Acupuncture may be an effective treatment for stress urinary incontinence (SUI). In a multicenter randomized clinical trial of 504 women with SUI, Liu and colleagues found that electroacupuncture involving the lumbosacral region, compared with sham electroacupuncture, resulted in less urine leakage after 6 weeks. In an Editorial on this and another article in this issue, Briggs and Shurtleff discuss the benefits, harms, and mechanisms of acupuncture.
Editorial and Related Article
Acupuncture can improve reproductive function, but there is insufficient evidence that it can induce ovulation in women with infertility. In a randomized clinical trial, Wu and colleagues randomized 1000 women with polycystic ovary syndrome to receive active vs control acupuncture, with or without clomiphene, and found that the use of acupuncture did not increase live births.
The prevalences of diabetes and prediabetes in Chinese ethnic subgroups have been estimated from surveys that are not directly comparable. In a nationally representative cross-sectional survey of 170 287 participants in mainland China, Wang and colleagues confirmed that the prevalences of diabetes and prediabetes in China are high, particularly in the Han population.
Under Medicaid managed care, a health plan may withdraw from a state’s Medicaid program if it is not financially successful. Ndumele and colleagues studied all US managed care plans that withdrew from a state’s Medicaid program during the period 2006-2014; plans that exited generally had lower quality ratings than those that remained, and the exits were not associated with significant overall changes in health care quality or patient experience.
The utility of screening and early detection of prostate cancer is controversial. Litwin and Tan explain how advances in the diagnosis and treatment of prostate cancer have improved risk stratification to enable clinicians to recommend therapy based on prognosis and patient preference.
High-intensity statin therapy is recommended for the secondary prevention of atherosclerotic cardiovascular disease (ASCVD). An article published in JAMA Cardiology reported that intensity of statin therapy was associated with survival in a retrospective cohort analysis of patients aged 21 to 84 years with ASCVD. In this From The JAMA Network article, Laing discusses why statin therapy is underused in clinical practice.
Audio and CME
Chromosomal microarray analysis (CMA), which uses a computer algorithm to compare a patient’s DNA with a control sample, can be used to guide the clinical management of children with neurodevelopmental disorders caused by genetic mutations. This JAMA Insights article by Martin and Ledbetter discusses the strengths and limitations of CMA testing for patients with unexplained developmental delay, intellectual disability, autism spectrum disorder, or congenital anomalies.
Author Audio Interview and CME
Highlights. JAMA. 2017;317(24):2463–2465. doi:10.1001/jama.2016.13185