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October 2020 - July 1883




December 17, 2019, Vol 322, No. 23, Pages 2261-2358

In This Issue of JAMA


Abstract Full Text
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JAMA. 2019;322(23):2261-2263. doi:10.1001/jama.2018.15641
Original Investigation

Effect of a Strategy of Comprehensive Vasodilation vs Usual Care on Mortality and Heart Failure Rehospitalization Among Patients With Acute Heart Failure: The GALACTIC Randomized Clinical Trial

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JAMA. 2019;322(23):2292-2302. doi:10.1001/jama.2019.18598

This randomized clinical trial compares the effect of early intensive and sustained vasodilation (using nitrates, hydralazine, renin-angiotensin inhibitors, and sacubitril-valsartan) vs usual care on a composite outcome of all-cause mortality and acute heart failure rehospitalization at 180 days among patients with acute heart failure.

Effect of Rocuronium vs Succinylcholine on Endotracheal Intubation Success Rate Among Patients Undergoing Out-of-Hospital Rapid Sequence Intubation: A Randomized Clinical Trial

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JAMA. 2019;322(23):2303-2312. doi:10.1001/jama.2019.18254

This noninferiority trial compares the effect of rocuronium vs succinylcholine on first-attempt tracheal intubation success rate in out-of-hospital emergency situations among patients undergoing rapid sequence intubation.

Association of Transcarotid Artery Revascularization vs Transfemoral Carotid Artery Stenting With Stroke or Death Among Patients With Carotid Artery Stenosis

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JAMA. 2019;322(23):2313-2322. doi:10.1001/jama.2019.18441

This study uses registry data to compare stroke and death outcomes for patients with carotid artery stenosis undergoing transcarotid artery revascularization vs transfemoral carotid artery stenting.

Research Letter

Identifying Potential Patient Safety Issues From the Federal Electronic Health Record Surveillance Program

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JAMA. 2019;322(23):2339-2340. doi:10.1001/jama.2019.17242

This study uses Department of Health and Human Services data to analyze surveillance of electronic health records for patient safety issues to identify those with a potential for patient harm, and the frequency of these issues.

Trends in Intentional and Unintentional Opioid Overdose Deaths in the United States, 2000-2017

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JAMA. 2019;322(23):2340-2342. doi:10.1001/jama.2019.16566

This study used data from the National Vital Statistics System Mortality to evaluate trends in US drug overdose deaths involving opioids certified as unintentional, suicide, or undetermined intent.


Implementation Strategies for Cardiovascular Polypills

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JAMA. 2019;322(23):2279-2280. doi:10.1001/jama.2019.18102

This Viewpoint reviews evidence for the benefits of polypills, corrects misconceptions about what they are and where and in whom they should be used, and outlines uncertainties that should be accounted for in strategies and research to increase their use.

Cardiovascular Disease Prevention at a Crossroads:Precision Medicine or Polypill?

Abstract Full Text
JAMA. 2019;322(23):2281-2282. doi:10.1001/jama.2019.19026

With rates of cardiovascular disease (CVD) no longer declining, this Viewpoint explains the pros and cons of 2 divergent strategies to addressing CVD—the polypill vs precision medicine—and summarizes how a clinical trial could help clinicians and health systems determine which approach is best for patients.

Machine Learning, Predictive Analytics, and Clinical Practice: Can the Past Inform the Present?

Abstract Full Text
JAMA. 2019;322(23):2283-2284. doi:10.1001/jama.2019.17831

This Viewpoint discusses the conditions that need to be in place for the wealth of patient data available in electronic health records to be converted into useful prediction scores usable by clinicians to make clinical decisions.

Lifecycle Regulation of Artificial Intelligence– and Machine Learning–Based Software Devices in Medicine

Abstract Full Text
JAMA. 2019;322(23):2285-2286. doi:10.1001/jama.2019.16842

This Viewpoint discusses the appropriateness of existing US Food and Drug Administration regulatory pathways for artificial intelligence (AI) and machine learning (ML) software in health care, and proposes a lifecyle-based framework given the iterative nature of AI/ML algorithms, including prespecified “safe harbor” provisions for change and postapproval audits of accuracy.

A Piece of My Mind

Of Warsaw and Calgary

Abstract Full Text
JAMA. 2019;322(23):2287. doi:10.1001/jama.2019.19994

In this narrative medicine essay, an internist recalls how a patient with metastatic hepatocellular cancer forces him into mindfulness through bravery and gratitude following the disclosure that patient’s treatment options are exhausted.


Vasodilator Therapy in Acute Heart Failure

Abstract Full Text
JAMA. 2019;322(23):2288-2289. doi:10.1001/jama.2019.20285

The Challenges of Sharing Data in an Era of Politicized Science

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JAMA. 2019;322(23):2290-2291. doi:10.1001/jama.2019.19786
The Rational Clinical Examination

Does This Patient Have Hip Osteoarthritis?The Rational Clinical Examination Systematic Review

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JAMA. 2019;322(23):2323-2333. doi:10.1001/jama.2019.19413

This Rational Clinical Examination systematic review characterizes the accuracy of clinical and x-ray findings associated with hip osteoarthritis.

JAMA Insights

Coronary Microvascular Dysfunction Causing Cardiac Ischemia in Women

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JAMA. 2019;322(23):2334-2335. doi:10.1001/jama.2019.15736

This JAMA Insights summary reviews the presence and differential diagnosis of ischemia with no evidence of obstructive coronary artery disease (INOCA) in women, and proposes an approach for diagnosis and management of microvascular disease based on empirical therapy and noninvasive and invasive testing.

JAMA Diagnostic Test Interpretation

Point-of-Care Urine Pregnancy Tests

Abstract Full Text
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JAMA. 2019;322(23):2336-2337. doi:10.1001/jama.2019.15833

A 40-year-old woman with Graves disease presented with abdominal pain and constipation. Thyroid-stimulating hormone was undetectable and physical examination revealed a tender midline abdominal mass. Three months earlier she was evaluated for 3 to 4 months of amenorrhea, and a urine human chorionic gonadotropin test was negative for pregnancy. What would you do next?

Medical News & Perspectives

Heritage Diets and Culturally Appropriate Dietary Advice May Help Combat Chronic Diseases

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JAMA. 2019;322(23):2271-2273. doi:10.1001/jama.2019.18431

This Medical News article discusses how culturally appropriate dietary advice may aid in combatting chronic illnesses.

Quick Uptakes

Study Clarifies Cancer Risk Among People With Psoriasis

Abstract Full Text
JAMA. 2019;322(23):2273-2274. doi:10.1001/jama.2019.18582

This Medical News story discusses a meta-analysis that shows a more convincing link between psoriasis and the risk of developing and dying of cancer than previous studies had reported.

News From the Food and Drug Administration

New Therapy for Rare Anemia

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JAMA. 2019;322(23):2277. doi:10.1001/jama.2019.20128

Test for HIV Drug–Resistance Mutations

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JAMA. 2019;322(23):2277. doi:10.1001/jama.2019.19710

Update on Biotin Interference With Troponin Tests

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JAMA. 2019;322(23):2277. doi:10.1001/jama.2019.20129
The JAMA Forum

Making Health Care More Productive

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JAMA. 2019;322(23):2274-2275. doi:10.1001/jama.2019.19695
Global Health

WHO Takes Aim at Noncommunicable Diseases and Traffic Injuries

Abstract Full Text
JAMA. 2019;322(23):2276. doi:10.1001/jama.2019.19689

Poliovirus Type 3 Is Eradicated

Abstract Full Text
JAMA. 2019;322(23):2276. doi:10.1001/jama.2019.20068

Widespread Blood Shortages Threaten Global Public Health

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JAMA. 2019;322(23):2276. doi:10.1001/jama.2019.20070
Poetry and Medicine

I Hope They Don’t Drop Me

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JAMA. 2019;322(23):2345. doi:10.1001/jama.2019.18013
JAMA Revisited

I Remember It Well

Abstract Full Text
JAMA. 2019;322(23):2353. doi:10.1001/jama.2018.15649
JAMA Patient Page

Testing for Coronary Microvascular Dysfunction

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JAMA. 2019;322(23):2358. doi:10.1001/jama.2019.16625

This JAMA Patient Page describes coronary microvascular dysfunction and the procedures for testing for this condition.

Comment & Response

Blood Pressure Indexes Associated With Mortality and Cardiovascular Outcomes

Abstract Full Text
JAMA. 2019;322(23):2342-2343. doi:10.1001/jama.2019.16836

Blood Pressure Indexes Associated With Mortality and Cardiovascular Outcomes—Reply

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JAMA. 2019;322(23):2343-2344. doi:10.1001/jama.2019.16839

Bone Turnover Markers in Osteoporosis

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JAMA. 2019;322(23):2344. doi:10.1001/jama.2019.17668

Bone Turnover Markers in Osteoporosis—Reply

Abstract Full Text
JAMA. 2019;322(23):2344. doi:10.1001/jama.2019.17671
JAMA Masthead


Abstract Full Text
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JAMA. 2019;322(23):2265-2266. doi:10.1001/jama.2018.15642