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In This Issue of JAMA Pediatrics
December 2018


JAMA Pediatr. 2018;172(12):1111. doi:10.1001/jamapediatrics.2017.3387

Keim and colleagues conducted a randomized, fully masked, placebo-controlled trial of daily microencapsulated docosahexaenoic acid (DHA), 200 mg, and arachidonic acid (AA), 200 mg (DHA and AA), or microencapsulated corn oil (placebo). They found that daily supplementation with 200 mg of DHA and 200 mg of AA for 6 months resulted in no improvement in cognitive development and early measures of executive function vs placebo and may have resulted in negative effects on language development and effortful control in certain subgroups of children.

Continuing Medical Education

Dudovitz and colleagues conducted a natural experiment of 1270 students using admission lotteries, which mimic a random assignment, to estimate the association of school environments and adolescent health. They found that the “intervention” group reported less marijuana misuse than the control group (mean marijuana misuse score, 0.46 vs 0.71) as well as fewer peers who used substances (9.6% vs 12.7%), more time studying (mean, 2.63 vs 2.49 hours), less truancy (84.3% vs 77.3% with no truancy), greater teacher support for college (mean scores, 7.20 vs 7.02), more orderly schools (mean order score, 7.06 vs 6.83), and less school mobility (21.4% vs 28.4%) (all P < .05).


Author Audio Interview

Schrempft and colleagues conducted a cohort study of 925 twin pairs and found that the heritability of body mass index (calculated as weight in kilograms divided by height in meters squared) at 4 years for those living in higher-risk obesogenic home environments was 86% and more than double that for those living in lower-risk obesogenic home environments (39%).


Whittington and colleagues conducted a cost-effectiveness analysis using a decision analytic model to extrapolate trial evidence to estimate the long-term survival and value of tisagenlecleucel for children and young adults with relapsed or refractory B-cell acute lymphoblastic leukemia. They found an incremental cost-effectiveness ratio between $37 000 and $78 000 per quality-adjusted life-year gained over a patient lifetime horizon, with more than 40% of those initiating tisagenlecleucel treatment becoming long-term survivors.