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June 2019 - January 1908

Decade

Year

Issue

May 2019, Vol 179, No. 5, Pages 601-736

In This Issue of JAMA Internal Medicine

Highlights

Abstract Full Text
free access
JAMA Intern Med. 2019;179(5):601-603. doi:10.1001/jamainternmed.2018.5491
Viewpoint

Less Is More

Precision Preventive Medicine—Ready for Prime Time?

Abstract Full Text
JAMA Intern Med. 2019;179(5):605-606. doi:10.1001/jamainternmed.2019.0142

This Viewpoint discusses the potential overstatement of findings in 2 studies that used predictive risk scores to draw conclusions about precision preventive medicine and suggests that improvements to predictive methods are necessary before being more widely applied.

Physician Work Environment and Well-Being

Physicians’ Goodness and Guilt—Emotional Challenges of Practicing Medicine

Abstract Full Text
JAMA Intern Med. 2019;179(5):607-608. doi:10.1001/jamainternmed.2019.0428

This Viewpoint discusses how physician burnout, depression, and suicide can arise from guilt feelings that physicians have sublimated into their work.

Perspective

Unseen Trauma—Our Responsibility to Discover

Abstract Full Text
JAMA Intern Med. 2019;179(5):609. doi:10.1001/jamainternmed.2019.0234

This Perspective describes the physician’s role in caring for survivors of domestic abuse.

Firearm Violence

Mass Shootings and the Numbing of America

Abstract Full Text
JAMA Intern Med. 2019;179(5):610-611. doi:10.1001/jamainternmed.2019.0578

This article discusses the high frequency of mass shootings in the United States and outlines potential legislative solutions.

Original Investigation

Patient Outcomes After Hospital Discharge to Home With Home Health Care vs to a Skilled Nursing Facility

Abstract Full Text
JAMA Intern Med. 2019;179(5):617-623. doi:10.1001/jamainternmed.2018.7998

This cohort study uses Medicare claims data to investigate the association of patient outcomes and Medicare costs of discharge to home with home health care vs discharge to a skilled nursing facility.

Evaluation of Journal Registration Policies and Prospective Registration of Randomized Clinical Trials of Nonregulated Health Care Interventions

Abstract Full Text
JAMA Intern Med. 2019;179(5):624-632. doi:10.1001/jamainternmed.2018.8009

This study analyzes the prospective registration policies of specialty journals that publish randomized clinical trials of drugs, biologics, and medical devices not regulated by the US Food and Drug Administration.

Association of Daily Aspirin Therapy With Risk of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B

Abstract Full Text
JAMA Intern Med. 2019;179(5):633-640. doi:10.1001/jamainternmed.2018.8342

This nationwide cohort study examines the risk of hepatocellular carcinoma in Taiwanese patients with chronic hepatitis B who are receiving daily aspirin therapy.

Estimation of Study Time Reduction Using Surrogate End Points Rather Than Overall Survival in Oncology Clinical Trials

Abstract Full Text
JAMA Intern Med. 2019;179(5):642-647. doi:10.1001/jamainternmed.2018.8351

This study analyzes the original and updated clinical trials that led to FDA-approved drug indications in oncology from 2006 to 2017 to assess reduction in clinical trial duration derived from using surrogate end points of response rate or progression-free survival rather than overall survival as the basis for cancer drug approval.

Less Is More

Evaluation of an Intervention to Reduce Low-Value Preoperative Care for Patients Undergoing Cataract Surgery at a Safety-Net Health System

Abstract Full Text
has active quiz
JAMA Intern Med. 2019;179(5):648-657. doi:10.1001/jamainternmed.2018.8358

This study assesses the utilization and costs of a multipronged quality improvement initiative to reduce low-value preoperative utilization for patients undergoing cataract surgery at 2 safety-net health systems in California.

Performance of Screening Ultrasonography as an Adjunct to Screening Mammography in Women Across the Spectrum of Breast Cancer Risk

Abstract Full Text
has active quiz
JAMA Intern Med. 2019;179(5):658-667. doi:10.1001/jamainternmed.2018.8372

This cohort study investigates the performance of screening mammography plus screening ultrasonography compared with screening mammography alone among women at low, intermediate, and high risk for breast cancer.

Association of Functional Impairment in Middle Age With Hospitalization, Nursing Home Admission, and Death

Abstract Full Text
JAMA Intern Med. 2019;179(5):668-675. doi:10.1001/jamainternmed.2019.0008

This cohort study uses data from the Health and Retirement Study to determine whether middle-aged individuals who develop functional impairment are at increased risk for hospitalization, nursing home admission, and death.

Clinician-Family Communication About Patients’ Values and Preferences in Intensive Care Units

Abstract Full Text
JAMA Intern Med. 2019;179(5):676-684. doi:10.1001/jamainternmed.2019.0027

This secondary analysis of a cohort study examines communications between clinicians and surrogate decision makers on what the surrogates believe reflect the goals of care of critically ill patients.

Health Care Reform

Association Between Insurance Status and Access to Hospital Care in Emergency Department Disposition

Abstract Full Text
JAMA Intern Med. 2019;179(5):686-693. doi:10.1001/jamainternmed.2019.0037

This study analyzes data from the 2015 National Emergency Department Sample for hospital-based emergency department discharges, transfers, and admissions for patients presenting with pneumonia, chronic obstructive pulmonary disease, and asthma.

Editorial

JAMA Internal Medicine—The Year in Review, 2018

Abstract Full Text
free access
JAMA Intern Med. 2019;179(5):612-613. doi:10.1001/jamainternmed.2019.0508

Health Care Policy and Law

The Need to Realign Health System Processes for Patients Discharged From the Hospital—Getting Patients Home

Abstract Full Text
JAMA Intern Med. 2019;179(5):614-616. doi:10.1001/jamainternmed.2019.0232
Invited Commentary

Aspirin Use and Risk of Hepatocellular Carcinoma in Hepatitis B

Abstract Full Text
JAMA Intern Med. 2019;179(5):640-641. doi:10.1001/jamainternmed.2018.8314

Communication About Treatment Options and Shared Decision Making in the Intensive Care Unit

Abstract Full Text
JAMA Intern Med. 2019;179(5):684-685. doi:10.1001/jamainternmed.2019.0034

EMTALA—A Noble Policy That Needs Improvement

Abstract Full Text
JAMA Intern Med. 2019;179(5):693-694. doi:10.1001/jamainternmed.2019.0026
Editor's Note

Lisa M. Schwartz, MD, MS, 1963-2018

Abstract Full Text
JAMA Intern Med. 2019;179(5):709-710. doi:10.1001/jamainternmed.2018.8126

The Case for Implementing the Centers for Medicare & Medicaid Services’ Shared Decision-Making Mandate: Where the Rubber Meets the Code

Abstract Full Text
JAMA Intern Med. 2019;179(5):718-719. doi:10.1001/jamainternmed.2018.6440

This Editor’s Note advocates for greater implementation of the shared decision-making visit before lung cancer screening, citing the high percentage of patients who choose not to undergo screening after discussion of benefits vs harms.

Communicating, and Justifying, Nonefficacy Benefits for New Drugs Approved on the Basis of Noninferiority Trials

Abstract Full Text
JAMA Intern Med. 2019;179(5):721-722. doi:10.1001/jamainternmed.2018.8019
Special Communication

Less Is More

A Clinical Overview of Off-label Use of Gabapentinoid Drugs

Abstract Full Text
has audio
JAMA Intern Med. 2019;179(5):695-701. doi:10.1001/jamainternmed.2019.0086

This Special Communication summarizes the limited published evidence to support off-label gabapentinoid uses, describes clinical cases in which off-label use is problematic, and notes how review articles and guidelines tend to overstate gabapentinoid effectiveness.

Research Letter

Physicians’ Perspectives on FDA Approval Standards and Off-label Drug Marketing

Abstract Full Text
JAMA Intern Med. 2019;179(5):707-709. doi:10.1001/jamainternmed.2018.8121

This nationwide survey of US primary care internists and medical specialists evaluates physicians’ attitudes about the US Food and Drug Administration’s drug approval standards and off-label drug marketing.

Health Care Policy and Law

Prevalence and Severity of Rationing During Drug Shortages: A National Survey of Health System Pharmacists

Abstract Full Text
JAMA Intern Med. 2019;179(5):710-711. doi:10.1001/jamainternmed.2018.8251

This study examines national survey results from hospital pharmacy managers to investigate current drug allocation and rationing practices of US hospitals during drug shortages.

Quality of Outpatient Care With Internal Medicine Residents vs Attending Physicians in Veterans Affairs Primary Care Clinics

Abstract Full Text
JAMA Intern Med. 2019;179(5):711-713. doi:10.1001/jamainternmed.2018.8624

This assessment of common primary care measures from 10 Veterans Affairs clinics from 2014 compares outcomes in patients of resident physicians with patients of attending physicians.

Assessment of Price Changes of Existing Tumor Necrosis Factor Inhibitors After the Market Entry of Competitors

Abstract Full Text
JAMA Intern Med. 2019;179(5):713-716. doi:10.1001/jamainternmed.2018.7656

This study uses wholesale medication acquisition costs and Medicare claims data to assess how prices of existing tumor necrosis factor inhibitors changed in response to the market entry of new tumor necrosis factor inhibitors.

Use of the Shared Decision-Making Visit for Lung Cancer Screening Among Medicare Enrollees

Abstract Full Text
JAMA Intern Med. 2019;179(5):716-718. doi:10.1001/jamainternmed.2018.6405

This study analyzes Medicare data from 2015 and 2016 to estimate the percentage of Medicare enrollees who underwent low-dose computed tomographic screening for lung cancer during this period and had participated in a shared decision-making visit to discuss the benefits and risks of the procedure before screening.

Communication of Nonefficacy Benefits of New Drugs Approved on the Basis of Noninferiority Trials Alone: Cohort Study of FDA and Sponsor Communication, 2011-2017

Abstract Full Text
JAMA Intern Med. 2019;179(5):719-721. doi:10.1001/jamainternmed.2018.7040

This cohort study of FDA- and drug sponsor–written communications evaluates the communication of nonefficacy benefits of new drugs approved on the basis of noninferiority trials alone.

Frequency of Sale and Reasons for Purchase of Over-the-Counter Insulin in the United States

Abstract Full Text
JAMA Intern Med. 2019;179(5):722-723. doi:10.1001/jamainternmed.2018.7279

This survey study evaluates the frequency of sales of over-the-counter insulin at US pharmacies.

Challenges in Clinical Electrocardiography

Bradycardia-Induced Syncope With a Twist

Abstract Full Text
JAMA Intern Med. 2019;179(5):702-703. doi:10.1001/jamainternmed.2019.0104

This case report presents the electrocardiographic findings of a man who noted a low pulse when checking his blood pressure and had no symptoms of bradycardia, such as dizziness, syncope, or fatigue.

A Nearly Stressful Situation—A Case of Wellens Syndrome

Abstract Full Text
JAMA Intern Med. 2019;179(5):704-706. doi:10.1001/jamainternmed.2019.0216

This case report presents the electrocardiographic findings of a man in his 70s with Wellens syndrome.

Comment & Response

High-Quality Food Combined With Organic Food Consumption and the Risk of Cancer

Abstract Full Text
JAMA Intern Med. 2019;179(5):723. doi:10.1001/jamainternmed.2019.0110

Finding the Magic in Magic Mouthwash

Abstract Full Text
JAMA Intern Med. 2019;179(5):723-724. doi:10.1001/jamainternmed.2019.0267

Finding the Magic in Magic Mouthwash

Abstract Full Text
JAMA Intern Med. 2019;179(5):724. doi:10.1001/jamainternmed.2019.0288

Less Is More

Finding the Magic in Magic Mouthwash—Reply

Abstract Full Text
JAMA Intern Med. 2019;179(5):724-725. doi:10.1001/jamainternmed.2019.0291

Clinical Interpretation of High-Sensitivity Troponin Testing

Abstract Full Text
JAMA Intern Med. 2019;179(5):725-726. doi:10.1001/jamainternmed.2019.0371

Clinical Interpretation of High-Sensitivity Troponin Testing—Reply

Abstract Full Text
JAMA Intern Med. 2019;179(5):726. doi:10.1001/jamainternmed.2019.0374

Revisiting Results on Use of Inferior Vena Cava Filters in Older Adults

Abstract Full Text
JAMA Intern Med. 2019;179(5):726-727. doi:10.1001/jamainternmed.2019.0468

Revisiting Results on Use of Inferior Vena Cava Filters in Older Adults—Reply

Abstract Full Text
JAMA Intern Med. 2019;179(5):727-728. doi:10.1001/jamainternmed.2019.0465

Comparison of Scheduled vs Emergency-Only Dialysis in Undocumented Immigrants With End-stage Renal Disease

Abstract Full Text
JAMA Intern Med. 2019;179(5):728. doi:10.1001/jamainternmed.2019.0540

Comparison of Scheduled vs Emergency-Only Dialysis in Undocumented Immigrants With End-stage Renal Disease—Reply

Abstract Full Text
JAMA Intern Med. 2019;179(5):728-729. doi:10.1001/jamainternmed.2019.0537

Analyze Patient Tests for Importance Before Ordering

Abstract Full Text
JAMA Intern Med. 2019;179(5):729. doi:10.1001/jamainternmed.2018.8333

Analyze Patient Tests for Importance Before Ordering

Abstract Full Text
JAMA Intern Med. 2019;179(5):729-730. doi:10.1001/jamainternmed.2018.8369

Analyze Patient Tests for Importance Before Ordering—Reply

Abstract Full Text
JAMA Intern Med. 2019;179(5):730-731. doi:10.1001/jamainternmed.2018.8336

Artificial Intelligence Algorithms for Medical Prediction Should Be Nonproprietary and Readily Available

Abstract Full Text
JAMA Intern Med. 2019;179(5):731. doi:10.1001/jamainternmed.2019.0597

Health Care Reform

Artificial Intelligence Algorithms for Medical Prediction Should Be Nonproprietary and Readily Available—Reply

Abstract Full Text
JAMA Intern Med. 2019;179(5):731-732. doi:10.1001/jamainternmed.2019.0609

Teaching High-Value Care Through Conscious Ordering of Diagnostic Tests

Abstract Full Text
JAMA Intern Med. 2019;179(5):732. doi:10.1001/jamainternmed.2019.0017

Less Is More

Teaching High-Value Care Through Conscious Ordering of Diagnostic Tests—Reply

Abstract Full Text
JAMA Intern Med. 2019;179(5):732-733. doi:10.1001/jamainternmed.2019.0459
Correction

Error in Key Points

Abstract Full Text
free access
JAMA Intern Med. 2019;179(5):733. doi:10.1001/jamainternmed.2019.0618

Typographical Error in Table 3

Abstract Full Text
free access
JAMA Intern Med. 2019;179(5):733. doi:10.1001/jamainternmed.2019.1275

Error in Table 2

Abstract Full Text
free access
JAMA Intern Med. 2019;179(5):733. doi:10.1001/jamainternmed.2019.1493
Images From Our Readers

American Bittern, Sweetwater Preserve, Gainesville, Florida

Abstract Full Text
JAMA Intern Med. 2019;179(5):706. doi:10.1001/jamainternmed.2019.0415
Peer Reviewers List

JAMA Internal Medicine Peer Reviewers in 2018

Abstract Full Text
free access online only
JAMA Intern Med. 2019;179(5):e190115. doi:10.1001/jamainternmed.2019.0115
JAMA Internal Medicine Patient Page

I Have Arthritis of the Knees: What Should I Do?

Abstract Full Text
free access
JAMA Intern Med. 2019;179(5):736. doi:10.1001/jamainternmed.2018.8478

Precis

JAMA Internal Medicine Masthead

JAMA Internal Medicine

Abstract Full Text
free access
JAMA Intern Med. 2019;179(5):604. doi:10.1001/jamainternmed.2018.5492
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