March 23/30, 2021, Vol 325, No. 12, Pages 1125-1234

In This Issue of JAMA

Audio Highlights

Abstract Full Text

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JAMA. 2021;325(12):e2017857. doi:10.1001/jama.2020.17857

Audio Editors' Summary: Endotracheal Intubation and Ventilator Weaning Practices Internationally, USPSTF Guideline on Screening for Hearing Loss in Older Adults, and more

Original Investigation

Caring for the Critically Ill Patient

Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries

Vincenzo Russotto, MD; Sheila Nainan Myatra, MD; John G. Laffey, MD, MA; et al.

Abstract Full Text

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JAMA. 2021;325(12):1164-1172. doi:10.1001/jama.2021.1727

This international cohort study describes the incidence and nature of cardiovascular instability, severe hypoxemia, and cardiac arrest surrounding endotracheal intubation.

Editorial
International Variation in Intubation and Extubation Practices and Adverse Events Among Critically Ill Patients Receiving Mechanical Ventilation
Hayley B. Gershengorn, MD

JAMA

Caring for the Critically Ill Patient

Ventilator Weaning and Discontinuation Practices for Critically Ill Patients

Karen E. A. Burns, MD, MSc; Leena Rizvi, BSc; Deborah J. Cook, MD, MSc; et al.

Abstract Full Text

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JAMA. 2021;325(12):1173-1184. doi:10.1001/jama.2021.2384

This critical care epidemiology study describes practice variation in invasive mechanical ventilation weaning and discontinuation practices, associations between initial discontinuation events and outcomes, and factors associated with use of select discontinuation strategies and failed initial spontaneous breathing trials among critically ill patients in ICUs in 19 countries.

Editorial
International Variation in Intubation and Extubation Practices and Adverse Events Among Critically Ill Patients Receiving Mechanical Ventilation
Hayley B. Gershengorn, MD

JAMA

Association of Convalescent Plasma Treatment With Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis

Perrine Janiaud, PhD; Cathrine Axfors, MD, PhD; Andreas M. Schmitt, MD; et al.

Abstract Full Text

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JAMA. 2021;325(12):1185-1195. doi:10.1001/jama.2021.2747

This meta-analysis of randomized trials reported in medical journals, preprint servers, and press releases estimates associations between convalescent plasma treatment and clinical outcomes (all-cause mortality, length of stay, clinical improvement, clinical deterioration, mechanical ventilation use, serious adverse events) in patients with COVID-19.

Editorial
Emerging Lessons From COVID-19 for the US Clinical Research Enterprise
Derek C. Angus, MD; Anthony C. Gordon, MD; Howard Bauchner, MD

JAMA

Research Letter

Association Between the Proportion of Black Patients Cared for at Hospitals and Financial Penalties Under Value-Based Payment Programs

Rahul Aggarwal, MD; J. Gmerice Hammond, MD, MPH; Karen E. Joynt Maddox, MD, MPH; et al.

Abstract Full Text

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JAMA. 2021;325(12):1219-1221. doi:10.1001/jama.2021.0026

This study evaluates whether US hospitals with mostly Black patients are more likely than other hospitals to have penalties associated with Centers for Medicare & Medicaid Services (CMS) value-based payment programs.

Association of Clinician Minority Patient Caseload With Performance in the 2019 Medicare Merit-based Incentive Payment System

Kenton J. Johnston, PhD, MPH; David J. Meyers, PhD, MPH; Gmerice Hammond, MD, MPH; et al.

Abstract Full Text

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JAMA. 2021;325(12):1221-1223. doi:10.1001/jama.2021.0031

This study assesses the association between US clinicians’ caseload of minority patients and their 2019 Medicare Merit-based Incentive Payment System performance score.

US Preventive Services Task Force

Recommendation Statement

Screening for Hearing Loss in Older Adults: US Preventive Services Task Force Recommendation Statement

US Preventive Services Task Force

Abstract Full Text

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JAMA. 2021;325(12):1196-1201. doi:10.1001/jama.2021.2566

This 2021 US Preventive Services Task Force Recommendation Statement concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for hearing loss in older adults (I statement).

Conversations with Dr Bauchner: USPSTF Recommendation: Screening for Hearing Loss in Older Adults

Editorial
Screening for Hearing Loss in Older Adults: Insufficient Evidence Does Not Mean Insufficient Benefit
Bevan Yueh, MD, MPH; Jay F. Piccirillo, MD

JAMA
- Conversations with Dr Bauchner: USPSTF Recommendation: Screening for Hearing Loss in Older Adults
USPSTF Recommendations for Hearing Loss Screening in Asymptomatic Older Adults—A Case of Missing Evidence and Missing Treatment Options
Jennifer A. Deal, PhD; Frank R. Lin, MD, PhD

JAMA Netw Open
- Conversations with Dr Bauchner: USPSTF Recommendation: Screening for Hearing Loss in Older Adults

Evidence Report

Screening for Hearing Loss in Older Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Cynthia Feltner, MD, MPH; Ina F. Wallace, PhD; Christine E. Kistler, MD, MASc; et al.

Abstract Full Text

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JAMA. 2021;325(12):1202-1215. doi:10.1001/jama.2020.24855

This systematic review to support the 2021 US Preventive Services Task Force Recommendation Statement on screening for hearing loss in older adults summarizes published evidence on the benefits and harms of screening and interventions for hearing loss in adults aged 50 years or older.

Conversations with Dr Bauchner: USPSTF Recommendation: Screening for Hearing Loss in Older Adults

Editorial
Screening for Hearing Loss in Older Adults: Insufficient Evidence Does Not Mean Insufficient Benefit
Bevan Yueh, MD, MPH; Jay F. Piccirillo, MD

JAMA
- Conversations with Dr Bauchner: USPSTF Recommendation: Screening for Hearing Loss in Older Adults
USPSTF Recommendations for Hearing Loss Screening in Asymptomatic Older Adults—A Case of Missing Evidence and Missing Treatment Options
Jennifer A. Deal, PhD; Frank R. Lin, MD, PhD

JAMA Netw Open
- Conversations with Dr Bauchner: USPSTF Recommendation: Screening for Hearing Loss in Older Adults

Viewpoint

Health Policy

Envisioning the Veterans Affairs Health Care System of the Future

Baligh R. Yehia, MD, MPP; Stephan D. Fihn, MD, MPH

Abstract Full Text

JAMA. 2021;325(12):1143-1144. doi:10.1001/jama.2021.0961

This Viewpoint proposes strategies the Veterans Affairs (VA) health care system can pursue to shore up its mission in response to declining numbers of veterans and impending budget constraints, including accelerating a transition to value-based care, optimization of infrastructure, and strengthening engagement with employees and the public.

Editorial
Health Care Is a Right, Not a Privilege: A New Series on US Health Care and Health Policy
Howard Bauchner, MD; Phil B. Fontanarosa, MD, MBA; Karen Joynt Maddox, MD, MPH

JAMA
- Video: Health Care Reform in the Biden Era
- Conversations with Dr Bauchner: Health Care Reform in the Biden Era

Health Policy

Federally Qualified Health Centers and Related Primary Care Workforce Issues

Mary Wakefield, PhD, RN

Abstract Full Text

JAMA. 2021;325(12):1145-1146. doi:10.1001/jama.2021.1964

This Viewpoint proposes education, training, and funding reforms to expand the primary care workforce to supply federally qualified health centers (FQHCs), government-funded community-based health care sites that by providing safety-net primary care in underserved areas will be vital to addressing health inequities in the US.

Editorial
Health Care Is a Right, Not a Privilege: A New Series on US Health Care and Health Policy
Howard Bauchner, MD; Phil B. Fontanarosa, MD, MBA; Karen Joynt Maddox, MD, MPH

JAMA
- Video: Health Care Reform in the Biden Era
- Conversations with Dr Bauchner: Health Care Reform in the Biden Era

Removing One Barrier to Opioid Use Disorder Treatment: Is It Enough?

Melissa B. Weimer, DO, MCR; Sarah E. Wakeman, MD; Richard Saitz, MD, MPH

Abstract Full Text

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JAMA. 2021;325(12):1147-1148. doi:10.1001/jama.2021.0958

This Viewpoint discusses policy reforms necessary to advance medical management of opioid use disorder in the wake of retraction by the Biden adminstration of proposed federal Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder.

Conversations with Dr Bauchner: Removing One Barrier to Opioid Use Disorder Treatment—Is It Enough?

Overcoming Barriers to Treatment of Opioid Use Disorder

Yngvild Olsen, MD, MPH; Ruchi M. Fitzgerald, MD; Sarah E. Wakeman, MD

Abstract Full Text

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JAMA. 2021;325(12):1149-1150. doi:10.1001/jama.2021.1741

This Viewpoint discusses federal guidance that would exempt physicians from a standing requirement to apply for a waiver to prescribe buprenorphine for opioid use disorder (OUD) and makes additional recommendations to expand access to medication treatment of OUD, including expanded prescriber training and office-based methadone treatment.

Conversations with Dr Bauchner: Removing One Barrier to Opioid Use Disorder Treatment—Is It Enough?

Continued Increases in Overdose Deaths Related to Synthetic Opioids: Implications for Clinical Practice

Grant T. Baldwin, PhD, MPH; Puja Seth, PhD; Rita K. Noonan, PhD

Abstract Full Text

JAMA. 2021;325(12):1151-1152. doi:10.1001/jama.2021.1169

This Viewpoint summarizes a 2021 MMWR report documenting a concerning rise in illicit and synthetic opioid overdose deaths in the US between 2013 and 2019 and proposes strategies to connect clinicians and health systems with public health, public safety, and other community partners to share data, monitor trends, and better respond to the overdose epidemic.

The US Regulatory System and COVID-19 Vaccines: The Importance of a Strong and Capable FDA

Joshua M. Sharfstein, MD; Jesse L. Goodman, MD, MPH; Luciana Borio, MD

Abstract Full Text

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JAMA. 2021;325(12):1153-1154. doi:10.1001/jama.2021.1961

This Viewpoint examines the important role of the Food and Druf Administration (FDA) in facilitating the rapid development of coronavirus disease 2019 (COVID-19) vaccines.

Editorial
Reassuring the Public and Clinical Community About the Scientific Review and Approval of a COVID-19 Vaccine
Howard Bauchner, MD; Preeti N. Malani, MD, MSJ; Joshua Sharfstein, MD

JAMA
- Video: Coronavirus Vaccine Update With Anthony Fauci
- Video: Coronavirus Update With Anthony Fauci - October 28, 2020
- Video: Coronavirus Q&A With Anthony Fauci, MD – September 25, 2020
- Video: Coronavirus Update With Michael T. Osterholm, PhD, MPH
- Video: COVID-19 Vaccine Approval and the FDA
- Conversations with Dr Bauchner: COVID-19 Vaccine Approval and the FDA
- Conversations with Dr Bauchner: Coronavirus Update With Michael T. Osterholm, PhD, MPH
- Conversations with Dr Bauchner: Coronavirus Q&A With Anthony Fauci, MD – September 25, 2020
- Conversations with Dr Bauchner: Coronavirus Update With Anthony Fauci - October 28, 2020
- Conversations with Dr Bauchner: Coronavirus Vaccine Update With Anthony Fauci

A Piece of My Mind

I Am Not Burned Out

Sarah M. Bagley, MD, MSc

Abstract Full Text

JAMA. 2021;325(12):1155-1156. doi:10.1001/jama.2021.2861

In this narrative medicine essay, a pediatrician describes her struggle to recognize postpartum depression with the birth of her third child and how she found her way out.

Editorial

International Variation in Intubation and Extubation Practices and Adverse Events Among Critically Ill Patients Receiving Mechanical Ventilation

Hayley B. Gershengorn, MD

Abstract Full Text

JAMA. 2021;325(12):1157-1159. doi:10.1001/jama.2021.1178

Emerging Lessons From COVID-19 for the US Clinical Research Enterprise

Derek C. Angus, MD; Anthony C. Gordon, MD; Howard Bauchner, MD

Abstract Full Text

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JAMA. 2021;325(12):1159-1161. doi:10.1001/jama.2021.3284

Screening for Hearing Loss in Older Adults: Insufficient Evidence Does Not Mean Insufficient Benefit

Bevan Yueh, MD, MPH; Jay F. Piccirillo, MD

Abstract Full Text

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JAMA. 2021;325(12):1162-1163. doi:10.1001/jama.2021.2020

Conversations with Dr Bauchner: USPSTF Recommendation: Screening for Hearing Loss in Older Adults

Editorial
USPSTF Recommendations for Hearing Loss Screening in Asymptomatic Older Adults—A Case of Missing Evidence and Missing Treatment Options
Jennifer A. Deal, PhD; Frank R. Lin, MD, PhD

JAMA Netw Open
- Conversations with Dr Bauchner: USPSTF Recommendation: Screening for Hearing Loss in Older Adults

JAMA Diagnostic Test Interpretation

Evaluation of Hypokalemia

Morgan E. Grams, MD, PhD; Melanie P. Hoenig, MD; Ewout J. Hoorn, MD, PhD

Abstract Full Text

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JAMA. 2021;325(12):1216-1217. doi:10.1001/jama.2020.17672

This case report describes the evaluation of a 52-year-old woman taking a thiazide diuretic with hypokalemia (potassium, 2.6 mEq/L) and hypertension (blood pressure, 159/94 mm Hg) and presents an algorithm for the diagnosis and management of underlying causes of low serum potassium levels.

Medical News & Perspectives

When the Human Voice Speaks Volumes About Lung Function

Kristin Walter, MD, MS

Abstract Full Text

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JAMA. 2021;325(12):1130-1131. doi:10.1001/jama.2020.22460

This Medical News article describes how the human voice might be harnessed to diagnose obstructive lung disease and monitor lung function.

JAMA Medical News Audio: March 2021 Medical News Summary

The JAMA Forum

The Coronavirus Pandemic 1 Year On—What Went Wrong?

Lawrence O. Gostin, JD

Abstract Full Text

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JAMA. 2021;325(12):1132-1133. doi:10.1001/jama.2021.3207

News From the Centers for Disease Control and Prevention

Survey—Many High School Students Have Experienced Violence

Bridget M. Kuehn, MSJ

Abstract Full Text

JAMA. 2021;325(12):1136. doi:10.1001/jama.2021.2934

Sexual Minorities Have Greater COVID-19 Risk Factors

Bridget M. Kuehn, MSJ

Abstract Full Text

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JAMA. 2021;325(12):1136. doi:10.1001/jama.2021.3356

Clinical Trials Update

With Good Adherence, Daily Aspirin May Prevent Pregnancy Loss

Anita Slomski

Abstract Full Text

JAMA. 2021;325(12):1135. doi:10.1001/jama.2021.1788

Virtual Postoperative Visits Noninferior to In-Person Visits

Anita Slomski

Abstract Full Text

JAMA. 2021;325(12):1135. doi:10.1001/jama.2021.3570

Better Hypertension Control With Digital Self-monitoring

Anita Slomski

Abstract Full Text

JAMA. 2021;325(12):1135. doi:10.1001/jama.2021.3572

Molecular Point-of-Care Test Improved Influenza Care

Anita Slomski

Abstract Full Text

JAMA. 2021;325(12):1135. doi:10.1001/jama.2021.3574

Polypill Plus Aspirin Effective for Cardiovascular Disease Prevention

Anita Slomski

Abstract Full Text

JAMA. 2021;325(12):1135. doi:10.1001/jama.2021.3576

Health Agencies Update

Another Explanation for Why Cloth Masks Reduce COVID-19 Severity

Rita Rubin, MA

Abstract Full Text

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JAMA. 2021;325(12):1134. doi:10.1001/jama.2021.2955

VA Nursing Homes’ History of Infection Control Shortcomings

Rita Rubin, MA

Abstract Full Text

JAMA. 2021;325(12):1134. doi:10.1001/jama.2021.3562

HHS Expands Number of People Who Can Vaccinate Against COVID-19

Rita Rubin, MA

Abstract Full Text

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JAMA. 2021;325(12):1134. doi:10.1001/jama.2021.3564

The Arts and Medicine

“Self-Portrait as Exit Wounds”: A Graphic Story

Ankit Mehta, MD

Abstract Full Text

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JAMA. 2021;325(12):1127-1129. doi:10.1001/jama.2020.27162

This wordless graphic story conveys the loss and powerlessness felt by health care workers, patients, and families confronting the coronavirus pandemic, and was drawn by a community hospitalist as a tribute to each.

Poetry and Medicine

Shelter

Susan Dix Lyons, MA

Abstract Full Text

JAMA. 2021;325(12):1229. doi:10.1001/jama.2021.3481

JAMA Revisited

Beware, the Sporothrix

Abstract Full Text

JAMA. 2021;325(12):1230. doi:10.1001/jama.2020.17858

JAMA Patient Page

Screening for Hearing Loss in Older Adults

Jill Jin, MD, MPH

Abstract Full Text

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JAMA. 2021;325(12):1234. doi:10.1001/jama.2021.2513

This JAMA Patient Page summarizes the US Preventive Services Task Force’s 2021 recommendation that current evidence is insufficient to assess the balance of benefits and harms of screening for hearing loss in older adults (I statement).