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July 2016, Vol 176, No. 7, Pages 877-1037

In This Issue of JAMA Internal Medicine

Highlights

Abstract Full Text
free access
JAMA Intern Med. 2016;176(7):877-879. doi:10.1001/jamainternmed.2015.4888
Viewpoint

Time-Based Billing: What Primary Care in the United States Can Learn From Switzerland

Abstract Full Text
JAMA Intern Med. 2016;176(7):881-882. doi:10.1001/jamainternmed.2016.2230

This Viewpoint examines the time-based billing system of Switzerland and makes recommendations to improve the US health care system.

Accelerated Drug Approval and Health Inequality

Abstract Full Text
JAMA Intern Med. 2016;176(7):883-884. doi:10.1001/jamainternmed.2016.2534

This Viewpoint argues that the acceleration of the drug approval process could unequally distribute the costs and burdens of testing to vulnerable patient populations.

Inside Story

Less Is More

I Wish Someone Had Told Us the Risks and Benefits of Replacing My Father’s Defibrillator

Abstract Full Text
JAMA Intern Med. 2016;176(7):885. doi:10.1001/jamainternmed.2016.1926

Ductal Carcinoma In Situ Stage 0 Breast Cancer: When Less May Be Better

Abstract Full Text
JAMA Intern Med. 2016;176(7):887. doi:10.1001/jamainternmed.2016.2254
Original Investigation

Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: A Systematic Review and Meta-analysis

Abstract Full Text
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JAMA Intern Med. 2016;176(7):958-968. doi:10.1001/jamainternmed.2016.1251

This systematic review and meta-analysis examines the efficacy, tolerability, and dose-dependent effects of opioid analgesics for low back pain.

Population-Based Colonoscopy Screening for Colorectal Cancer: A Randomized Clinical Trial

Abstract Full Text
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JAMA Intern Med. 2016;176(7):894-902. doi:10.1001/jamainternmed.2016.0960

This randomized clinical trial investigates participation rate, adenoma yield, performance, and adverse events of population-based colonoscopy screening in several European countries.

Effect of Pictorial Cigarette Pack Warnings on Changes in Smoking Behavior: A Randomized Clinical Trial

Abstract Full Text
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JAMA Intern Med. 2016;176(7):905-912. doi:10.1001/jamainternmed.2016.2621

This randomized clinical trial compares the effects of graphic pictorial vs usual text-based cigarette package health warnings on smoking cessation attempts of smokers.

Telephone-Based Cognitive Behavioral Therapy for Insomnia in Perimenopausal and Postmenopausal Women With Vasomotor Symptoms: A MsFLASH Randomized Clinical Trial

Abstract Full Text
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JAMA Intern Med. 2016;176(7):913-920. doi:10.1001/jamainternmed.2016.1795

This randomized clinical trial evaluates the efficacy of telephone-based cognitive behavioral therapy for insomnia vs menopause education control.

Comparison of Posthospitalization Function and Community Mobility in Hospital Mobility Program and Usual Care Patients: A Randomized Clinical Trial

Abstract Full Text
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JAMA Intern Med. 2016;176(7):921-927. doi:10.1001/jamainternmed.2016.1870

This randomized clinical trial examines the effect of an in-hospital mobility program on posthospitalization function and community mobility in hospitalized patients 65 years and older.

Patient Navigation for Comprehensive Cancer Screening in High-Risk Patients Using a Population-Based Health Information Technology System: A Randomized Clinical Trial

Abstract Full Text
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JAMA Intern Med. 2016;176(7):930-937. doi:10.1001/jamainternmed.2016.0841

This randomised clinical trial examines the effect of patient navigation on breast, cervical, and colorectal cancer screening levels in low-income and racial/ethnic minority populations.

Effect of Adding Liraglutide vs Placebo to a High-Dose lnsulin Regimen in Patients With Type 2 Diabetes: A Randomized Clinical Trial

Abstract Full Text
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JAMA Intern Med. 2016;176(7):939-947. doi:10.1001/jamainternmed.2016.1540

This randomized clinical trial compares the effects on HbA1c levels of adding liraglutide vs placebo to high-dose insulin treatment among patients with type 2 diabetes.

Centrally Assisted Collaborative Telecare for Posttraumatic Stress Disorder and Depression Among Military Personnel Attending Primary Care: A Randomized Clinical Trial

Abstract Full Text
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JAMA Intern Med. 2016;176(7):948-956. doi:10.1001/jamainternmed.2016.2402

This randomized clinical trial compares centrally assisted collaborative telecare with usual integrated care for military-related posttraumatic stress disorder and depression.

Less Is More

Intensive Treatment and Severe Hypoglycemia Among Adults With Type 2 Diabetes

Abstract Full Text
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JAMA Intern Med. 2016;176(7):969-978. doi:10.1001/jamainternmed.2016.2275

This pharmacoepidemiology study uses claims data to investigate the association between intensive glucose-lowering treatment and severe hypoglycemia among adults with type 2 diabetes between 2001 and 2013.

Characteristics and Outcomes of Patients Presenting With Hypertensive Urgency in the Office Setting

Abstract Full Text
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JAMA Intern Med. 2016;176(7):981-988. doi:10.1001/jamainternmed.2016.1509

This cohort study investigates whether referral to the hospital is associated with better outcomes in a population of patients presenting with hypertensive urgency in the office setting.

Hospital Prescribing of Opioids to Medicare Beneficiaries

Abstract Full Text
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JAMA Intern Med. 2016;176(7):990-997. doi:10.1001/jamainternmed.2016.2737

This random sample analysis estimates the frequency and characteristics of opioid prescribing at hospital discharge among Medicare beneficiaries who had no opioid prescription claim 60 days prior to hospitalization.

Less Is More

Comparison of Low-Value Care in Medicaid vs Commercially Insured Populations

Abstract Full Text
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JAMA Intern Med. 2016;176(7):998-1004. doi:10.1001/jamainternmed.2016.2086

This cross-sectional study compares low-value care in the Medicaid and commercially insured populations in Oregon, tests whether provision of low-value care is associated with insurance type, and assesses whether local practice patterns are associated with the provision of low-value care.

Invited Commentary

A Maturing Use of Defibrillators

Abstract Full Text
JAMA Intern Med. 2016;176(7):886. doi:10.1001/jamainternmed.2016.1933

Less Is More

When Less Is Better, but Physicians Are Afraid Not to Intervene

Abstract Full Text
JAMA Intern Med. 2016;176(7):888-889. doi:10.1001/jamainternmed.2016.2257

Colorectal Cancer Screening With Colonoscopy

Abstract Full Text
JAMA Intern Med. 2016;176(7):903-904. doi:10.1001/jamainternmed.2016.1333

Activating Hospitalized Older Patients to Confront the Epidemic of Low Mobility

Abstract Full Text
JAMA Intern Med. 2016;176(7):928-929. doi:10.1001/jamainternmed.2016.1874

Cancer Screening Navigation: From Promising Practice to Standard of Care

Abstract Full Text
JAMA Intern Med. 2016;176(7):937-938. doi:10.1001/jamainternmed.2016.2295

Extending Collaborative Care for Posttraumatic Mental Health

Abstract Full Text
JAMA Intern Med. 2016;176(7):956-957. doi:10.1001/jamainternmed.2016.2537

Less Is More

Deintensification of Routine Medical Services: The Next Frontier for Improving Care Quality

Abstract Full Text
JAMA Intern Med. 2016;176(7):978-980. doi:10.1001/jamainternmed.2016.2292

Less Is More

Hypertensive Urgency—Is This a Useful Diagnosis?

Abstract Full Text
JAMA Intern Med. 2016;176(7):988-989. doi:10.1001/jamainternmed.2016.1498
Editor's Note

Simplification of Insulin Regimens in Patients With Type 2 Diabetes

Abstract Full Text
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JAMA Intern Med. 2016;176(7):1025. doi:10.1001/jamainternmed.2016.2298
Evidence to Practice

Nonfasting for Routine Lipid Testing: From Evidence to Action

Abstract Full Text
JAMA Intern Med. 2016;176(7):1005-1006. doi:10.1001/jamainternmed.2016.1979

This review assesses the relative merits of using nonfasting blood draws for routine lipid testing.

Teachable Moment

Educating the Primary Care Clinician on Preexposure Prophylaxis for Human Immunodeficiency Virus: A Teachable Moment

Abstract Full Text
JAMA Intern Med. 2016;176(7):890-891. doi:10.1001/jamainternmed.2016.2225

This Teachable Moment details the importance of educating primary care clinicians in preexposure prophylaxis for human immunodeficiency virus.

Avoidance of Carotid Ultrasound in Syncope—Keeping It Simple: A Teachable Moment

Abstract Full Text
JAMA Intern Med. 2016;176(7):892-893. doi:10.1001/jamainternmed.2016.2531

This Teachable Moment explores whether carotid duplex ultrasonography for possible syncope should be used as part of a preopeartive workup.

Challenges in Clinical Electrocardiography

Refractory Hypotension and “Ventricular Fibrillation” With Large U Waves After Overdose

Abstract Full Text
JAMA Intern Med. 2016;176(7):1007-1009. doi:10.1001/jamainternmed.2016.2065

Syncope Following Orthotopic Heart Transplant: Sinoatrial or Atrioventricular Nodal Block?

Abstract Full Text
JAMA Intern Med. 2016;176(7):1010-1012. doi:10.1001/jamainternmed.2016.1995

A Case of Ventricular Arrhythmia: When the Right Isn’t Right

Abstract Full Text
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JAMA Intern Med. 2016;176(7):1013-1015. doi:10.1001/jamainternmed.2016.1982

A woman in her 60s presented to the emergency department with palpitation and dyspnea. Her blood pressure was 154/78 mm Hg, her pulse was 184 beats per minute, and the arrhythmia did not respond to adenosine. What is your diagnosis?

Research Letter

The Musical Footprint of Cushing Syndrome

Abstract Full Text
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JAMA Intern Med. 2016;176(7):1016-1017. doi:10.1001/jamainternmed.2016.2078

This case report describes a patient presenting with the lyre-shaped abdominal striae associated with Cushing syndrome.

Palliative Care for Patients With End-Stage Cardiovascular Disease and Devices: A Report From the Palliative Care Working Group of the Geriatrics Section of the American College of Cardiology

Abstract Full Text
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JAMA Intern Med. 2016;176(7):1017-1019. doi:10.1001/jamainternmed.2016.2096

This survey study assesses attitudes among clinicians toward palliative care in patients receiving transcatheter aortic valve replacement and ventricular assist devices.

Less Is More

Testing Vitamin D Levels and Choosing Wisely

Abstract Full Text
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JAMA Intern Med. 2016;176(7):1019-1020. doi:10.1001/jamainternmed.2016.1929

This article describes a criteria-based approach to testing vitamin D levels.

Characteristics of Decedents in Medicare Advantage and Traditional Medicare

Abstract Full Text
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JAMA Intern Med. 2016;176(7):1020-1023. doi:10.1001/jamainternmed.2016.2266

This study uses Health and Retirement survey data to examine differences in characteristics of decedents in Medicare Advantage vs fee-for-service Medicare at the end of their lives.

Simplification of Insulin Regimen in Older Adults and Risk of Hypoglycemia

Abstract Full Text
free access
JAMA Intern Med. 2016;176(7):1023-1025. doi:10.1001/jamainternmed.2016.2288

This case series describes HbA1c levels and frequency of hypoglycemia among older patients with type 2 diabetes whose treatment regimen was simplified to once-a-day glargine with or without noninsulin agents.

Estimated Cost of Injectable Medication Waste Attributable to Syringe Dead Space

Abstract Full Text
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JAMA Intern Med. 2016;176(7):1025-1027. doi:10.1001/jamainternmed.2016.2301

This study estimates differences in the cost of injectable medication waste attributable to high vs low dead-space syringes.

Medication Sharing, Storage, and Disposal Practices for Opioid Medications Among US Adults

Abstract Full Text
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JAMA Intern Med. 2016;176(7):1027-1029. doi:10.1001/jamainternmed.2016.2543

This study examines the sharing, storage, and disposal of opioid medications by adults as well as the sources of information on those practices.

A National Study of the Prevalence of Life-Threatening Diagnoses in Patients With Chest Pain

Abstract Full Text
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JAMA Intern Med. 2016;176(7):1029-1032. doi:10.1001/jamainternmed.2016.2498

This study analyzed the National Hospital Ambulatory Medical Care Survey database to assess the accuracy of diagnoses in patients who present to the emergency department with nontraumatic chest pain.

Comment & Response

A Perspective on Hospice Reform and Additional Caregiver Support

Abstract Full Text
JAMA Intern Med. 2016;176(7):1032. doi:10.1001/jamainternmed.2016.2734

A Perspective on Hospice Reform and Additional Caregiver Support—Reply

Abstract Full Text
JAMA Intern Med. 2016;176(7):1032-1033. doi:10.1001/jamainternmed.2016.2742

Osteoporosis Overtreatment—A Clinical Problem That Needs to Be Discussed

Abstract Full Text
JAMA Intern Med. 2016;176(7):1033-1034. doi:10.1001/jamainternmed.2016.2731

A Perspective on Hospice Reform and Additional Caregiver Support—Reply

Abstract Full Text
JAMA Intern Med. 2016;176(7):1033. doi:10.1001/jamainternmed.2016.2745

Telemedicine in Heart Failure—Ineffective or Just Ill Used?

Abstract Full Text
JAMA Intern Med. 2016;176(7):1034-1035. doi:10.1001/jamainternmed.2016.2854

Telemedicine in Heart Failure—Ineffective or Just Ill Used?

Abstract Full Text
JAMA Intern Med. 2016;176(7):1035. doi:10.1001/jamainternmed.2016.2857

Telemedicine in Heart Failure—Ineffective or Just Ill Used?—Reply

Abstract Full Text
JAMA Intern Med. 2016;176(7):1035-1036. doi:10.1001/jamainternmed.2016.2860

The Two-Question Method in Other High-Stress Settings

Abstract Full Text
JAMA Intern Med. 2016;176(7):1036-1037. doi:10.1001/jamainternmed.2016.3193
Correction

Error in SI Conversion Factor

Abstract Full Text
free access
JAMA Intern Med. 2016;176(7):1037. doi:10.1001/jamainternmed.2016.3478
Images From Our Readers

The Mavericks

Abstract Full Text
JAMA Intern Med. 2016;176(7):889. doi:10.1001/jamainternmed.2016.2787
JAMA Internal Medicine Masthead

JAMA Internal Medicine

Abstract Full Text
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JAMA Intern Med. 2016;176(7):880. doi:10.1001/jamainternmed.2015.4889
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