Curated News: JAMA

• share
• favorite_border

Providing financial incentives to both primary care physicians and patients leads to a greater reduction in low-density lipoprotein (LDL) cholesterol in patients than paying only the physician or only the patient, according to a new study led by researchers at the Perelman School of Medicine at the University of Pennsylvania. The study, which is the first to test physician-only and patient-only incentives compared to incentives shared by patients and physicians, is published in the November 10 issue of JAMA.

• share
• favorite_border

A team of scientists, led by researchers at University of California, San Diego Moores Cancer Center and The University of Texas MD Anderson Cancer Center, report that a genetic biomarker called loss of heterozygosity or LOH is able to predict which patients with premalignant mouth lesions are at highest risk of developing oral cancer. The findings, published in the November 5, 2015 online issue of Journal of the American Medical Association Oncology, present a new tool that could be used to identify patients most likely to benefit from chemoprevention — and may be applicable to preventing other types of cancer.

• share
• favorite_border

A common heart drug may stop the progression of angiosarcoma, a cancer of the inner lining of blood vessels, according to a study by researchers at Texas Tech University Health Sciences Center (TTUHSC) El Paso.

• share
• favorite_border

Patients who are divorced, separated or widowed had an approximately 40 percent greater chance of dying or developing a new functional disability in the first two years following cardiac surgery than their married peers, according to a new study from researchers at the Perelman School of Medicine at the University of Pennsylvania published in this week’s JAMA Surgery.

• share
• favorite_border

An analysis of deaths in the United States between 1969 and 2013 finds an overall decreasing trend in the age-standardized death rate for all causes combined and for heart disease, cancer, stroke, unintentional injuries, and diabetes, although the rate of decrease appears to have slowed for heart disease, stroke, and diabetes, according to a study in the October 27 issue of JAMA.

• share
• favorite_border

Among black adults with asthma treated with an inhaled corticosteroid, adding a long-acting beta-agonist did not improve the time to an asthma exacerbation compared with adding the anticholinergic tiotropium, according to a study in the October 27 issue of JAMA.

• share
• favorite_border

In a study of federal marketplace insurance plans, nearly 15 percent completely lacked in-network physicians for at least 1 specialty, a practice found among multiple states and issuers, raising concerns regarding patient access to specialty care, according to a study in the October 27 issue of JAMA.

• share
• favorite_border

Anyone who takes medicine to get their blood sugar or blood pressure down – or both – knows their doctor prescribed it to help them. But what if stopping, or at least cutting back on, such drugs could help even more? Two new studies suggest doctors should be doing that more.

• share
• favorite_border

Pregnant women with preeclampsia have a higher risk of delivering an infant with a congenital heart defect.

• share
• favorite_border

The American Cancer Society has issued new recommendations on when women should get mammograms and how frequently they should get them. This is in contrast to the previous guidelines which stated that women should get them at age 40.

• share
• favorite_border

Drug-resistant bacteria have dominated news headlines and the attention of public health experts, but a study by experts at the Johns Hopkins Children’s Center and the Duke Clinical Research Institute shows that nonresistant bacterial infections occur far more often and can take just as great a toll on newborns as their drug-resistant cousins.

• share
• favorite_border

Health care providers must have detailed discussions with their older adult patients to better determine their true life expectancy, as older adults do not accurately predict their own prognosis, a key factor in making decisions about future health interventions, according to researchers at UC San Francisco and San Francisco Veterans Affairs Medical Center.

• share
• favorite_border

Despite the quadrupling of heroin overdose deaths over the past decade and a dramatic rise in deaths from prescription painkillers, the percentage of people getting treatment for their opioid abuse and dependence has remained the same, new Johns Hopkins Bloomberg School of Public Health research suggests.

• share
• favorite_border

A new JAMA Oncology study from Memorial Sloan Kettering Cancer Center finds that risk-adjusted Medicare claims data — without information about the cancer stage of individual patients — may be sufficient to calculate the long-term survival rates at hospitals providing cancer care in the United States.

• share
• favorite_border

Gay and bisexual men were up to six times more likely than heterosexual men to take part in indoor tanning, and twice as likely to report a history of skin cancer, including nonmelanoma and melanoma, according to a study led by UC San Francisco researchers.

• share
• favorite_border

Online advertising based on Google search terms is a potentially effective way to deliver targeted cancer prevention education, according to a study led by Eleni Linos, MD, DrPH, an assistant professor of dermatology at UC San Francisco.

• share
• favorite_border

When it comes to treating depression, how well a person responds to a fake medicine may determine how well they’ll respond to a real one, a new study shows. Those who can muster their brain’s own chemical forces against depression have a head start in overcoming symptoms with help from medication.

• share
• favorite_border

When an older person gets hospitalized for pneumonia, where’s the best place to care for them? New research findings about deaths and health care costs in such patients fly in the face of conventional wisdom – and could change where doctors decide to treat them.

• share
• favorite_border

The researchers studied almost 700,000 hip surgery patients more than 45 years old in France between 2010 and 2013, and found that the total hip replacement patients were younger, more commonly men and had less other medical problems than hip fracture patients.

• share
• favorite_border

The addition of a daily outdoor activity class at school for three years for children in Guangzhou, China, resulted in a reduction in the rate of myopia (nearsightedness, the ability to see close objects more clearly than distant objects), according to a study in the September 15 issue of JAMA.

• share
• favorite_border

Women are less likely than men to be full professors at U.S. medical schools, and receive less start-up support from their institutions for biomedical research, according to two studies in the September 15 issue of JAMA.

• share
• favorite_border

Patients undergoing surgery for a hip fracture were older and had more medical conditions than patients who underwent an elective total hip replacement, factors that may contribute to the higher risk of in-hospital death and major postoperative complications experienced by hip fracture surgery patients, according to a study in the September 15 issue of JAMA.

• share
• favorite_border

A prospective longitudinal study of U.S. Marines suggests that reduced heart rate variability – the changing time interval between heartbeats – may be a contributing risk factor for post-traumatic stress disorder (PTSD). The findings are reported in the September 9 online issue of JAMA Psychiatry by researchers at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System.

• share
• favorite_border

The widespread practice of incentivizing mammogram completion via cash payments, typically by insurance companies and ranging from $10 to $250, is unethical according to a Viewpoint article published this week in JAMA by an expert from the Perelman School of Medicine at the University of Pennsylvania. Instead, incentives should be offered to women to use evidence-based decision aids to decide if they want a mammogram, even if this policy likely averts fewer breast cancer deaths overall.

• share
• favorite_border

Following the 2014 Ebola outbreak in West Africa that took the lives of more than 11,200 people in the region, the National Eye Institute, part of the National Institutes of Health, has deployed a team of clinicians and technical experts to Monrovia, Liberia to investigate the long-term effects of Ebola on the eye.

• share
• favorite_border

Over the last 20 years, complications have decreased and survival has improved for extremely preterm infants, according to a study in the September 8 issue of JAMA.

• share
• favorite_border

Among women in a malaria-endemic region in Kenya, daily iron supplementation during pregnancy did not result in an increased risk of malaria, according to a study in the September 8 issue of JAMA. Iron supplementation did result in increased birth weight, gestational duration, neonatal length, and a decreased risk of low birth weight and prematurity.

• share
• favorite_border

The lack of adherence to usability testing standards among several widely used electronic health record (EHR) products that were certified as having met these requirements may be a major factor contributing to the poor usability of EHRs, according to a study in the September 8 issue of JAMA.

• share
• favorite_border

In 2011-2012, the estimated prevalence of diabetes among U.S. adults was 12 percent to 14 percent and the prevalence of prediabetes was 37 percent to 38 percent, indicating that about half of the U.S. adult population has either diabetes or prediabetes, according to a study in the September 8 issue of JAMA. Though data from recent years suggests that the increasing prevalence of diabetes may be leveling off.

• share
• favorite_border

Over the last 20 years, complications have decreased and survival has improved for extremely preterm infants, according to a study in the September 8 issue of JAMA.

• share
• favorite_border

Among women in a malaria-endemic region in Kenya, daily iron supplementation during pregnancy did not result in an increased risk of malaria, according to a study in the September 8 issue of JAMA. Iron supplementation did result in increased birth weight, gestational duration, neonatal length, and a decreased risk of low birth weight and prematurity.

• share
• favorite_border

The lack of adherence to usability testing standards among several widely used electronic health record (EHR) products that were certified as having met these requirements may be a major factor contributing to the poor usability of EHRs, according to a study in the September 8 issue of JAMA.

• share
• favorite_border

Banning smoking in the workplace and increasing taxes on cigarettes have discouraged teens and young adults from taking up smoking, according to a study by researchers at UC San Francisco and UC Merced.

• share
• favorite_border

Women who are carriers of mutated BRCA genes are known to have a significantly higher risk for developing breast and ovarian cancers than those who don’t have the mutations. But a new study by UCLA faculty questions the value of screening for the genetic mutations in the general population—including those who do not have cancer or have no family history of the disease— because of the high cost.

• share
• favorite_border

Among patients with diabetes and kidney disease, most receiving an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker, the addition of the medication finerenone compared with placebo resulted in improvement in albuminuria (the presence of excessive protein [chiefly albumin] in the urine), according to a study in the September 1 issue of JAMA.

• share
• favorite_border

Among patients with diabetes and kidney disease, most receiving an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker, the addition of the medication finerenone compared with placebo resulted in improvement in albuminuria (the presence of excessive protein [chiefly albumin] in the urine), according to a study in the September 1 issue of JAMA.

• share
• favorite_border

The use of two newer genetic testing technologies (chromosomal microarray analysis and whole-exome sequencing) among children with autism spectrum disorder may help identify genetic mutations potentially linked to the disorder, according to a study in the September 1 issue of JAMA. The study also found that children with certain physical anomalies were more likely to have genetic mutations, findings that may help identify children who could benefit most from genetic testing.

• share
• favorite_border

Survivors of an intracerebral hemorrhage (ICH; a type of hemorrhagic stroke in which bleeding occurs directly into the brain) who had inadequate blood pressure (BP) control during follow-up had a higher risk of ICH recurrence, with this association appearing stronger with worsening severity of hypertension, according to a study in the September 1 issue of JAMA.

• share
• favorite_border

In a study that included children and young adults with relapsed or refractory cancer, incorporation of integrative clinical genomic sequencing data into clinical management was feasible, revealed potentially actionable findings in nearly half of the patients, and was associated with change in treatment and family genetics counseling for a small proportion of patients, according to a study in the September 1 issue of JAMA.

• share
• favorite_border

Between 1998 and 2013, there was a large increase in bicycle-related injuries and hospital admissions of adults in the United States, with the increase in injuries driven by more injuries among adults older than 45 years of age, according to a study in the September 1 issue of JAMA.

• share
• favorite_border

Women who are deficient in vitamin D and have a specific high-risk genotype are 6.7 times more likely to develop AMD than women with sufficient vitamin D status and no high risk genotype.

• share
• favorite_border

Degenerating neurons in patients with Alzheimer’s disease (AD) measurably responded to an experimental gene therapy in which nerve growth factor (NGF) was injected into their brains, report researchers at University of California, San Diego School of Medicine in the current issue of JAMA Neurology.

• share
• favorite_border

A genetic test that helps predict whether some women’s breast cancer will recur might influence how chemotherapy is used, according to a study from Duke Medicine. The study found that low-risk patients who had the test appeared to opt for more treatment, and high-risk patients who were tested got less.

• share
• favorite_border

For patients with an often-deadly form of leukemia, new research suggests that lingering cancer-related mutations – detected after initial treatment with chemotherapy – are associated with an increased risk of relapse and poor survival. Using genetic profiling to study bone marrow samples from patients with acute myeloid leukemia (AML), researchers found that those whose cells still carried mutations 30 days after the initiation of chemotherapy were about three times more likely to relapse and die than patients whose bone marrow was cleared of these mutations. The study, by a team at Washington University School of Medicine in St. Louis, is published Aug. 25 in JAMA.

• share
• favorite_border

As e-cigarette usage among high school students continues to climb, a recent study from The Journal of the American Medical Association reveals an unsettling trend: that adolescent e-cigarette users are more likely than their non-vaping peers to initiate use of combustible tobacco products such as cigarettes, cigars and hookahs.

• share
• favorite_border

Among high school students in Los Angeles, those who had ever used electronic cigarettes were more likely to report initiation of smokable (“combustible”) tobacco (such as cigarettes, cigars, and hookah) use over the next year compared with nonusers, according to a study in the August 18 issue of JAMA.

• share
• favorite_border

Among patients with active cancer and acute symptomatic venous thromboembolism (VTE; blood clots in the deep veins), the use of the low molecular-weight heparin tinzaparin daily for 6 months compared with warfarin did not significantly reduce recurrent VTE and was not associated with reductions in overall death or major bleeding, but was associated with a lower rate of clinically relevant nonmajor bleeding, according to a study in the August 18 issue of JAMA.

• share
• favorite_border

In a commentary published in the Aug. 13 issue of JAMA, Johns Hopkins experts say consolidation of hospitals into massive chains threatens healthy competition, reduces patient choice and could drive up medical expenses.

• share
• favorite_border

Two Florida laws, enacted to combat prescription drug abuse and misuse in that state, led to a small but significant decrease in the amount of opioids prescribed the first year the laws were in place, a new study by Johns Hopkins Bloomberg School of Public Health researchers suggests.

• share
• favorite_border

A multicenter study involving Mayo Clinic researchers has found that the National Cancer Institute's Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), was accurate, reliable and responsive, compared to other, established patient-reported and clinical measures. The study is published today in the journal JAMA Oncology.