Food for Thought

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JAMA. 2019;322(18):1753-1754. doi:10.1001/jama.2019.16477

The first installment of this new Medical News feature examines the health effects of grapes, blueberries, cilantro, and mushrooms.

The JAMA Forum

Heritable Genome Editing—Edited Eggs and Sperm to the Rescue?

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JAMA. 2019;322(18):1754-1755. doi:10.1001/jama.2019.17538
News From the Centers for Disease Control and Prevention

PFAS Water Contamination Examined

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JAMA. 2019;322(18):1757. doi:10.1001/jama.2019.17263

Tuberculosis in Deer Hunters

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JAMA. 2019;322(18):1757. doi:10.1001/jama.2019.18029
Biotech Innovations

“Electronic Nose” Predicts Immunotherapy Response

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JAMA. 2019;322(18):1756. doi:10.1001/jama.2019.18225

Supercooling Triples Liver Preservation Time

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JAMA. 2019;322(18):1756. doi:10.1001/jama.2019.17613

Microneedle Sensor Monitors Antibiotics

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JAMA. 2019;322(18):1756. doi:10.1001/jama.2019.18226
The Arts and Medicine

Man’s 4th Best Hospital

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JAMA. 2019;322(18):1746-1750. doi:10.1001/jama.2019.16384

Precis: In this chapter excerpt from Samuel Shem’s Man’s 4th Best Hospital, a 2019 sequel to the classic 1978 novel The House of God, Roy Basch reunites with the Fat Man to save a patient’s life, diagnose the ills of electronic health records, and train the next generation of patient-centered physicians.

Poetry and Medicine

The Dying Psychiatrist

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JAMA. 2019;322(18):1831. doi:10.1001/jama.2019.16431
JAMA Revisited

Physicians and Statistics

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JAMA. 2019;322(18):1832. doi:10.1001/jama.2018.15594
JAMA Patient Page

Testing for Nonalcoholic Fatty Liver Disease

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JAMA. 2019;322(18):1836. doi:10.1001/jama.2019.10696

This JAMA Patient Page describes nonalcoholic fatty liver disease and how it is diagnosed and treated.

Comment & Response

Historical Practice of Separating Twins at Birth

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JAMA. 2019;322(18):1827. doi:10.1001/jama.2019.14402

Historical Practice of Separating Twins at Birth—Reply

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JAMA. 2019;322(18):1827-1828. doi:10.1001/jama.2019.14408

Intraoperative Ventilation Strategies to Reduce Pulmonary Complications in Obese Patients

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JAMA. 2019;322(18):1828. doi:10.1001/jama.2019.14394

Intraoperative Ventilation Strategies to Reduce Pulmonary Complications in Obese Patients—Reply

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JAMA. 2019;322(18):1829. doi:10.1001/jama.2019.14400
Correction

Incorrect and Omitted Names for Collaborators

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JAMA. 2019;322(18):1829-1830. doi:10.1001/jama.2019.16415

Clarification of Reporting of Conflicts of Interest

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JAMA. 2019;322(18):1830. doi:10.1001/jama.2019.17553

Incorrect Word Affecting Meaning of Sentence

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JAMA. 2019;322(18):1830. doi:10.1001/jama.2019.17850
JAMA Masthead

JAMA

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JAMA. 2019;322(18):1735-1736. doi:10.1001/jama.2018.15587
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