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In This Issue of JAMA
December 3, 2019


JAMA. 2019;322(21):2043-2045. doi:10.1001/jama.2018.15619

Radiotherapy may be less burdensome for severely ill patients if received at one time rather than over several hospital visits. Hoskin and colleagues randomized 686 patients with malignant metastatic solid tumors and spinal canal compression and found that a single radiotherapy dose, compared with a multifraction dose delivered over 5 days, did not meet the primary end point for noninferiority.

Visual Abstract and CME

Most e-cigarettes contain nicotine, which can harm the developing brain. Cullen and colleagues analyzed cross-sectional survey data from 18 934 US high school and middle school students and found that in 2019 the prevalence of self-reported e-cigarette use was high among high school and middle school students, with many current e-cigarette users reporting frequent use and most of the exclusive e-cigarette users reporting use of flavored e-cigarettes.

Related Article


Early identification of individuals at risk of developing chronic kidney disease (CKD) may help to prevent adverse health outcomes. Nelson and colleagues for the CKD Prognosis Consortium developed risk prediction equations for incident CKD using data provided by 5 222 711 participants from 34 multinational cohorts. In an Editorial, Tummalapalli and Estrella suggest that the prevention and management of CKD may be facilitated by risk-based, individualized interventions.


High-poverty neighborhoods may limit residents’ access to health-promoting resources or increase their exposure to crime and environmental toxins. Pollack and colleagues conducted an exploratory analysis of data for 4604 families living in public housing and found that adults who received a housing voucher did not experience significant differences in hospital use or spending, but receipt of a voucher during childhood was associated with lower rates of hospitalization and less inpatient spending during long-term follow-up. In an Editorial, Yurkovic and colleagues consider whether the benefits of social mobility interventions may extend to multiple sectors of society.



Clinical Review & Education

Concerns about the under-recognition of depression in medical practice have led to calls for improved detection. This JAMA Insights article by Zimmerman reviews the performance of the 9-item Patient Health Questionnaire as a tool for screening and clinical management of depression.

This JAMA Clinical Challenge by Sharma and Wu presents a 30-year-old man with tachycardia and palpitations that did not respond to initial therapies. What would you do next?

This JAMA Diagnostic Test Interpretation by Anderson and colleagues presents a 59-year-old man receiving warfarin therapy for many years who was found to have an elevated international normalized ratio (INR) measurement on point-of-care testing. What would you do next?