This randomized clinical trial compares the effect on relapse of continuing olanzapine vs placebo among patients with psychotic depression who achieved remission of psychosis and depressive symptoms while taking olanzapine and sertraline.
This individual participant data meta-analysis pooled data from 19 cohort studies to assess whether maternal thyroid function test abnormalities and thyroid autoimmunity are risk factors for preterm birth among pregnant women without overt thyroid disease.
This cohort study uses Framingham Heart Study data to assess the association between years since smoking cessation and incident cardiovascular disease (CVD), compared with current and never smoking, among participants without baseline CVD over a median follow-up of 26 years.
This study uses 2017 court records to characterize how frequently Virginia hospitals take legal action to garnish patients’ wages to recover unpaid medical expenses, and the characteristics of hospitals and patient employers associated with the actions.
This 2019 Recommendation Statement from the US Preventive Services Task Force recommends that women with a family or personal history associated with increased risk for harmful mutations in the BRCA1/2 genes and with a positive result on a brief familial risk assessment tool should receive genetic counseling and, if indicated, genetic testing (B recommendation) and recommends against routine risk assessment, genetic counseling, or genetic testing for women whose personal or family history is not associated with potentially harmful BRCA1/2 gene mutations (D recommendation).
This systematic review to support the 2019 US Preventive Services Task Force Recommendation Statement on risk assessment, genetic counseling, and genetic testing for BRCA-related cancer summarizes published evidence on the benefits and harms of assessment, counseling, and testing in women without recently diagnosed BRCA1/2-related cancer.
In the context of joint preliminary recommendations from the Federation of State Medical Boards and the National Board of Medical Examiners to consider moving the USMLE examination to pass-fail score reporting, this Viewpoint discusses how the current 3-digit score reporting structure is used by residency program directors and medical schools, how it may distract students from developing qualities of innovation and humanism important to medicine, and how it may facilitate workforce underrepresentation of some student groups.
In May 2019 the US Supreme Court sent back to lower courts the question of whether Merck Sharpe & Dohme Corp was liable for atypical fractures from its osteoporosis drug alendronate because it did not identify the adverse effect in the product’s label. This Viewpoint discusses the legal questions of liability raised by the case and the implication of the decision for the pharmaceutical industry and for patients alleging harmed from prescription drugs.
This Viewpoint discusses the potential risks faced by pregnant women with substance use disorders who participate in clinical research, including criminal prosecution for drug use while pregnant and custody loss of their children, and proposes changes to research procedures and disclosure provisions to encourage their participation so the evidence base informing their care and addressing the opioid epidemic more generally can advance.
This Viewpoint argues that the near-universal adoption of electronic fetal monitoring (EFM) in labor and delivery units has occurred without evidence that it has reduced adverse neurological events and has contributed to an increase in US cesarean delivery rates, and calls for the education of physicians and the public about EFM’s demonstrated reliability and value.
In this narrative medicine essay, a critical care physician works through lessons he learned from his experience with a man with end-stage lung disease going into terminal respiratory failure who consented to intubation only if he had a chance for a lung transplant and considers how to balance patient autonomy with medical paternalism when good outcomes are unlikely and the best decisions are uncertain.
This JAMA Insights Clinical Update reviews management approaches to atrial fibrillation (AF), including assessment of the need for anticoagulation, and controversies over the need for rhythm control and the role of catheter ablation for maintaining sinus rhythm and reducing AF-associated symptoms.
This Clinical Challenge reviews ways to distinguish atrial ectopy, AV block, multifocal atrial tachycardia, and other supraventricular tachycardias from atrial fibrillation in patients with absent P waves, irregularly irregular R-R intervals, and f waves on electrocardiography.
This Medical News article discusses a recent meta-analysis of oral immunotherapy trials for people with peanut allergies.
This Medical News interview discusses the value of social media for health care.
This JAMA Patient Page describes the US Preventive Services Task Force’s recently published recommendations on risk assessment and genetic counseling and testing for BRCA mutations and BRCA-related cancers.
Create a personal account or sign in to: