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Day

July 31, 2020
Viewpoint

Weighing the Benefits and Risks of Proliferating Observational Treatment Assessments: Observational Cacophony, Randomized Harmony

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JAMA. Published online July 31, 2020. doi:10.1001/jama.2020.13319

This Viewpoint discusses the role of observational study designs and data in the rapid stand-up of an evidence base for managing the COVID-19 pandemic, proposing ways to position observational research as a foundation for rapid follow-on randomized evaluation without premature overinterpretation of its findings.

Exome Sequencing and Clinical Diagnosis

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JAMA. Published online July 31, 2020. doi:10.1001/jama.2020.11126

This Viewpoint describes indications and proper clinical use and interpretation of exome sequencing, explaining that the testing is not diagnostic in itself but requires correlation with patients’ history and presentation in the context of a comprehensive clinical evaluation.

Women Physicians and the COVID-19 Pandemic

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JAMA. Published online July 31, 2020. doi:10.1001/jama.2020.14797

This Viewpoint describes how the COVID-19 pandemic has made more obvious the work-life imbalance inherent in the practice of medicine and how the moment offers the profession the chance to recalibrate gender role stereotypes that have traditionally disadvantaged the careers of women physicians and researchers.

July 30, 2020
Viewpoint

COVID-19 and Dexamethasone: A Potential Strategy to Avoid Steroid-Related Strongyloides Hyperinfection

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JAMA. Published online July 30, 2020. doi:10.1001/jama.2020.13170

Anticipating widespread global use of dexamethasone for COVID-19 in the wake of RECOVERY trial findings, this Viewpoint summarizes the theoretical risk of triggering Strongyloides hyperinfection/dissemination syndrome in people with asymptomatic strongyloidiasis, and proposes an algorithm to for assessing and managing the risk in outpatient and hospital settings.

Integrating Personalized Medicine With Population Health Management: The Path Forward

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JAMA. Published online July 30, 2020. doi:10.1001/jama.2020.1406

This Viewpoint discusses genome-wide sequencing (GWS) as a potential pathway not only to personalized medicine but also to population health, and proposes 5 dimensions health care organizations might consider when deciding on markers to screen for as they move toward genomic approaches to caring for their patient populations.

A Piece of My Mind

Non Sei Solo

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JAMA. Published online July 30, 2020. doi:10.1001/jama.2020.14420

In this narrative medicine essay a father recalls the traumatic death of his healthy young son and the steps he and his family took to overcome their guilt, repair their relationships, and honor the boy’s life.

July 29, 2020
Original Investigation

Association Between Statewide School Closure and COVID-19 Incidence and Mortality in the US

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JAMA. Published online July 29, 2020. doi:10.1001/jama.2020.14348

This population epidemiology study estimates associations of school closures in the US and the timing of those closures in March 2020 with change in daily coronavirus disease 2019 (COVID-19) incidence and mortality through the first week of May, accounting for other contemporaneous public health interventions.

Viewpoint

Black Kidney Function Matters: Use or Misuse of Race?

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JAMA. Published online July 29, 2020. doi:10.1001/jama.2020.13378

This Viewpoint discusses the practice of using patient race as a variable in algorithms to determine kidney function and suggests that estimating tools be developed that are equally precise but exclude race as a factor.

Reopening K-12 Schools During the COVID-19 Pandemic: A Report From the National Academies of Sciences, Engineering, and Medicine

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JAMA. Published online July 29, 2020. doi:10.1001/jama.2020.14745

This Viewpoint summarizes recommendations made in a National Academies of Sciences, Engineering, and Medicine report about how to safely reopen and operate elementary and secondary schools for the 2020-2021 school year, which emphasizes the need for partnerships with public health officials and community leaders, and for transparent communication of risks and rewards that will result from every policy decision.

Editorial

COVID-19 and School Closures

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JAMA. Published online July 29, 2020. doi:10.1001/jama.2020.13092
July 28, 2020
Original Investigation

Discriminative Accuracy of Plasma Phospho-tau217 for Alzheimer Disease vs Other Neurodegenerative Disorders

Abstract Full Text
JAMA. Published online July 28, 2020. doi:10.1001/jama.2020.12134

This cross-sectional study compares the accuracy of plasma tau phosphorylated at threonine 217 (P-tau217) levels vs other plasma-, MRI-, CSF-, and PET-based markers for distinguishing Alzheimer from other neurodegenerative diseases in 3 cohorts in Arizona, Sweden, and Columbia with or at risk for dementia.

July 27, 2020
Original Investigation

Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis

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JAMA. Published online July 27, 2020. doi:10.1001/jama.2020.10888

This nonrandomized controlled trial allowed children with appendicitis and their families to choose antibiotic therapy vs laparoscopic appendectomy as initial management, and compares 1-year disability days and treatment success—no need for later surgery—between the groups.

Viewpoint

National Hospital Quality Rankings: Improving the Value of Information in Hospital Rating Systems

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JAMA. Published online July 27, 2020. doi:10.1001/jama.2020.11165

This Viewpoint uses US News & World Report’s annual hospital rankings to discuss how such efforts typically disadvantage hospitals caring for patients of lower socioeconomic status (SES) in regions with poorer population health, and argues for transparent and accurate ratings methods that use patient-centric quality measures and account for population SES.

Editor's Note

Success of Antibiotic Therapy vs Laparoscopic Appendectomy for Uncomplicated Appendicitis in Children: A Matter of Perspective

Abstract Full Text
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JAMA. Published online July 27, 2020. doi:10.1001/jama.2020.13381
July 24, 2020
Preliminary Communication

Presence of Genetic Variants Among Young Men With Severe COVID-19

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JAMA. Published online July 24, 2020. doi:10.1001/jama.2020.13719

This case series describes rare putative X-chromosomal loss-of-function variants associated with impaired peripheral mononuclear blood cell interferon signaling in 4 young male patients hospitalized with severe coronavirus disease 2019 (COVID-19) in the Netherlands.

Viewpoint

Clinical, Legal, and Ethical Aspects of Artificial Intelligence–Assisted Conversational Agents in Health Care

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JAMA. Published online July 24, 2020. doi:10.1001/jama.2020.2724

This Viewpoint discusses evidence supporting use of conversational agents in health care—artificial intelligence (AI) programs that interpret users’ questions or concerns and respond with answers—and proposes 12 domains (eg, safety, transparency, security) that clinicians and health care organizations should evaluate before using them for patient care.

Editorial

Molecular Underpinnings of Severe Coronavirus Disease 2019

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JAMA. Published online July 24, 2020. doi:10.1001/jama.2020.14015
July 23, 2020
Viewpoint

COVID-19 Response in Lebanon: Current Experience and Challenges in a Low-Resource Setting

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JAMA. Published online July 23, 2020. doi:10.1001/jama.2020.12695

This Viewpoint describes the unique challenges faced by Lebanon, a small densely populated country with a fragmented health care system, in its response to the emerging COVID-19 pandemic, and it summarizes organizational, testing, and communications policies the nation has implemented that might be useful to other resource-limited countries and settings.

COVID-19: Beyond Tomorrow

The Work of Philanthropy in Responding to COVID-19 and Addressing Inequality: A New Foundation

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JAMA. Published online July 23, 2020. doi:10.1001/jama.2020.12904

In this Viewpoint the president of the Ford Foundation calls on philanthropic and other wealthy organizations to make creative and generous grants to less well-endowed counterpart institutions and communities to redress the racial and socioeconomic disparities exposed by the COVID-19 pandemic and continued killings of Black Americans.

Prevention of Unintentional Medication Overdose Among Children: Time for the Promise of the Poison Prevention Packaging Act to Come to Fruition

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JAMA. Published online July 23, 2020. doi:10.1001/jama.2020.2152

This Viewpoint discusses the success of US legislation to help prevent medication overdoses in children and suggests strategies to continue to reduce these overdoses, including changes to child-resistant packaging.

July 22, 2020
Viewpoint

Pooling Data From Individual Clinical Trials in the COVID-19 Era

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JAMA. Published online July 22, 2020. doi:10.1001/jama.2020.13042

This Viewpoint proposes principles and processes to allow pooling of individual patient data from clinical trials given decelerating participant recruitment at sites where the COVID-19 surge has been controlled and new cases are diminishing.

The Advisory Committee on Immunization Practices and Its Role in the Pandemic Vaccine Response

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JAMA. Published online July 22, 2020. doi:10.1001/jama.2020.13167

This Viewpoint discusses the role of the Advisory Committee on Immunization Practices, a federal advisory committee that makes vaccine-related recommendations to the CDC and DHHS, in guiding the development and deployment of COVID-19 vaccines.

JAMA Insights

Clinical Update

Lipids and Lipoproteins in 2020

Abstract Full Text
JAMA. Published online July 22, 2020. doi:10.1001/jama.2020.5685

This JAMA Insights Clinical Update reviews the central role of apolipoprotein B100 molecule (apoB)–containing lipoproteins in the development of atherosclerotic cardiovascular disease (ASCVD), with implications for patient risk assessment and choice of lipid-lowering therapy.

July 21, 2020
Editorial

Serosurveillance and the COVID-19 Epidemic in the US: Undetected, Uncertain, and Out of Control

Abstract Full Text
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JAMA. Published online July 21, 2020. doi:10.1001/jama.2020.14017
July 20, 2020
Research Letter

Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System

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JAMA. Published online July 20, 2020. doi:10.1001/jama.2020.13372

This study examines the incidence of and risk factors for venous and arterial thrombosis in patients hospitalized with COVID-19 in 4 New York City hospitals.

Ketoacidosis in Children and Adolescents With Newly Diagnosed Type 1 Diabetes During the COVID-19 Pandemic in Germany

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JAMA. Published online July 20, 2020. doi:10.1001/jama.2020.13445

This study uses diabetes registry data to compare the frequency of diabetic ketoacidosis (DKA) in children and adolescents at time of type 1 diabetes diagnosis in Germany during the first 2 months of the coronavirus disease 2019 (COVID-19) pandemic vs the same time period in 2018 and 2019.

July 17, 2020
JAMA Clinical Challenge

Abdominal Pain and an Appendiceal Mass

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JAMA. Published online July 17, 2020. doi:10.1001/jama.2020.4707

A 68-year-old woman with history of uterine carcinoma (unknown histology) treated 30 years prior had 2 months of generalized abdominal pain and distention but no fever, nausea, vomiting, diarrhea, constipation, blood in the stool, or weight loss. CBC and serum chemistries were unremarkable; CT and MRI showed pelvic ascites and an enhancing lesion at the base of the cecum; CEA level was 18 ng/mL (normal <5 ng/mL). What is the diagnosis and what would you do next?

The Arts and Medicine

Amabié—A Japanese Symbol of the COVID-19 Pandemic

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JAMA. Published online July 17, 2020. doi:10.1001/jama.2020.12660

This Arts and Medicine feature discusses Amabié, a 19th-century Japanese yōkai character said to protect against spread of infection, who has become the symbol of public health hygiene in Japan during the COVID-19 pandemic.

July 16, 2020
A Piece of My Mind

Dressing Up

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JAMA. Published online July 16, 2020. doi:10.1001/jama.2020.12779

In this narrative medicine essay, an emergency department physician faces her daily dread of donning PPE during the COVID-19 pandemic by recalling her grandfather’s gear when diving into Idaho mine shafts and compares his heroism fighting for miners’ rights to safety and wonders what he would think of calling health care works on the frontlines heroes.

Medical News & Perspectives

Social Isolation—the Other COVID-19 Threat in Nursing Homes

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JAMA. Published online July 16, 2020. doi:10.1001/jama.2020.13484

This Medical News article discusses the mental and physical effects of infection-control lockdowns on nursing home residents during the novel coronavirus pandemic.

July 14, 2020
Research Letter

Association Between Universal Masking in a Health Care System and SARS-CoV-2 Positivity Among Health Care Workers

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JAMA. Published online July 14, 2020. doi:10.1001/jama.2020.12897

This study describes SARS-CoV-2 PCR test positivity among health care workers before, during, and after implementation of a policy requiring universal masking of all health care workers and patients in a large health care system in Massachusetts.

Viewpoint

Evidence-Based Practice for Public Health Emergency Preparedness and Response: Recommendations From a National Academies of Sciences, Engineering, and Medicine Report

Abstract Full Text
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JAMA. Published online July 14, 2020. doi:10.1001/jama.2020.12901

This Viewpoint summarizes recommendations from a 2020 National Academies of Sciences, Engineering, and Medicine (NASEM) report on transforming the infrastructure, funding, and methods of public health emergency preparedness and response (PHEPR) research to ensure it is grounded in the best science about what works where, why, and for whom.

Editorial

Universal Masking to Prevent SARS-CoV-2 Transmission—The Time Is Now

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JAMA. Published online July 14, 2020. doi:10.1001/jama.2020.13107
July 10, 2020
Research Letter

Change in the Incidence of Stillbirth and Preterm Delivery During the COVID-19 Pandemic

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JAMA. Published online July 10, 2020. doi:10.1001/jama.2020.12746

This study compares pregnancy outcomes, including rates of stillbirth (fetal death ≥24 weeks’ gestation), preterm and cesarean delivery, and neonatal unit admission in the months preceding vs during the 2020 COVID-19 pandemic at a London university hospital.

Review

Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review

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JAMA. Published online July 10, 2020. doi:10.1001/jama.2020.12839

This narrative review discusses what is currently known about the pathophysiology, epidemiology, diagnosis, management, prognosis, and prevention of coronavirus disease 2019 (COVID-19).

JAMA Patient Page

What Is COVID-19?

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JAMA. Published online July 10, 2020. doi:10.1001/jama.2020.12984

This JAMA Patient Page provides an overview of COVID-19 transmission, symptoms, diagnosis, disease course, and treatment.

July 9, 2020
Research Letter

Persistent Symptoms in Patients After Acute COVID-19

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JAMA. Published online July 9, 2020. doi:10.1001/jama.2020.12603

This case series describes COVID-19 symptoms persisting a mean of 60 days after onset among Italian patients previously discharged from COVID-19 hospitalization.

A Piece of My Mind

Good for Us All

Abstract Full Text
JAMA. Published online July 9, 2020. doi:10.1001/jama.2020.12630

In this narrative medicine essay, a gastroenterologist recalls a microagression from a patient during fellowship training and realizes the fault lay with the medicine profession and calls for antiracist training as one measure in dismantling race-based health disparities.

Medical News & Perspectives

School Superintendents Confront COVID-19—“There Are No Good Options for Next Year”

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JAMA. Published online July 9, 2020. doi:10.1001/jama.2020.12575

This Medical News story discusses the challenge of minimizing the risk of COVID-19 in kindergarten through 12th grades while maintaining prepandemic educational standards.

July 8, 2020
Research Letter

COVID-19 Cases and Deaths in Federal and State Prisons

Abstract Full Text
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JAMA. Published online July 8, 2020. doi:10.1001/jama.2020.12528

This study describes coronavirus disease 2019 (COVID-19) case rates and deaths among federal and state prisoners and compares them with corresponding rates for the US population.

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