JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JULY 10, 2018

Media advisory: To contact corresponding author Steven R. Steinhubl, M.D., email press@scripps.edu. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.8102

Bottom Line: For approximately 20 percent of individuals who experience a stroke due to atrial fibrillation (AF; an irregular and often rapid heart rate), the occurrence of AF was not diagnosed until the time of their stroke or shortly afterward. Improved AF diagnosis and treatment could reduce the risk of stroke. In a randomized trial that included about 2,600 participants at increased risk of AF, immediate monitoring with a home-based, self-applied wearable ECG sensor patch resulted in a higher rate of AF diagnosis after four months compared with delayed monitoring (3.9 percent vs 0.9 percent). In an observational study, monitored individuals had higher rates of AF diagnosis, greater initiation of blood thinners, but also increased health care resource use at one year compared with non-monitored controls. Further research is needed regarding the clinical implications of these findings.

Authors: Steven R. Steinhubl, M.D., Scripps Translational Science Institute, La Jolla, California, and coauthors

To Learn More: The full study is available on the For The Media website.

Related material available on the For The Media website:

A summary video is available for download or to embed on your website. Download the video as a high-quality MP4 file by clicking on this link and then right-clicking and selecting “save video as.” In addition, you may copy and paste the html code below to embed the video on your website.

The editorials: “Evaluating Health Technology Through Pragmatic Trials,” by Eric D. Peterson, M.D., M.P.H., of Duke University Medical Center, Durham, North Carolina, and Robert A. Harrington, M.D., Stanford University, Stanford, California; and “Screening for Atrial Fibrillation With a Wearable Device,” by Benjamin A. Steinberg, M.D., M.H.S., University of Utah Health Sciences Center, Salt Lake City, and Jonathan P. Piccini, M.D., M.H.S., Duke University Medical Center, Durham, North Carolina.

(doi:10.1001/jama.2018.8102)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Video embed code:

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JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JULY 10, 2018

Media advisory: To contact corresponding author Jacques Baillargeon, Ph.D., email Donna Ramirez at donna.ramirez@utmb.edu. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.7999

Bottom Line: Testosterone use in the United States tripled from 2001 through 2011, mostly in men without a clear indication. In late 2013 and early 2014, two studies reported increased heart attack and stroke associated with testosterone use, and the U.S. Food and Drug Administration (FDA) issued a safety bulletin in early 2014. An examination of testosterone prescribing in the U.S. from 2002- 2016 found that the percentage of men receiving testosterone prescriptions decreased from 2013 through 2016, with the steepest decrease coinciding with the published reports of testosterone-associated adverse cardiovascular events and the FDA safety bulletin.

Authors: Jacques Baillargeon, Ph.D., University of Texas Medical Branch, Galveston, Texas, and coauthors

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.7999)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JULY 10, 2018

Media advisory: To contact corresponding author Dawn L. Hershman, M.D., M.S., email Alexandra Simpson at ajs9044@nyp.org. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.8907

Bottom Line: Treatment for breast cancer with aromatase inhibitors often results in joint pain, which can contribute to treatment nonadherence. Several small studies have suggested that acupuncture may decrease aromatase inhibitor-related joint pain. In a randomized trial that included 226 postmenopausal women with early-stage breast cancer who were taking an aromatase inhibitor and experiencing joint pain, women who received acupuncture twice a week for six weeks had a greater reduction in pain compared with sham acupuncture (received acupuncture at non-acupuncture points) or those who did not receive any acupuncture. The observed improvement was of uncertain clinical importance.

Authors: Dawn L. Hershman, M.D., M.S., of NewYork-Presbyterian and Columbia University Irving Medical Center, New York, and coauthors

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.8907)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JULY 10, 2018

Media advisory: To contact the U.S. Preventive Services Task Force, email the Media Coordinator at Newsroom@USPSTF.net or call 202-572-2044. The full report is available on the For The Media website.

Want to embed a link to these reports in your story? Links will be live at the embargo time and all links to all USPSTF articles remain free indefinitely. Here’s the link to the recommendation statement on screening for PAD and CVD risk assessment with the ABI: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.8357  Here’s the link to the recommendation statement on risk assessment for CVD with nontraditional risk factors: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.8359

Bottom Line: In two new statements, the U.S. Preventive Services Task Force (USPSTF) concludes current evidence is insufficient to make recommendations assessing cardiovascular disease (CVD) risk with certain nontraditional risk factors and screening for peripheral artery disease (PAD) and CVD risk with the ankle-brachial index (ABI).

What: In the first statement, evidence is insufficient to make a recommendation regarding screening for PAD and CVD risk with the ABI in asymptomatic adults.

What: In the second statement, evidence is insufficient to make a recommendation regarding adding the nontraditional risk factors of the ABI, high-sensitivity C-reactive protein (hsCRP) level, and coronary artery calcium (CAC) score to traditional risk assessments for CVD in asymptomatic adults to prevent CVD events.

Related material

The following related elements from The JAMA Network are also available on the For The Media website:

— A podcast interview with Michael J. Barry, M.D., a member of the USPSTF and co-author of the recommendation statements.

— Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment With the Ankle-Brachial Index – US Preventive Services Task Force Recommendation Statement

— Screening for Peripheral Artery Disease Using the Ankle-Brachial Index – Evidence Report and Systematic Review for the US Preventive Services Task Force

— Ankle-Brachial Index Screening and Improving Peripheral Artery Disease Detection and Outcomes – JAMA editorial

— Screening for Peripheral Artery Disease With Ankle-Brachial Index – JAMA Patient Page

— Risk Assessment for Cardiovascular Disease With Nontraditional Risk Factors – US Preventive Services Task Force Recommendation Statement

— Nontraditional Risk Factors in Cardiovascular Disease Risk Assessment – Evidence Report and Systematic Review for the US Preventive Services Task Force

— USPSTF Recommendations for Assessment of Cardiovascular Risk With Nontraditional Risk Factors – JAMA editorial

— Viewing the Value of Coronary Artery Calcium Testing From Different Perspectives – JAMA Cardiology editorial

Editor’s Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Note: More information about the U.S. Preventive Services Task Force, its process, and its recommendations can be found on the newsroom page of its website.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JULY 3, 2018

Media advisory: To contact corresponding author Jeptha P. Curtis, M.D., email Ziba Kashef at ziba.kashef@yale.edu. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.8151

Bottom Line: A U.S. Department of Justice investigation into the placement of implantable cardioverter-defibrillators (ICDs) in Medicare patients who didn’t qualify for them based upon Medicare coverage criteria was associated with significant decreases in the use of the devices that shock the heart to restore normal rhythm and in the proportion of devices not meeting these established criteria.

Why The Research Is Interesting: The Department of Justice (DOJ) announced in 2010 it was investigating hospitals under the False Claims Act for overusing ICDs in patients who didn’t meet criteria for Medicare reimbursement. The DOJ concluded its investigation in 2016 and reached settlements with more than 500 hospitals for more than $280 million. 

Who and When: 300,151 ICDs implanted to prevent arrhythmia and sudden cardiac death in Medicare beneficiaries from 2007-2015 at 1,809 U.S. hospitals, of which 452 hospitals subsequently reached settlements with the DOJ. 

What (Study Measures and Outcomes): DOJ investigation announcement in 2010 (exposure); proportion of ICDs not meeting Medicare coverage criteria (outcomes). 

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control for all the natural differences that could explain the study results. 

Authors: Jeptha P. Curtis, M.D., Yale School of Medicine, New Haven, Connecticut, and coauthors 

Results: The volume of ICDs and the proportion of devices not meeting Medicare coverage criteria decreased overall, and larger decreases were observed at hospitals that reached settlements with the DOJ.  

Study Limitations: Analysis may not reflect all cases among non-Medicare beneficiaries and no public listing identifies all hospitals investigated by the DOJ.  

Study Conclusions: The DOJ investigation was associated with significant declines in ICDs placed outside the National Coverage Determination at all hospitals, including patient populations that were not the focus of the investigation. The potential unintended consequences of the DOJ investigation warrant further study.

Related material: The editorial, “US Department of Justice Investigations of Implantable Cardioverter-Defibrillators and Quality Improvement in Health Care,” by Paul A. Heidenreich, M.D., M.S., Stanford University School of Medicine, Palo Alto, California, is also available on the For The Media website.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.8151)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JULY 3, 2018

Media advisory: To contact corresponding author Gina Suzanne Ogilvie, M.D., F.C.F.P., Dr.P.H., email Kevin Sauve of BC Cancer at kevin.sauve@bccancer.bc.ca or call 604-877-6436. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.7464

Bottom Line:  Nearly all cervical cancers are associated with persistent cervical infection from cancer-related human papillomavirus (HPV) strains. Testing for HPV alone, or combined with a Pap smear (cytology) for cervical screening, has been associated with increased detection of precancerous lesions compared with Pap smears alone. Some organizations have recommended primary HPV-based cervical cancer screening, while others have called for clinical trials of primary HPV testing alone. This study reports the results of a large randomized clinical trial of about 19,000 women that compared primary HPV testing alone versus Pap test for cervical screening. The study demonstrates that primary HPV testing of women detects precancerous lesions earlier, and more accurately than the Pap test. Furthermore, women who were HPV negative were less likely than women screened by Pap tests to have cervical pre-cancer after four years. More research is needed to understand the long-term outcomes and cost-effectiveness of HPV testing.

Authors: Gina Suzanne Ogilvie, M.D., F.C.F.P., Dr.P.H., University of British Columbia, Vancouver, Canada, and coauthors

Visual Abstract: JAMA is introducing this new feature initially focused on randomized clinical trials. A predictive link to the abstract that will work when the embargo lifts is here.

Related material: The editorial, “Replacing the Pap Test With Screening Based on Human Papillomavirus Assays,” by L. Stewart Massad, M.D., Washington University School of Medicine, St. Louis, Missouri, is also available on the For The Media website.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.7464)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

An author podcast accompanies the JAMA study, “Association of Initiation of Basal Insulin Analogs vs Neutral Protamine Hagedorn Insulin With Hypoglycemia-Related Emergency Department Visits or Hospital Admissions and With Glycemic Control in Patients With Type 2 Diabetes,” by Kasia J. Lipska, M.D., M.H.S., Yale School of Medicine, New Haven, Conn., and coauthors, and is available for listening and download on this page.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JUNE 26, 2018

Media advisory: To contact the U.S. Preventive Services Task Force, email the Media Coordinator at Newsroom@USPSTF.net or call 202-572-2044. The full report is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time and all links to all USPSTF articles remain free indefinitely: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.7498

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older and in postmenopausal women younger than 65 years at increased risk of osteoporosis.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. This latest statement is an update of its 2011 recommendation on screening for osteoporosis. By 2020, approximately 12 million individuals in the U.S. older than 50 years are expected to have osteoporosis. Osteoporotic fractures are associated with chronic pain, disability and decreased quality of life.

The USPSTF Concludes:

Related material

The following related elements from The JAMA Network are also available on the For The Media website:

— A podcast interview with Chien-Wen Tseng, M.D., M.P.H., M.S.E.E., a member of the USPSTF and co-author of the recommendation statement.

— Screening for Osteoporosis to Prevent Fractures – US Preventive Services Task Force Recommendation Statement

— Screening to Prevent Osteoporotic Fractures – Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

— JAMA editorial: Screening for Osteoporosis

— JAMA Internal Medicine editorial: Osteoporosis Screening—2 Steps May Be Too Much for Women Younger Than 65 Years

— JAMA Patient Page: Screening for Osteoporosis to Prevent Fractures

To Learn More: The full report is available on the For The Media website.

(doi:10.1001/jama.2018.7498)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Note: More information about the U.S. Preventive Services Task Force, its process, and its recommendations can be found on the newsroom page of its website.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 8 A.M. (ET), SATURDAY, JUNE 23, 2018

Media advisory: To contact corresponding author Anny H. Xiang, Ph.D., email Elita Fielder at Elita.T.Fielder@kp.org. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.7614

Translation available: A translation in simplified Chinese is available below.

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: The risk of autism spectrum disorder (ASD) was increased in children of mothers with the three main types of diabetes that complicate pregnancy, findings that add new information on type 1 diabetes and extend what is already known about type 2 and gestational diabetes.

Why The Research Is Interesting: Maternal preexisting type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) diagnosed by 26 weeks have been associated with increased risk of ASD in children in prior research. Less is known about ASD risk associated with maternal preexisting type 1 diabetes (T1D).

Who and When: 419,425 children born at 28 to 44 weeks from 1995-2012.

What (Study Measures and Outcomes): Maternal T1D, T2D and GDM (exposures); diagnosis in children of ASD, which includes autistic disorders, Asperger syndrome and pervasive developmental disorder not otherwise specified (outcomes)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Anny H. Xiang, Ph.D., Kaiser Permanente Southern California, Pasadena, California, and coauthors

Results: Risk of ASD was higher in children exposed in utero to maternal preexisting T1D, T2D and gestational diabetes diagnosed by 26 weeks compared with no maternal diabetes exposure.

Study Limitations: Risk factors of the father, along with other intrauterine and postnatal exposures, couldn’t be assessed.

Study Conclusions: Results suggest the severity of maternal diabetes and the timing of exposure (early vs late in pregnancy) may be associated with the risk of ASD in children of mothers with diabetes.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.7614)

Editor’s Note: This study is being presented at the American Diabetes Association’s 78th Scientific Sessions. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年6月23日，星期六，美国东部时间上午8点

媒体咨询：联系通讯作者Anny H. Xiang, Ph.D.，请发电子邮件到Elita Fielder Elita.T.Fielder@kp.org。

母亲患糖尿病会使儿童患自闭症的风险增加

概要: 根据《美国医学会杂志 》(JAMA)发表的一项研究，母亲在怀孕期间患有三种主要类型的糖尿病会导致儿童患自闭症谱系障碍（ASD）的风险增加，这些发现增加了关于1型糖尿病的新信息并扩展了已知的对于2型和妊娠糖尿病的认识。

为何对该问题感兴趣：在之前的研究中发现，到怀孕26周时诊断出的母亲预先存在的2型糖尿病（T2D）和妊娠糖尿病（GDM）与儿童ASD风险增加有关联， 而与母亲先前存在的1型糖尿病（T1D）有关的ASD风险则知之甚少。

研究参与者及时间：从1995年至2012年，28至44周出生419,425名儿童。

研究内容（研究手段及结果）：母亲T1D，T2D和GDM（暴露）; 儿童的ASD诊断，包括自闭症，阿斯伯格综合征和其它非指定的广泛性发育障碍（结果）

如何研究（研究设计）：这是一项观察性研究。 研究人员不会为研究目而进行干预，也无法控制可以解释研究结果的所有自然差异。

作者：Anny H. Xiang, Ph.D., 南加州凯萨医疗机构（Kaiser Permanente Southern California），帕萨迪纳，加利福尼亚州，以及共同作者。

研究结果：与非糖尿病孕妇的暴露因素相比，26周时诊断出孕妇患有预先存在的T1D，T2D和妊娠期糖尿病的暴露因素使子宫内的胎儿将来患有ASD的风险升高。

研究局限：父亲的风险因素以及其它宫内和产后暴露因素未被评估。

研究结论：该研究结果表明，母亲糖尿病的严重程度和暴露时间（妊娠早期与妊娠晚期）可能与患糖尿病母亲的儿童的ASD风险有关联。

欲了解更多信息：在下面网站可以获得该研究的全文，For The Media：https://media.jamanetwork.com/。

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JUNE 26, 2018

Media advisory: To contact corresponding author Cyprian Wejnert, Ph.D., email CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention Media Relations at NCHHSTPmediaTeam@cdc.gov. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.7611

Bottom Line: The U.S. Centers for Disease Control and Prevention recommends at least annual testing for people at high risk for human immunodeficiency virus (HIV), including men who have sex with men and people who inject drugs. A new study from the CDC estimates substantial numbers of people infected with HIV, but unaware of their infection, weren’t offered HIV testing by clinicians they’ve recently seen.

Authors: Cyprian Wejnert, Ph.D., U.S. Centers for Disease Control and Prevention, Atlanta, and coauthors

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.7611)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JUNE 26, 2018

Media advisory: To contact corresponding author Sarah M. Roberts, Dr.P.H., email Jason Harless at Harless.Jason@ucsf.edu. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.7675

Bottom Line: Performing an abortion in an ambulatory surgery center instead of in an office-based setting was not associated with a significant difference in abortion-related complications such as infection and hemorrhage.

Why The Research Is Interesting: Multiple states have laws requiring abortion facilities to meet ambulatory surgery center (ASC) standards. More than 95 percent of abortions are provided in non-hospital-based settings in abortion clinics, other clinics or physician offices. Limited evidence exists about abortion-related complications after an abortion at performed at an ASC compared with an office-based setting.

Who and When: 49,287 women with private health insurance who had 50,311 abortions in an ASC or in an office-based setting from 2011 to 2014

What (Study Measures and Outcomes): Facility type where the abortion was performed (ASC vs office-based setting, which included abortion clinics, other clinics and physician offices) (exposures); any abortion-related complication (such as perforation of the uterus, infection, hemorrhage, tissue that remains in the uterus) within six weeks after an abortion (outcomes).

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Sarah M. Roberts, Dr.P.H., University of California, San Francisco, and coauthors

Results:

Study Limitations: Only included abortions paid for by private insurance so the findings may not be generalizable to all abortions in the United States

Study Conclusions:

Related material: The editorial, “Abortion-Related Adverse Events by Facility Type,” by Carolyn L. Westhoff, M.D., M.S., and Anne R. Davis, M.D., M.P.H., Columbia University Medical Center, New York, is also available on the For The Media website.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.7675)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 8:15 P.M. (ET), MONDAY, JUNE 25, 2018

Media advisory: To contact corresponding author Joan M. Teno, M.D., M.S., email Franny White at whitef@ohsu.edu. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.8981

Bottom Line: Where are Medicare patients most likely to die? A new study found that from 2000 to 2015 there was a decline in deaths in an acute-care hospital and an increase in deaths in a home or other community setting such as an assisted-living facility. In addition, since 2009 there was a reduction in patients dying within three days of a transition in health care; ICU use in the last month of life has stabilized.

Authors: Joan M. Teno, M.D., M.S., Oregon Health & Science University, Portland, and coauthors

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.8981)

Editor’s Note: This study is being presented at AcademyHealth’s Annual Research Meeting. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JUNE 19, 2018

Media advisory: To contact corresponding author Elizabeth L. Tung, M.D., M.S., email Matthew Wood at Matthew.Wood@uchospitals.edu. The full article is available on the For The Media website.

Want to embed a link to this article in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.6798

Bottom Line: A JAMA Clinical Guidelines Synopsis article examines the American College of Physicians’ (ACP’s) 2018 guidance statement on HbA_1c goals in nonpregnant adults with type 2 diabetes, including the possible effect of a recommended HbA_1c level between 7 percent and 8 percent for most patients with type 2 diabetes, a range that is higher than other guidelines.

Authors: Elizabeth L. Tung, M.D., M.S., University of Chicago, and coauthors

To Learn More: The full article is available on the For The Media website.

(doi:10.1001/jama.2018.6798)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Related material

The following related elements from The JAMA Network are also available on the For The Media website:

— A summary video, “Hemoglobin A_1c Targets in Type 2 Diabetes,” is available for download or to embed on your website. Download the video as a high-quality MP4 file by clicking on this link and then right-clicking and selecting “save video as.” In addition, you may copy and paste the html code below to embed the video on your website.

— A podcast, “A Goal Too Far: Rethinking HbA_1c Targets for Diabetes Treatment,”  is available for listening and download on this page.

— In JAMA’s From The Medical Letter on Drugs and Therapeutics section, the article “Ertugliflozin for Type 2 Diabetes.”

— The JAMA Medical News & Perspectives article, “For Patients With Type 2 Diabetes, What’s the Best Target Hemoglobin A_1C?”

Video embed code:

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JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JUNE 19, 2018

Media advisory: To contact corresponding author Huan Song, M.D., Ph.D., email huan.song@ki.se. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.7028

Bottom Line: Stress-related disorders brought on by traumatic or stressful life events were associated with increased risk of developing an autoimmune disease.

Why The Research Is Interesting: Development of stress-related disorders such as posttraumatic stress disorder (PTSD) may influence multiple bodily systems, including immune function. Whether this contributes to risk for autoimmune disease remains unclear.

Who and When: 106,464 patients in Sweden diagnosed with stress-related disorders between 1981-2013 and compared with 126,652 of their siblings and nearly 1.1 million individuals without stress-related disorders.

What (Study Measures and Outcomes): Diagnosis of stress-related disorders, such as PTSD, acute stress reaction, adjustment disorder and other stress reactions (exposures); development of 41 autoimmune diseases, such as rheumatoid arthritis, psoriasis, Crohn disease and celiac disease (outcomes)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Huan Song, M.D., Ph.D., University of Iceland, Reykjavik, and coauthors

Results: A stress-related disorder was associated with an increased risk of a subsequent autoimmune disease compared with siblings and other individuals without stress-related disorders.

Study Limitations: Diagnoses from primary care aren’t included in a Swedish patient register, which could result in fewer stress-related disorders and autoimmune diseases being detected, particularly when the conditions are less severe.

Study Conclusions: More studies are needed to understand possible reasons behind the association of stress-related disorders and the development of autoimmune diseases.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.7028)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JUNE 19, 2018

Media advisory: To contact corresponding authors Cynthia L. Ogden, Ph.D., email paoquery@cdc.gov. The full studies are available on the For The Media website.

Bottom Line: Two studies used national survey data to examine differences in rates of obesity and severe obesity among children, teens and adults based on demographic factors (including sex, age, race, education) and whether people lived in urban or rural areas of the United States. The studies by researchers at the U.S. Centers for Disease Control and Prevention and the U.S. Public Health Service analyzed measured weight and height for participants in the National Health and Nutrition Examination Survey, a nationally representative survey of the U.S population.

What: An analysis of data for 6,863 children and teens (ages 2 to 19) suggests rates of severe obesity were higher in rural areas than large urban areas. Rates of obesity showed similar patterns, but weren’t statistically significant. Higher rates of obesity and severe obesity were associated with older age and a lower level of head-of-household education, and more common among non-Hispanic black and Hispanic youth compared with non-Hispanic white youth.

(doi:10.1001/jama.2018.5158)

Analysis of data for 10,792 adults (20 and older) suggests rates of severe obesity (defined as a body mass index [BMI] at or above 40) were higher in rural areas than large urban areas, and rates for obesity (defined as BMI at or above 30) showed similar patterns.

(doi:10.1001/jama.2018.7270)

Authors: Cynthia L. Ogden, Ph.D., U.S. Centers for Disease Control and Prevention, Hyattsville, Maryland, and coauthors

Want to embed a link to these studies in your story? Links will be live at the embargo time. Here’s the link to the study including children and teens: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.5158  Here’s the link to the study including adults: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.7270

To Learn More: The full studies are available on the For The Media website.

Editor’s Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 10 A.M. (ET), TUESDAY, JUNE 12, 2018

Media advisory: To contact corresponding author Francis S. Collins, M.D., Ph.D., email Rebecca Baker at rebecca.baker@nih.gov. The full article is available on the For The Media website.

Want to embed a link to this article in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.8826

Bottom Line: In the JAMA Viewpoint, “Helping to End Addiction Over the Long-Term: The Research Plan for the NIH HEAL Initiative,” National Institutes of Health Director Francis S. Collins, M.D., Ph.D., and coauthors discuss an interdisciplinary program aimed at advancing addiction and pain research in the United States to improve treatments for opioid misuse and addiction and to enhance pain management.

To Learn More: The full article is available on the For The Media website.

(doi:10.1001/jama.2018.8826)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JUNE 12, 2018

Media advisory: To contact corresponding author Dima Mazen Qato, Pharm.D., M.P.H., Ph.D., email Jacqueline Carey at jmcarey@uic.edu. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.6741

Bottom Line: More than one-third of U.S. adults may use prescription medications that have depression as a possible side effect.

Why The Research Is Interesting: Prescription medications are widely used among adults and many prescriptions, such as hormonal contraceptives and beta-blockers, are associated with increased risk of depression.

Who and When: 26,192 adults who participated in a nationally representative survey between 2005-2014

What (Study Measures): Prescription medications with depression as a possible side effect (exposure); use of medications with potential to cause depression and depression (outcomes)

How (Study Design): This was a population-based survey study.

Authors: Dima Mazen Qato, Pharm.D., M.P.H., Ph.D., University of Illinois at Chicago, College of Pharmacy, and coauthors

Results: An estimated 37 percent of adults used prescription medications that had depression as a potential side effect; the use of multiple medications with depression as a possible side effect was associated with a greater likelihood of depression.

Study Limitations: Cause-and-effect inferences cannot be made about the use of prescription medications and depressive symptoms; the survey cannot account for a history of depression

Study Conclusions: Physicians should consider discussing associations between prescription medications and the likelihood of depression with patients who are prescribed medications with depression as a possible side effect.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.6741)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JUNE 12, 2018

Media advisory: To contact the U.S. Preventive Services Task Force, email the Media Coordinator at Newsroom@USPSTF.net or call 202-572-2044. The full report is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time and all links to all USPSTF articles remain free indefinitely: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.6848

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) recommends against adding screening with electrocardiography (ECG) to standard risk assessment to prevent cardiovascular disease (CVD) events in adults without symptoms at low risk.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. This latest statement is an update of the 2012 recommendation on screening for coronary heart disease with ECG. Cardiovascular disease, which includes conditions such as coronary heart disease, cerebrovascular disease and peripheral arterial disease, is the most common cause of death among adults in the United States.

The USPSTF Concludes:

Related material

The following related elements from The JAMA Network are also available on the For The Media website:

— A podcast interview with Seth Landefeld, M.D., a member of the USPSTF and co-author of the recommendation statement.

— Screening for Cardiovascular Disease Risk With Electrocardiography – US Preventive Services Task Force Recommendation Statement

— Screening for Cardiovascular Disease Risk With Resting or Exercise Electrocardiography – Evidence Report and Systematic Review for the US Preventive Services Task Force

— JAMA editorial: The Screening ECG and Cardiac Risks

— JAMA Internal Medicine editorial: Screening for Cardiovascular Disease Risk With Electrocardiography

— JAMA Cardiology editorial: Does Resting or Exercise Electrocardiography Assist Clinicians in Preventing Cardiovascular Events in Asymptomatic Adults?

— JAMA Patient Page: Screening for Cardiovascular Disease Risk With ECG

To Learn More: The full report is available on the For The Media website.

(doi:10.1001/jama.2018.3710)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Note: More information about the U.S. Preventive Services Task Force, its process, and its recommendations can be found on the newsroom page of its website.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 22, 2018

Media advisory: To contact corresponding author Henrik T. Sorensen, D.M.Sc., email hts@clin.au.dk. To contact corresponding author George J. Chang, M.D., M.S., email Laura Sussman at lsussman@mdanderson.org. The full studies and editorial are available on the For The Media website.

Bottom Line: Two studies and a related editorial examined the effect of more or less frequent follow-up testing after treatment or surgery for colorectal cancer.

Why The Research Is Interesting: Follow-up testing is performed after treatment or surgery for colorectal cancer (CRC). However, it is unclear and the evidence is limited about the effect the frequency of testing has on detection of cancer recurrence or patient survival.

Who:

— Henrik T. Sorensen, D.M.Sc., of Aarhus University Hospital, Aarhus, Denmark, and coauthors report on the “Effect of More vs Less Frequent Follow-up Testing on Overall and Colorectal Cancer-Specific Mortality in Patients With Stage II or Ill Colorectal Cancer.” In this randomized clinical trial of more than 2,500 patients with colorectal cancer, more frequent follow-up testing with imaging and a blood test compared with less frequent testing didn’t make a significant difference in rates of death from any cause or colorectal cancer over five years.

Want to embed a link to the study above in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.5623

— George J. Chang, M.D., M.S., of the University of Texas MD Anderson Cancer Center, Houston, and coauthors report on the “Association Between Intensity of Posttreatment Surveillance Testing and Detection of Recurrence in Patients With Colorectal Cancer.” In this study of more than 8,500 patients with colorectal cancer, there was no significant association between the frequency of surveillance testing and the time to detection of colorectal cancer recurrence.

Want to embed a link to the study above in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.5816

— Hanna K. Sanoff, M.D., of the University of North Carolina at Chapel Hill, wrote an accompanying editorial, “Best Evidence Supports Annual Surveillance for Resected Colorectal Cancer.” In it, Sanoff writes: “Current guidelines should be reevaluated in the context of the data from [these studies], and of the potential harms of more frequent testing including distress, radiation exposure, and patient and societal financial burden. Surveillance that incorporates a more nuanced assessment of cancer biology will ultimately be needed to further improve cure rates for patients with stage II and III colorectal cancer.”

Want to embed a link to the editorial above in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.5817

For more details and to read the full studies and editorial, please visit the For The Media website.

(doi:10.1001/jama.2018.5623, Sorensen et al study; doi:10.1001/jama.2018.5816, Chang et al study; doi:10.1001/jama.2018.5817, Sanoff editorial)

Editor’s Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 22, 2018

Media advisory: To contact corresponding author Anna Maria Hibbs, M.D., M.S.C.E., email Ansley Gogol (Ansley.Gogol@case.edu) or Katelyn McCarthy (Katelyn.McCarthy@UHhospitals.org). The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.5729

Translation available: A translation in simplified Chinese is available below.

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: Black infants born preterm who received sustained vitamin D supplementation had a lower likelihood of recurrent wheezing by age 1.

Why The Research Is Interesting: Wheezing is a common complication of preterm birth and black infants have higher rates of prematurity-associated wheezing. This randomized clinical trial assessed two vitamin D supplementation strategies in preventing recurrent wheezing.

Who and When: 300 black infants born at 28 to 36 weeks between January 2013 and January 2016.

What (Study Interventions and Measures): 400 IU/day of vitamin D until 6 months of age adjusted for prematurity or a diet-limited approach (stopping supplementation once a baby was receiving at least 200 IU/day of vitamin D from formula or a fortifier added to human milk) (interventions); recurrent wheezing by age 1 (outcome).

How (Study Design): This was a randomized clinical trial (RCT). RCTs allow for the strongest inferences to be made about the true effect of an intervention. However, not all RCT results can be replicated in real-world settings because patient characteristics or other variables may differ from those studied in the RCT.

Authors: Anna Maria Hibbs, M.D., M.S.C.E., Case Western Reserve University School of Medicine, Cleveland, and coauthors

Results:

Study Limitations: There was the potential for misclassification of wheezing by the study’s questionnaire.

Study Conclusions:

Related material: The editorial, “Prenatal vs Infant Vitamin D Supplementation and the Risk of Wheezing in Childhood,” by Frank R. Greer, M.D., University of Wisconsin School of Medicine and Public Health, Madison, is also available on the For The Media website.

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jama.2018.5729)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年5月22日，星期二，东部时间上午11点

媒体咨询：联系通讯作者Anna Maria Hibbs, M.D., M.S.C.E.，请发电子邮件到Ansley Gogol (Ansley.Gogol@case.edu) 或Katelyn McCarthy (Katelyn.McCarthy@UHhospitals.org)。

维生素D是否会减少早产黑人婴儿患喘鸣的可能性？

概要: 根据《美国医学会杂志》(JAMA)发表的一项研究，接受持续维生素D补充治疗的早产黑人婴儿在1岁时患复发性喘鸣的可能性较低。

为何对该问题感兴趣：喘鸣是早产的常见并发症之一，而黑人婴儿早产相关性喘鸣的发生率较高。这项随机临床试验评估了两种维生素D补充方案对预防复发性喘鸣的效果。

研究参与者及时间：2013年1月至2016年1月期间出生的28至36周的300名黑人婴儿。

研究内容（研究干预及措施）：每天补充400 IU 的维生素D，直到出生后6个月调整为早产或饮食限制（一旦婴儿能通过奶粉或添加到母乳中的强化剂来接受至少每天200 IU 的维生素D，则停止补充）（干预）; 1岁时复发性喘鸣（结果）。

如何研究（研究设计）：这是一项随机临床试验（RCT）。 RCT可以对干预的真实效果做出最强有力的推论。 但是，并非所有的RCT结果都可以在现实中被重复，因为患者特征或其他变量可能与RCT中所研究的不同。

作者：Anna Maria Hibbs, M.D., M.S.C.E., 凯斯西储大学医学院，克利夫兰，以及合作者

研究结果：在1岁时患复发性喘鸣：持续补充组中的31.1％的婴儿; 饮食限制组中的41.8％的婴儿。

研究局限：研究问卷有可能导致喘鸣分类错误。

研究结论：

结论及相关性  在早产的黑人婴儿中，与饮食限制性补充相比，持续补充维生素D会减少在12个月时患复发性喘鸣的风险。还需要进一步的研究来了解补充维生素D对早产婴儿喘鸣影响的内在机理及长期作用。

欲了解更多详情并阅读完整的研究报告，请访问For The Media网站：https://media.jamanetwork.com/。

JAMA

EMBARGOED FOR RELEASE: 12:15 P.M. (ET), SUNDAY, MAY 20, 2018

Media advisory: To contact corresponding author Emmanuel Martinod, M.D., Ph.D., email emmanuel.martinod@aphp.fr. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.4653

Bottom Line: An early study suggests it may be feasible to use human aortic grafts preserved by freezing to rebuild windpipe and airway sections removed because of disease.

Why The Research Is Interesting: Airway replacement could potentially benefit many patients with lung cancer and be an option for patients with end-stage tracheobronchial disease.

Who and When: 20 patients with lung tumors or tracheal lesions, of which 13 patients had diseased airway sections removed and underwent airway transplantation (5 tracheal, 7 bronchial and 1 carinal, which is where the trachea divides into the bronchi of the lungs); study conducted from October 2009 through February 2017, with final patient follow-up in November 2017

What (Study Measures): Airway transplantation using a cryopreserved aortic graft and custom-made stent inserted into the graft to keep the airway from collapsing but was later removed (exposure); 90-day morality (primary outcome)

How (Study Design): This was a cohort study where people were followed over time.

Authors: Emmanuel Martinod, M.D., Ph.D., Assistance Publique-Hopitaux de Paris, Bobigny, France, and coauthors

Results:

Study Limitations: Limited number of patients in this feasibility study at a single center without a comparison group; larger studies needed to further assess effectiveness and safety

Study Conclusions: This study demonstrated the feasibility for complex tracheal and bronchial reconstruction.

Featured Image:

What The Image Shows: (Click on the image for a full-size version. Right click to “save image as” to download.) Illustration of airway reconstruction method.

Related material: The editorial, “Has Reconstruction of the Central Airways Been Transformed?” by Valerie W. Rusch, M.D., Memorial Sloan Kettering Cancer Center, New York; JAMA Medical News & Perspectives article, “The Body’s Largest Artery Aids in Building a Better Trachea,” and an author podcast with Emmanuel Martinod, M.D., Ph.D., are also available on the For The Media website.

For more details and to read the full articles, please visit the For The Media website.

(doi:10.1001/jama.2018.4653)

Editor’s Note:  This study is being published to coincide with its presentation at the American Thoracic Society International Conference. Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 15, 2018

Media advisory: To contact corresponding author Wei Bao, M.D., Ph.D., email Tom Snee at Tom-snee@uiowa.edu. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.4658

Bottom Line: National survey data suggests an increase in U.S. adults who have ever used electronic cigarettes, even trying them just once, from 2014 to 2016, while reported current use among adults declined during that same period.

Why The Research Is Interesting: Electronic cigarettes (e-cigarettes) are widely marketed for smoking cessation and as an alternative to conventional cigarettes. Previous studies have reported a rapid increase in their use among U.S. adults since 2010. This study examined new national survey data to estimate the changes from 2014-2016.

Authors: Wei Bao, M.D., Ph.D., University of Iowa, Iowa City, and coauthors

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jama.2018.4658)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 15, 2018

Media advisory: To contact coauthor Cynthia L. Ogden, Ph.D., email paoquery@cdc.gov. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.5690

Bottom Line: Estimates of prescription medication use by U.S. children and adolescents declined overall from 1999 to 2014 and patterns of use varied by medication class.

Why The Research Is Interesting: Monitoring prescription medication trends among children and adolescents can help to show changes in access to health care and medicine, illustrate shifts in disease patterns, and highlight the use of appropriate or inappropriate treatments.

Who and When: 38,277 children and adolescents (from birth to age 19) who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999-2014, a nationally representative survey conducted every two years.

What (Study Measures): Sex, age, race, household income, education, insurance status and current health status (exposures); use of prescription medications, use of medications by therapeutic class, and trends in medication use from 1999-2002 to 2011-2014 (outcomes)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Craig M. Hales, M.D., Centers for Disease Control and Prevention, Hyattsville, Maryland, and coauthors

Results: The reported use of any prescription medication by children and adolescents in the past 30 days declined from 24.6 percent in 1999-2002 to 21.9 percent in 2011-2014, amid increases and decreases in the use of some specific medications.

Study Limitations: NHANES did not capture dosages, formulations or frequency of use, and the survey didn’t collect data on most over-the-counter medications; under reporting of prescription medication use is possible.

Study Conclusions:

Related material: The editorial, “Medication Prescribing for Children,” by Gary L. Freed, M.D., M.P.H., University of Michigan, Ann Arbor, is also available on the For The Media website.

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jama.2018.5690)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 15, 2018

Media advisory: To contact corresponding author Caroline A. Smith, Ph.D., email caroline.smith@westernsydney.edu.au. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.5336

Translation available: A translation in simplified Chinese is available below.

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: Acupuncture among women undergoing in vitro fertilization didn’t affect live birth rates.

Why The Research Is Interesting: Acupuncture is widely used by women undergoing in vitro fertilization (IVF), although there is conflicting evidence about its effect.

Who and When: 824 women undergoing IVF in Australia and New Zealand between June 2011 and October 2015, with follow-up until August 2016.

What (Study Interventions and Outcomes): Women received either acupuncture or a “sham” acupuncture procedure (where a noninvasive needle was placed away from the true acupuncture points) around the time of ovarian stimulation and embryo transfer (interventions); live birth (delivery of one or more living infants at greater than 20 weeks’ gestation or birth weight of at least 14.1 ounces) (outcomes)

How (Study Design): This was a randomized clinical trial (RCT). RCTs allow for the strongest inferences to be made about the true effect of an intervention. However, not all RCT results can be replicated in real-world settings because patient characteristics or other variables may differ from those that were studied in the RCT.

Authors: Caroline A. Smith, Ph.D., Western Sydney University, Penrith, Australia, and coauthors

Results: The rate of live births was 18.3 percent among women who received acupuncture and 17.8 percent among women who had the “sham” procedure, which resulted in a nonsignificant difference in live birth rates.

Study Limitations: The planned study sample size could not be achieved; the stage of embryo transfer was not balanced between the study groups; and the length of the treatment intervention was short.

Study Conclusions:

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jama.2018.5336)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

#  #  #

For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email mediarelations@jamanetwork.org.

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年5月15日 星期二，美国东部时间上午11点

媒体咨询：联系通讯作者Caroline A. Smith, Ph.D.，请发电子邮件到caroline.smith@westernsydney.edu.au。

针灸会增加正在接受体外受精治疗的妇女的生产几率吗？

概要: 根据《美国医学会杂志》(JAMA)发表的一项研究，针灸并不影响接受体外受精的妇女的活产率。

为何对该问题感兴趣：尽管关于其效果的证据存在许多矛盾，但接受体外受精（IVF）的妇女会广泛使用针灸。

研究参与者及时间：2011年6月至2015年10月期间，824名在澳大利亚和新西兰接受体外受精的妇女，随访至2016年8月。

研究什么（研究的干预和结果）：在卵巢刺激和胚胎移植期间，妇女接受针灸或“假”针灸治疗（非侵入性针头放置在真正的针灸穴位之外）（干预）； 活产（在妊娠20周以上产下一个或多个活的婴儿或者出生体重至少为14.1盎司）（结果）

如何研究（研究设计）：这是一项随机临床试验（RCT）。 RCT可以对干预的真实效果做出最强有力的推论。 然而，由于患者特征或其他变量可能与RCT中所研究的不同，因此并非所有的RCT结果都可以在现实世界中被重复。

作者：Caroline A. Smith, Ph.D., 西悉尼大学，彭里斯，澳大利亚，以及共同作者

研究结果：接受针灸治疗的妇女的活产率为18.3％，而接受“假”针灸治疗的妇女的活产率为17.8％，二者的活产率差异不大。

研究局限：计划的研究样本量无法实现; 研究组之间的胚胎移植阶段未被平衡; 治疗干预的时间短。

研究结论：

意义  本研究的发现不支持通过在卵巢刺激和胚胎移植期间进行针灸治疗来提高活产率。

欲了解更多详情并阅读完整的研究报告，请访问For The Media网站：https://media.jamanetwork.com/。