January 19, 2021, Vol 325, No. 3, Pages 205-316

In This Issue of JAMA

Audio Highlights

Abstract Full Text

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JAMA. 2021;325(3):e2017749. doi:10.1001/jama.2020.17749

Audio Editors' Summary: Thrombolysis Before Thrombectomy for Stroke, USPSTF Guideline on Smoking Cessation, US Health Policy Theme Issue, and more

Original Investigation

Effect of Endovascular Treatment Alone vs Intravenous Alteplase Plus Endovascular Treatment on Functional Independence in Patients With Acute Ischemic Stroke: The DEVT Randomized Clinical Trial

Wenjie Zi, MD; Zhongming Qiu, MD; Fengli Li, MD; et al.

Abstract Full Text

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JAMA. 2021;325(3):234-243. doi:10.1001/jama.2020.23523

This noninferiority trial compares the effects of endovascular treatment with vs without intravenous alteplase on 90-day functional independence among patients with acute ischemic stroke.

Conversations with Dr Bauchner: Thrombolysis Before Thrombectomy for Stroke

Editorial
Intravenous Thrombolysis Before Endovascular Thrombectomy for Acute Ischemic Stroke
Jeffrey L. Saver, MD; Opeolu Adeoye, MD, MS
- Conversations with Dr Bauchner: Thrombolysis Before Thrombectomy for Stroke

Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis on Functional Outcome Among Patients With Acute Ischemic Stroke: The SKIP Randomized Clinical Trial

Kentaro Suzuki, MD, PhD; Yuji Matsumaru, MD, PhD; Masataka Takeuchi, MD; et al.

Abstract Full Text

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JAMA. 2021;325(3):244-253. doi:10.1001/jama.2020.23522

This noninferiority trial compares the effects of mechanical thrombectomy with vs without intravenous thrombolysis (0.6-mg/kg alteplase) on 90-day disability among patients with acute large vessel occlusive ischemic stroke.

Conversations with Dr Bauchner: Thrombolysis Before Thrombectomy for Stroke

Editorial
Intravenous Thrombolysis Before Endovascular Thrombectomy for Acute Ischemic Stroke
Jeffrey L. Saver, MD; Opeolu Adeoye, MD, MS
- Conversations with Dr Bauchner: Thrombolysis Before Thrombectomy for Stroke

Effect of Discontinuing vs Continuing Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on Days Alive and Out of the Hospital in Patients Admitted With COVID-19: A Randomized Clinical Trial

Renato D. Lopes, MD, PhD; Ariane V. S. Macedo, MD, MSc; Pedro G. M. de Barros E Silva, MD, PhD; et al.

Abstract Full Text

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JAMA. 2021;325(3):254-264. doi:10.1001/jama.2020.25864

This randomized clinical trial compares the effect of discontinuing vs continuing angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) on days alive and out of the hospital at 30 days among patients with COVID-19 taking the drugs prior to hospitalization.

Research Letter

Readmission and Death After Initial Hospital Discharge Among Patients With COVID-19 in a Large Multihospital System

John P. Donnelly, PhD; Xiao Qing Wang, MPH; Theodore J. Iwashyna, MD, PhD; et al.

Abstract Full Text

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JAMA. 2021;325(3):304-306. doi:10.1001/jama.2020.21465

This study describes reasons for readmission, use of ICU interventions during readmission, and proportions of death after initial hospital discharge of COVID-19 patients from US Veterans Affairs (VA) hospitals in March-June 2020.

US Preventive Services Task Force

Recommendation Statement

Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement

US Preventive Services Task Force

Abstract Full Text

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JAMA. 2021;325(3):265-279. doi:10.1001/jama.2020.25019

This 2021 US Preventive Services Task Force Recommendation Statement recommends that clinicians ask all adults about tobacco use, advise them to stop using tobacco, and provide behavioral interventions and pharmacotherapy for cessation (A recommendation) and concludes that evidence is insufficient to assess the benefits and harms of tobacco cessation pharmacotherapy in pregnant persons and e- cigarettes for tobacco cessation in any adult (I statement).

Conversations with Dr Bauchner: USPSTF Recommendation: Tobacco Cessation in Adults
Audio Clinical Review: Pharmacologic Management of Tobacco Cessation

Editorial
A Comprehensive Approach to Increase Adult Tobacco Cessation
Brenna VanFrank, MD, MSPH; Letitia Presley-Cantrell, PhD
- Conversations with Dr Bauchner: USPSTF Recommendation: Tobacco Cessation in Adults

Evidence Report

Interventions for Tobacco Cessation in Adults, Including Pregnant Persons: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Carrie D. Patnode, PhD, MPH; Jillian T. Henderson, PhD, MPH; Erin L. Coppola, MPH; et al.

Abstract Full Text

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JAMA. 2021;325(3):280-298. doi:10.1001/jama.2020.23541

This systematic review to support the 2021 US Preventive Services Task Force Recommendation Statement on interventions for tobacco cessation in adults summarizes published evidence on the benefits and harms of interventions for tobacco cessation in adults, including pregnant persons.

Conversations with Dr Bauchner: USPSTF Recommendation: Tobacco Cessation in Adults

Editorial
A Comprehensive Approach to Increase Adult Tobacco Cessation
Brenna VanFrank, MD, MSPH; Letitia Presley-Cantrell, PhD
- Conversations with Dr Bauchner: USPSTF Recommendation: Tobacco Cessation in Adults

Viewpoint

Health Policy

The Language of Health Care Reform

Larry Levitt, MPP

Abstract Full Text

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JAMA. 2021;325(3):215-216. doi:10.1001/jama.2020.25717

This Viewpoint posits that the US will engage in another debate about health care reform to consider expanding coverage, improving affordability, and containing costs.

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

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

Health Policy

Executive Action to Expand Health Services in the Biden Administration

Timothy M. Westmoreland, JD; M. Gregg Bloche, MD, JD; Lawrence O. Gostin, JD

Abstract Full Text

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JAMA. 2021;325(3):217-218. doi:10.1001/jama.2020.25888

This Viewpoint proposes measures the incoming Biden administration can take to increase access to health insurance coverage under the Affordable Care Act (ACA) and Medicaid, including limiting short-term ACA coverage provisions, rolling back state Medicaid waivers, and simplifying Medicaid eligibility.

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

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

The Ethics of Continuing Placebo in SARS-CoV-2 Vaccine Trials

Annette Rid, MD; Marc Lipsitch, DPhil; Franklin G. Miller, PhD

Abstract Full Text

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JAMA. 2021;325(3):219-220. doi:10.1001/jama.2020.25053

This Viewpoint proposes that prioritizing all placebo-group participants in coronavirus vaccine trials as vaccine first receivers could perpetuate health inequities and compromise the chance to learn from their participation, proposing instead to limit prioritization to placebo participants who would be prioritized for vaccination anyway under NASEM or ACIP frameworks.

Conversations with Dr Bauchner: Coronavirus Vaccine FDA Update
Conversations with Dr Bauchner: COVID-19 Vaccines and Herd Immunity

Evaluating SARS-CoV-2 Vaccines After Emergency Use Authorization or Licensing of Initial Candidate Vaccines

Steven Joffe, MD, MPH

Abstract Full Text

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JAMA. 2021;325(3):221-222. doi:10.1001/jama.2020.25127

This Viewpoint discusses the ethics of including a placebo arm in randomized trials of coronavirus vaccines once authorized vaccines have become widely available, and proposes use of adaptive platform trial designs as an optimal approach to nimbly and ethically compare future investigational COVID-19 vaccines with proven effective ones.

Conversations with Dr Bauchner: Coronavirus Vaccine FDA Update
Conversations with Dr Bauchner: COVID-19 Vaccines and Herd Immunity
Conversations with Dr Bauchner: Coronavirus Vaccine Update With Arnold S. Monto, MD

Public Health Messaging in an Era of Social Media

Raina M. Merchant, MD, MSHP; Eugenia C. South, MD, MSHP; Nicole Lurie, MD, MSPH

Abstract Full Text

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JAMA. 2021;325(3):223-224. doi:10.1001/jama.2020.24514

This Viewpoint discusses the rapid spread of scientific misinformation on social media platforms throughout the COVID-19 pandemic and proposes strategies to counteract its adverse effects including surveillance of digital data and partnering with trusted messengers to engage the public and advance scientifically sound public health measures.

Conversations with Dr Bauchner: Public Health Messaging in an Era of Social Media

A Piece of My Mind

Root Cause Analysis

Megan Paulsen, MD

Abstract Full Text

JAMA. 2021;325(3):225-226. doi:10.1001/jama.2020.24911

In this narrative medicine essay, a neonatologist describes the fear of losing her twin boys after assisted reproduction and their premature births and relies on a form of root cause analysis to identify the sources of her trauma and to learn from it enough to support her patients and their families.

Editorial

Health Policy

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

Abstract Full Text

has multimedia has audio

JAMA. 2021;325(3):227-228. doi:10.1001/jama.2020.23915

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

Editorial
JAMA Health Forum—A New JAMA Network Specialty Journal
Howard Bauchner, MD; John Z. Ayanian, MD, MPP; Melinda B. Buntin, PhD; Annette Flanagin, RN, MA; Brian Shields, MBA

Intravenous Thrombolysis Before Endovascular Thrombectomy for Acute Ischemic Stroke

Jeffrey L. Saver, MD; Opeolu Adeoye, MD, MS

Abstract Full Text

has multimedia has audio

JAMA. 2021;325(3):229-231. doi:10.1001/jama.2020.22388

Conversations with Dr Bauchner: Thrombolysis Before Thrombectomy for Stroke

A Comprehensive Approach to Increase Adult Tobacco Cessation

Brenna VanFrank, MD, MSPH; Letitia Presley-Cantrell, PhD

Abstract Full Text

has audio

JAMA. 2021;325(3):232-233. doi:10.1001/jama.2020.23608

Conversations with Dr Bauchner: USPSTF Recommendation: Tobacco Cessation in Adults

JAMA Performance Improvement

Safe Central Venous Access in an Overburdened Health System

Karen Woo, MD, MS; David Rigberg, MD; Peter F. Lawrence, MD

Abstract Full Text

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JAMA. 2021;325(3):299-300. doi:10.1001/jama.2020.20361

This JAMA Performance Improvement article summarizes findings from an international survey study of hospital experience with central venous access line insertion teams to manage high procedural volume and safety during the COVID-19 pandemic.

JAMA Clinical Guidelines Synopsis

Initiating Pharmacologic Treatment in Tobacco-Dependent Adults

Atul Jain, MD, MS; Andrew M. Davis, MD, MPH

Abstract Full Text

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JAMA. 2021;325(3):301-302. doi:10.1001/jama.2020.24790

This JAMA Clinical Guidelines Synopsis summarizes the American Thoracic Society’s 2020 recommendations for treating tobacco dependence with pharmacologic therapy in adults.

Audio Clinical Review: Pharmacologic Management of Tobacco Cessation

Medical News & Perspectives

COVID-19 Conspiracies and Beyond: How Physicians Can Deal With Patients’ Misinformation

Jennifer Abbasi

Abstract Full Text

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JAMA. 2021;325(3):208-210. doi:10.1001/jama.2020.22018

This Medical News article is an interview with communication science expert Brian Southwell, PhD, whose new training workshop helps clinicians navigate medical misinformation.

JAMA Medical News Audio: COVID-19 Conspiracies and Beyond: How Physicians Can Deal With Patients’ Misinformation
JAMA Medical News Audio: January 2021 Medical News Summary

Quick Uptakes

New Guidance for Type 1 Diabetes Continuous Glucose Monitoring Use During Exercise

Mary Chris Jaklevic, MSJ

Abstract Full Text

JAMA. 2021;325(3):211-212. doi:10.1001/jama.2020.22890

This story describes guidelines to help people with type 1 diabetes respond to readings on glucose monitors before, during, and after exercise.

News From the Food and Drug Administration

First Drug Approved for Rare Genetic Disorder Affecting Kidneys

Mary Chris Jaklevic, MSJ

Abstract Full Text

JAMA. 2021;325(3):214. doi:10.1001/jama.2020.26382

Avoid Masks With Metal During Magnetic Resonance Imaging

Mary Chris Jaklevic, MSJ

Abstract Full Text

JAMA. 2021;325(3):214. doi:10.1001/jama.2020.25687

Imaging Drug for Prostate Cancer

Mary Chris Jaklevic, MSJ

Abstract Full Text

JAMA. 2021;325(3):214. doi:10.1001/jama.2020.26384

Global Health

WHO Launches Global Push to Eliminate Cervical Cancer

Bridget M. Kuehn, MSJ

Abstract Full Text

JAMA. 2021;325(3):213. doi:10.1001/jama.2020.25668

Monthly Malaria Prophylaxis Cuts Child Deaths in Sub-Saharan Africa

Bridget M. Kuehn, MSJ

Abstract Full Text

JAMA. 2021;325(3):213. doi:10.1001/jama.2020.26584

Drop in Vaccination Causes Surge in Global Measles Cases, Deaths

Bridget M. Kuehn, MSJ

Abstract Full Text

JAMA. 2021;325(3):213. doi:10.1001/jama.2020.26586

Poetry and Medicine

Spraying Cotton in Bolivar County, Mississippi, the Summer Following My First Year of Medical School

Doug Hester, MD

Abstract Full Text

JAMA. 2021;325(3):310. doi:10.1001/jama.2020.20959

JAMA Revisited

The Cause of Cancer

Abstract Full Text

JAMA. 2021;325(3):311. doi:10.1001/jama.2020.17762

JAMA Patient Page

Interventions to Promote Tobacco Cessation

Jill Jin, MD, MPH

Abstract Full Text

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JAMA. 2021;325(3):316. doi:10.1001/jama.2020.25605

This JAMA Patient Page summarizes the USPSTF 2020 guideline recommending that physicians ask all adults about tobacco use, advise them to stop using tobacco, and provide behavioral interventions and drugs shown effective for stopping cigarette and other tobacco use.