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Year

Day

February 21, 2020
Research Letter

Presumed Asymptomatic Carrier Transmission of COVID-19

Abstract Full Text
free access
JAMA. Published online February 21, 2020. doi:10.1001/jama.2020.2565

This study describes possible transmission of novel coronavirus disease 2019 (COVID-19) from an asymptomatic Wuhan resident to 5 family members in Anyang, a Chinese city in the neighboring province of Hubei.

JAMA Insights

Clinical Update

Preventing Surgical Site Infections: Looking Beyond the Current Guidelines

Abstract Full Text
JAMA. Published online February 21, 2020. doi:10.1001/jama.2019.20830

This JAMA Insights Clinical Update summarizes current guidelines for prevention of surgical site infections and discusses emerging prevention strategies, such as preoperative bowel preparation and negative-pressure wound therapy, that are challenging longstanding surgical practices.

February 20, 2020
Original Investigation

Effect of Intravenous Tenecteplase Dose on Cerebral Reperfusion Before Thrombectomy in Patients With Large Vessel Occlusion Ischemic Stroke: The EXTEND-IA TNK Part 2 Randomized Clinical Trial

Abstract Full Text
free access
JAMA. Published online February 20, 2020. doi:10.1001/jama.2020.1511

This randomized clinical trial compares the effects of 2 tenecteplase doses (0.40 vs 0.25 mg/kg) prior to endovascular thrombectomy on blood flow restoration to brain ischemic territory in patients with large vessel occlusion ischemic stroke.

Viewpoint

COVID-19 in Singapore—Current Experience: Critical Global Issues That Require Attention and Action

Abstract Full Text
free access
JAMA. Published online February 20, 2020. doi:10.1001/jama.2020.2467

This Viewpoint discusses public health measures implemented in Singapore to manage potential COVID-19 infection based on the country’s experience with SARS in 2003 and reviews critical information gaps necessary to help manage the outbreak, such as viral shedding patterns and optimal timing of antiviral treatment after exposure.

February 19, 2020
Viewpoint

The Need to Improve the Clinical Utility of Direct-to-Consumer Genetic Tests: Either Too Narrow or Too Broad

Abstract Full Text
free access
JAMA. Published online February 19, 2020. doi:10.1001/jama.2019.22504

This Viewpoint summarizes current shortcomings in direct-to-consumer genetic tests, which often lack clinical utility for consumers, and explains how tests that encompass entire genes and include only genes with well-established risk estimates and medical management guidelines could provide more valuable insight into their disease risk.

Preparing for the Most Critically Ill Patients With COVID-19: The Potential Role of Extracorporeal Membrane Oxygenation

Abstract Full Text
free access
JAMA. Published online February 19, 2020. doi:10.1001/jama.2020.2342

This Viewpoint discusses the potential role of ECMO (extracorporeal membrane oxygenation) in the management of novel coronavirus disease 2019 (COVID-19) and cautions about the risk of overuse and the shortage of ECMO capability given the numbers of people infected if the technology is not appropriately utilized.

Medical News & Perspectives

Discussing the ABCs of Health Security—Antibiotic Resistance, Biothreats, and Coronavirus

Abstract Full Text
free access has multimedia has audio
JAMA. Published online February 19, 2020. doi:10.1001/jama.2019.21022

In this Medical News article, Tom Inglesby, MD, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, speaks about natural and deliberate biological threats to US national security.

February 17, 2020
Original Investigation

Effect of Intravenous Interferon β-1a on Death and Days Free From Mechanical Ventilation Among Patients With Moderate to Severe Acute Respiratory Distress Syndrome: A Randomized Clinical Trial

Abstract Full Text
free access
JAMA. Published online February 17, 2020. doi:10.1001/jama.2019.22525

This randomized trial compares the effects of intravenous interferon β-1a vs placebo on 28-day mortality and on ventilator-free days in patients with moderate to severe acute respiratory distress syndrome (ARDS).

Preliminary Communication

Caring for the Critically Ill Patient

Effect of a Machine Learning–Derived Early Warning System for Intraoperative Hypotension vs Standard Care on Depth and Duration of Intraoperative Hypotension During Elective Noncardiac Surgery: The HYPE Randomized Clinical Trial

Abstract Full Text
free access
JAMA. Published online February 17, 2020. doi:10.1001/jama.2020.0592

This unblinded randomized trial compares the effect of a machine learning–derived system that uses arterial waveform information to predict cardiovascular decompensation vs standard monitoring by anesthesiologists on the depth and duration of intraoperative hypotension in patients undergoing elective noncardiac surgery.

Editorial

Lack of Clinical Benefit of Interferon β-1a Among Patients With Severe Acute Respiratory Distress Syndrome: Time to Overhaul Drug Trials in ARDS?

Abstract Full Text
free access
JAMA. Published online February 17, 2020. doi:10.1001/jama.2019.22524

Randomized Clinical Trials of Artificial Intelligence

Abstract Full Text
free access
JAMA. Published online February 17, 2020. doi:10.1001/jama.2020.1039
February 16, 2020
Original Investigation

Caring for the Critically Ill Patient

Association of Physician Orders for Life-Sustaining Treatment With ICU Admission Among Patients Hospitalized Near the End of Life

Abstract Full Text
free access
JAMA. Published online February 16, 2020. doi:10.1001/jama.2019.22523

This cohort study uses electronic health record (EHR) data to evaluate the association between Physician Orders for Life-Sustaining Treatment (POLST) and intensive care unit (ICU) admission and the incidence of and risk factors for POLST-discordant intensive care among adult patients hospitalized 6 months or less before death.

Editorial

Physician Orders for Life-Sustaining Treatment and Limiting Overtreatment at the End of Life

Abstract Full Text
free access
JAMA. Published online February 16, 2020. doi:10.1001/jama.2019.22522
February 14, 2020
Research Letter

Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China

Abstract Full Text
free access has multimedia has audio
JAMA. Published online February 14, 2020. doi:10.1001/jama.2020.2131

This study characterizes the demographic, epidemiologic, and clinical characteristics of hospitalized infants diagnosed with coronavirus disease 2019 infection between December 8, 2019, and February 6, 2020, in China.

JAMA Insights

Genomics and Precision Health

Genetic Ancestry Testing: What Is It and Why Is It Important?

Abstract Full Text
JAMA. Published online February 14, 2020. doi:10.1001/jama.2020.0517

This Genomics and Precision Health article explains how genetic testing is used to identify the probable geographic origins of one’s ancestors and how it can aid in risk assessment for some heritable conditions, and summarizes the contexts in which its information provides clinically relevant information.

February 13, 2020
Viewpoint

US Emergency Legal Responses to Novel Coronavirus: Balancing Public Health and Civil Liberties

Abstract Full Text
free access has multimedia has audio
JAMA. Published online February 13, 2020. doi:10.1001/jama.2020.2025

This Viewpoint discusses the policy and legal ramifications of the national public health emergency declared by the US government in response the coronavirus disease 2019 (COVID-19) outbreak, and examines the lawfulness of quarantine and other compulsory measures.

Homeless Special Needs Plans for People Experiencing Homelessness

Abstract Full Text
free access
JAMA. Published online February 13, 2020. doi:10.1001/jama.2019.22376

This Viewpoint proposes the creation of a homelessness-focused special needs plan, a Medicare Advantage insurance plan aimed at meeting the unique care needs of specific populations, to help offer the intensive case management and care coordination necessary for providing health care to homeless individuals.

JAMA Diagnostic Test Interpretation

Diagnostic Testing for Acute Hepatitis

Abstract Full Text
has active quiz
JAMA. Published online February 13, 2020. doi:10.1001/jama.2019.21895

An 18-year-old man who recently emigrated from India presented with fever, malaise, and anorexia for 4 days. He was afebrile with scleral icterus and a palpable liver edge; had a white blood cell count of 3.9 × 103/μL with elevations in total and direct bilirubin, alkaline phosphatase, and liver enzymes; and laboratory test results were positive for HBsAg and HBV core IgG. What is the cause of his hepatitis, and what would you do next?

February 12, 2020
Original Investigation

Caring for the Critically Ill Patient

Effect of Reduced Exposure to Vasopressors on 90-Day Mortality in Older Critically Ill Patients With Vasodilatory Hypotension: A Randomized Clinical Trial

Abstract Full Text
has multimedia
JAMA. Published online February 12, 2020. doi:10.1001/jama.2020.0930

This randomized clinical trial compares the effect of vasopressors guided by a mean arterial pressure (MAP) target of 60 to 65 mm Hg with a MAP level determined by the treating physician on 90-day mortality among critically ill older patients with vasodilatory hypotension.

Editorial

Choosing the Best Blood Pressure Target for Vasopressor Therapy

Abstract Full Text
JAMA. Published online February 12, 2020. doi:10.1001/jama.2019.22526
February 11, 2020
Viewpoint

Preparation for Possible Sustained Transmission of 2019 Novel Coronavirus: Lessons From Previous Epidemics

Abstract Full Text
free access has active quiz has audio
JAMA. Published online February 11, 2020. doi:10.1001/jama.2020.1960

This Viewpoint discusses the concepts of transmissibility and severity as the critical factors that determine the extent of an epidemic, drawing on the previous pandemic of influenza A(H1N1) and epidemics of SARS and MERS to consider what the scope, morbidity, and mortality of the 2019 novel coronavirus (2019-nCoV) epidemic might be.

February 10, 2020
Original Investigation

Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock

Abstract Full Text
JAMA. Published online February 10, 2020. doi:10.1001/jama.2020.0254

This study uses registry data to compare risk of in-hospital mortality and major bleeding among patients with acute coronary syndrome and cardiogenic shock managed with an intravascular microaxial left ventricular assist device (LVAD) vs intra-aortic balloon pulsation (IABP).

Editorial

Microaxial Left Ventricular Assist Devices: In Search of an Appropriate Indication

Abstract Full Text
JAMA. Published online February 10, 2020. doi:10.1001/jama.2019.22382
February 7, 2020
Original Investigation

Caring for the Critically Ill Patient

Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

Abstract Full Text
free access has active quiz has multimedia has audio
JAMA. Published online February 7, 2020. doi:10.1001/jama.2020.1585

This single-center case series describes the demographics, symptoms, laboratory and imaging findings, treatment, and clinical course of 138 patients hospitalized with 2019 novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) in Wuhan, China, highlighting presumed human-to-human hospital-associated transmission in many cases.

Research Letter

Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China

Abstract Full Text
free access has active quiz has multimedia has audio
JAMA. Published online February 7, 2020. doi:10.1001/jama.2020.1623

This case series uses patient hospital data to summarize the clinical presentation and laboratory and imaging findings of 13 patients with confirmed 2019-nCoV infection admitted to hospitals in Beijing in January 2020.

Viewpoint

Potential Consequences of Changing Disease Classifications

Abstract Full Text
free access has audio
JAMA. Published online February 7, 2020. doi:10.1001/jama.2019.22373

This Viewpoint discusses the potential harms that can emerge from changing disease classifications, generally to broaden criteria for diagnosing greater numbers of patients, and calls for a balanced and systematic evaluation of the benefits and risks of shifting illness thresholds before formalizing changes.

JAMA Insights

Clinical Update

Diagnosis and Management of Primary Hyperparathyroidism

Abstract Full Text
JAMA. Published online February 7, 2020. doi:10.1001/jama.2020.0538

This JAMA Insights article reviews the presentation and diagnostic workup of primary hyperparathyroidism, and indications for surgical vs surveillance management.

February 6, 2020
Viewpoint

Enhancing Private Sector Health System Preparedness for 21st-Century Health Threats: Foundational Principles From a National Academies Initiative

Abstract Full Text
free access
JAMA. Published online February 6, 2020. doi:10.1001/jama.2020.1310

This Viewpoint summarizes recommendations made by National Academies of Sciences, Engineering, and Medicine (NASEM) experts to address the US health system’s preparedness for major threats, highlighting 5 principles to help regions prepare for specific threats as a prelude to partnerships that would facilitate more comprehensive national preparedness.

JAMA Clinical Guidelines Synopsis

Diagnosis and Treatment of Adults With Community-Acquired Pneumonia

Abstract Full Text
JAMA. Published online February 6, 2020. doi:10.1001/jama.2019.21118

This JAMA Guidelines Synopsis summarizes the American Thoracic Society (ATS)/Infectious Diseases Society of America (IDSA) 2019 recommendations on diagnosis and treatment of adults with community-acquired pneumonia.

From The Medical Letter on Drugs and Therapeutics

Corticosteroids in Community-Acquired Pneumonia

Abstract Full Text
JAMA. Published online February 6, 2020. doi:10.1001/jama.2020.0216

This Medical Letter review summarizes evidence underlying American Thoracic Society and Infectious Diseases Society of America guideline recommendations on the use of corticosteroids as an adjunct to antimicrobials for the treatment of community-acquired pneumonia

February 5, 2020
Viewpoint

2019 Novel Coronavirus—Important Information for Clinicians

Abstract Full Text
free access has active quiz has multimedia has audio
JAMA. Published online February 5, 2020. doi:10.1001/jama.2020.1490

This Viewpoint summarizes the epidemiology and clinical features of 2019-nCoV infection and reviews CDC criteria to guide evaluation and management of patients with possible infection.

Medical News & Perspectives

Taking Medicine to the Streets to Care for Those Who Live There

Abstract Full Text
free access has multimedia
JAMA. Published online February 5, 2020. doi:10.1001/jama.2019.21515

This Medical News feature discusses “street medicine,” the practice of caring for unsheltered homeless individuals.

February 3, 2020
Viewpoint

Refocusing Medication Prior Authorization on Its Intended Purpose

Abstract Full Text
free access has audio
JAMA. Published online February 3, 2020. doi:10.1001/jama.2019.21428

This Viewpoint discusses the challenge prior medication authorization procedures presents for patients, physicians, and practices, and it proposes principles to guide “prior auth” reform, including focusing the procedures on the initial intended purpose of managing use of high-cost drugs that have equivalent lower-cost alternatives, protecting the continuity of medication for patients, and being transparent, efficient, and fair in their requirements.

Changing the Game of Prior Authorization: The Patient Perspective

Abstract Full Text
free access
JAMA. Published online February 3, 2020. doi:10.1001/jama.2020.0070

In this Viewpoint, Berwick and colleagues review the evolution of prior authorization (“prior auth”) into a process where insurers deny previously approved coverage, patients receive surprise bills, and clinicians spend time appealing charges, and propose the introduction of legal provisions that make authorization decisions binding and absolve patients, clinicians, and organization of financial responsibility for previously approved services.

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