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October 2020 - July 1883




July 16, 2019, Vol 322, No. 3, Pages 183-282

In This Issue of JAMA


Abstract Full Text
free access has audio
JAMA. 2019;322(3):183-185. doi:10.1001/jama.2018.15421
Original Investigation

Caring for the Critically Ill Patient

Effect of Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit: The ICU Visits Randomized Clinical Trial

Abstract Full Text
free access has active quiz
JAMA. 2019;322(3):216-228. doi:10.1001/jama.2019.8766

This cluster-crossover randomized clinical trial compares the effects of a flexible visitation policy (up to 12 hours per day) vs a standard visitation policy (up to 4.5 hours per day) on delirium incidence among ICU patients.

Caring for the Critically Ill Patient

Effect of an ICU Diary on Posttraumatic Stress Disorder Symptoms Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial

Abstract Full Text
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JAMA. 2019;322(3):229-239. doi:10.1001/jama.2019.9058

This randomized clinical trial compared the effects of a diary filled out by clinicians and family members during an intensive care unit (ICU) stay to ground their memory of events after discharge vs usual care on symptoms of posttraumatic stress disorder, anxiety, and depression in patients and family members after discharge.

Association Between State-Mandated Protocolized Sepsis Care and In-hospital Mortality Among Adults With Sepsis

Abstract Full Text
free access
JAMA. 2019;322(3):240-250. doi:10.1001/jama.2019.9021

This cohort study uses hospital discharge data to compare 30-day in-hospital mortality of patients with sepsis in New York State before vs after implementation of regulations mandating rapid administration of antibiotics and fluid resuscitation and compares those data with mortality in 4 comparison states (Florida, Maryland, Massachusetts, and New Jersey) without such a mandate.

Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice

Abstract Full Text
free access has active quiz has multimedia
JAMA. 2019;322(3):252-263. doi:10.1001/jama.2019.8286

This cohort study uses data from the Get With the Guidelines-Stroke registry to report associations between time to treatment and functional outcomes among patients in clinical practice with acute ischemic stroke treated with endovascular recanalization.

Research Letter

Price Increases of Protected-Class Drugs in Medicare Part D, Relative to Inflation, 2012-2017

Abstract Full Text
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JAMA. 2019;322(3):267-269. doi:10.1001/jama.2019.7521

This study characterizes price increases exceeding inflation between 2012 and 2017 for protected-class drugs (antineoplastics, antiretrovirals, antidepressants, antipsychotics, anticonvulsants, and immunosuppressants for transplant patients) that would lead to their exclusion from Medicare Part D coverage based on excessive cost under a 2018 CMS rule intended to facilitate more effective price negotiations.

Association Between Declared Hurricane Disasters and Survival of Patients With Lung Cancer Undergoing Radiation Treatment

Abstract Full Text
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JAMA. 2019;322(3):269-271. doi:10.1001/jama.2019.7657

This study uses National Cancer Database data to estimate associations between hurricane disaster declarations, which could disrupt electrical power, and survival of patients undergoing radiotherapy for nonoperative locally advanced non–small cell lung cancer between 2004 and 2014.


Health Policy

State Efforts to Lower Health Care Prices Paid by Private Insurers

Abstract Full Text
JAMA. 2019;322(3):201-202. doi:10.1001/jama.2019.7028

This Viewpoint proposes an array of approaches state governments might take to lower health care prices paid by private insurance, including rate setting using reference pricing; scrutiny of hospital mergers; expanding scope-of-practice laws to increase workforce; and investing in alternative payment models.

Academic Medical Centers: Too Large for Their Own Health?

Abstract Full Text
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JAMA. 2019;322(3):203-204. doi:10.1001/jama.2019.6834

This Viewpoint discusses the conflict between the role of academic medical centers as providers of complex uncompensated care, and the large profit margins they realize from expensive fee-for-service clinical activity that puts them at odds with attempts to reorganize medicine to provide value-based care.

Advancing the Academic Medical Center Value Debate: Are Teaching Hospitals Worth It?

Abstract Full Text
JAMA. 2019;322(3):205-206. doi:10.1001/jama.2019.8306

This Viewpoint reviews evidence about the outcomes and costs of health care at teaching vs nonteaching hospitals in an attempt to answer the question of whether the costs of academic medical centers are defensible and whether they deliver value for their price.

Employ Cybersecurity Techniques Against the Threat of Medical Misinformation

Abstract Full Text
JAMA. 2019;322(3):207-208. doi:10.1001/jama.2019.6857

This Viewpoint discusses the rapidly growing threat to public health that the dissemination of medical misinformation enables and the active measures that must be taken to stop it.

Preserving Civility in Vaccine Policy Discourse: A Way Forward

Abstract Full Text
JAMA. 2019;322(3):209-210. doi:10.1001/jama.2019.7445

This Viewpoint calls out the threat to vaccine policy posed by a very small number of antivaccine (“antivax”) advocates who disrupt attempts to engage vaccine-hesitant persons in public hearings about risks and benefits of vaccination and, acknowledging the concerns of a skeptical public, calls for a renewed commitment to civility in discussing public health policy.

A Piece of My Mind

What’s in a Name?

Abstract Full Text
JAMA. 2019;322(3):211-212. doi:10.1001/jama.2019.8647

In this narrative medicine essay, an associate director of an internal medicine residency program describes when a student addressed her in an email by her first name but at the same time the student addressed a male colleague as “Doctor” and explains how she decided to handle the discrepancy.


Psychological Consequences of Admission to the ICU: Helping Patients and Families

Abstract Full Text
JAMA. 2019;322(3):213-215. doi:10.1001/jama.2019.9059
JAMA Clinical Challenge

Dilated Pupil in a Patient With Hyperhidrosis

Abstract Full Text
has active quiz
JAMA. 2019;322(3):264-265. doi:10.1001/jama.2019.8589

A 39-year-old woman with a history of palmar and axillary hyperhidrosis had anisocoria more pronounced in bright lighting conditions. She appeared well; denied double vision, ptosis, headache, or weakness; had normal visual acuity; and her neurologic examination was unremarkable. What is the diagnosis and what would you do next?

Editor's Note

Government Regulation of Sepsis Care

Abstract Full Text
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JAMA. 2019;322(3):250-251. doi:10.1001/jama.2019.9230

Endovascular Therapy for Acute Ischemic Stroke Treated in Clinical Practice

Abstract Full Text
free access
JAMA. 2019;322(3):263. doi:10.1001/jama.2019.8289
Medical News & Perspectives

New Guidelines Aim to Expand Palliative Care Beyond Specialists

Abstract Full Text
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JAMA. 2019;322(3):193-195. doi:10.1001/jama.2019.5939

This Medical News article discusses how all physicians who treat seriously ill patients can integrate palliative care into their practices.

Building a Better Death, One Conversation at a Time

Abstract Full Text
JAMA. 2019;322(3):195-197. doi:10.1001/jama.2019.6885

In this Medical News article, experts discuss how—or whether—the United States should have a national conversation about death and dying.

News From the Food and Drug Administration

Episodic Cluster Headache Antibody Therapy

Abstract Full Text
JAMA. 2019;322(3):199. doi:10.1001/jama.2019.9917

Cranial Nerve Stimulator for Adolescents With IBS

Abstract Full Text
JAMA. 2019;322(3):199. doi:10.1001/jama.2019.9477

Chemoimmunotherapy for Lymphoma

Abstract Full Text
JAMA. 2019;322(3):199. doi:10.1001/jama.2019.9918
Global Health

Containing Nipah Virus Infection

Abstract Full Text
JAMA. 2019;322(3):198. doi:10.1001/jama.2019.8837

Growing Global Alcohol Use

Abstract Full Text
JAMA. 2019;322(3):198. doi:10.1001/jama.2019.9914

Reducing Cervical Cancer Deaths

Abstract Full Text
JAMA. 2019;322(3):198. doi:10.1001/jama.2019.9915
The Arts and Medicine

The Bleeding Edge: Documenting Innovation and Injury in the Medical Device Industry

Abstract Full Text
JAMA. 2019;322(3):190-192. doi:10.1001/jama.2019.8147

This Arts and Medicine essay reviews The Bleeding Edge, a Netflix documentary about the medical device industry and the harms that can come to patients when innovation, regulatory approval, and adoption of devices in practice outpace evidence of their safety and benefit.

Poetry and Medicine

Jacqui’s Comet

Abstract Full Text
JAMA. 2019;322(3):277. doi:10.1001/jama.2019.4331
JAMA Revisited

About Foot Wear

Abstract Full Text
JAMA. 2019;322(3):278. doi:10.1001/jama.2018.15429
JAMA Patient Page

Steroid Side Effects

Abstract Full Text
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JAMA. 2019;322(3):282. doi:10.1001/jama.2019.8506

This JAMA Patient Page describes use of steroid medications and the side effects that can result.

Comment & Response

Intravenous Acetaminophen for Postoperative Delirium

Abstract Full Text
JAMA. 2019;322(3):271-272. doi:10.1001/jama.2019.6130

Intravenous Acetaminophen for Postoperative Delirium—Reply

Abstract Full Text
JAMA. 2019;322(3):272. doi:10.1001/jama.2019.6134

Cannabis as a Substitute for Opioids

Abstract Full Text
JAMA. 2019;322(3):272-273. doi:10.1001/jama.2019.6451

Cannabis as a Substitute for Opioids—Reply

Abstract Full Text
JAMA. 2019;322(3):273-274. doi:10.1001/jama.2019.6471

Outcomes Associated With Overlapping Surgery

Abstract Full Text
JAMA. 2019;322(3):274. doi:10.1001/jama.2019.6459

Outcomes Associated With Overlapping Surgery

Abstract Full Text
JAMA. 2019;322(3):274-275. doi:10.1001/jama.2019.6463

Outcomes Associated With Overlapping Surgery—Reply

Abstract Full Text
JAMA. 2019;322(3):275-276. doi:10.1001/jama.2019.6475

Incorrect Data Due to Incorrect Conversion Factor

Abstract Full Text
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JAMA. 2019;322(3):276. doi:10.1001/jama.2019.8270

Addition of Funding Source

Abstract Full Text
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JAMA. 2019;322(3):276. doi:10.1001/jama.2019.8749
JAMA Masthead


Abstract Full Text
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JAMA. 2019;322(3):187-188. doi:10.1001/jama.2018.15422