This Viewpoint uses provisions in President Trump’s 2019 American Kidney Health Executive order calling for an increase in access to kidney transplantation to discuss strategies to increase deceased and living donor pools, improve allocation of organs from higher-risk donors, and support the long-term medical needs of living donors.
This Viewpoint discusses the importance of structuring value-based purchasing models around principles of physician professionalism to ensure that measures that lead to more payment are clinically meaningful, do not increase administrative burden, do not displace clinicians’ intrinsic motivation to help patients with financial motivations, and do not incentivize physicians to avoid sicker, more complicated patients.
This randomized noninferiority clinical trial examines the effect of treatment with the dipeptidyl peptidase-4 inhibitor linagliptin vs the commonly used sulfonylurea glimepiride on cardiovascular safety in patients with type 2 diabetes and cardiovascular risk factors or established atherosclerotic cardiovascular disease.
This cohort study uses data from the National Veterans Health Administration, Medicare, Medicaid, and National Death Index to compare major adverse cardiovascular events among patients with diabetes and reduced kidney function who continued treatment with metformin or sulfonylurea.
This Medical News article discusses a recent study about the effect of fans on relieving the physiological stress of high temperatures.
In this Medical News article, experts discuss sensitive ways to tell older adults that they no longer need cancer screening when their life expectancy is less than 10 years.
This population epidemiology study uses 2014-2018 data from National Health Interview Surveys to assess trends in prevalence of current and daily e-cigarette use by US adults and to characterize trends by sociodemographic and smoking status among young adults (18-24 years).
In this Viewpoint, Milton Packer and colleagues argue that reliance on a threshold of LVEF ≤40% to define heart failure with reduced ejection fraction (HFrEF) may exclude patients with impaired systolic function and subnormal LVEF from evidence-based treatments that reduce morbidity and mortality, and the authors propose that the LVEF threshold for HFrEF treatment be increased to ≤50%.
In the context of “attribution gaps” that leave payers uncertain which physicians are to be credited with patient care quality and outcome measures in accountable care organization (ACO) payment models, this Viewpoint discusses the importance of patient selection of primary care providers to patient-centered value-based care, and changes CMS will need to implement to integrate the measure.
An asymptomatic 57-year-old man with obesity, hypertension, and dyslipidemia requests screening for diabetes. Would you offer laboratory-based or point-of-care glucose or HbA1c testing?
This Medical News article reports on a recent analysis that concludes that older candidates’ ages shouldn’t be a concern in the 2020 presidential election.
This Medical News article is an update on important clinical research in the world of heart disease and stroke.
In this Viewpoint, 2019 Albert Lasker Basic Medical Research Award winners Max Dale Cooper and Jacques F. A. P. Miller discuss their discovery of B and T cells, which provided the organizing principle of the adaptive immune system and launched the course of modern immunology.
In this Viewpoint, 2019 Lasker-DeBakey Clinical Medical Research Award winner H. Michael Shepard discusses development of trastuzumab, the first fully humanized monoclonal antibody for solid tumor treatment and the first tyrosine kinase inhibitor, for treatment of breast cancer.
In this Viewpoint, the CEO of Lasker-Bloomberg Public Service Award winner Gavi, the Vaccine Alliance, describes its work improving access to affordable childhood vaccines in low-income countries.
This Viewpoint discusses how problems with the methodology, structure, and recommendations of the Relative Value Scale Update Committee can lead to outdated or inaccurate physician payment data and lower quality of care, and calls for the use of empirical data and patient-specific outcomes to inform physician reimbursement.
This Viewpoint reviews evidence for associations between Medicaid expansion under the Affordable Care Act and self-reported health outcomes, condition-specific outcome measures from administrative data, and state and national health indicators for low-income populations.
This JAMA Insights Clinical Update reviews infection control and treatment strategies to manage Candida auris, a new drug-resistant fungal species that can cause severe invasive infection with high morbidity and mortality in patients with underlying comorbid illnesses.
In the wake of a 2019 executive order requiring hospitals to publicly post paid prices and requiring clinicians, insurers, and health plans to provide estimated out-of-pocket costs to patients, this Viewpoint reviews available evidence about the likelihood that price transparency might influence consumer choice, put downward pressure on prices, and influence insurers to incentivize patients to seek lower-cost care.
A 66-year-old man had bilateral carpal tunnel syndrome and 6 years of chronic joint pain and stiffness of the shoulders, hips, and knees. He reported occasional bruising around his eyes; physical examination showed raised soft tissue masses around the sternoclavicular joints and scapulae, and laboratory examination was notable for significant levels of protein and albumin. What is the diagnosis and what would you do next?
This Medical News article discusses recent research that shows increasing their vitamin K intake could help patients who take warfarin to maintain stable anticoagulation.
This Medical News article discusses how pigs, rear-fanged snakes, and dogs may help improve our understanding of brain connectivity, vaccine delivery, and myocardial oxygenation.
This genetic epidemiology study uses UK Biobank database data to estimate the association between genetic variants associated with lower low-density lipoprotein cholesterol (LDL-C), lower systolic blood pressure (SBP), or both and cardiovascular disease (CVD), defined as coronary death, nonfatal, myocardial infarction, or coronary revascularization.
This matched-cohort study uses Cleveland Clinic Health System data to investigate the association between bariatric surgery and major adverse cardiovascular events (MACE), including mortality, coronary disease and stroke, in adult patients with type 2 diabetes and obesity.
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