April 27, 2021, Vol 325, No. 16, Pages 1593-1688

In This Issue of JAMA

Audio Highlights

Abstract Full Text

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JAMA. 2021;325(16):e2017905. doi:10.1001/jama.2020.17905

Audio Editors' Summary: Anticoagulation for COVID-19, Reducing Cesarean Deliveries for Low-Risk Births, USPSTF Hypertension Screening Guideline, and more

Original Investigation

Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinical Trial

INSPIRATION Investigators

Abstract Full Text

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JAMA. 2021;325(16):1620-1630. doi:10.1001/jama.2021.4152

This randomized trial compares the effect of intermediate-dose vs standard prophylactic enoxaparin on a composite outcome of acute venous thromboembolism (VTE), arterial thrombosis, need for extracorporeal membrane oxygenation (ECMO), and all-cause mortality within 30 days among patients with COVID-19 admitted to the ICU.

Editorial
Finding the Optimal Thromboprophylaxis Dose in Patients With COVID-19
Hanny Al-Samkari, MD

Hospital Quality Improvement Interventions, Statewide Policy Initiatives, and Rates of Cesarean Delivery for Nulliparous, Term, Singleton, Vertex Births in California

Melissa G. Rosenstein, MD, MAS; Shen-Chih Chang, MS, PhD; Christa Sakowski, MSN; et al.

Abstract Full Text

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JAMA. 2021;325(16):1631-1639. doi:10.1001/jama.2021.3816

This population epidemiology study compares rates of cesarean delivery for nulliparous, term, singleton, vertex (NTSV) births in California before vs after a statewide intervention to reduce cesarean deliveries and compares trends in California with those in the US.

Editorial
Initiatives to Reduce Cesarean Delivery Rates for Low-risk First Births
David B. Nelson, MD; Catherine Y. Spong, MD

Association Between Age at Diabetes Onset and Subsequent Risk of Dementia

Claudio Barbiellini Amidei, MD; Aurore Fayosse, MSc; Julien Dumurgier, PhD; et al.

Abstract Full Text

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JAMA. 2021;325(16):1640-1649. doi:10.1001/jama.2021.4001

This cohort study uses UK Whitehall cohort data to examine the association between age at type 2 diabetes onset and incident dementia.

Research Letter

HPV Vaccination Among Young Adults in the US

Michelle M. Chen, MD, MHS; Nicole Mott, BS; Sarah J. Clark, MPH; et al.

Abstract Full Text

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JAMA. 2021;325(16):1673-1674. doi:10.1001/jama.2021.0725

This study uses data from the 2010-2018 National Health Interview Survey to characterize trends in human papillomavirus (HPV) vaccination rates, ages at vaccination, and numbers of doses received among young adults in the US between 2010 and 2018.

Out-of-Network Laboratory Test Spending, Utilization, and Prices in the US

Zirui Song, MD, PhD; Timothy Lillehaugen, MPH; Jacob Wallace, PhD

Abstract Full Text

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JAMA. 2021;325(16):1674-1676. doi:10.1001/jama.2021.0720

In the context of concerns about the appropriateness and costs to insurers and patients of laboratory testing, this study uses data from the IBM MarketScan Commercial Claims and Encounters Database to examine out-of-network laboratory test spending, utilization, and prices in the US in 2008-2016.

Reasons for Admissions to US Children’s Hospitals During the COVID-19 Pandemic

Peter J. Gill, MD, DPhil; Sanjay Mahant, MD, MSc; Matt Hall, PhD; et al.

Abstract Full Text

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JAMA. 2021;325(16):1676-1679. doi:10.1001/jama.2021.4382

This study uses Pediatric Health Information System database data to compare hospitalizations in US children’s hospitals early in the COVID-19 pandemic (March-August 2020) vs the same period in 2017-2019, overall and for respiratory, chronic, nonrespiratory, and other conditions.

US Preventive Services Task Force

Recommendation Statement

Screening for Hypertension in Adults: US Preventive Services Task Force Reaffirmation Recommendation Statement

US Preventive Services Task Force

Abstract Full Text

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JAMA. 2021;325(16):1650-1656. doi:10.1001/jama.2021.4987

This 2021 US Preventive Services Task Force Reaffirmation Recommendation Statement recommends screening for hypertension in adults 18 years or older with office blood pressure measurement and obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment (A recommendation).

Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults
JAMAevidence: The Rational Clinical Examination: Does This Adult Patient Have Hypertension? Interview With Dr Anthony Joseph Viera

Editorial
USPSTF Recommendation Statement on Hypertension Screening in Adults—Where Do We Go From Here?
D. Edmund Anstey, MD, MPH; Corey Bradley, MD; Daichi Shimbo, MD
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults
Will the 2021 USPSTF Hypertension Screening Recommendation Decrease or Worsen Racial/Ethnic Disparities in Blood Pressure Control?
Keith C. Ferdinand, MD; Angela L. Brown, MD
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults
The USPSTF Recommendation on Blood Pressure Screening: Making 2021 the Transformative Year in Controlling Hypertension
Marwah Abdalla, MD, MPH; Paul Muntner, PhD; Eric D. Peterson, MD, MPH
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults
USPSTF Recommendations for Screening for Hypertension in Adults: It Is Time to Unmask Hypertensive Risk
Yuichiro Yano, MD, PhD; Donald M. Lloyd-Jones, MD, ScM
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults

Evidence Report

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

Janelle M. Guirguis-Blake, MD; Corinne V. Evans, MPP; Elizabeth M. Webber, MS; et al.

Abstract Full Text

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JAMA. 2021;325(16):1657-1669. doi:10.1001/jama.2020.21669

This systematic review to support the 2021 US Preventive Services Task Force Recommendation Statement on screening for hypertension summarizes published evidence on the benefits and harms of hypertension screening and confirmatory blood pressure measurements in adults 18 years or older without known hypertension.

Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults
JAMAevidence: The Rational Clinical Examination: Does This Adult Patient Have Hypertension? Interview With Dr Anthony Joseph Viera

Editorial
USPSTF Recommendation Statement on Hypertension Screening in Adults—Where Do We Go From Here?
D. Edmund Anstey, MD, MPH; Corey Bradley, MD; Daichi Shimbo, MD
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults
Will the 2021 USPSTF Hypertension Screening Recommendation Decrease or Worsen Racial/Ethnic Disparities in Blood Pressure Control?
Keith C. Ferdinand, MD; Angela L. Brown, MD
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults
The USPSTF Recommendation on Blood Pressure Screening: Making 2021 the Transformative Year in Controlling Hypertension
Marwah Abdalla, MD, MPH; Paul Muntner, PhD; Eric D. Peterson, MD, MPH
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults
USPSTF Recommendations for Screening for Hypertension in Adults: It Is Time to Unmask Hypertensive Risk
Yuichiro Yano, MD, PhD; Donald M. Lloyd-Jones, MD, ScM
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults

Viewpoint

Prioritizing Nutrition Security in the US

Dariush Mozaffarian, MD, DrPH; Sheila Fleischhacker, PhD, JD, RDN; José R. Andrés

Abstract Full Text

JAMA. 2021;325(16):1605-1606. doi:10.1001/jama.2021.1915

This Viewpoint addresses nutrition security—defined as having consistent access, availability, and affordability of foods and beverages that promote well-being and prevent or even treat disease—and its importance to clinical care and public policy in the US.

The Interstate Medical Licensure Compact: Attending to the Underserved

Eli Y. Adashi, MD, MS; I. Glenn Cohen, JD; Winston L. McCormick, BS

Abstract Full Text

JAMA. 2021;325(16):1607-1608. doi:10.1001/jama.2021.1085

This Viewpoint reviews the creation of the US Interstate Medical Licensure Compact (IMLC), which facilitates licensure for physicians who wish to practice in multiple states with the aim of increasing access to care for patients in underserved areas and emphasizes its growing importance to states and physicians given more widespread use of telemedicine.

State Medical Board Recommendations for Stronger Approaches to Sexual Misconduct by Physicians

Patricia A. King, MD, PhD; Humayun J. Chaudhry, DO, MS; Mark L. Staz, MA

Abstract Full Text

JAMA. 2021;325(16):1609-1610. doi:10.1001/jama.2020.25775

This Viewpoint discusses recommendations adopted by the US Federation of State Medical Boards (FSMB) to guide state boards on how to respond to reports of sexual misconduct by physicians toward patients, including harassment and abuse.

Editorial
Sexual Misconduct in Academic Medicine
Julie Ann Freischlag, MD; Katherine Files, MBA

A Piece of My Mind

Becoming a Mother and Gaining Perspective

Lauren Rissman, MD

Abstract Full Text

JAMA. 2021;325(16):1611-1612. doi:10.1001/jama.2021.5160

In this narrative medicine essay, a pediatric intensive care fellow tells of her near death from postpartum hemorrhage in childbirth, her first delayed introduction to her daughter, and her struggle with helplessness in caring for her premature daughter during her convalescence.

Editorial

Finding the Optimal Thromboprophylaxis Dose in Patients With COVID-19

Hanny Al-Samkari, MD

Abstract Full Text

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JAMA. 2021;325(16):1613-1615. doi:10.1001/jama.2021.4295

Initiatives to Reduce Cesarean Delivery Rates for Low-risk First Births

David B. Nelson, MD; Catherine Y. Spong, MD

Abstract Full Text

JAMA. 2021;325(16):1616-1617. doi:10.1001/jama.2021.0084

Recommendation Statement

The USPSTF Recommendation on Blood Pressure Screening: Making 2021 the Transformative Year in Controlling Hypertension

Marwah Abdalla, MD, MPH; Paul Muntner, PhD; Eric D. Peterson, MD, MPH

Abstract Full Text

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JAMA. 2021;325(16):1618-1619. doi:10.1001/jama.2021.4499

Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults

Editorial
USPSTF Recommendation Statement on Hypertension Screening in Adults—Where Do We Go From Here?
D. Edmund Anstey, MD, MPH; Corey Bradley, MD; Daichi Shimbo, MD
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults
Will the 2021 USPSTF Hypertension Screening Recommendation Decrease or Worsen Racial/Ethnic Disparities in Blood Pressure Control?
Keith C. Ferdinand, MD; Angela L. Brown, MD
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults
USPSTF Recommendations for Screening for Hypertension in Adults: It Is Time to Unmask Hypertensive Risk
Yuichiro Yano, MD, PhD; Donald M. Lloyd-Jones, MD, ScM
- Audio Clinical Review: USPSTF Recommendation: Screening for Hypertension in Adults

JAMA Insights

First-Dose COVID-19 Vaccination Coverage Among Skilled Nursing Facility Residents and Staff

Radhika Gharpure, DVM, MPH; Anita Patel, PharmD, MS; Ruth Link-Gelles, PhD, MPH

Abstract Full Text

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JAMA. 2021;325(16):1670-1671. doi:10.1001/jama.2021.2352

This JAMA Insights review from CDC COVID-19 Response team members presents data on the number of long-term care facilities and the numbers of residents and staff of those facilities who received first-dose vaccination through mid-January 2021 under the agency’s public-private partnership with CVS, Walgreens, and Managed Health Care Associates.

Audio Clinical Review: Vaccinating Nursing Home and Long-term Care Facility Residents for Coronavirus

Medical News & Perspectives

How Sharing Clinical Notes Affects the Patient-Physician Relationship

Rita Rubin, MA

Abstract Full Text

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JAMA. 2021;325(16):1596-1598. doi:10.1001/jama.2021.4755

This Medical News feature describes the impact of open visit notes on patient care.

JAMA Medical News Audio: April 2021 Medical News Summary

The JAMA Forum

To Address Drug Affordability, Grab the Low-hanging Fruit

Michelle M. Mello, JD, PhD, MPhil; Trish Riley, MS

Abstract Full Text

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JAMA. 2021;325(16):1599-1600. doi:10.1001/jama.2021.4619

News From the Centers for Disease Control and Prevention

Israel’s Real-life Evidence That Vaccine Can Prevent Severe COVID-19

Bridget M. Kuehn, MSJ

Abstract Full Text

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JAMA. 2021;325(16):1603. doi:10.1001/jama.2021.5617

More Severe Obesity Leads to More Severe COVID-19 in Study

Bridget M. Kuehn, MSJ

Abstract Full Text

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JAMA. 2021;325(16):1603. doi:10.1001/jama.2021.4853

Clinical Trials Update

N-of-1 Trial Finds No Effect of Statins on Muscle Symptoms

Anita Slomski, MA

Abstract Full Text

JAMA. 2021;325(16):1602. doi:10.1001/jama.2021.4801

Relugolix Combination Therapy for Uterine Fibroids

Anita Slomski, MA

Abstract Full Text

JAMA. 2021;325(16):1602. doi:10.1001/jama.2021.5857

Low-Income African American Women With Hypertension and Depression

Anita Slomski, MA

Abstract Full Text

JAMA. 2021;325(16):1602. doi:10.1001/jama.2021.5861

Bimekizumab Offers Rapid and Durable Psoriasis Treatment

Anita Slomski, MA

Abstract Full Text

JAMA. 2021;325(16):1602. doi:10.1001/jama.2021.5863

Health Agencies Update

Vaccination Priorities Delay Shots for Higher-Risk People of Color

Rita Rubin, MA

Abstract Full Text

JAMA. 2021;325(16):1601. doi:10.1001/jama.2021.5115

NIH Launches Program to Investigate COVID-19 in Children

Rita Rubin, MA

Abstract Full Text

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JAMA. 2021;325(16):1601. doi:10.1001/jama.2021.5880

Medicare Raises Payment for Administering COVID-19 Vaccines

Rita Rubin, MA

Abstract Full Text

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JAMA. 2021;325(16):1601. doi:10.1001/jama.2021.5882

Poetry and Medicine

COVID Dying

Ralph James Savarese, PhD

Abstract Full Text

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JAMA. 2021;325(16):1684. doi:10.1001/jama.2021.1912

JAMA Revisited

Financial Support of Medical Schools

Abstract Full Text

JAMA. 2021;325(16):1685. doi:10.1001/jama.2020.17906

JAMA Patient Page

Screening for Hypertension in Adults

Jill Jin, MD, MPH

Abstract Full Text

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JAMA. 2021;325(16):1688. doi:10.1001/jama.2021.5288

This JAMA Patient Page summarizes the US Preventive Services Task Force’s 2021 recommendation that all adults aged 18 years or older be screened for high blood pressure (A statement).