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August 2019 - July 1883




June 25, 2019, Vol 321, No. 24, Pages 2383-2478

In This Issue of JAMA


Abstract Full Text
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JAMA. 2019;321(24):2383-2385. doi:10.1001/jama.2018.15388
Original Investigation

Effect of 1-Month Dual Antiplatelet Therapy Followed by Clopidogrel vs 12-Month Dual Antiplatelet Therapy on Cardiovascular and Bleeding Events in Patients Receiving PCI: The STOPDAPT-2 Randomized Clinical Trial

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JAMA. 2019;321(24):2414-2427. doi:10.1001/jama.2019.8145

This randomized trial compares the effects of 1 month of dual antiplatelet therapy (DAPT) followed by clopidogrel monotherapy vs 12 months of DAPT with aspirin and clopidogrel on cardiovascular and bleeding events in patients in Japan who underwent percutaneous coronary intervention (PCI).

Effect of P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention: The SMART-CHOICE Randomized Clinical Trial

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JAMA. 2019;321(24):2428-2437. doi:10.1001/jama.2019.8146

This randomized noninferiority trial compares the effect of P2Y12 inhibitor monotherapy vs dual antiplatelet therapy (DAPT) on cardiac and cerebrovascular events in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents.

Discriminative Accuracy of FEV1:FVC Thresholds for COPD-Related Hospitalization and Mortality

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JAMA. 2019;321(24):2438-2447. doi:10.1001/jama.2019.7233

This study used harmonized and pooled data from 4 US general population–based cohorts to determine the discriminative accuracy of various FEV1:FVC fixed thresholds for predicting COPD-related hospitalization and mortality.

Research Letter

Characteristics and Scope of Training of Clinicians Participating in the US Direct-to-Consumer Marketplace for Unproven Stem Cell Interventions

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JAMA. 2019;321(24):2463-2464. doi:10.1001/jama.2019.5837

This study describes the credentials and scope of training of physician and nonphysician practitioners working for US companies marketing unproven stem cell procedures.

Association Between Quantity of Opioids Prescribed After Surgery or Preoperative Opioid Use Education With Opioid Consumption

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JAMA. 2019;321(24):2465-2467. doi:10.1001/jama.2019.6125

This cohort study investigates the association between reducing the number of opioid tablets prescribed after anterior cruciate ligament (ACL) reconstruction and postoperative opioid consumption and between preoperative opioid use education about nonopioid pain strategies and duration and quantity of opioid use.


Health Policy

Single-Payer Reform—“Medicare for All”

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JAMA. 2019;321(24):2399-2400. doi:10.1001/jama.2019.7031

In this Viewpoint, Woolhandler and Himmelstein review the potential benefits of single-payer health care reform, including savings on administrative costs and lower drug prices, and argue against partial solutions that might expand coverage without reducing costs and waste.

Evolving Issues in the Treatment of Depression

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JAMA. 2019;321(24):2401-2402. doi:10.1001/jama.2019.4990

This Viewpoint discusses recent evidence documenting benefits of nonpharmacological and drug therapies for major depressive disorder including exercise, Mediterranean diet and structured dietary support, ketamine and esketamine, brexanolone, and psilocybin.

Emergence of Hybrid Models of Genetic Testing Beyond Direct-to-Consumer or Traditional Labs

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JAMA. 2019;321(24):2403-2404. doi:10.1001/jama.2019.5670

This Viewpoint reviews the recent growth and potential benefits and harms of hybrid models of genetic testing, in which testing services retain the low costs of direct-to-consumer testing and send results to patients but clinicians order the tests and also receive results that they can interpret for patients.

The Proliferation of Reports on Clinical Scoring Systems: Issues About Uptake and Clinical Utility

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JAMA. 2019;321(24):2405-2406. doi:10.1001/jama.2019.5284

This Viewpoint charts the rise in publications describing risk prediction tools, such as the FRAX, CHADS2, and SOFA scores, and discusses the implications of using algorithms for clinical decisions in the absence of evidence about the effects of the tools on patient care and outcomes.

A Piece of My Mind

A Pitiful Sanctuary

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JAMA. 2019;321(24):2407-2408. doi:10.1001/jama.2019.7998

In this narrative medicine essay, a physician at Boston’s Health Care for the Homeless program describes the experience of responding to frequent injection drug overdoses in the clinic’s restrooms, sees the phenomenon as a result of society’s abandonment of substance users, and argues for clearner, safer spaces where people can use drugs and be connected to others for help.


Dual Antiplatelet Therapy: Is It Time to Cut the Cord With Aspirin?

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JAMA. 2019;321(24):2409-2411. doi:10.1001/jama.2019.7025

Accuracy of Airflow Obstruction Thresholds for Predicting COPD-Related Hospitalization and Mortality: Can Simple Diagnostic Thresholds Be Used for a Complex Disease?

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JAMA. 2019;321(24):2412-2413. doi:10.1001/jama.2019.6584
The Rational Clinical Examination

Did This Patient Have Cardiac Syncope?The Rational Clinical Examination Systematic Review

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JAMA. 2019;321(24):2448-2457. doi:10.1001/jama.2019.8001

This Rational Clinical Examination systematic review summarizes the accuracy of the clinical examination and electrocardiogram for distinguishing patients with vs without cardiac causes of syncope.

JAMA Insights

Women's Health

Menopausal Hormone Therapy

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JAMA. 2019;321(24):2458-2459. doi:10.1001/jama.2019.5346

This JAMA Insights Clinical Update reviews the use of hormonal therapy to manage menopausal vasomotor symptoms and proposes an algorithm for deciding if therapy should be initiated or continued based on a woman’s age, duration since onset of menopause, and risk factors for adverse outcomes.

JAMA Clinical Challenge

A Febrile, Hypotensive Patient With Bilateral Lung Crackles

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JAMA. 2019;321(24):2460-2461. doi:10.1001/jama.2019.6546

A 61-year-old man with 1 day of dyspnea and weakness was febrile (38.4°C), hypotensive, tachycardic, diaphoretic, and had poor dentition, a soft S1, and basilar bilateral crackles on examination and aortic regurgitation on transesophageal echocardiography. What is the diagnosis and what would you do next?

Medical News & Perspectives

The US Military Considers Whether Controversial Opioid Is Fit for Battlefield Duty

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JAMA. 2019;321(24):2389-2391. doi:10.1001/jama.2019.5636

This Medical News article describes research proposals the US military is weighing to evaluate sufentanil sublingual tablets, an opioid that gained a controversial FDA approval last year, for battlefield use.

Gene Variant Associated With Menthol Cigarette Smoking in Some African Americans

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JAMA. 2019;321(24):2391-2392. doi:10.1001/jama.2019.5243

This Medical News article discusses the recent discovery of a gene variant strongly associated with menthol cigarette use.

The JAMA Forum

Coordinating Community Planning for Transportation and Health

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JAMA. 2019;321(24):2393-2394. doi:10.1001/jama.2019.7769
News From the Centers for Disease Control and Prevention

Preventing Maternal Deaths

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JAMA. 2019;321(24):2397. doi:10.1001/jama.2019.7438

Lupus Survival Disparities

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JAMA. 2019;321(24):2397. doi:10.1001/jama.2019.7867
Clinical Trials Update

Another Amyloid-beta Blocker Fails to Halt Dementia

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JAMA. 2019;321(24):2396. doi:10.1001/jama.2019.7821

Placental Growth Factor Testing for Faster Preeclampsia Diagnosis

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JAMA. 2019;321(24):2396. doi:10.1001/jama.2019.8397

Wearable Device Promotes Socialization in Kids With Autism

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JAMA. 2019;321(24):2396. doi:10.1001/jama.2019.8398

Cariprazine Benefits Patients With Bipolar Depression

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JAMA. 2019;321(24):2396. doi:10.1001/jama.2019.8399

Supplements Improve Insulin Sensitivity

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JAMA. 2019;321(24):2396. doi:10.1001/jama.2019.8400
Health Agencies Update

Method Verifies Whether Pediatric Patients Fasted Before Blood Testing

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JAMA. 2019;321(24):2395. doi:10.1001/jama.2019.7710

HHS Issues Final “Conscience” Rule

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JAMA. 2019;321(24):2395. doi:10.1001/jama.2019.8394

Veterans Genomic Cohort Nearing 1 Million

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JAMA. 2019;321(24):2395. doi:10.1001/jama.2019.8395
Poetry and Medicine


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JAMA. 2019;321(24):2474. doi:10.1001/jama.2019.3321
JAMA Revisited

Critique & Cavil …

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JAMA. 2019;321(24):2475. doi:10.1001/jama.2018.15396
JAMA Patient Page

Sigmoid Volvulus

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JAMA. 2019;321(24):2478. doi:10.1001/jama.2019.2349

This JAMA Patient Page describes sigmoid volvulus, its symptoms, and its treatment.

Comment & Response

Dietary Supplements for Brain Health

Abstract Full Text
JAMA. 2019;321(24):2467. doi:10.1001/jama.2019.4963

Dietary Supplements for Brain Health—Reply

Abstract Full Text
JAMA. 2019;321(24):2467-2468. doi:10.1001/jama.2019.4967

Low Free Sugar Diet in Adolescents With Nonalcoholic Fatty Liver Disease

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JAMA. 2019;321(24):2468-2469. doi:10.1001/jama.2019.5141

Low Free Sugar Diet in Adolescents With Nonalcoholic Fatty Liver Disease—Reply

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JAMA. 2019;321(24):2469. doi:10.1001/jama.2019.5153

Electroencephalography-Guided Anesthetic Administration and Postoperative Delirium

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JAMA. 2019;321(24):2469-2470. doi:10.1001/jama.2019.5145

Electroencephalography-Guided Anesthetic Administration and Postoperative Delirium

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JAMA. 2019;321(24):2470. doi:10.1001/jama.2019.5157

Electroencephalography-Guided Anesthetic Administration and Postoperative Delirium

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JAMA. 2019;321(24):2470-2471. doi:10.1001/jama.2019.5149

Electroencephalography-Guided Anesthetic Administration and Postoperative Delirium—Reply

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JAMA. 2019;321(24):2471-2472. doi:10.1001/jama.2019.5161
JAMA Masthead


Abstract Full Text
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JAMA. 2019;321(24):2387-2388. doi:10.1001/jama.2018.15389