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September 2021 - July 1883

Decade

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Issue

March 10, 2020, Vol 323, No. 10, Pages 909-1008

In This Issue of JAMA

Audio Highlights

Abstract Full Text
free access online only has audio
JAMA. 2020;323(10):e200012. doi:10.1001/jama.2020.0012
Original Investigation

Caring for the Critically Ill Patient

Effect of Reduced Exposure to Vasopressors on 90-Day Mortality in Older Critically Ill Patients With Vasodilatory Hypotension: A Randomized Clinical Trial

Abstract Full Text
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JAMA. 2020;323(10):938-949. doi:10.1001/jama.2020.0930

This randomized clinical trial compares the effect of vasopressors guided by a mean arterial pressure (MAP) target of 60 to 65 mm Hg with a MAP level determined by the treating physician on 90-day mortality among critically ill older patients with vasodilatory hypotension.

Caring for the Critically Ill Patient

Association of Physician Orders for Life-Sustaining Treatment With ICU Admission Among Patients Hospitalized Near the End of Life

Abstract Full Text
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JAMA. 2020;323(10):950-960. doi:10.1001/jama.2019.22523

This cohort study uses electronic health record (EHR) data to evaluate the association between Physician Orders for Life-Sustaining Treatment (POLST) and intensive care unit (ICU) admission and the incidence of and risk factors for POLST-discordant intensive care among adult patients hospitalized 6 months or less before death.

Mortality and Hospitalizations for Dually Enrolled and Nondually Enrolled Medicare Beneficiaries Aged 65 Years or Older, 2004 to 2017

Abstract Full Text
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JAMA. 2020;323(10):961-969. doi:10.1001/jama.2020.1021

This population epidemiology study compares annual changes in all-cause mortality, hospitalization rates, and hospitalization-related mortality among beneficiaries aged 65 years or older dually enrolled in Medicare fee-for-service and Medicaid vs those nondually enrolled (Medicare only).

Research Letter

Prevalence of Pathogenic Variants in Cancer Susceptibility Genes Among Women With Postmenopausal Breast Cancer

Abstract Full Text
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JAMA. 2020;323(10):995-997. doi:10.1001/jama.2020.0229

This study uses Women’s Health Initiative data to compare the prevalence of pathogenic variants (PVs) in breast cancer susceptibility genes in postmenopausal women with vs without breast cancer to guide decisions about who should undergo PV testing.

US Preventive Services Task Force

Recommendation Statement

Screening for Hepatitis C Virus Infection in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement

Abstract Full Text
free access has active quiz has audio
JAMA. 2020;323(10):970-975. doi:10.1001/jama.2020.1123

This 2020 Recommendation Statement from the US Preventive Services Task Force recommends screening for hepatitis C virus infection in adults aged 18 to 79 years (B recommendation).

Evidence Report

Screening for Hepatitis C Virus Infection in Adolescents and Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Abstract Full Text
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JAMA. 2020;323(10):976-991. doi:10.1001/jama.2019.20788

This systematic review to support the 2020 US Preventive Services Task Force Recommendation Statement on screening for hepatitis C virus (HCV) infection summarizes published evidence on the benefits and harms of HCV screening and treatment in adolescents and adults.

Viewpoint

Potential Consequences of Changing Disease Classifications

Abstract Full Text
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JAMA. 2020;323(10):921-922. doi:10.1001/jama.2019.22373

This Viewpoint discusses the potential harms that can emerge from changing disease classifications, generally to broaden criteria for diagnosing greater numbers of patients, and calls for a balanced and systematic evaluation of the benefits and risks of shifting illness thresholds before formalizing changes.

Clarifying the Language of Clinician Distress

Abstract Full Text
JAMA. 2020;323(10):923-924. doi:10.1001/jama.2019.21576

This Viewpoint argues that moral dilemma, moral distress, and moral injury more accurately and etiologically characterize what most people refer to as physician burnout, and proposes that this reconception can lead to more effective prevention strategies and targeted solutions to address physician stress, frustration, dissatisfaction, and depression.

The Need to Incorporate Additional Patient Information Into Risk Adjustment for Medicare Beneficiaries

Abstract Full Text
JAMA. 2020;323(10):925-926. doi:10.1001/jama.2019.22370

This Viewpoint discusses concern that current risk adjustment models used by CMS to tie payment to performance do not account for dementia, frailty, and social risk, and proposes ways to add reliable measures of each to the agency’s CMS-HCC model to more equitably reimburse clinicians and facilities caring for patients with challenging conditions.

Homeless Special Needs Plans for People Experiencing Homelessness

Abstract Full Text
JAMA. 2020;323(10):927-928. doi:10.1001/jama.2019.22376

This Viewpoint proposes the creation of a homelessness-focused special needs plan, a Medicare Advantage insurance plan aimed at meeting the unique care needs of specific populations, to help offer the intensive case management and care coordination necessary for providing health care to homeless individuals.

A Piece of My Mind

Trauma Surgery

Abstract Full Text
JAMA. 2020;323(10):929-930. doi:10.1001/jama.2020.1331

In this narrative medicine essay a psychiatrist finds parallels between his attempts to locate the source of a patient’s psychological trauma and those of trauma surgeons opening up patients to reveal their injuries and shares how a successful connection heals both doctor and patient.

Editorial

Choosing the Best Blood Pressure Target for Vasopressor Therapy

Abstract Full Text
JAMA. 2020;323(10):931-933. doi:10.1001/jama.2019.22526

Physician Orders for Life-Sustaining Treatment and Limiting Overtreatment at the End of Life

Abstract Full Text
JAMA. 2020;323(10):934-935. doi:10.1001/jama.2019.22522

Universal Screening for Hepatitis C Virus Infection: A Step Toward Elimination

Abstract Full Text
has audio
JAMA. 2020;323(10):936-937. doi:10.1001/jama.2019.22313
JAMA Diagnostic Test Interpretation

Diagnostic Testing for Acute Hepatitis

Abstract Full Text
has active quiz
JAMA. 2020;323(10):992-993. doi:10.1001/jama.2019.21895

An 18-year-old man who recently emigrated from India presented with fever, malaise, and anorexia for 4 days. He was afebrile with scleral icterus and a palpable liver edge; had a white blood cell count of 3.9 × 103/μL with elevations in total and direct bilirubin, alkaline phosphatase, and liver enzymes; and laboratory test results were positive for HBsAg and HBV core IgG. What is the cause of his hepatitis, and what would you do next?

Medical News & Perspectives

Discussing the ABCs of Health Security—Antibiotic Resistance, Biothreats, and Coronavirus

Abstract Full Text
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JAMA. 2020;323(10):912-914. doi:10.1001/jama.2019.21022

In this Medical News article, Tom Inglesby, MD, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, speaks about natural and deliberate biological threats to US national security.

The JAMA Forum

Measles as Metaphor—What Resurgence Means for the Future of Immunization

Abstract Full Text
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JAMA. 2020;323(10):914-915. doi:10.1001/jama.2020.1372
News From the Centers for Disease Control and Prevention

US Zika-Related Birth Defects in High-Transmission Areas

Abstract Full Text
JAMA. 2020;323(10):917. doi:10.1001/jama.2020.1934

Rising Emergency Department Visits for Suicidal Ideation and Self-harm

Abstract Full Text
JAMA. 2020;323(10):917. doi:10.1001/jama.2020.1596
Biotech Innovations

CAR Natural Killer Cell Therapy Safe and Effective in First Trial

Abstract Full Text
JAMA. 2020;323(10):916. doi:10.1001/jama.2020.1940

Oral Injections Tested in Proof-of-Concept Trial

Abstract Full Text
JAMA. 2020;323(10):916. doi:10.1001/jama.2020.1740

23andMe Develops First Drug Compound Using Consumer Data

Abstract Full Text
JAMA. 2020;323(10):916. doi:10.1001/jama.2020.2238
Poetry and Medicine

Prognosis

Abstract Full Text
JAMA. 2020;323(10):1003. doi:10.1001/jama.2019.21997
JAMA Revisited

Alcohol and School Physiologies

Abstract Full Text
JAMA. 2020;323(10):1004. doi:10.1001/jama.2019.13345
JAMA Patient Page

Screening for Hepatitis C Virus Infection

Abstract Full Text
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JAMA. 2020;323(10):1008. doi:10.1001/jama.2020.1761

This JAMA Patient Page describes the recent USPSTF recommendations on screening for hepatitis C virus infection in adults.

Comment & Response

Prophylaxis Against Invasive Fungal Disease for Neutropenic Children and Young Adults

Abstract Full Text
JAMA. 2020;323(10):997-998. doi:10.1001/jama.2020.0172

Prophylaxis Against Invasive Fungal Disease for Neutropenic Children and Young Adults—Reply

Abstract Full Text
JAMA. 2020;323(10):998-999. doi:10.1001/jama.2020.0175

Radiation Oncology Alternative Payment Model

Abstract Full Text
JAMA. 2020;323(10):999. doi:10.1001/jama.2020.0400

Radiation Oncology Alternative Payment Model—Reply

Abstract Full Text
JAMA. 2020;323(10):999-1000. doi:10.1001/jama.2020.0403

Dissenting Opinions in Nutrition Research

Abstract Full Text
JAMA. 2020;323(10):1000. doi:10.1001/jama.2020.0490

Dissenting Opinions in Nutrition Research—Reply

Abstract Full Text
JAMA. 2020;323(10):1000-1001. doi:10.1001/jama.2020.0491
Correction

Data Errors in Table 3 and Figure 1

Abstract Full Text
free access
JAMA. 2020;323(10):1001. doi:10.1001/jama.2020.1316
JAMA Masthead

JAMA

Abstract Full Text
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JAMA. 2020;323(10):909-910. doi:10.1001/jama.2019.13338
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