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Year

Day

2019
October September August
October 11, 2019
Viewpoint

Firearm Violence Research: Improving Availability, Accessibility, and Content of Firearm-Related Data Systems

Ali Rowhani-Rahbar, MD, MPH, PhD; Morgan A. Bellenger, MA, MPA; Frederick P. Rivara, MD, MPH
Abstract Full Text
free access
JAMA. Published online October 11, 2019. doi:10.1001/jama.2019.16286

This Viewpoint discusses the importance of developing national data systems for the study of firearm violence, and calls for investments in infrastructure and regulations to promote data availability and accessibility as an essential means to reduce the adverse public health effects of gun-related injury and mortality.

JAMA Diagnostic Test Interpretation

The Point-of-Care INR Test for Vitamin K Antagonist Monitoring

Irsk Anderson, MD; Geoffrey D. Wool, MD, PhD; William Madden, PharmD
Abstract Full Text
has active quiz
JAMA. Published online October 11, 2019. doi:10.1001/jama.2019.15720

A 59-year-old man taking warfarin for recurrent VTE has a point-of-care (POC) international normalized ratio (INR) value of 3.7 (target 2.0 to 3.0). What would you do next?

October 10, 2019
Viewpoint

Patient-Centered Reduction or Discontinuation of Long-term Opioid Analgesics: The HHS Guide for Clinicians

Deborah Dowell, MD, MPH; Wilson M. Compton, MD, MPE; Brett P. Giroir, MD
Abstract Full Text
free access has audio
JAMA. Published online October 10, 2019. doi:10.1001/jama.2019.16409

In this Viewpoint, co-chairs of the US Department of Health and Human Services (HHS) workgroup on patient-centered reduction or discontinuation of long-term opioid analgesics summarize their 2019 guidance, including criteria for and approaches to opioid tapering; behavioral health support; and management of withdrawal symptoms, pain, and other complications.

  • Audio Interview: The HHS Guide to Patient-Centered Dose Reduction or Discontinuation of Long-term Opioids
JAMA Insights

Pain Management With Opioids in 2019-2020

Evan Wood, MD, PhD; David L. Simel, MD, MHS; Jan Klimas, PhD, MSc
Abstract Full Text
JAMA. Published online October 10, 2019. doi:10.1001/jama.2019.15802

This JAMA Insights Clinical Update reviews evidence-based use of opioids to manage noncancer pain, proposing opioid-sparing pain management strategies for patients with chronic pain not yet prescribed opioids, those with chronic pain receiving opioids, and those with acute pain and not currently receiving opioid therapy.

October 9, 2019
Viewpoint

Alternative Payment for Radiation Oncology

David H. Howard, PhD; Mylin A. Torres, MD
Abstract Full Text
free access
JAMA. Published online October 9, 2019. doi:10.1001/jama.2019.15888

This Viewpoint discusses details of the Radiation Oncology Model, a 90-day episode-based alternative payment model proposed by the Centers for Medicare & Medicaid Services (CMS) intended to reduce inappropriate overuse of proton beam therapy, intensity-modulated radiation therapy (IMRT), and other expensive radiation oncology services.

Disappointment in the Value-Based Era: Time for a Fresh Approach?

Jose F. Figueroa, MD, MPH; Kathryn E. Horneffer, BA; Ashish K. Jha, MD, MPH
Abstract Full Text
free access
JAMA. Published online October 9, 2019. doi:10.1001/jama.2019.15918

In the context of limited evidence to date that national health care quality improvement (QI) initiatives are effective, this Viewpoint proposes shifting the focus of QI efforts to high-need, high-cost individuals, such as frail older patients and those at the end of life, because they are especially vulnerable to adverse consequences of low-value, high-cost care.

October 7, 2019
Special Communication

Waste in the US Health Care System: Estimated Costs and Potential for Savings

William H. Shrank, MD, MSHS; Teresa L. Rogstad, MPH; Natasha Parekh, MD, MS
Abstract Full Text
free access has audio
JAMA. Published online October 7, 2019. doi:10.1001/jama.2019.13978

This Special Communication uses a systematic literature review to update previous dollar estimates of waste in the US health care system attributable to failure of care delivery and coordination, low-value care, price inflation, fraud, and administrative complexity.

  • Audio Interview: Waste in the US Health Care System: Estimated Costs and Potential for Savings
Editorial

Elusive Waste: The Fermi Paradox in US Health Care

Donald M. Berwick, MD, MPP
Abstract Full Text
free access has audio
JAMA. Published online October 7, 2019. doi:10.1001/jama.2019.14610
  • Audio Interview: Waste in the US Health Care System: Estimated Costs and Potential for Savings

Toward Evidence-Based Policy Making to Reduce Wasteful Health Care Spending

Karen E. Joynt Maddox, MD, MPH; Mark B. McClellan, MD, PhD
Abstract Full Text
free access has audio
JAMA. Published online October 7, 2019. doi:10.1001/jama.2019.13977
  • Audio Interview: Waste in the US Health Care System: Estimated Costs and Potential for Savings

Waste in the US Health Care System

Howard Bauchner, MD; Phil B. Fontanarosa, MD, MBA
Abstract Full Text
free access has audio
JAMA. Published online October 7, 2019. doi:10.1001/jama.2019.15353
  • Audio Interview: Waste in the US Health Care System: Estimated Costs and Potential for Savings
October 4, 2019
Viewpoint

Potential Liability for Physicians Using Artificial Intelligence

W. Nicholson Price II, JD, PhD; Sara Gerke, Dipl-Jur Univ; I. Glenn Cohen, JD
Abstract Full Text
free access
JAMA. Published online October 4, 2019. doi:10.1001/jama.2019.15064

This Viewpoint proposes a template for thinking about physician malpractice liability arising from use of artificial intelligence (AI) in clinical practice, and identifies scenarios with and without injury and liability vs based on alignment of AI recommendations with standards of care, AI accuracy, and physician decisions in response.

JAMA Clinical Guidelines Synopsis

Primary Prevention of Cardiovascular Disease

Atul Jain, MD, MS; Andrew M. Davis, MD, MPH
Abstract Full Text
JAMA. Published online October 4, 2019. doi:10.1001/jama.2019.15915

This JAMA Clinical Guidelines Synopsis summarizes the 2019 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on primary prevention of cardiovascular disease.

October 3, 2019
Medical News & Perspectives

Matters of the Mind: Honest Placebos, Hostility and Heart Attacks, and Sleepless Nights

Rita Rubin, MA
Abstract Full Text
free access
JAMA. Published online October 3, 2019. doi:10.1001/jama.2019.15983

This Medical News feature discusses how placebo pills, hostility, and insomnia can affect health.

Quick Uptakes

Subconcussive Football Hits May Leave a Telltale Signature of Brain Damage

Feyza Sancar, PhD
Abstract Full Text
free access
JAMA. Published online October 3, 2019. doi:10.1001/jama.2019.15361

This Medical News article discusses recent findings linking subconcussive football hits to midbrain white matter damage.

The JAMA Forum

The San Francisco Ban and the Future of e-Cigarettes

Howard K. Koh, MD, MPH; Clifford E. Douglas, JD
Abstract Full Text
free access
JAMA. Published online October 3, 2019. doi:10.1001/jama.2019.16181
October 2, 2019
Original Investigation

Caring for the Critically Ill Patient

Effect of Selepressin vs Placebo on Ventilator- and Vasopressor-Free Days in Patients With Septic Shock: The SEPSIS-ACT Randomized Clinical Trial

Pierre-Francois Laterre, MD; Scott M. Berry, PhD; Allan Blemings, MS; et al.
Abstract Full Text
JAMA. Published online October 2, 2019. doi:10.1001/jama.2019.14607

This phase 2b/3 randomized clinical trial compares the effects of selepressin, a selective vasopressin V1a receptor agonist and noncatecholaminergic vasopressor, vs placebo on ventilator- and vasopressor-free days within 30 days among adult patients with septic shock receiving norepinephrine.

Caring for the Critically Ill Patient

Effect of Postextubation High-Flow Nasal Oxygen With Noninvasive Ventilation vs High-Flow Nasal Oxygen Alone on Reintubation Among Patients at High Risk of Extubation Failure: A Randomized Clinical Trial

Arnaud W. Thille, MD, PhD; Grégoire Muller, MD; Arnaud Gacouin, MD; et al.
Abstract Full Text
JAMA. Published online October 2, 2019. doi:10.1001/jama.2019.14901

This randomized clinical trial compares the effect of high-flow nasal oxygen with prophylactic noninvasive ventilation applied immediately after extubation vs high-flow nasal oxygen alone on the rate of reintubation in patients at high risk of extubation failure in the intensive care unit (ICU).

Caring for the Critically Ill Patient

Changes in End-of-Life Practices in European Intensive Care Units From 1999 to 2016

Charles L. Sprung, MD; Bara Ricou, MD; Christiane S. Hartog, MD; et al.
Abstract Full Text
JAMA. Published online October 2, 2019. doi:10.1001/jama.2019.14608

This study compares changes in end-of-life practices (withholding or withdrawing of life-prolonging therapy, active shortening of the dying process, failed CPR, documentation of brain death) in 22 European ICUs between 1999-2000 and 2015-2016.

Editorial

A Measured Dose of Optimism for the Evolution of ICU-Based Palliative Care

Christopher E. Cox, MD, MPH; May Hua, MD, MS; David Casarett, MD, MA
Abstract Full Text
JAMA. Published online October 2, 2019. doi:10.1001/jama.2019.12660

Added Benefit of Noninvasive Ventilation to High-Flow Nasal Oxygen to Prevent Reintubation in Higher-Risk Patients

Irene Telias, MD; Niall D. Ferguson, MD, MSc
Abstract Full Text
JAMA. Published online October 2, 2019. doi:10.1001/jama.2019.14609

Latest Issue

Highlights
In This Issue of JAMA | October 8, 2019
Effect of Intra-Articular Sprifermin vs Placebo on Femorotibial Joint Cartilage Thickness in Patients With Osteoarthritis: The FORWARD Randomized Clinical Trial
Original Investigation | October 8, 2019
Effect of a Hospital-Initiated Program Combining Transitional Care and Long-term Self-management Support on Outcomes of Patients Hospitalized With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial
Original Investigation | October 8, 2019
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