Halloween Associated with Increased Risk of Pedestrian Fatalities

Posted October 26, 2018 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 30, 2018

Media advisory: To contact author John A. Staples, M.D., M.P.H., email john.a.staples@gmail.com and to contact author Donald Redelmeier email dar@ices.on.ca. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.4052

Bottom Line: Children in the United States celebrate Halloween by going door-to-door collecting candy. New research suggests the popular October 31 holiday is associated with increased pedestrian traffic fatalities, especially among children. Researchers used data from the National Highway Traffic Safety Administration to compare the number of pedestrian fatalities from 1975 to 2016 that happened on October 31 each year between 5 p.m. and 11:59 p.m. with those that happened during the same hours on a day one week earlier (on October 24) and a day one week later (on November 7). During the 42-year study period, 608 pedestrian fatalities happened on the 42 Halloween evenings, whereas 851 pedestrian fatalities happened on the 84 other evenings used for comparison. The relative risk (an expression of probability) of a pedestrian fatality was higher on Halloween than those other nights. Absolute mortality rates averaged 2.07 and 1.45 pedestrian fatalities per hour on Halloween nights and the other evenings, respectively, which is equivalent to the average Halloween resulting in four additional pedestrian deaths each year. The biggest risk was among children ages 4 to 8. Absolute risk of pedestrian fatality per 100 million Americans was small and declined from 4.9 to 2.5 between the first and final decades of the study interval. Ways to prevent Halloween pedestrian fatalities could include slowing down traffic and automated speed enforcement in residential neighborhoods, as well as improving pedestrian visibility by limiting on-street parking and putting reflective patches on children’s clothing.

Authors: John A. Staples, M.D., M.P.H., University of British Columbia, Vancouver, Canada, and coauthors

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

(doi:10.1001/jamapediatrics.2018.4052)

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

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

Study Examines Racial Disparities in Patient Characteristics, Survival After Heart Attack

Posted October 30, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, NOVEMBER 2, 2018

Media advisory: To contact corresponding study author Garth Graham, M.D., M.P.H., email newsmedia@saint-lukes.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.4240

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: This study analyzed data for about 6,400 patients who had heart attacks to compare black and white patients across a range of characteristics (demographic, socioeconomic status, social factors, lifestyle factors, medical history, clinical presentation, health status and depression). Researchers looked at how these patient characteristics differed by race, how they were associated with survival after heart attack, and whether the association differed for black and white patients who had similar characteristics. Analyses suggest a difference in mortality rate based on characteristics that were more common in black patients but no differences in survival rates at one and five years between black and white patients with similar characteristics. These findings call for more understanding about how and why certain patient characteristics that are more common in black patients, such as lower socioeconomic status, are associated with survival so that new strategies can be developed to reduce observed racial disparities.

Authors: Garth Graham, M.D., M.P.H., Saint Luke’s Mid America Heart Institute, Kansas City, Missouri, and co-authors

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

(doi:10.1001/jamanetworkopen.2018.4240)

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

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

How Often Are Cost Considerations Documented in Clinical Notes?

Posted October 30, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, NOVEMBER 2, 2018

Media advisory: To contact corresponding study author Deborah D. Gordon, M.B.A., email Gail Chalef at gail_chalef@hks.harvard.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.4178

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Treatment in intensive care units (ICUs) is driven by urgency rather than economic considerations. Many clinicians have been trained not to consider financial issues when making treatment decisions but health care costs can be an important concern for patients and their families. To investigate how financial concerns are associated with health care decision making, researchers analyzed clinical notes from more than 46,000 ICU admissions at a large academic medical center. They report nearly 2,000 patients (about 4 percent) had at least one note reflecting financial considerations during the ICU stay. Among the total admissions, 142 (0.3 percent) included notes describing a change in the discharge plan, 142 (0.3 percent) describing a change in the treatment plan, and 303 (0.7 percent) describing a change in medication or previous nonadherence to medication associated with financial considerations. The findings highlight the importance of understanding how financial constraints may alter treatment decisions in ICUs.

Authors: Deborah D. Gordon, M.B.A., Harvard Kennedy School, Cambridge, Massachusetts, and coauthors

Visual Abstract

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

(doi:10.1001/jamanetworkopen.2018.4178)

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

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

Studies Focus on Financial Conflicts of Interest Disclosures by Authors of Clinical Practice Guidelines

Posted October 25, 2018 by Jim Michalski

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 29, 2018

Media advisory: To contact corresponding author Samir C. Grover, M.D., M.Ed., F.R.C.P.C., email Heidi Singer at Heidi.Singer@utoronto.ca. To contact corresponding author Tyler R. Combs, B.S., email Melani Hamilton at melani.hamilton@okstate.edu. The full studies are available on the For The Media website.

Want to embed a link to these studies in your story? Links will be live at the embargo time. Grover study: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.5106

Combs study: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4730

Bottom Line: Two studies and an Editor’s Note focus on financial conflicts of interest disclosures by authors of clinical practice guidelines (CPGs).

What: One study reports that authors of CPGs related to high-revenue medications have a substantial number of undeclared payments from industry, including from pharmaceutical companies that market the medications recommended in those CPGs. Researchers identified 18 CPGs that provided recommendations for the top 10 revenue medications of 2016, written by 160 authors who were U.S.-based physicians. Nearly half of the authors declared a payment in the CPG or supplemental materials. More than half (57 percent) of the authors had a financial conflict of interest and about a quarter had received but not disclosed payments from companies marketing one of the medications recommended in the CPGs. In addition, most guidelines failed to adhere to national standards for financial conflicts of interest in CPGs. A limitation of the study is the potential inaccuracies in the reported data.

Authors: Samir C. Grover, M.D., M.Ed., F.R.C.P.C., University of Toronto, and coauthors

(doi:10.1001/jamainternmed.2018.5106)

What: The second study reports that financial conflicts of interest disclosures of authors of gastroenterology CPGs often don’t agree with what’s reported in a payments database. Researchers evaluated industry payments received by 83 authors of 15 gastroenterology CPGs and their financial conflicts of interest disclosure practices. More than half (53 percent) of the authors received industry payments; the median total payments received by guideline authors was $1,000. Financial conflicts of interest disclosures of authors of these CPGs agreed with the Centers for Medicare and Medicaid Services OpenPayments database between 19 percent and 34 percent of the time. A limitation of the study was the ability to only evaluate a period of 12 months for each guideline.

Authors: Tyler R. Combs, B.S., Oklahoma State University, Tulsa, and coauthors

(doi:10.1001/jamainternmed.2018.4730)

Related material: The Editor’s Note, “Continuing Problems With Financial Conflicts of Interest and Clinical Practice Guidelines,” is also available on the For The Media website.

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.

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

Prenatal Exposures to Medication Affecting Brain Neurotransmitter Systems and Risk of ASD

Posted October 29, 2018 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 31, 2018

Media Advisory: To contact corresponding author Magdalena Janecka, Ph.D., email Elizabeth Dowling at Elizabeth.Dowling@mountsinai.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.2728

Bottom Line: An exploratory study that examined autism spectrum disorder (ASD) risk and prenatal exposure to medications that affect neurotransmitters, including the typical targets of antidepressants and antipsychotics, suggests that most medications weren’t associated with higher estimates of ASD risk. The study used data from a large health maintenance organization in Israel for an analytic sample that included 34 groups of medications and 96,249 children, including 1,405 with ASD. Children exposed prenatally to the medications were compared with those not exposed. Most associations between ASD risk and prenatal exposure to the medications were modified when maternal diagnoses were considered. The authors acknowledge their findings needs to be replicated in other studies and that they may not be generalizable because rates of ASD in Israel are low.

Authors: Magdalena Janecka, Ph.D., of the Icahn School of Medicine at Mount Sinai, New York, New York, and coauthors

Related Material: An author podcast and the editorial, “A Biology-First Approach in Perinatal Pharmacoepidemiology of Autism: Potential and Pitfalls,” by Diana Schendel, Ph.D., Aarhus University, Denmark, and coauthors also are available on the For The Media website.

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

(doi:10.1001/ jamapsychiatry.2018.2728)

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

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

Do High-Performing Schools Lead to Less Risky Teen Marijuana Use?

Posted October 25, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 29, 2018

Media advisory: To contact corresponding author Rebecca N. Dudovitz, M.D., M.S., email Elaine Schmidt at ESchmidt@mednet.ucla.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.3074

Bottom Line: Results of admissions lotteries at five high-performing public charter schools in low-income minority communities in Los Angeles, California, were used to examine the relationship between exposure to high-performing schools and risky teen behaviors. The admissions lotteries served as a natural experiment in this study of 1,270 students who applied to at least 1 of the 5 high schools. The study’s primary outcome was self-reported marijuana use but it also looked at other health outcomes and factors. Winning the admissions lottery was associated with less marijuana misuse. The authors call school environments an important prevention tool that should be targeted in addressing social determinants of health.

Authors: Rebecca N. Dudovitz, M.D., M.S., of the David Geffen School of Medicine at UCLA, Los Angeles, California, and coauthors

Related Material: The editorial, “Addressing Risky Health Behaviors Among Vulnerable Youth Through the School Environment: Location, Location, Location,” by Kendra S. Liljenquist, Ph.D., of the University of Washington, and Yumaini R. Corker, M.D., M.B.A., of Seattle Children’s Research Institute, both in Seattle, Washington, also is available on the For The Media website.

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

(doi:10.1001/jamapediatrics.2018.3074)

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

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

Author Interview: Evaluation of Wound Photography for Remote Postoperative Assessment

Posted October 22, 2018 by Jim Michalski

Listen to an interview with Benjamin K. Poulose, M.D., M.P.H., Vanderbilt University Medical Center, Nashville, Tennessee, co-author of the JAMA Surgery study, “Evaluation of Wound Photography for Remote Postoperative Assessment of Surgical Site Infections.” The podcast is available for listening and download on this page.

Factors Associated With Persistent Opioid Use Among Injured Workers

Posted October 23, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, OCTOBER 26, 2018

Media advisory: To contact corresponding study author Gerard P. Slobogean, M.D., M.P.H., F.R.C.S.C., email Karen Warmkessel at kwarmkessel@umm.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.4050

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Persistent opioid use was common among injured workers who filed workers’ compensation claims. This observational study included more than 9,500 injured workers who filed claims in Maryland from 2008 to 2016 and who were initially treated with an opioid prescription. Nearly 30 percent of those injured workers continued to fill opioid prescriptions more than 90 days after injury. Factors including older age, a preinjury income of more than $60,000, crush injuries, strain or sprain injuries, claims resulting in permanent total disability, and an associated diagnosis of chronic joint pain were associated with persistent opioid use. The study’s authors suggest evaluating the effectiveness of alternative pain management strategies and interventions to lower persistent opioid use that target patients with characteristics identified in the study.

Authors: Gerard P. Slobogean, M.D., M.P.H., F.R.C.S.C., University of Maryland School of Medicine, Baltimore, and coauthors

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

(doi:10.1001/jamanetworkopen.2018.4050)

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

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

Study Examines Subsequent Flu Vaccine Effectiveness in Children Previously Vaccinated

Posted October 23, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, OCTOBER 26, 2018

Media advisory: To contact corresponding study author Huong Q. McLean, Ph.D., M.P.H., email Jeff Starck at starck.jeffrey@marshfieldclinic.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.3742

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Influenza vaccination one year wasn’t associated with reduced vaccine effectiveness the next year in children, findings the authors of this study say support current recommendations for children to be vaccinated annually against influenza. The effects of prior-season influenza vaccination on subsequent vaccine effectiveness aren’t well understood in children. This study analyzed data from a vaccine effectiveness study conducted over three seasons that examined the association of prior-season vaccination with vaccine effectiveness and the risk of influenza among vaccinated children between the ages of 2 and 17 by the vaccine type they received. While influenza vaccine effectiveness varied by influenza type and subtype and vaccine type, prior-season vaccination wasn’t associated with reduced vaccine effectiveness.

Authors: Huong Q. McLean, Ph.D., M.P.H., Marshfield Clinic Research Institute, Marshfield, Wisconsin, and co-authors

Related Material: The invited commentary, “Repeated Vaccination May Protect Children From Influenza Infection,” by Sarah Cobey, Ph.D., University of Chicago, also is available on the For The Media website.

Visual Abstract:

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

(doi:10.1001/jamanetworkopen.2018.3742)

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

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

Clinical, Financial Burden Associated With Firearm-Related Injuries in Pediatric Patients

Posted October 25, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 29, 2018

Media advisory: To contact corresponding author Faiz Ganim M.B.B.S., email Beatriz Vianna at bvianna@jhmi.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.3091

Bottom Line: This research letter describes trends in the clinical and financial burden associated with firearm-related injuries among pediatric patients. About 75,000 emergency department (ED) visits were identified for patients younger than 18 for firearm-related injuries from 2006 through 2014, and total charges for the ED visit or an inpatient admission were pulled from each record. ED visits for firearm-related injuries decreased until 2013 and then increased from 2013 through 2014; ED visits were more common for male patients, especially those between the ages of 15 to 17; and assault was the most common intent of the injury, followed by unintentional injuries and suicides. Total charges associated with the injuries were about $2.5 billion. The study has some limitations due to the Nationwide Emergency Department Sample that was used and researchers weren’t able to follow-up on patients after discharge.

Authors: Faiz Gani, M.B.B.S., and Joseph K. Canner, M.H.S., of the Johns Hopkins University School of Medicine, Baltimore, Maryland

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

(doi:10.1001/jamapediatrics.2018.3091)

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

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

Audio Interview: Association of Organic Food Consumption With Cancer Risk

Posted October 18, 2018 by Deanna Bellandi

Some Weather Conditions Associated With Heart Attack Risk

Posted October 22, 2018 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 24, 2018

Media advisory: To contact corresponding author David Erlinge, M.D., Ph.D., email david.erlinge@gmail.com. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamacardiology/fullarticle/10.1001/jamacardio.2018.3466

Bottom Line: Some weather conditions are associated with risk of heart attack. This observational study examined data for more than 274,000 patients who had heart attacks reported in Sweden from 1998 to 2013 and for which weather data were available over the same period of time. Days with low air temperature, low atmospheric air pressure, high wind velocity and shorter periods of sunshine were associated with risk of heart attack. The strongest association appeared to be for air temperature, with a higher risk of heart attack on days when air temperatures were less than 32°F. Although results observed in the study were statistically significant, the differences were modest.

Authors: David Erlinge, M.D., Ph.D., Lund University, Lund, Sweden, and coauthors

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

(doi:10.1001/jamacardio.2018.3466)

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

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

Visual Abstract: Insurance Coverage Denials for ED Visits With Nonemergent Diagnoses

Posted October 16, 2018 by Jim Michalski

A Visual Abstract is available below for the JAMA Network Open study, “Analysis of a Commercial Insurance Policy to Deny Coverage for Emergency Department Visits With Nonemergent Diagnoses,” by Shih-Chuan Chou, M.D., M.P.H., Brigham and Women’s Hospital, Boston, and coauthors.

This is the link to the abstract when the embargo lifts.

Medical Crowdfunding for Treatments Unsupported by Evidence or Potentially Unsafe

Posted October 18, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 23, 2018

Media advisory: To contact corresponding author Ford Vox, M.D., email Kerry Ludlam at kerry.ludlam@shepherd.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.10264

Bottom Line: Medical crowdfunding is using social media to appeal for help in paying for medical care. These campaigns can fill insurance gaps but they can also raise money for scientifically unsupported, ineffective or potentially dangerous treatments. This study examined crowdfunding activity for five such treatments since November 2015 and identified more than 1,000 campaigns that raised nearly $6.8 million. The campaigns collected money for homeopathic or naturopathic cancer treatments, hyperbaric oxygen therapy for brain injury, stem cell therapies for brain and spinal cord injury, and long-term antibiotic therapy for chronic Lyme Disease. Limitations of the study include only five treatments and four crowdfunding platforms were analyzed.

Authors: Ford Vox, M.D., Brain Injury Rehabilitation, Shepherd Center, Atlanta, and coauthors

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

(doi:10.1001/jama.2018.10264)

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

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

Shift in Types of Weight-Loss Surgery Performed Among Pediatric Patients

Posted October 18, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 22, 2018

Media advisory: To contact corresponding author Numa P. Perez, Jr., M.D., email Noah Brown at nbrown9@partners.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.3030

Bottom Line: This study identified a shift in the kind of metabolic and bariatric surgery (so-called MBS surgery because it can help patients achieve long-term weight loss and the resolution of coexisting metabolic conditions such as type 2 diabetes) performed among pediatric patients. An estimated 14,178 MBS procedures were performed among patients 20 or younger from 2005-2014. This research letter reports an increasing frequency of vertical sleeve gastrectomy and decreasing frequency of laparoscopic Roux-en-Y gastric bypass and the use of the adjustable gastric band, all changes that reflect trends in adult MBS procedures.

Authors: Numa P. Perez, Jr., M.D., of Massachusetts General Hospital, Boston, and coauthors

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

(doi:10.1001/jamapediatrics.2018.3030)

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

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

Study Examines Long-Term Rate of Mesh Sling Removal, Reoperation

Posted October 18, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 23, 2018

Media advisory: To contact corresponding author Ipek Gurol-Urganci, Ph.D., email press@lshtm.ac.uk. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.14997

Bottom Line: Treatment for women with stress urinary incontinence (SUI) can include inserting a mesh sling to support the urethra. An estimated 250,000 midurethral mesh sling (MUS) operations were performed in 2010 in the United States. There is concern that some women experience pain, persistent urinary incontinence and other issues but little clinical trial evidence exists about these longer-term outcomes. This observational study examined long-term mesh removal and reoperations in about 95,000 women in England who underwent MUS operations for SUI between 2006 and 2015. Within nine years, the rate of sling removal was 3.3 percent and the rate of reoperation for SUI was 4.5 percent. Reasons for removal or reoperations weren’t available.

Authors: Ipek Gurol-Urganci, Ph.D., London School of Hygiene & Tropical Medicine, London, and coauthors

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

(doi:10.1001/jama.2018.14997)

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

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

USPSTF Recommendation Statement on Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults

Posted October 18, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 23, 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: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.14741

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) recommends clinicians screen women of reproductive age for intimate partner violence and then connect women who screen positive to ongoing support services. However, current evidence is insufficient regarding screening older or vulnerable adults for abuse and neglect.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. This latest statement is an update of its 2013 recommendation on screening for intimate partner violence (IPV), elder abuse, and abuse of vulnerable adults, which are common in the United States but often remain undetected. In addition to the immediate effects of intimate partner violence, which may include injury and death, there may be other health consequences, including the development of depression, anxiety, substance abuse, and chronic pain. Long-term negative health effects from elder abuse may include higher risk of nursing home placement and death.

The USPSTF Concludes:

Related Material

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

— Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults – US Preventive Services Task Force Final Recommendation Statement

— Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults – Evidence Report and Systematic Review for the US Preventive Services Task Force

— JAMA editorial: Challenges and Opportunities for Studying Routine Screening for Abuse

— JAMA Internal Medicine editorial: Addressing Intimate Partner Violence and Abuse of Older or Vulnerable Adults in the Health Care Setting – Beyond Screening

— JAMA Patient Page: Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults

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

(doi:10.1001/jama.2018.14741)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. 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.

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

Pod-Based Electronic Cigarette Use Among California Youth

Posted October 16, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, OCTOBER 19, 2018

Media advisory: To contact corresponding study author Bonnie Halpern-Felsher, Ph.D., email Erin Digtale at digitale@stanford.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.3535

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Adolescents and young adults who used new pod-based electronic cigarettes commonly did so along with other e-cigarettes and traditional cigarettes.

Why The Research Is Interesting: E-cigarettes are the most commonly used tobacco product among adolescents and young adults. More information is needed on how new pod-based e-cigarette products affect attitudes, initiation and use of tobacco products. This study examined pod-based e-cigarette use and compared it with the use of other e-cigarettes and traditional cigarettes by California adolescents and young adults.

Who and When: 445 California adolescents and young adults (average age 19) from an ongoing study with data collected in 2018 about the use of tobacco products and perceptions of tobacco products

What (Study Measures and Outcomes): Use of pod-based e-cigarettes, e-cigarettes and traditional cigarettes (exposures); use of the products at various intervals, use of flavors and nicotine in pod-based e-cigarettes and e-cigarettes; and perceptions about risks, benefits and nicotine dependence (outcomes)

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

Authors: Bonnie Halpern-Felsher, Ph.D., Stanford University, Palo Alto, California, and coauthors

Results: Among users of pod-based cigarettes, the use of other e-cigarettes and cigarettes was common (see image below); the first pod ever used was flavored for the majority of users; and the average perceived chances of experiencing social and health risks from either pod-based e-cigarettes or other e-cigarettes was about 40 percent.

Study Limitations: The survey drew only from California schools and survey questions about pod-based e-cigarettes weren’t designed to address differences in understanding of the devices.

Study Conclusions:

Related Material: The invited commentary, “Pod Mod Electronic Cigarettes – An Emerging Threat to Public Health,” by Tory R. Spindle, Ph.D., of Johns Hopkins University School of Medicine, Baltimore, Maryland, and Thomas Eissenberg, Ph.D., of Virginia Commonwealth University, Richmond, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.3535)

Editor’s Note: The article contains funding/support disclosures. 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.

Did Leonardo da Vinci Have a Vision Disorder That May Have Helped Him Capture Space on a Flat Canvas?

Posted October 16, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, OCTOBER 18, 2018

Media advisory: To contact corresponding author Christopher W. Tyler, Ph.D., D.Sc., email cwtyler2020@gmail.com. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.3833

Bottom Line: Beginning with Rembrandt, a number of famous artists have been identified as having strabismus, a misalignment of the eyes. Some forms of eye misalignment are thought to be beneficial for artistic work by suppressing the deviating eye, which provides 2-dimensional monocular vision advantageous to painting and drawing. In this study, images considered to be of Leonardo da Vinci (sculptures, oil paintings and drawings) were analyzed. The author found evidence that suggests da Vinci may have had intermittent exotropia (a tendency for the outward turn of an eye). This would result in a capability to switch to monocular vision, which may help to explain his ability to depict the 3-dimensional aspects of faces and objects in the world and the distant depth of mountainous scenes.

Author: Christopher W. Tyler, Ph.D., D.Sc., City University of London, United Kingdom

Images Suggesting Leonardo da Vinci May Have Had Eye Misalignment

Right click on image to download

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

(doi:10.1001/jamaophthalmol.2018.3833)

# # #

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

More Caffeine from Coffee Associated With Decreased Rosacea Risk

Posted October 15, 2018 by Deanna Bellandi

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 17, 2018

Media Advisory: To contact corresponding author Wen-Qiing Li, Ph.D., email Mollie Rappe at mollie_rappe@brown.edu. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Link will be live at the embargo time https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2018.3301

Bottom Line: Consuming caffeine from coffee but not from other foods (tea, soda and chocolate) was associated with less risk of rosacea, a common chronic inflammatory skin disease where the skin appears red and flushed. This observational study included more than 82,000 women in the Nurses’ Health Study II with data collected on coffee, tea, soda and chocolate consumption. Compared with people who had less than one serving of caffeinated coffee per month, those who had four servings or more per day had the lowest risk for rosacea. Decaffeinated coffee wasn’t associated with decreased rosacea risk. Rosacea symptoms may be lessened because of caffeine’s vasoconstrictive and immunosuppressant effects but further studies are to needed to understand the reasons for the observed association.

Authors: Wen-Qing Li, Ph.D., of the Warren Alpert Medical School at Brown University, Providence, Rhode Island, and coauthors

Related Material: The editorial, “One More Reason to Continue Drinking Coffee – It May Be Good for Your Skin,” by Mackenzie R. Wehner, M.D., M.Phil., of the University of Pennsylvania, Philadelphia, and Eleni Linos, M.D., M.P.H., Dr.P.H., of the University of California, San Francisco, also is available on the For The Media website.

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

(doi:10.1001/jamadermatol.2018.3301)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. 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.

Listen to the Podcast: An Update on the Diagnosis and Treatment of Venous Thromboembolic Disease

Posted October 11, 2018 by Jim Michalski

Listen to an interview with Philip S. Wells, M.D., of the University of Ottawa, Canada, co-author of the JAMA study, “Venous Thromboembolism – Advances in Diagnosis and Treatment.” The podcast is available for listening and download on this page.

Emergency Department Blood Test May Help Rule Out Heart Attack Within 15 Minutes

Posted October 15, 2018 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 17, 2018

Media advisory: To contact corresponding author Martin P. Than, M.B.B.S., email martinthan@xtra.co.nz. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamacardiology/fullarticle/10.1001/jamacardio.2018.3368

Bottom Line: A new, quick and accurate, bedside blood test done in an emergency department could help reduce the time it takes to rule out heart attacks. A preliminary study suggests a 15-minute blood test in the emergency department to measure a protein in the blood (cardiac troponin) may have similar ability to rule out a heart attack as blood tests that take longer to be measured in a laboratory. The analysis in this observational study at a single regional emergency department included about 350 patients with symptoms of a heart attack. Confirmation in larger studies is needed.

Authors: Martin P. Than, M.B.B.S., Christchurch Hospital, Christchurch, New Zealand, and coauthors

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

(doi:10.1001/jamacardio.2018.3368)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. 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.

How Common Are Tobacco, Marijuana Use in Hip-Hop Music Videos?

Posted October 11, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 15, 2018

Media advisory: To contact study author Kristin E. Knutzen, M.P.H., email Paige Stein at Paige.Stein@dartmouth.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4488

Bottom Line: Popular hip-hop music videos frequently feature tobacco and marijuana use, and because of the genre’s broad appeal, this may contribute to growing public health concern about the use of these products in traditional combustible or new electronic forms.

Why The Research Is Interesting: Hip-hop artists model behavior to their fans because of their prominence and the commentary in their songs. Depictions of tobacco and marijuana use in music videos may help to increase the products’ appeal and decrease fans’ perceptions of risks and harms. This study analyzed leading hip-hop music videos over five years (2013-2017) to characterize the extent to which tobacco and marijuana use appeared.

What and When: 796 hip-hop music videos on Billboard magazine’s weekly Hot R&B/Hip Hop Songs list between 2013 and 2017

Study Measures and Outcomes: How common was the appearance or use of combustible tobacco and marijuana products; the appearance of smoke or vapor; the appearance or use of electronic tobacco and marijuana products; tobacco or marijuana brand placement; and the appearance or use of combustible and electronic tobacco and marijuana by the main or featured artist

How (Study Design): This was a content analysis.

Authors: Kristin E. Knutzen, M.P.H., of the Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, and coauthors

Results:

Study Limitations: More than 30 percent of leading hip-hop songs didn’t have music videos; and demographic and socioeconomic characteristics and residency weren’t known about people who watched hip-hop videos

Conclusions:

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

(doi:10.1001/jamainternmed.2018.4488)

Editor’s Note: The article contains funding/support disclosures. 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 emailmediarelations@jamanetwork.org.

No Decrease in X-Rays for Infants With Lower Respiratory Tract Infections

Posted October 11, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 16, 2018

Media advisory: To contact corresponding author Brett Burstein, M.D.C.M., Ph.D., M.P.H., email Stephanie Tsirgiotis at stephanie.tsirgiotis@muhc.mcgill.ca. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.9245

Bottom Line: Revised guidelines recommend against routine X-rays for infants with bronchiolitis, a viral lower respiratory tract infection that often lands babies in the hospital. Unnecessary X-rays contribute to health care costs and radiation exposure. Despite the guidelines, an analysis of emergency department visits in the United States suggests no decrease in the rate of X-rays from 2007 to 2015, with nearly half of children under 2 with bronchiolitis still getting imaging. The study lacked clinical data to determine the appropriateness of X-rays.

Authors: Brett Burstein, M.D.C.M., Ph.D., M.P.H., Montreal Children’s Hospital, Montreal, Canada, and coauthors

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

(doi:10.1001/jama.2018.9245)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. 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.

Is Weight-Loss Surgery Associated With Lower Risk of Macrovascular Events Like Heart Attack, Stroke for Patients with Type 2 Diabetes?

Posted October 11, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 16, 2018

Media advisory: To contact corresponding author David Arterburn, M.D., M.P.H., email Rebecca Hughes (Rebecca.F.Hughes@kp.org) or Heather Platisha (Heather.Platisha@creation.io). The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.14619

Bottom Line: Macrovascular disease events, which include heart attack and stroke, are a leading cause of illness and death for patients with type 2 diabetes. Medical management, including lifestyle changes, may not reduce patient risk but bariatric surgery may help. In this observational study of about 20,000 patients with severe obesity and type 2 diabetes who underwent bariatric surgery or received usual medical care for diabetes, bariatric surgery was associated with a lower risk of macrovascular disease events at five years of follow-up (2.1 percent vs 4.3 percent). The findings require confirmation in randomized clinical trials.

Authors: David Arterburn, M.D., M.P.H., Kaiser Permanente Washington Health Research Institute, Seattle, and coauthors

Related Material

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

— A video abstract is available to view on this page and to embed on your website by copying and pasting the HTML code below. To download the video, email mediarelations@jamanetwork.org for information.

— The JAMA editorial, “Preventing Macrovascular Events With Bariatric Surgery,” by Sayeed lkramuddin, M.D., M.H.A., University of Minnesota, Minneapolis, and coauthors.

— The JAMA Surgery editorial: “Standardized Uniform Reporting and Indications for Bariatric and Metabolic Surgery,” by Paulina Salminen, M.D., Turku University Hospital, Turku, Finland.

— The JAMA study, “Comparison of the Performance of Common Measures of Weight Regain After Bariatric Surgery for Association With Clinical Outcomes,” by Wendy C. King, Ph.D., University of Pittsburgh, and coauthors.

The JAMA editorial, “Setting Appropriate Expectations After Bariatric Surgery,” by Amir A. Ghaferi, M.D., M.S., and Oliver A. Varban, M.D., University of Michigan, Ann Arbor.

Previously published by JAMA: Bariatric Surgery for Type 2 Diabetes

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

(doi:10.1001/jama.2018.14619)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. 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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Unapproved Ingredients in Over-the-Counter Supplements

Posted October 9, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, OCTOBER 12, 2018

Media advisory: To contact corresponding study author Madhur Kumar, M.S., Ph.D., email Corey Egel at cdphpress@cdph.ca.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.3337

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Potentially harmful and undeclared pharmaceuticals were identified in more than 700 over-the-counter dietary supplements in an analysis of U.S. Food and Drug Administration warnings from 2007 through 2016.

Why The Research Is Interesting: More than half of adults in the United States report using dietary supplements, and the FDA has warned about unapproved pharmaceutical ingredients in some of these supplements. This study analyzed data from a tainted supplements database maintained by the FDA for trends in adulterated dietary supplements associated with a warning by the FDA.

What and When: Data from the FDA’s Center for Drug Evaluation and Research, Tainted Products Marketed as Dietary Supplements_CDER database from 2007 through 2016; date, product name, company, hidden ingredients, product category, source of sample and warning type (i.e. voluntary recall, public notification, news release, consumer update or warning letter) for each warning were recorded

How (Study Design): This was a quality improvement study.

Authors: Madhur Kumar, M.S., Ph.D., California Department of Public Health, Sacramento, and coauthors

Results: Unapproved pharmaceutical ingredients were identified in 776 dietary supplements, most of them marketed for sexual enhancement, weight loss or muscle building; 20 percent of the products had more than one unapproved ingredient; and 28 products were named in two or three warnings.

Study Limitations: Analysis was independent of FDA involvement; total number and variety of products tested by the FDA each year are unknown; and findings are limited to drugs for which the FDA tested.

Study Conclusions:

Related Material: The invited commentary, “The FDA and Adulterated Supplements — Dereliction of Duty,” by Pieter A. Cohen, M.D., Somerville Hospital Primary Care, Somerville, Massachusetts, also is available on the For The Media website.

Visual Abstract:

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

(doi:10.1001/jamanetworkopen.2018.3337)

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.

Obesity Associated With Higher Colorectal Cancer Risk Among Younger Women

Posted October 9, 2018 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, OCTOBER 11, 2018

Media advisory: To contact corresponding author Yin Cao, M.P.H., Sc.D., email Jim Goodwin at jgoodwin@wustl.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.4280

Bottom Line: Obesity was associated with an increased risk of early onset colorectal cancer (CRC) among women younger than 50.

Why The Research Is Interesting: New cases of CRC and death are increasing among people younger than 50 and the reasons for this are largely unknown. This study used data from a large group of women in the Nurses’ Health Study II to examine the association of obesity with CRC diagnosed before age 50.

Who and When: 85,256 women ages 25 to 42 who were free of cancer and inflammatory bowel disease when they enrolled in the study and followed up from 1989 through 2011.

What (Study Measures and Outcomes): Current body mass index (BMI), BMI at age 18 and weight gain since age 18 (exposures); relative risk, which is a statistical measure of probability, for new early onset CRC (outcome)

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

Authors: Yin Cao, M.P.H., Sc.D., of the Washington University School of Medicine, St. Louis, Missouri, and coauthors

Results: There were 114 cases of early onset CRC among the 85,256 women studied. Higher current BMI, BMI at age 18 and weight gain since early adulthood were associated with increased risk of early onset CRC. Obesity, which is a BMI of 30 or above, was associated with highest risk.

Limitations: The study included mainly white women so the findings need to be validated among other races/ethnicities and among men.

Study Conclusions: Obesity and weight gain since early adulthood were associated with increased risk of early onset CRC. This study highlights the importance of weight control throughout life and the potential role of body weight in complementing CRC screening for the early detection of early onset CRC.

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

(doi:10.1001/jamaoncol.2018.4280)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. 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.

Medical Marijuana for Symptoms in Patients with Multiple Sclerosis

Posted October 9, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, OCTOBER 12, 2018

Media advisory: To contact corresponding study author Mari Carmen Torres-Moreno, Ph.D., email mariacarmen.torres@e-campus.uab.cat. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.3485

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: This study analyzed 17 clinical trials including 3,161 patients to evaluate medicinal cannabinoids — the chemical compounds in cannabis — for the treatment of symptoms in patients with multiple sclerosis (MS). Cannabinoids were associated with a limited and mild reduction in the subjective patient assessment of spasticity (contracted muscles), pain and bladder dysfunction in this systematic review and meta-analysis. A meta-analysis combines the results of multiple studies identified in a systematic review and quantitatively summarizes the overall association between the same exposure and outcomes measured across all studies. The analysis in this report suggests therapy using these drugs can be considered safe, although the number of adverse events is higher than placebo for treating symptoms in patients with MS.

Authors: Mari Carmen Torres-Moreno, Ph.D., Universitat Autònoma de Barcelona (UAB), Spain, and coauthors

Related Material: The invited commentary, “Cannabinoids for Symptoms of Multiple Sclerosis: Benefits to Patients Still Unclear,” by Marissa Slaven, M.D., and Oren Levine, M.D., M.Sc., of McMaster University, Hamilton, Ontario, Canada, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.3485)

Editor’s Note: The article contains funding/support disclosures. 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: In Memoriam—Honoring the Victims of Opioid Addiction

Posted October 5, 2018 by Deanna Bellandi

The photos below accompany the article and are available for use. Right click to save the image.

Caption: Engraved pills memorializing those who die each year due to prescription opioid misuse.

Caption: Details of the pill engraving.

Long-Term Follow-Up of Using Patients’ Own Fat to Correct Deformities After Breast Cancer Surgery

Posted October 8, 2018 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, OCTOBER 10, 2018

Media advisory: To contact corresponding author Todor Krastev, M.D., email dr.todor.krastev@gmail.com. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2018.3744

Bottom Line: One technique to correct disfiguring deformities after breast cancer surgery is autologous fat transfer (AFT or fat grafting), which involves injecting a patient’s own fat into a soft tissue deformity. Previous studies examining the safety of this procedure in regard to cancer relapse have been limited by a relatively short follow-up. This study included nearly 600 women with breast cancer who underwent fat grafting or conventional breast reconstruction. After five years of follow-up, fat grafting wasn’t associated with increased rates of cancer relapse, with no significant difference in the rate of cancer relapse between the two groups. Although the study didn’t demonstrate significant differences in recurrence rates, it cannot eliminate the possibility that an association between AFT and cancer relapse may still be present.

Authors: Todor Krastev, M.D., Ph.D., Maastricht University Medical Centre, Maastricht, the Netherlands, and coauthors

Related material: The commentary, “The Third Postmastectomy Reconstruction Option – Autologous Fat Transfer,” by Roger K. Khouri, M.D., Miami Breast Center. Key Biscayne, Florida and coauthors, 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/jamasurg.2018.3744)

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.

Study Examines Changes Made at Home After Unintentional Injuries to Children

Posted October 4, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 8, 2018

Media advisory: To contact corresponding author Vanya C. Jones, Ph.D., M.P.H., email Barbara Benham at bbenham1@jhu.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.2781

Bottom Line: A research letter looked at how parents made changes at home after unintentional injuries sent children to emergency departments. In the study of 104 children (6 months to 7 years old) who experienced 123 injuries, falls at home were most common with most injuries to the head/neck/face area. More than half of parents made modifications at home, such as storing hazardous products, after an unintentional injury to a child. Medical records were reviewed and parents were interviewed for the study.

Authors: Vanya C. Jones, Ph.D., M.P.H., of Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and coauthors

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

(doi:10.1001/jamapediatrics.2018.2781)

Editor’s Note: The article contains finding/support disclosures. 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.

Can the Timing of Pushing During Delivery Affect Outcomes?

Posted October 4, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 9, 2018

Media advisory: To contact corresponding author Alison G. Cahill, M.D., M.S.C.I., email Diane Duke Williams at Williamsdia@wustl.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.13986

Bottom Line: The best time to push during the second stage of labor (when the cervix is completely dilated through delivery) is unknown and it’s unclear whether the timing affects rates of natural delivery or possible complications. The two most common approaches are either immediate pushing (pushing with uterine contractions once complete cervical dilation occurs) or delayed pushing to allow for spontaneous descent of the fetus. In this randomized clinical trial, immediate pushing compared with delayed pushing didn’t result in a significant difference in the rates of spontaneous vaginal delivery (without the use of forceps, vacuum or cesarean delivery) or overall adverse outcomes among newborns. Rates of hemorrhage and infection were higher among women in the delayed pushing group. The clinical trial included about 2,400 women who received pain medication for labor and delivery and who had not previously given birth. This study may not have been able to detect clinically important differences in some other outcomes.

Authors: Alison G. Cahill, M.D., M.S.C.I., Washington University in St. Louis, and coauthors

Related Material

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

— The editorial, “Immediate vs Delayed Pushing During the Second Stage of Labor,” by Jeffrey D. Sperling, M.D., M.S., and Dana R. Gossett, M.D., M.S.C.I., of the University of California, San Francisco.

— A video abstract is available to view on this page and to embed on your website by copying and pasting the HTML code below. The transcript is available here. To download the video, email mediarelations@jamanetwork.org for information.

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

(doi:10.1001/jama.2018.13986)

Editor’s Note: The article includes funding/support disclosures. 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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Timing of 3rd-Trimester Maternal Tdap Immunization Associated With Levels of Whooping Cough Antibodies in Newborns

Posted October 4, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 9, 2018

Media advisory: To contact corresponding author C. Mary Healy, M.D., email Jeannette Jimenez at Jeannette.Jimenez@bcm.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.14298

Bottom Line: Risk of whooping cough (pertussis) is highest in infants too young to have completed their primary immunization series (6 months old or younger) and they are at highest risk of developing life-threatening complications. Immunizing pregnant women with the tetanus, diphtheria and acellular pertussis (Tdap) vaccine can create enough maternal antibodies to protect infants, but the best time to immunize mothers to maximize concentrations of neonatal pertussis toxin antibodies is unknown. This observational study included 626 pregnancies and compared pertussis antibody concentrations in umbilical cord blood among newborns whose mothers received Tdap immunization in the third trimester, as is recommended by the U.S. Centers for Disease Control and Prevention, with those whose mothers didn’t receive the Tdap vaccine during pregnancy. Maternal immunization with the Tdap vaccine during the third trimester of pregnancy was associated with higher concentrations of pertussis antibodies in infants at birth, with immunization early in the third trimester associated with the highest concentrations of antibodies. Definitive antibody concentration levels for immunity from whooping cough for infants are unknown. The study design doesn’t allow for cause-and-effect interpretations of the findings.

Authors: C. Mary Healy, M.D., Baylor College of Medicine, Houston, and coauthors

Related Material

Previously published by JAMA: Safety and Immunogenicity of Tetanus Diphtheria and Acellular Pertussis (Tdap) Immunization During Pregnancy in Mothers and Infants

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

(doi:10.1001/jama.2018.14298)

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

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

Risk of Attempted Suicide Among Sexual Minority Adolescents

Posted October 4, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 8, 2018

Media advisory: To contact corresponding author Ester di Giacomo, M.D., email ester.digiacomo@yahoo.com. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.2731

Bottom Line: Adolescents who don’t identify as heterosexual appear to have a greater risk of attempted suicide.

Why The Research Is Interesting: Suicide is among the leading causes of death for adolescents and increasing evidence suggests a greater risk of attempted suicide by adolescents who are sexual minorities. This study estimated the risk of attempted suicide among sexual minority adolescents and differentiated between sexual minority groups (homosexual, bisexual and transgender).

Who and When: More than 2.3 million heterosexual and 113,468 sexual minority adolescents from 35 studies conducted in 10 countries

What (Study Measures and Outcomes): Increased odds of attempted suicide among sexual minority youths compared with heterosexual peers

How (Study Design): This was a systematic review and meta-analysis. A meta-analysis combines the results of multiple studies identified in a systematic review and quantitatively summarizes the overall association between the same exposure and outcomes measured across all studies.

Authors: Ester di Giacomo, M.D., of the University of Milano-Bicocca, Italy, and coauthors

Results:

Study Limitations: Data were self-reported; transgender youths were identified as an individual group in one study

Study Conclusions: Public awareness is important. Education and public health planning should include an evaluation of supportive strategies for sexual minority adolescents such as support programs, counseling and efforts at destigmatizing.

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

(doi:10.1001/jamapediatrics.2018.2731)

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

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

Study Examines Processes to Request Patient Medical Records in U.S. Hospitals

Posted October 2, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, OCTOBER 5, 2018

Media advisory: To contact corresponding study author Harlan M. Krumholz, M.D., S.M., email Kendall Teare at kendall.teare@yale.edu. The full study is available on the For The Media website. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.3014

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Patients can face barriers when trying to obtain their medical records and a study of top-ranked U.S. hospitals suggests noncompliance with federal and state regulations regarding certain aspects of medical records request processes and discrepancies in information provided to patients may contribute.

Why The Research Is Interesting: A rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) gives patients the right to access their protected health information. A comprehensive review of the challenges patients experience when requesting the release of their medical records was needed.

What and When: 83 top-ranked U.S. hospitals (based on 2016-2017 U.S. News & World Report national rankings) in 29 states; researchers collected medical records release authorization forms from each hospital and telephoned each hospital’s medical records department to collect data on records release, processing times and cost to simulate a patient experience.

What (Study Measures and Outcomes): Scripted interview with medical records departments in a simulated patient experience (exposure); requested information, formats of release (pick up in person, mail, fax, email, CD and online patient portal), costs and request processing times that were identified on medical records release authorization forms and through telephone calls with medical records departments (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: Harlan M. Krumholz, M.D., S.M., Yale School of Medicine, New Haven, Connecticut, and a member of the JAMA Network Open editorial board, and co-authors

Results:

Study Limitations: Only highly ranked hospitals were included and may not be representative of the medical request processes at all hospitals; telephone calls resulted in conversations with one person at each hospital and that person may disclose information not representative of the department or conflict with information others in the department might give

Study Conclusions:

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

(doi:10.1001/jamanetworkopen.2018.3014)

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

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

Study Uses Hospital Discharge Data to Examine Eye Injury Rates

Posted October 2, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, OCTOBER 4, 2018

Media advisory: To contact corresponding author Syed M.A. Shah, M.D., email Allison Hydzik at hydzikam@upmc.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.4685

Bottom Line: Eye trauma is a common cause of vision impairment or vision loss. An analysis of hospital discharge data from 2001-2014 estimated nearly 940,000 hospital admissions for eye trauma occurred in the United States during the period. The increase in eye trauma as a secondary diagnosis was mostly attributed to increasing falls in adults older than 65. Limitations of the study include those inherent with the use of large administrative database.

Authors: Syed M.A. Shah, M.D., University of Pittsburgh Medical Center, Pittsburgh, and coauthors

Related material: The commentary, “National Trends in Ocular Injury,” by Julie C. Leonard, M.D., M.P.H., of the Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, is available on the For The Media website.

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

(doi:10.1001/jamaophthalmol.2018.4685)

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

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

Articles Examine Aspects of Sexual Assault, Harassment

Posted October 1, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 9 A.M. (ET), WEDNESDAY, OCTOBER 3, 2018

Media advisory: To contact corresponding author Rebecca C. Thurston, Ph.D., email Ashley Trentrock at trentrockar@upmc.edu and to contact corresponding author Sabine Oertelt-Prigione, M.D., M.Sc.P.H., Ph.D., email sabine.oertelt-prigione@radboudumc.nl. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4886 and https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4859

Bottom Line: Two articles are being published to coincide with the North American Menopause Society annual meeting. An original investigation by Rebecca C. Thurston, Ph.D., of the University of Pittsburgh, Pennsylvania, and coauthors looked at the association of sexual harassment and sexual assault with blood pressure, mood, anxiety and sleep among midlife women. In the study of 304 women between the ages of 40 and 60, 19 percent reported a history of workplace sexual harassment and 22 percent reported a history of sexual assault. Sexual harassment was associated with higher odds of hypertension and clinically significant sleep problems, and in the case of sexual assault, a greater likelihood of clinically significant elevations in depression, anxiety and poor sleep. In addition, a research letter by Sabine Oertelt-Prigione, M.D., M.Sc.P.H., Ph.D., of Radboud University Medical Center, Nijmegen, the Netherlands, surveyed physicians at a tertiary referral center in Berlin, Germany, about sexual harassment and the results suggest sexual harassment frequently affects female and male physicians during their careers. There were 737 participants included in the analysis and, among them, 70 percent reported some form of misconduct while working, and the most common form self-reported as harassment was verbal harassment.

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

(doi:10.1001/jamainternmed.2018.4886 and doi:10.1001/jamainternmed.2018.4859)

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

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

How Have Mortality Rates Changed Over Time for Infants, Children?

Posted September 27, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 1, 2018

Media advisory: To contact corresponding author Meredith S. Shiels, Ph.D., M.H.S., email the NCI Press Office at ncipressofficers@mail.nih.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.3317

Bottom Line: Mortality rates for death from any cause declined in all age groups from 1999 to 2015 in a study that analyzed death certificate data for people younger than 25 in the United States, Canada and England/Wales. More than 1.1 million deaths occurred during the study period in the United States, where mortality rates for death from any cause were the highest. The study identifies leading causes of death and analyzes changes in mortality rates by age and race/ethnicity in the United States. The authors highlight mortality rate trends in the United States among major causes of death, including declining rates for sudden infant death syndrome and, for young people, declines in unintentional injury deaths and homicides. In addition, mortality rates from suffocation and strangulation in bed increased for infants, while suicide and drug poisonings increased over time among young people.

Authors: Meredith S. Shiels, Ph.D., M.H.S., of the National Cancer Institute, Bethesda, Maryland, and coauthors

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

(doi:10.1001/jamapediatrics.2018.3317)

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

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

Southern Diet is Top Factor Associated with Higher Risk of High Blood Pressure Among Black Adults

Posted September 27, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 2, 2018

Media advisory: To contact corresponding author George Howard, Dr.P.H., email Holly Gainer at hgainer@uab.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.13467

Bottom Line: High blood pressure is widespread among black adults in the United States and it is a major contributor to disparities in life expectancy, although reasons for this increased hypertension risk are unknown. Researchers examined 12 factors and their association with the development of hypertension among 6,900 black and white adults who didn’t have hypertension when they entered the study in 2003-2007 and who were followed-up nine years later. The biggest factor associated with increased risk of hypertension among black adults was high consumption of a Southern diet, which was defined as eating lots of fried foods, organ meats, processed meats, eggs and egg dishes, added fats, high-fat dairy foods, sugar-sweetened beverages and bread.

Authors: George Howard, Dr.P.H., University of Alabama at Birmingham, and coauthors

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

(doi:10.1001/jama.2018.13467)

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

Related Material

Previously published by the JAMA Network:

Racial Differences in Associations of Blood Pressure Components in Young Adulthood With Incident Cardiovascular Disease by Middle Age

Racial Differences in the Impact of Elevated Systolic Blood Pressure on Stroke Risk

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

Is Thyroid Hormone Therapy for Early Underactive Thyroid Associated With Better Quality of Life?

Posted September 27, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, OCTOBER 2, 2018

Media advisory: To contact corresponding author Martin Feller, M.D., M.Sc., email martin.feller@insel.ch. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.13770

Bottom Line: An early form of underactive thyroid (when the body doesn’t produce enough thyroid hormones) called subclinical hypothyroidism is a common condition but the benefit of thyroid hormone therapy on quality of life and symptoms is uncertain. This study, which analyzed the combined results of 21 randomized clinical trials with 2,200 participants with subclinical hypothyroidism, reports that thyroid hormone therapy wasn’t associated with improved quality of life or thyroid-related symptoms. The authors suggest the results don’t support routine use of thyroid hormone therapy in adults with subclinical hypothyroidism.

Authors: Martin Feller, M.D., M.Sc., University of Bern, Switzerland, and coauthors

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

(doi:10.1001/jama.2018.13770)

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

Related Material

Previously published by JAMA:

Thyroid-Stimulating Hormone in the Evaluation of Subclinical Hypothyroidism

Subclinical Thyroid Dysfunction and Fracture Risk

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

Women Who Drank More Water Had Less Frequent Urinary Tract Infections

Posted September 27, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 1, 2018

Media advisory: To contact corresponding author Thomas M. Hooton, M.D., email Kai Hill at KHill@med.miami.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4204

Bottom Line: Premenopausal women with recurrent urinary tract infections (cystitis) who drank more water had less frequent infections in a randomized clinical trial. The study included 140 women with recurrent cystitis who reported drinking less than 1.5 liters of total fluid daily (about six 8-ounce glasses). During the 12 months of the trial, half the women were assigned to drink 1.5 liters of water in addition to their regular fluids, while the others not change their regular fluid intake. Episodes of cystitis were less frequent in women who drank more water for 12 months (average number of cystitis episodes was 1.7 for the women who drank more water compared with 3.2 for the women who didn’t). The study can’t tell researchers what amount of daily water intake is sufficient to reduce the risk of urinary tract infections or whether drinking more water is beneficial for women at lower risk for recurrent cystitis or women who regularly drink more fluids than those in this study. The authors suggest that drinking more water is a safe and inexpensive alternative strategy to prescribing antimicrobial treatment to try to prevent these infections.

Authors: Thomas M. Hooton, M.D., of University of Miami, Florida, and coauthors

Related Material: The Editor’s Note, “Drinking More Water for Prevention of Recurrent Cystitis,” by JAMA Internal Medicine Deputy Editor Deborah Grady, M.D., M.P.H., of the University of California San Francisco, also is available on the For The Media website.

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

(doi:10.1001/jamainternmed.2018.4204)

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

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

High-Pressure Oxygen Therapy May Be Beneficial in Treating Sudden Hearing Loss

Posted September 25, 2018 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, SEPTEMBER 27, 2018

Media advisory: To contact corresponding author Tae-Min Rhee, M.D., D.M.O./U.M.O., email imcrtm@gmail.com. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2018.2133

Bottom Line: The addition of hyperbaric oxygen therapy (where patients receive pure oxygen in a pressurized chamber) to standard medical treatment was associated with an improved likelihood that patients who experience sudden deafness might recover all or some of their lost hearing. Sudden deafness, also known as sudden sensorineural hearing loss (SSNHL), is hearing loss that happens within a few days and often has no identifiable cause. This study combined the results of 19 studies, including three randomized clinical trials, and suggests a greater benefit of adding the hyperbaric oxygen therapy may be associated with those patients who have severe to profound hearing loss and who failed to recover after standard medical treatment. A limitation of this study is that because a substantial number of patients with SSNHL will spontaneously recover, the benefits of treatment may not have been accurately evaluated.

Authors: Tae-Min Rhee, M.D., D.M.O./U.M.O., National Maritime Medical Center, Changwon, Republic of Korea, and coauthors

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

(doi:10.1001/jamaoto.2018.2133)

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

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

Did Rate of Concussions Change Following Experimental Kickoff Rule in Ivy League Football?

Posted September 27, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, OCTOBER 1, 2018

Media advisory: To contact corresponding author Douglas J. Wiebe, Ph.D., email Greg Richter at greg.richter@pennmedicine.upenn.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.14165

Bottom Line: The kickoff return in football has been associated with a substantial number of concussions because players run toward each other and there is potential for significant hits. In 2015, kickoffs accounted for 6 percent of all plays but 21 percent of concussions in the Ivy League, a Division 1 conference of eight private universities. Ivy League football coaches recommended a rule change and, in 2016, the kickoff and touchback line were moved to reduce the likelihood of a player advancing the ball on a kickoff. A new research letter reports that during 68,479 plays from 2013 through 2017, there were 159 concussions (126 before the rule change and 33 after). The average annual concussion rate per 1,000 kickoff plays was 10.93 before the rule change (2013-2015) and 2.04 after (2016-2017). Although these results may not be generalizable beyond the Ivy League, they could be helpful to the National Collegiate Athletic Association (NCAA) as it considers adjusting kickoff rules in all collegiate football conferences.

Authors: Douglas J. Wiebe, Ph.D., University of Pennsylvania, Philadelphia, and coauthors

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

(doi:10.1001/jama.2018.14165)

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

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

Study Finds Substantial Variation in Survival Between EMS Agencies Treating Out-Of-Hospital Cardiac Arrest

Posted September 24, 2018 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, SEPTEMBER 26, 2018

Media advisory: To contact corresponding author Masashi Okubo, M.D., M.S., email Courtney Caprara at capraracl@upmc.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamacardiology/fullarticle/10.1001/jamacardio.2018.3037

Bottom Line: Emergency medical services (EMS) deliver essential initial care when patients in the community have cardiac arrest. How do patient outcomes differ between EMS agencies? This observational study suggests the odds of surviving to hospital discharge could differ more than 50 percent for any two otherwise similar patients treated by any two randomly selected EMS agencies for cardiac arrest that occurred outside a hospital. More research is needed to identify the factors that might contribute to this. This study included nearly 44,000 adults treated by 112 EMS agencies in the U.S. and Canada.

Authors: Masashi Okubo, M.D., M.S., University of Pittsburgh School of Medicine, and coauthors

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

(doi:10.1001/jamacardio.2018.3037)

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

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

How Do Minority Resident Physicians View the Role of Race/Ethnicity in Training Experiences?

Posted September 25, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 28, 2018

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

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.2723

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Workplace experiences of minority resident physicians in training are described in a new study.

Why The Research Is Interesting: Black, Hispanic and Native American physicians are underrepresented in medicine. Exploring the role of race/ethnicity in the professional lives of minority physicians is an essential step toward identifying barriers that hinder workforce diversity and developing interventions that foster diverse work environments.

Who and When: 27 minority resident physicians: 19 (70%) black, three (11%) Hispanic, one (4%) Native American and four (15%) of mixed race/ethnicity. Participants were interviewed at the 2017 Annual Medical Education Conference.

What (Study Measures and Outcomes): Interview responses from black, Hispanic and Native American resident physicians in graduate medical education about their workplace experiences.

How (Study Design): This was a qualitative study and the 27 residents interviewed represented a diverse range of medical specialties and geographic locations.

Authors: Aba Osseo-Asare, M.D., Yale School of Medicine, New Haven, and co-authors

Results: Minority resident physicians described three common scenarios in residency training: they routinely experienced racial/ethnic bias and were reluctant to report it; residency programs lacked institutional systems to promote diversity and relied on minority residents to be race/ethnicity ambassadors; and it was challenging to balance professional and personal identity.

Study Limitations: This was qualitative research so the themes that emerged need to be tested in further research.

Study Conclusions:

Related Material: The invited commentary, “The Plight of the Minority Resident Physician — Similar Challenges in a Different World,” by Kendall M. Campbell, M.D., of East Carolina University, Greenville, North Carolina, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.2723)

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

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

To What Extent Are Adolescents Using Multiple Types of Cannabis?

Posted September 25, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 28, 2018

Media advisory: To contact corresponding study author Adam M. Leventhal, Ph.D., email Gary Polakovic at polakovi@usc.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.2765

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Most 10th-graders who had ever used cannabis had used more than one type of the drug, including cannabis products that were combustible, edible or vaporized.

Why The Research Is Interesting: Cannabis use in adolescents is associated with increased risk for chronic use throughout adulthood, cannabis use disorder, impaired cognitive development and lower educational attainment. New cannabis products raise concerns about pediatric health amid the legalization of medical and recreational cannabis in some states and an increasing normalization of cannabis use in society.

Who and When: 3,177 10th-graders from 10 Los Angeles, California, area high schools surveyed from January to October 2015

What (Study Measures and Outcomes): Self-reported sex, race/ethnicity and socioeconomic status (exposures); self-report of ever use and past 30-day use of cannabis, as well as the frequency of use (number of days in past 30 days) of combustible, edible and vaporized cannabis (outcomes)

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

Authors: Adam M. Leventhal, Ph.D., the Keck School of Medicine of University of Southern California, Los Angeles, and co-authors

Results: Of the 33.9 percent of 10th-graders (1,077 of 3,177) who reported ever using cannabis, combustible cannabis was the most popular followed by cannabis products that were edible or vaporized. Most 10th-graders who had ever used cannabis (665[61.7 percent]) used multiple products to administer the drug.

Study Limitations: Whether 10th-graders who used two or more different cannabis products initiated cannabis use with noncombustible products and later transitioned to combustible cannabis or vice versa was unclear; and the survey didn’t differentiate cannabis products by potency, strain or types of cannabis formulation

Study Conclusions:

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

(doi:10.1001/jamanetworkopen.2018.2765)

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

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

Collection of JAMA Articles Focus on Race, Medicine and Medical Research

Posted September 20, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 24, 2018

Media advisory: For more information, email JAMA Network Media Relations at mediarelations@jamanetwork.org. The articles are available on the For The Media website.

Bottom Line: A collection of JAMA articles (an editorial and three Viewpoints) focuses on race, medicine and medical research. Excerpts of the articles are below along with links that will be live when the embargo lifts.

Editorial: “Race, Ancestry, and Medical Research,” by JAMA Executive Editor Phil B. Fontanarosa, M.D., M.B.A., and JAMA Editor in Chief Howard Bauchner, M.D.

Article Excerpt:

Want to embed a link to this article in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.14438

Viewpoint: “Race, Ancestry, and Reporting in Medical Journals,” by Richard S. Cooper, M.D., Loyola University Medical School, Maywood, Illinois, and coauthors

Article Excerpt:

Want to embed a link to this article in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.10960

Viewpoint: “Historical Aspects of Race and Medicine – The Case of J. Marion Sims,” by Keith Wailoo, Ph.D., Princeton University, Princeton, New Jersey

Article Excerpt:

Want to embed a link to this article in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.11944

Viewpoint: “Examining How Race, Ethnicity, and Ancestry Data Are Used in Biomedical Research,” by Vence L. Bonham, J.D., National Institutes of Health, Bethesda, Maryland, and coauthors

Article Excerpt:

Want to embed a link to this article in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.13609

To Learn More: All the articles 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, etc.

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

Mental Distress Associated With Nonconforming Gender Expression Among High School Students

Posted September 20, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 24, 2018

Media advisory: To contact corresponding author Richard Lowry, M.D., M.S., email nchhstpmediateam@cdc.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.2140

Bottom Line: Mental distress was associated with gender nonconformity among female and male high school students.

Why The Research Is Interesting: Gender nonconformity describes when an individual’s gender expression, such as through appearance or behavior, doesn’t align with societal expectations of their gender. More information is needed about the associations of gender nonconformity with mental health and substance use among the general population of adolescents independent of sexual orientation. This study was based on representative survey data from three large urban school districts in California and Florida.

Who, What and When: 6,082 high school students who were racially/ethnically diverse and representative of all high school students in those three school districts; the survey assessed gender expression, mental distress and substance use; this study analyzed data to describe the spectrum of gender expression and associations between nonconforming gender expression, mental distress and substance use among students

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: Richard Lowry, M.D., M.S., of the Centers for Disease Control and Prevention, Atlanta, Georgia, and coauthors

Results:

Study Limitations: The data apply only to young people who attend school, and sexual minority and gender minority students may be disproportionately represented among high school dropouts or those who are absent from school; data can suggest only association, not causality; and self-reported behaviors can be under or over reported.

Study Conclusions:

Related Material: The editorial, “Gender Diversity and Adolescent Well-Being,” by Ellen Selkie, M.D., M.P.H., of the University of Michigan, Ann Arbor, also is available on the For The Media website.

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

(doi:10.1001/jamapediatrics.2018.2140)

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

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

What is Long-Term Risk of Appendicitis Reoccurring in Patients Treated With Antibiotics?

Posted September 20, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 25, 2018

Media advisory: To contact corresponding author Paulina Salminen, M.D., Ph.D., email paulina.salminen@tyks.fi. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.13201

Bottom Line: About 60 percent of patients with uncomplicated acute appendicitis who were initially treated with antibiotics did not undergo appendectomy in five years in a follow-up to a randomized clinical trial. The clinical trial included 273 patients who had an appendectomy and 257 patients initially treated with antibiotics for uncomplicated acute appendicitis. In all, 100 of 257 patients initially treated with antibiotics underwent appendectomy during the five-year course of this study, including 15 patients operated on during the initial hospitalization. The findings suggest antibiotics may be a feasible alternative to surgery for patients with uncomplicated acute appendicitis.

Authors: Paulina Salminen, M.D., Ph.D., Turku University Hospital, Turku, Finland, and coauthors

Related Material

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

— The editorial, “Antibiotic Treatment for Uncomplicated Appendicitis Really Works,” by Edward H. Livingston, M.D., Deputy Editor, JAMA

— A video abstract is available to embed on your website by copying and pasting the HTML code below. The transcript is available here. To download the video, email mediarelations@jamanetwork.org for information.

Previously published by the JAMA Network:

Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis – The APPAC Randomized Clinical Trial

Patient Preferences for Surgery or Antibiotics for the Treatment of Acute Appendicitis

Comparison of Antibiotic Therapy and Appendectomy for Acute Uncomplicated Appendicitis in Children – A Meta-analysis

Effectiveness of Patient Choice in Nonoperative vs Surgical Management of Pediatric Uncomplicated Acute Appendicitis

Antibiotics vs Surgery for Acute Appendicitis: Toward a Patient-Centered Treatment Approach

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

(doi:10.1001/jama.2018.13201)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. 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:

<div style="display: block; position: relative; max-width: 300px;"><div style="padding-top: 50%;"><iframe src="//players.brightcove.net/864352215001/default_default/index.html?videoId=5829368006001" allowfullscreen webkitallowfullscreen mozallowfullscreen style="width: 100%; height: 100%; position: absolute; top: 0px; bottom: 0px; right: 0px; left: 0px;"></iframe></div></div>

How Common Are Traumatic Brain Injuries in Children?

Posted September 20, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 24, 2018

Media advisory: To contact corresponding author Juliet Haarbauer-Krupa, Ph.D., email Courtney Lenard at zvq5@cdc.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.2740

Bottom Line: An estimated 2.5 percent of U.S. children have experienced traumatic brain injury (TBI) during their lifetime based on reports from parents in an analysis of national survey data.

Why The Research Is Interesting: TBI in children is a public health concern because such injuries send children to emergency departments and carry risk for long-term adverse outcomes. This study analyzed national survey data to estimate how common it is for children to have a TBI during their lifetime based on reports from parents of a concussion or brain injury diagnosed by a health care professional.

Who, What and When: An analysis of data from the 2011-2012 National Survey of Children’s Health to estimate lifetime TBI in children, associated childhood health conditions, and health insurance type and adequacy based on reports from parents

How (Study Design): This was a data analysis.

Authors: Juliet Haarbauer-Krupa, Ph.D., of the Centers for Disease Control and Prevention, Atlanta, Georgia, and coauthors.

Results:

Study Limitations: The study didn’t examine medical records and relies on parents reporting diagnoses.

Study Conclusions:

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

(doi:10.1001/jamapediatrics.2018.2740)

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

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

Health Data Breaches on the Rise

Posted September 20, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 25, 2018

Media advisory: To contact corresponding author Thomas H. McCoy Jr., M.D., email Noah Brown at nbrown9@partners.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.9222

Bottom Line: The ongoing transition to electronic health records may increase data breaches involving patient records. An analysis of reported breaches of health data from 2010 through 2017 found that except for 2015, the number of breach reports increased each year. During this time there were 2,149 breaches comprising a total of 176.4 million records. The most common entity breached was a health care provider, with 1,503 breaches (70 percent) compromising a total of 37.1million records. Health plans accounted for the largest share of breached records (110.4 million). There was an increasing number of breaches associated with health care providers over time. The greatest numbers of records breached were accessed via network-connected information. A limitation of the study is that the results describe trends but do not allow for inferences about the causes of those trends.

Authors: Thomas H. McCoy Jr., M.D., and Roy H. Perlis, M.D., M.Sc., Massachusetts General Hospital, Boston, and Associate Editor, JAMA Network Open (Dr. Perlis)

Related Material

Previously published by JAMA:

Data Breaches of Protected Health Information in the United States

Keeping Personal Health Information Safe

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

(doi:10.1001/jama.2018.9222)

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

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

JAMA Network Retracts 6 Articles That Included Dr. Brian Wansink as Author

Posted September 19, 2018 by Deanna Bellandi

FOR IMMEDIATE RELEASE: SEPTEMBER 19, 2018

Media advisory: To contact JAMA Network Media Relations email mediarelations@jamanetwork.org.

CHICAGO – JAMA, JAMA Internal Medicine and JAMA Pediatrics have retracted six articles that included Brian Wansink, Ph.D., of Cornell University, Ithaca, New York, as author. Below is the notice of retraction published online today by JAMA, which references the retracted articles (see references 4-9). Similar notices were published online today in JAMA Internal Medicine and JAMA Pediatrics.

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

Is Survival Associated With Time to Defibrillation for In-Hospital Cardiac Arrest in Pediatric Patients?

Posted September 18, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 21, 2018

Media advisory: To contact corresponding study author Elizabeth A. Hunt, M.D., M.P.H., Ph.D., email Chanapa Tantibanchachai at chanapa@jhmi.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.2643

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: The time until a first attempt at defibrillation in pediatric patients who experienced cardiac arrest in the hospital wasn’t associated with survival or other main outcomes. This is in contrast to children who have a cardiac arrest outside of the hospital setting, or adult patients in or out of the hospital, where worse outcomes are associated with defibrillation delayed more than two minutes.

Why The Research Is Interesting: About 6,000 children each year in the United States experience cardiac arrest while in the hospital. In adults, delayed defibrillation attempts of more than two minutes are a national quality measure.

Who and When: Data for 477 pediatric patients younger than 18 from 113 hospitals with an in-hospital cardiac arrest, a documented loss of pulse and least one defibrillation attempt from 2000 to 2015.

What (Study Measures and Outcomes): Time between loss of pulse and first defibrillation attempt (exposure); survival to hospital discharge (primary outcome); return of circulation, 24-hour survival, and favorable neurologic outcome at hospital discharge (secondary 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: Elizabeth A. Hunt, M.D., M.P.H., Ph.D., of Johns Hopkins Charlotte Bloomberg Children’s Center, Baltimore, Maryland, and co-authors

Results: Most pediatric patients (71 percent) had a first attempt at defibrillation within two minutes of loss of pulse. There was no difference associated with survival in pediatric patients with a first defibrillation attempt in two minutes or less compared with more than two minutes; time to the first defibrillation attempt also wasn’t associated with the other outcomes. The authors offer several possibilities to explain their results.

Study Limitations: The sample size; that most first defibrillation attempts were within two minutes of loss of pulse; and that the sudden nature of cardiac arrest may have led to some misclassification of time and other variables.

Study Conclusions:

Related Material: The invited commentary, “Shorter Time to Defibrillation in Pediatric CPR — Children Are Not Small Adults But Shock Them Like They Are,” by Alexis Topjian, M.D., M.S.C.E., of the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.2643)

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

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

Do Rates of Burnout, Career-Choice Regret Vary by Specialty Among Resident Physicians?

Posted September 13, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 18, 2018

Media advisory: To contact corresponding author Liselotte N. Dyrbye, M.D., M.H.P.E., email Robert Nellis at newsbureau@mayo.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.12615

Bottom Line: Burnout is common among physicians. But do rates of burnout symptoms and career-choice regret vary among physicians in training by clinical specialty? In a study of nearly 3,600 second-year residents who were followed-up with questionnaires since medical school, 45 percent reported burnout symptoms and 14 percent reported regret over their career choice. The frequency of burnout symptoms and career-choice regret varied widely by specialty. Residents who trained in urology, neurology, emergency medicine or general surgery were more likely to report burnout symptoms compared with residents training in internal medicine, while residents who trained in pathology and anesthesiology were more likely to report career regret. Limitations of this observational study include that study participants may not be representative of all U.S. resident physicians. Regardless of specialty, high levels of anxiety and low levels of empathy reported during medical school were associated with burnout symptoms during residency.

Authors: Liselotte N. Dyrbye, M.D., M.H.P.E., Mayo Clinic, Rochester, Minnesota and coauthors

Related Material

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

— The JAMA study, “Prevalence of Burnout Among Physicians.”

— The JAMA editorial, “Physician Burnout—A Serious Symptom, But of What?”

Previously published:

— From JAMA Surgery, “Multiple-Institution Comparison of Resident and Faculty Perceptions of Burnout and Depression During Surgical Training.”

— From JAMA Internal Medicine, “Workplace Factors Associated With Burnout of Family Physicians.”

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

(doi:10.1001/jama.2018.12615)

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

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

Helping Parents Decide on Care for Children with Minor Head Trauma

Posted September 18, 2018 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 21, 2018

Media advisory: To contact study author Erik P. Hess, M.D., M.Sc., email Bob Shepard at bshep@uab.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.2430

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: More than 450,000 children visit emergency departments every year because of head trauma and many will undergo head computed tomography (CT) imaging, although few scans will show evidence of traumatic brain injury. Efforts have been made to avoid unnecessary CT imaging in children and to reduce radiation exposure. An information tool to help parents decide about care for their children with minor head trauma didn’t reduce the rate of CT imaging in emergency departments in this randomized clinical trial. However, parent knowledge increased, they were more involved in decisions over CT use, and health care utilization decreased during the following week.

Authors: Erik P. Hess, M.D., M.Sc., University of Alabama at Birmingham, and coauthors

Related Material: The invited commentary, “Shared Decision-Making Tools in Pediatric Acute Care,” by M. Denise Dowd, M.D., M.P.H., Children’s Mercy Hospital, Kansas City, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.2430)

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

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

Cannabis Use in E-Cigarettes by U.S. Youth

Posted September 13, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 17, 2018

Media advisory: To contact corresponding author Katrina F. Trivers, Ph.D., M.S.P.H., email Joel London at jlondon@cdc.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.1920

Bottom Line: An analysis of survey data estimates nearly 1 in 11 U.S. middle and high school students used cannabis in electronic-cigarettes in 2016. Among e-cigarette users, nearly 1 in 3 high school students and nearly 1 in 4 middle school students reported having ever used cannabis in e-cigarettes. Data were from a 2016 survey of students in the 6th through 12th grades which used a nationally representative sample of students in public and private schools. Researchers note their estimates were consistent with or higher than previous study reports, and that comparability between studies could be limited by differences in survey question wording. Researchers suggest their findings reinforce the importance of strategies to reduce cannabis use in e-cigarettes.

Authors: Katrina F. Trivers, Ph.D., M.S.P.H., of the Centers for Disease Control and Prevention, Atlanta, Georgia, and coauthors

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

(doi:10.1001/jamapediatrics.2018.1920)

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

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

Updated Estimates of Frequency of Adverse Childhood Experiences

Posted September 13, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 17, 2018

Media advisory: To contact corresponding author Melissa T. Merrick, Ph.D., email Courtney Lenard at zvq5@cdc.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.2537

Bottom Line: A new survey study suggests childhood adversity is common across sociodemographic groups but that some people are at higher risk of having experienced childhood adversity. The study updates the estimated frequency of adverse childhood experiences in the U.S. adult population using a representative sample of people from 23 states. Findings suggest people who identified as black, Hispanic or multiracial, had less than a high school education, less than a $15,000 annual income, were unemployed or unable to work, and identified as gay/lesbian or bisexual reported higher exposure to adverse childhood experiences than other groups. The most common adverse childhood experiences were emotional abuse, parental separation or divorce, and household substance abuse. Prevention of adverse childhood experiences can improve health and life outcomes.

Authors: Melissa T. Merrick, Ph.D., of the Centers for Disease Control and Prevention, Atlanta, Georgia, and coauthors

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

(doi:10.1001/jamapediatrics.2018.2537)

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

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

Small Study Evaluates Use of Medical Scribes in Primary Care

Posted September 13, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 17, 2018

Media advisory: To contact corresponding author Pranita Mishra, M.P.P., email Janet Byron at Janet.L.Byron@kp.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.3956

Bottom Line: Medical scribes transcribe information during clinical visits in real time into electronic health records (EHRs) under physician supervision. A small study of 18 primary care physicians evaluated the association of using medical scribes with physician workflow and patient experience.

Authors: Pranita Mishra, M.P.P., of Kaiser Permanente Northern California, Oakland, California, and coauthors

Related Material: The invited commentary, “Use of Medical Scribes to Reduce Documentation Burden: Are They Where We Need to Go With Clinical Documentation,” by David W. Bates, M.D., M.Sc., and Adam B. Landman, M.D., of Brigham and Women’s Hospital, Boston, Massachusetts, and coauthors also is available.

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

(doi:10.1001/jamainternmed.2018.3956)

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

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

USPSTF Recommendation Statement on Behavioral Weight Loss Interventions to Prevent Obesity-Related Health Problems, Death in Adults

Posted September 13, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 18, 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: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.13022

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians offer or refer adults with a body mass index of 30 or higher to intensive behavioral interventions that focus on dietary changes and increased physical activity and that provide a variety of components to support weight loss and to maintain it.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. This latest statement is an update of its 2012 recommendation on screening for obesity in adults. More than 35 percent of men and 40 percent of women in the United States are obese. Obesity is associated with health problems such as increased risk for coronary heart disease, type 2 diabetes. various types of cancer and disability. Obesity is also associated with an increased risk for death, particularly among adults younger than 65 years.

The USPSTF Concludes:

Related Material

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

Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults – U.S. Preventive Services Task Force Recommendation Statement

Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults – Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

JAMA editorial: Weight Management in Adults With Obesity

JAMA Internal Medicine editorial: Treating Obesity – Moving From Recommendation to Implementation

JAMA Patient Page: Behavioral Interventions for Weight Loss

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

(doi:10.1001/jama.2018.13022)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. 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.

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

Listen to a Podcast: Aortic Vascular Inflammation and Coronary Artery Disease in Psoriasis

Posted September 10, 2018 by Jim Michalski

A podcast accompanies the JAMA Cardiology study, “Association Between Aortic Vascular Inflammation and Coronary Artery Plaque Characteristics in Psoriasis”, by Nehal N. Mehta, M.D., M.S.C.E., of the National Institutes of Health, Bethesda, Maryland, and coauthors, and the editorial, “Inflammation, Superadded Inflammation, and Out-of-Proportion Inflammation in Atherosclerosis,” by Jagat Narula, M.D., Ph.D., of the Icahn School of Medicine at Mount Sinai, New York, and coauthor, and is available for listening and download on this page.

Is Exposure to Lead, Cadmium Associated With Reduced Ability to See Contrast?

Posted September 11, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, SEPTEMBER 13, 2018

Media advisory: To contact corresponding author Adam J. Paulsen, M.S., email Emily Kumlien at EKumlien@uwhealth.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.3931

Bottom Line: Contrast sensitivity is a measure of how well someone sees an image against a background. Diminished contrast sensitivity can impact daily life because common low-contrast conditions include low light, fog or glare. Understanding what might contribute to a decrease in contrast sensitivity is important. An observational study of nearly 2,000 people taking part in an ongoing study of aging examined whether exposure to the heavy metals cadmium and lead was associated with increased risk of impaired contrast sensitivity. Results of the study suggest cadmium exposure, but not lead, was among the factors associated with increased risk. Cadmium exposure typically happens through inhaling cigarette smoke and eating green leafy vegetables, rice and shellfish. Limitations of the study include that no definitive conclusions can be drawn and that the association could be due to another element of cigarette smoking.

Authors: Adam J. Paulsen, M.S., University of Wisconsin-Madison, and coauthors

Related material: The commentary, “Examining the Association of Cadmium With Contrast Sensitivity,” by Xiang Li, Ph.D., Janssen Research & Development, LLC, Raritan, New Jersey, is available on the For The Media website.

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

(doi:10.1001/jamaophthalmol.2018.3931)

Editor’s Note: The article contains funding/support disclosures. 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.

Study Examines Law Enforcement-Inflicted Injuries Using California Hospital Data

Posted September 11, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, SEPTEMBER 14, 2018

Media advisory: To contact study author Renee Y. Hsia, M.D., M.Sc., email Elizabeth Fernandez at Elizabeth.Fernandez@UCSF.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.2150

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: An analysis of hospital visits in California shows trends in injuries inflicted by law enforcement officers in the line of duty and how those injuries were associated with the race and ethnicity of individuals they encountered.

Why The Research Is Interesting: Public concern about the use of police force has heightened but not much data are available about the resulting injuries.

What and When: 92,386 hospital visits in California from 2005 to 2015 were identified as resulting from “legal intervention injuries” (defined in injury codes as being inflicted by police or other law enforcement agents in the course of arresting, attempting to arrest, suppressing disturbances, maintaining order or other legal action)

What (Study Measures and Outcomes): All visits with injury codes classified as legal intervention injuries in men ages 14 to 64; the study analyzed trends in injury rates and disparities across racial and ethnic groups.

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: Renee Y. Hsia, M.D., M.Sc., of the University of California, San Francisco, and coauthors

Results: Rates of injuries inflicted by law enforcement officers increased from 2005 to 2009 but declined through 2015, and black individuals were at greatest risk of these injuries per capita. The proportion of these injuries involving firearms, such as shootings by police, declined. In addition, an increasing proportion of emergency department visits associated with legal intervention injuries were associated with co-occuring behavioral health diagnoses.

Study Limitations: Results could have been affected by changes in hospital coding practices; there could be differences across race and ethnicity in reporting to clinicians that police inflicted the injury; and the study cannot determine in instances where force was used whether it was excessive.

Study Conclusions:

Related Material: The invited commentary, “Understanding Police Use of Force via Hospital Administrative Data: Prospects and Problems,” by Ojmarrh Mitchell, Ph.D., of the University of South Florida, Tampa, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.2150)

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 emailmediarelations@jamanetwork.org.

Did Tai Ji Quan Balance Training Program Reduce Fall Risk for Older Adults?

Posted September 6, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 10, 2018

Media advisory: To contact corresponding author Fuzhong Li, Ph.D., email fuzhongl@sus.edu.cn. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.3915

Bottom Line: A program of tai ji quan balance training classes, developed on the classic concept of tai chi, was more effective at reducing falls among older adults at high risk for them than stretching exercises or a training program that incorporated aerobic, strength, balance and flexibility exercises after six months. This randomized clinical trial included 670 adults (70 and older) in Oregon who had fallen in the previous year or who had impaired mobility. Limitations of the clinical trial include that it was conducted in a single state, had a small number of African American participants, and used self-reported fall data, although efforts were made to ensure its accuracy.

Authors: Fuzhong Li, Ph.D., of the Oregon Research Institute, Eugene, and Shanghai University of Sport, Shanghai, China, and coauthors

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

(doi:10.1001/jamainternmed.2018.3915)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. 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 emailmediarelations@jamanetwork.org.

Video Abstract: Effect of Piperacillin-Tazobactam vs Meropenem in E coli or Klebsiella pneumoniae Infection

Posted September 6, 2018 by Jim Michalski

A video abstract is available for the JAMA study, “Effect of Piperacillin-Tazobactam vs Meropenem in E coli or Klebsiella pneumoniae Infection.” It 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.

Video embed code:

<div style="display: block; position: relative; max-width: 300px;"><div style="padding-top: 50%;"><iframe src="//players.brightcove.net/864352215001/default_default/index.html?videoId=5826583495001" allowfullscreen webkitallowfullscreen mozallowfullscreen style="width: 100%; height: 100%; position: absolute; top: 0px; bottom: 0px; right: 0px; left: 0px;"></iframe></div></div>

Association of Gestational Diabetes, Subsequent Glucose Metabolism Disorders in Mothers Under New Criteria

Posted September 6, 2018 by Jim Michalski

JAMA

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

Media advisory: To contact corresponding author Boyd E. Metzger, M.D., email Marla Paul at marla-paul@northwestern.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.11628

Bottom Line: Newer criteria mean more women are diagnosed with gestational diabetes than before. This observational study assessed whether untreated gestational diabetes defined after the fact based on newer criteria was associated with long-term risk of glucose metabolism disorders among 4,700 mothers and overweight or obesity in their children 10 to 14 years after pregnancy. Researchers report that untreated gestational diabetes was associated with development of glucose metabolism disorders (a composite of type 2 diabetes or prediabetes) in mothers but was not significantly associated with childhood overweight/obesity in combination. However, additional measures of fatness in children may be relevant in interpreting the study findings.

Authors: Boyd E. Metzger, M.D., Northwestern University Feinberg School of Medicine, Chicago, and coauthors

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

(doi:10.1001/jama.2018.11628)

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.

Articles Focus on Medicaid Work Requirements

Posted September 6, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, SEPTEMBER 10, 2018

Media advisory: To contact corresponding author Anna L. Goldman, M.D., M.P.H., email David Cecere at dcecere@challiance.org and to contact corresponding author David M. Silvestri, M.D., M.B.A., email Anne Doerr at anne.doerr@yale.edu. The full articles are available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4194 (Goldman study) and https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4196 (Silvestri study)

Bottom Line: Two research letters and an invited commentary examine work requirements for Medicaid recipients, a move favored by some states that have federal waivers or have applied for them to impose work rules.

One research letter estimated the number of Medicaid recipients at risk of losing coverage if work requirements were applied nationally and in states with approved or pending waivers to impose those rules. The article also calculated Medicaid spending for those at risk of losing Medicaid coverage. Authors: Anna M. Goldman, M.D., M.P.H., of the Cambridge Health Alliance and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts, and coauthors

A second research letter provides state-level population estimates of people who are subject to but not meeting proposed Medicaid work requirements. Authors: David M. Silvestri, M.D., M.B.A., of the Yale School of Medicine, New Haven, Connecticut, and coauthors

Related Material: The invited commentary, “Medicaid Work Requirements – English Poor Law Revisited,” by Dave A. Chokshi, M.D., M.Sc., and Mitchell H. Katz, M.D., of the NYC Health + Hospitals, also is available on the For The Media website. Dr. Katz is a JAMA Internal Medicine deputy editor.

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

(doi:10.1001/jamainternmed.2018.4194 and doi:10.1001/jamainternmed.2018.4196)

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 emailmediarelations@jamanetwork.org.

Lethality of Active Shooter Incidents With vs. Without Semiautomatic Rifles

Posted September 6, 2018 by Jim Michalski

JAMA

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

Media advisory: To contact corresponding author Adil H. Haider, M.D., M.P.H., email Elaine St. Peter at estpeter@bwh.harvard.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.11009

Bottom Line: Semiautomatic rifles, which have been used in some of the largest shootings by individuals in U.S. history, were banned in 1994 under the federal assault weapons ban, but that expired in 2004. This study compared the number of people wounded and killed during active shooter incidents (defined by the FBI as an individual killing or attempting to kill people in a confined or populated area) with, and without, semiautomatic rifles from 2000 through 2017. Of 248 active shooter incidents, a semiautomatic rifle was used in about 25 percent of the shootings, while the rest involved handguns, shotguns and rifles that weren’t semiautomatic; 898 people were wounded and 718 were killed. Active shooter incidents with semiautomatic rifles were associated with a higher risk of people being wounded and killed. Limitations of the study include the lack of data on specific injuries, demographics and other details of the incidents.

Authors: Adil H. Haider. M.D., M.P.H., Brigham and Women’s Hospital, Boston, and coauthors

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

(doi:10.1001/jama.2018.11009)

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.

Racial/Ethnic Disparities in Use of Low-Vision Devices among Medicare Recipients

Posted September 4, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, SEPTEMBER 6, 2018

Media advisory: To contact corresponding author Joshua R. Ehrlich, M.D., M.P.H., email Kara Gavin at kegavin@med.umich.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.3892

Bottom Line: Devices to assist individuals with low vision (uncorrectable vision impairment) are not covered by Medicare and many private insurers, although there is evidence that these devices, such as telescopic lenses, magnifiers, large print or talking materials, can improve functioning and quality of life. Little is known about whether sociodemographic disparities exist in the use of low-vision services by Medicare beneficiaries. This study included nationally representative survey data from about 3,000 Medicare beneficiaries 65 years and older with self-reported vision impairment. The authors found that compared with white individuals, adults from minority racial/ethnic groups were less likely to report using low-vision devices. However, they found no difference in the use of vision rehabilitation (evaluation of activities of daily living and implementation of a plan to improve functioning) – a service which is covered by Medicare – between racial/ethnic groups. A limitation of the study was the inability of the researchers to determine actual need for low-vision devices. If the findings are confirmed, it may suggest that policy makers could consider coverage of low-vision devices under Medicare to address disparities.

Authors: Joshua R. Ehrlich, M.D., M.P.H., University of Michigan Medical School, Ann Arbor, and coauthors

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

(doi:10.1001/jamaophthalmol.2018.3892)

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.

What is the Effect on Biomarkers of Smoke Exposure of Immediate Reduction of Nicotine Content in Cigarettes vs Gradual?

Posted August 30, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 4, 2018

Media advisory: To contact corresponding author Dorothy K. Hatsukami, Ph.D., email Krystle Barbour at kbarbour@umn.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.11473

Bottom Line: The optimal approach for reducing nicotine to minimally or nonaddictive levels in all cigarettes sold in the United States has not been determined. In this randomized clinical trial of 1,250 smokers, compared with gradual nicotine reduction, immediate reduction to 0.4 mg of nicotine per gram of tobacco cigarettes was associated with lower toxicant exposure across time, smoking fewer cigarettes per day, greater reduction in dependence and more cigarette-free days. However, the immediate reduction in nicotine caused greater withdrawal symptoms and higher study dropout rates. There was no significant difference between gradual reduction and the control group in decreases in biomarkers of smoke exposure across time. A limitation of the study was its duration of 20 weeks; the long-term effect of reduced nicotine content cigarettes is uncertain.

Authors: Dorothy K. Hatsukami, Ph.D., University of Minnesota, Minneapolis, and coauthors

Visual Abstract: This is the link to the abstract when the embargo lifts.

Related Material

— A video abstract that summarizes the results of this study 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 JAMA article, “Drugs for Tobacco Dependence,” is available on the For The Media website.

Previously published related articles:

— From JAMA Psychiatry, Nondaily Smokers’ Changes in Cigarette Consumption With Very Low-Nicotine-Content Cigarettes

— From JAMA, Will the FDA’s New Tobacco Strategy Be a Game Changer?

— From JAMA Network Open, Association of Reduced Nicotine Content Cigarettes With Smoking Behaviors and Biomarkers of Exposure Among Slow and Fast Nicotine Metabolizers

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

(doi:10.1001/jama.2018.11473)

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:

<div style="display: block; position: relative; max-width: 300px;"><div style="padding-top: 50%;"><iframe src="//players.brightcove.net/864352215001/default_default/index.html?videoId=5826583486001" allowfullscreen webkitallowfullscreen mozallowfullscreen style="width: 100%; height: 100%; position: absolute; top: 0px; bottom: 0px; right: 0px; left: 0px;"></iframe></div></div>

USPSTF Recommendation Statement on Screening for Syphilis Infection in Pregnant Women

Posted August 30, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 4, 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: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.11785

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) recommends early screening for syphilis infection in all pregnant women.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. This latest statement is an update of its 2009 recommendation on screening for syphilis infection in pregnant women. Untreated syphilis infection in pregnant women can be transmitted to the fetus (congenital syphilis) at any time during pregnancy or at birth, and is associated with stillbirth, neonatal death, and significant illness in infants (such as bone deformities and neurologic impairment). After a steady decline from 2008 to 2012, cases of congenital syphilis markedly increased from 2012 to 2016.

The USPSTF Concludes:

Related Material

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

— Screening for Syphilis Infection in Pregnant Women – US Preventive Services Task Force Reaffirmation Recommendation Statement

— Screening for Syphilis Infection in Pregnant Women – Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

— JAMA Dermatology editorial: Congenital Syphilis—Still a Shadow on the Land

— JAMA Patient Page: Screening for Syphilis in Pregnant Women

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.

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

Visual Abstract: Initial Laryngeal Tube Insertion vs Endotracheal Intubation Survival in Out-of-Hospital Cardiac Arrest

Posted August 23, 2018 by Jim Michalski

A Visual Abstract is available below for the JAMA study, “Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest,” by Henry E. Wang, M.D., M.S., the University of Texas Health Science Center at Houston, and coauthors.

This is the link to the abstract when the embargo lifts.

Higher Depression Risk in Young Adulthood Associated With Autism Spectrum Disorders

Posted August 28, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, AUGUST 31, 2018

Media advisory: To contact corresponding study author Dheeraj Rai, M.R.C.Psych., Ph.D., email dheeraj.rai@bristol.ac.uk. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.1465

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Autism spectrum disorders (ASD), especially without an accompanying intellectual disability, were associated with greater risk for depression in young adulthood compared with the general population and siblings without ASD.

Why The Research Is Interesting: Mental health problems, including depression, are considered common in people with ASD. Understanding depression in people with ASD is important because it can further reduce social function. The identification and treatment of depression in people with ASD may help improve their quality of life.

Who and When: 223,842 individuals in Sweden followed up to age 27 by 2011, of whom 4,073 were diagnosed with ASD and 219,769 were not

What (Study Measures and Outcomes): Clinical diagnosis of depressive disorders identified in local and national patient registers

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: Dheeraj Rai, M.R.C.Psych., Ph.D., of the University of Bristol, United Kingdom, and coauthors

Results:

Study Limitations: Study population may have included people with undiagnosed depression and others may have been misclassified as having depression.

Study Conclusions:

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

(doi:10.1001/jamanetworkopen.2018.1465)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. 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 emailmediarelations@jamanetwork.org.

Use of Robotic Surgery Increasing

Posted August 23, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, AUGUST 28, 2018

Media advisory: To contact corresponding author Christopher P. Childers, M.D., email Enrique Rivero at ERivero@mednet.ucla.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.9219

Bottom Line: A new research letter suggests the use of robotic surgery continues to increase. Estimated annual procedures increased from 136,000 in 2008 to 877,000 in 2017, with 73 percent of them performed in the United States, according to an analysis of data from the primary supplier to hospitals of operating robotic systems.

Authors: Christopher P. Childers, M.D., and Melinda Maggard-Gibbons, M.D., M.S.H.S., of the David Geffen School of Medicine at University of California, Los Angeles

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

(doi:10.1001/jama.2018.9219)

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

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

Opioid Prescribing After Rhinoplasty

Posted September 4, 2018 by Deanna Bellandi

JAMA Facial Plastic Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, SEPTEMBER 6, 2018

Media Advisory: To contact corresponding author David A. Shaye, M.D., M.P.H., email Suzanne Day at Suzanne_Day@meei.harvard.edu. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Links will be live at the embargo time: https://jamanetwork.com/journals/jamafacialplasticsurgery/fullarticle/10.1001/jamafacial.2018.0999

Bottom Line: A review of 173 patients who had rhinoplasty reports that nearly all were prescribed opioids (an average of 28 pills per patient) in addition to acetaminophen and refills were exceedingly rare, with some patients (11.3 percent) not even filling their initial narcotic prescription. Study results suggest patients experienced less pain than was expected, although the optimal number of tablets to manage postoperative pain from rhinoplasty is unclear.

Authors: David A. Shaye, M.D., M.P.H., of Harvard Medical School and Massachusetts Eye and Ear, Boston, Massachusetts, and coauthors

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

(doi:10.1001/jamafacial.2018.0999)

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.

Trends Over 20 Years in ADHD Diagnoses Among U.S. Children, Adolescents

Posted August 28, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, AUGUST 31, 2018

Media advisory: To contact corresponding study 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 study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.1471

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Diagnosed attention-deficit/hyperactivity disorder (ADHD) in U.S. children and adolescents appears to have become more common over 20 years, with an increase in estimated prevalence from 6.1 percent to 10.2 percent between 1997 and 2016, although the cause of this apparent uptick still needs to be better understood.

Why The Research Is Interesting: Current estimates of the prevalence of ADHD and details on long-term trends are needed for research, clinical care and policymaking.

Who and When: 186,457 U.S. children and adolescents (ages 4 to 17) with data collected from 1997 to 2016 as part of the National Health Interview Survey

What (Study Measures and Outcomes): ADHD diagnosed by a physician or other health care professional

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

Results:

Differences in how common diagnosed ADHD is in U.S. children and adolescents depend on age, sex, race/ethnicity, family income and geographic region, although all these subgroups showed an increase in prevalence from 1997 to 2016.

Reasons behind the increase in prevalence need to be better understood because other factors that could partly explain it include increased physician awareness about ADHD, changes in diagnostic criteria, and increased public awareness and better access to health care services that could lead to a higher likelihood of ADHD diagnosis.

Study Limitations: Parent-reported information about physicians’ diagnoses could result in misreporting; it wasn’t known whether children and adolescents with a diagnosis of ADHD still had ADHD at the time of the survey

Study Conclusions:

Related Material: The invited commentary, “Paying Attention to Attention-Deficit/Hyperactivity Disorder,” by Daniel P. Dickstein, M.D., of Brown University, East Providence, Rhode Island, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.1471)

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 emailmediarelations@jamanetwork.org.

Study Estimates Firearm Deaths Globally in 2016

Posted August 24, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, AUGUST 28, 2018

Media advisory: To contact corresponding author Mohsen Naghavi, M.D., Ph.D., email Kelly Bienhoff at kbien@uw.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.10060

Bottom Line: Around the world there were an estimated 195,000 to 276,000 firearm deaths in 2016, the majority of them homicides, compared with 1990 when there were an estimated 172,000 to 235,000 firearm deaths.

Why The Research Is Interesting: Understanding global firearm death rates and variation between countries can help to guide prevention policies and interventions.

What and When: Deaths due to firearms (homicides, suicides and unintentional deaths) in 195 countries and territories from 1990 to 2016

What (Study Measures and Outcomes): Firearm ownership and access (exposures); deaths by age, sex, location and year (outcomes).

How (Study Design): This was a data analysis.

Authors: Mohsen Naghavi, M.D., Ph.D., Institute for Health Metrics and Evaluation, University of Washington, Seattle, and coauthors

Results:

Study Limitations: A number of study imitations exist, including that the accuracy of estimates in the study depend on the availability of data and the quality and completeness of the data vary.

Related material available on the For The Media website:

— A Summary Video: This video reviews findings from a Global Burden of Disease study that estimates rates of firearm homicide and suicide and unintentional gun deaths in 195 countries and territories between 1990 and 2016, with editorial commentary by Daniel Webster, Sc.D., M.P.H., Director of the Johns Hopkins Center for Gun Policy and Research. Daniel Webster can be contacted at dwebster@jhu.edu.

The 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 JAMA editorial, “Firearm-Related Mortality – A Global Public Health Problem,” by Frederick P. Rivara, M.D., M.P.H., University of Washington, Seattle, and Editor in Chief, JAMA Network Open, and coauthors

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

(doi:10.1001/jama.2018.10060)

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.

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CDC Guideline on Diagnosis, Management of Mild Traumatic Brain Injury in Children

Posted August 30, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, SEPTEMBER 4, 2018

Media advisory: To contact corresponding author Matthew J. Breiding, Ph.D., email Tiffany Mallory at wvn7@cdc.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.2853

Bottom Line: A Centers for Disease Control and Prevention evidence-based guideline on the diagnosis and management of mild traumatic brain injury (concussion) in children is detailed in a special communication article. The guideline includes 19 sets of recommendations on the diagnosis, prognosis, management and treatment of pediatric mild traumatic brain injury, including return to school and symptom management.

Authors: Matthew J. Breiding, Ph.D., of the Centers for Disease Control and Prevention, Atlanta, Georgia, and coauthors

Related Material: The review article, “Diagnosis and Management of Mild Traumatic Brain Injury in Children: A Systematic Review,” by Matthew J. Breiding, Ph.D., of the Centers for Disease Control and Prevention, Atlanta, Georgia, and coauthors, and the editorial, “State of the Science on Pediatric Mild Traumatic Brain Injury: Progress Toward Clinical Translation,” by Michael McCrea, Ph.D., A.B.P.P., of the Medical College of Wisconsin, Milwaukee, and Geoff Manley, M.D., Ph.D., of the University of California, San Francisco, also are available on the For The Media website.

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

(doi:10.1001/jamapediatrics.2018.2853)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. 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.

Disparities in Geographic Distribution of Dermatologists

Posted September 4, 2018 by Deanna Bellandi

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, SEPTEMBER 5, 2018

Media Advisory: To contact corresponding author Jennifer A. Stein, M.D., Ph.D., email Jamie Liptack at Jamie.Liptack@nyulangone.org. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Link will be live at the embargo time https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2018.3022

Bottom Line: Disparities exist in the geographic distribution of dermatologists across the United States in this study of county-level data from 1995 to 2013. Although the dermatologist workforce increased during that time and dermatologist density increased more in rural and nonmetropolitan counties than metropolitan areas, the gap in dermatologist density between metropolitan and other areas widened. Researchers stress that correcting the dermatologist workforce disparity is important for patient care.

Authors: Jennifer A. Stein, M.D., Ph.D., of the New York University School of Medicine, New York, and coauthors

To Learn More: The full study is 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/jamadermatol.2018.3022)

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.

U.S. Soldiers Who Attempt Suicide Often Have No Prior Mental Health Diagnosis

Posted August 27, 2018 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, AUGUST 29, 2018

Media Advisory: To contact corresponding author Robert J. Ursano, M.D., email Sarah Marshall at sarah.marshall@usuhs.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.2069

Bottom Line: The latest study based on data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) reports that among 9,650 enlisted soldiers with a documented suicide attempt, more than one-third had no prior mental health diagnosis. Risk factors for attempting suicide (sociodemographic, service-related, physical health care-related, injury, being subject to crime, perpetrating crime and family violence) were similar for soldiers with or without a prior mental health diagnosis, although the degree to which they were factors differed. Risk factors most strongly associated with suicide attempt by soldiers with no prior mental health diagnosis included being in their first year of service. Being female, having less than a high school education, delayed promotion and past-year demotion increased the odds of suicide attempt in both groups of soldiers with or without a prior mental health diagnosis but the effect was more so in soldiers without a prior mental health diagnosis. The study is limited by administrative data that reflect only events that came to the Army’s attention. Study results suggest administrative records from personnel, medical, legal and family service systems could help to identify soldiers at risk for suicide attempt.

Authors: Robert J. Ursano, M.D., of the Uniformed Services University of the Health Sciences, Bethesda, Maryland, and coauthors

Related Material: The editorial, “Suicide Prevention in the U.S. Army: A Mission for More Than Mental Health Clinicians,” by Mark A. Reger, Ph.D., of the Veterans Affairs Puget Sound Health Care System, Seattle, Washington, and coauthors also is available on the For The Media website.

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

(doi:10.1001/ jamapsychiatry.2018.2069)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. 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.

ACA Associated With Decrease in Cost-Related Medication Nonadherence Among Survivors of Stroke

Posted August 23, 2018 by Deanna Bellandi

JAMA Neurology

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, AUGUST 27, 2018

Media Advisory: To contact corresponding author Deborah A. Levine, M.D., M.P.H., email Haley Otman at otmanh@med.umich.edu.The full study is available on the For The Media website.

To place an electronic embedded link in your story: Links will be live at the embargo time: https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/jamaneurol.2018.2302

Bottom Line: Implementation of the Affordable Care Act (ACA) was associated with a decrease in cost-related nonadherence to medication by adult survivors of stroke (ages 45 to 64), as Medicaid coverage increased and uninsurance decreased in this group. This study analyzed survey data and included almost 14,000 survivors of stroke. Adults younger than 65 who survive stroke frequently contend with high out-of-pocket costs, especially for prescription drugs because they take an average of 11 medications. Study limitations include self-reported data and that researchers couldn’t account for medication-taking attitudes or behaviors.

Authors: Deborah A. Levine, M.D., M.P.H., of the University of Michigan, Ann Arbor, and coauthors

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

(doi:10.1001/jamaneurol.2018.2302)

Editor’s Note: The article includes funding/support disclosures. 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.

Providing Care for Transgender Patients

Posted August 20, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, AUGUST 27, 2018

Media advisory: To contact corresponding author Nicole Rosendale, M.D., email Suzanne Leigh at Suzanne.Leigh@ucsf.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4179

Bottom Line: A review article discusses some best practices to help clinicians learn how to better engage with and care for transgender patients, and the article suggests ways health care facilities can move toward more inclusive systems of care.

Authors: Nicole Rosendale, M.D., of the University of California, San Francisco, and coauthors

Featured Image: The image provides gender identity terminology and definitions.

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

(doi:10.1001/jamainternmed.2018.4179)

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 emailmediarelations@jamanetwork.org.

How Not Saying ‘Cancer’ for Low-Risk Thyroid Cancer May Affect Treatment Preferences, Patient Anxiety

Posted August 21, 2018 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, AUGUST 23, 2018

Media advisory: To contact corresponding author Kirsten McCaffery, Ph.D., email kirsten.mccaffery@sydney.edu.au. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2018.1272

Bottom Line: Could removing “cancer” from the terminology for low-risk small papillary thyroid cancers (PTCs) reduce patients’ anxiety so they consider less invasive treatment than surgery and avoid possible overtreatment for what can be indolent tumors? An online survey study of 550 Australian men and women without thyroid cancer suggests the answer is “maybe.” Total and partial surgical removal of the thyroid are the most common management approaches for patients with PTC, but those procedures come with surgical risk, lifetime medication management and anxiety. In the study, when hypothetical scenarios described PTC as a lesion or abnormal cells, survey respondents were more likely to pick nonsurgical options such as active surveillance and they reported lower levels of anxiety.

Authors: Kirsten McCaffery, Ph.D., the University of Sydney, New South Wales Australia, and coauthors

Related material available on the For The Media website:

— A podcast interview is available for listening and download on this page.

— The commentary, “The Evolving Nomenclature of Thyroid Cancer,” by Andrew G. Shuman, M.D., University of Michigan Medical School, Ann Arbor.

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

(doi:10.1001/jamaoto.2018.1272)

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.

Study Explores Use of Eye Imaging for Identification of Preclinical Alzheimer Disease

Posted August 21, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, AUGUST 23, 2018

Media advisory: To contact corresponding authors Rajendra S. Apte, M.D., Ph.D., or Gregory P. Van Stavern, M.D., email Judy Martin at martinju@wustl.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.3556

Bottom Line: It is important to identify people with early-stage Alzheimer disease (AD) who could potentially benefit from treatment but current testing to do this is invasive and expensive. Optical coherence tomographic angiography (OCTA) is a noninvasive imaging technique of the eye that allows for analysis of certain changes of the retina that are altered in preclinical AD even prior to any symptoms. This study included 58 eyes from 30 cognitively normal adults (without any evidence of dementia) who underwent testing for biomarkers of preclinical AD and OCTA. Among the 30 people, 14 had biomarkers positive for AD and a diagnosis of preclinical AD; the other 16 people without biomarkers were used as a comparison group. While the study suggests certain changes in the retina were more likely among people with preclinical AD, larger studies are needed to determine the value of this finding in identifying early-stage AD.

Authors: Rajendra S. Apte, M.D., Ph.D., and Gregory P. Van Stavern, M.D., Washington University in St. Louis, and coauthors

Related material: The commentary, “Viewing Retinal Vasculature in Alzheimer Disease,” by Christine A. Curcio, Ph.D., University of Alabama at Birmingham, 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/jamaophthalmol.2018.3556)

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

Policy Intended to Curb Opioid Prescribing Associated With Increase in Filled Opioid Prescriptions after Surgery

Posted August 20, 2018 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, AUGUST 22, 2018

Media advisory: To contact corresponding author Jennifer Waljee, M.D., M.P.H., email Shantell Kirkendoll at smkirk@umich.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2018.2651

Bottom Line: The U.S. Drug Enforcement Administration in 2014 moved to limit prescribing of pain medications containing the opioid hydrocodone from schedule III (a class of controlled substances) to the more restrictive schedule II. As a result, commonly prescribed formulations of hydrocodone were limited to a 90-day supply and could no longer be prescribed by telephone or fax. This analysis examined opioid prescriptions filled by about 22,000 privately insured patients who had common elective surgical procedures from 2012 to 2015 in Michigan. Researchers found that changing hydrocodone to the more restrictive schedule II was associated with an increase in the amount of opioids filled in the initial prescription after surgery. Most of the increase was accounted for by hydrocodone, which was the most commonly prescribed opioid following surgery. Date were drawn from a single state so the study observations may not be generalizable to other regions. Future efforts aimed at curbing opioid prescribing should include prescriber education and follow-up to make sure corresponding reductions in opioid prescribing result.

Authors: Jennifer Waljee, M.D., M.P.H., University of Michigan, Ann Arbor, and coauthors

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

Related material: The JAMA Surgery study, “Association of the Use of a Mandatory Prescription Drug Monitoring Program With Prescribing Practices for Patients Undergoing Elective Surgery,” by Richard J. Barth Jr., M.D., Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, and coauthors is also available on the For The Media website.

(doi:10.1001/jamasurg.2018.2651)

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

Decline in Uninsured Hospitalizations for Cardiovascular Events After ACA Medicaid Expansion

Posted August 21, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, AUGUST 24, 2018

Media advisory: To contact corresponding study author Ehimare Akhabue, M.D., email Marla Paul at marla-paul@northwestern.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.1296

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Medicaid expansion under the Affordable Care Act (ACA) was associated with a decline in the proportion of uninsured hospitalizations for major cardiovascular events such as heart attack, stroke and heart failure.

Why The Research Is Interesting: Cardiovascular disease is the leading primary hospital discharge diagnosis and the most common cause of death in the United States. This study examined how state decisions about whether to expand Medicaid under the ACA were associated with changes in uninsured hospitalizations for these major cardiovascular events.

What and When: More than 3 million non-Medicare hospitalizations between 2009 and 2014 from inpatient databases in 30 states (17 expanded Medicaid; 13 didn’t)

What (Study Measures and Outcomes): State Medicaid expansion as of January 2014 (exposure); comparison of the average payer mix proportions (uninsured, Medicaid, and privately insured) and in-hospital mortality between expansion and nonexpansion states before the ACA Medicaid expansion (2009-2013) and in the year (2014) after the expansion (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: Ehimare Akhabue, M.D., of the Northwestern University Feinberg School of Medicine, Chicago, Illinois, and co-authors

Results:

Study Limitations: Total number of hospitalizations for cardiovascular events could have been underestimated; data were only available for one year after ACA implementation; and only 30 states were included in the analysis

Study Conclusions:

Related Material: The invited commentary, “Medicaid Expansion and In-Hospital Cardiovascular Mortality: Failure or Unrealistic Expectations,” by Rishi K. Wadhera, M.D., M.Phil., of Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, and Karen E. Joynt Maddox, M.D., M.P.H., of the Washington University School of Medicine in St. Louis, Missouri, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.1296)

Editor’s Note: The article contains funding/support disclosures. 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 emailmediarelations@jamanetwork.org.

Frequency of Prenatal Marijuana Use for Nausea, Vomiting in Pregnancy

Posted August 16, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, AUGUST 20, 2018

Media advisory: To contact corresponding author Kelly C. Young-Wolff, Ph.D., M.P.H., email Healther Platisha at Heather.Platisha@creation.io. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.3581

Bottom Line: Is prenatal marijuana use higher among women diagnosed with nausea and vomiting in pregnancy? A new research letter used data from Kaiser Permanente Northern California, which screens pregnant women for marijuana use through self-report and urine toxicology tests, to examine more than 220,000 pregnancies from 2009 through 2016. While the overall frequency of marijuana use in the first trimester was 5.3 percent, women with mild or severe nausea and vomiting in pregnancy had greater odds of marijuana use in the first trimester compared to women without nausea and vomiting in pregnancy. National guidelines suggest pregnant women discontinue the use of marijuana during pregnancy.

Authors: Kelly C. Young-Wolff, Ph.D., M.P.H., of Kaiser Permanente Northern California, Oakland, California, and coauthors

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

(doi:10.1001/jamainternmed.2018.3581)

Editor’s Note: The article contains funding/support disclosures. 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 emailmediarelations@jamanetwork.org.

Adolescents’ Concern Over Societal Discrimination Associated With Worse Behavioral Health

Posted August 16, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, AUGUST 20, 2018

Media advisory: To contact corresponding author Adam M. Leventhal, Ph.D., email Gary Polakovic at polakovi@usc.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.2022

Bottom Line: Many southern California high school students report being concerned that discrimination is increasing in society and that concern appears to be associated with behavioral health problems a year later, including more frequent substance use and higher odds of depression and attention-deficit/hyperactivity disorder symptoms. The authors of this survey study suggest public health attention and policy changes may be needed to address how public expressions of discrimination may affect adolescent health.

Authors: Adam M. Leventhal, Ph.D., of the Keck School of Medicine at the University of Southern California, Los Angeles, and coauthors

Related Material: The editorial, “Structuring Research to Address Discrimination as a Factor in Child and Adolescent Health,” by Nia Heard-Garris, M.D., M.Sc., of the Ann & Robert H. Lurie Children’s Hospital of Chicago, Illinois, also is available on the For The Media website.

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

(doi:10.1001/jamapediatrics.2018.2022)

Editor’s Note: The article contains funding/support disclosures. 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.

Higher Cost to Medicare for Use of Brand-Name Combo Drugs Instead of Generic Components

Posted August 16, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, AUGUST 21, 2018

Media advisory: To contact corresponding author Chana A. Sacks, M.D., M.P.H., email Elaine St. Peter at estpeter@bwh.harvard.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.11439

Bottom Line: Brand-name combination drugs can be more expensive than the sum of their parts, especially when generic components are available. An analysis of Medicare Part D spending suggests $925 million is the difference between what Medicare reported spending in 2016 for 29 brand-name combination drugs and what the estimated spending would have been if generic components had been used for the same number of doses. Prescriber education and more rational substitution policies may help promote generic substitution and therapeutic interchange to save money in the Medicare drug benefit program.

Authors: Chana A. Sacks, M.D., M.P.H., Brigham and Women’s Hospital and Harvard Medical School, Boston, and coauthors

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

(doi:10.1001/jama.2018.11439)

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.

USPSTF Recommendation Statement on Screening for Cervical Cancer

Posted August 16, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, AUGUST 21, 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: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.10897

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) has updated its recommendations regarding screening for cervical cancer, with the recommendations and type of screening method varying depending on the woman’s age and other factors.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. This latest statement is an update of its 2012 recommendation on screening for cervical cancer. The number of deaths from cervical cancer in the United States has decreased substantially since the implementation of widespread cervical cancer screening. Most cases occur among women who have not been adequately screened.

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 Carol M. Mangione, M.D., M.S.P.H., Task Force member and co-author of the recommendation statement, is available for listening and downloading on this page. The transcript of the podcast can be found here.

— Screening for Cervical Cancer – US Preventive Services Task Force Recommendation Statement

— Screening for Cervical Cancer With High-Risk Human Papillomavirus Testing – Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

— Screening for Cervical Cancer in Primary Care – A Decision Analysis for the US Preventive Services Task Force

— JAMA editorial: Screening for Cervical Cancer – New Tools and New Opportunities

— JAMA Internal Medicine editorial: Cervical Cancer Screening – Moving From the Value of Evidence to the Evidence of Value

— JAMA Patient Page: Screening for Cervical Cancer

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

(doi:10.1001/jama.2018.10897)

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.

Having Optimal Levels of Cardiovascular Health in Older Age Associated With Lower Dementia Risk

Posted August 16, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, AUGUST 21, 2018

Media advisory: To contact corresponding author Cecilia Samieri, Ph.D., email cecilia.samieri@u-bordeaux.fr. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.11499

Bottom Line: Having optimal levels in more measures of cardiovascular health (nonsmoking, weight, diet, physical activity, cholesterol, blood glucose and blood pressure) for older adults was associated with lower risk for dementia. This observational study included 6,626 adults in France 65 or older. A lower risk for dementia and lower rates of cognitive decline were associated with each additional metric at the recommended optimal level based on an American Heart Association seven-item checklist aimed at preventing cardiovascular disease. Limitations of the study include participants who were mostly urban and white so the results may not be generalizable to other groups and changes over time in cardiovascular health metrics were not accounted for because they were measured only at the start of the study.

Authors: Cecilia Samieri, Ph.D., Universite de Bordeaux, Bordeaux, France, and coauthors

Related material: The editorial, “Striving for Ideal Cardiovascular and Brain Health,” by Jeffrey L. Saver, M.D., University of California, Associate Editor, JAMA, and Mary Cushman, M.D., M.Sc., Larner College of Medicine at the University of Vermont, Burlington, and study, “Association of Cardiovascular Risk Factors With MRI Indices of Cerebrovascular Structure and Function and White Matter Hyperintensities in Young Adults,” by Paul Leeson, Ph.D., F.R.C.P., University of Oxford, United Kingdom, and coauthors are 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.2018.11499)

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.

Listen to a Podcast: Association of Left Ventricular Global Longitudinal Strain With Asymptomatic Severe Aortic Stenosis

Posted August 13, 2018 by Jim Michalski

A podcast accompanies the JAMA Cardiology study, “Association of Left Ventricular Global Longitudinal Strain With Asymptomatic Severe Aortic Stenosis,” by Jeroen J. Bax, M.D., Ph.D., Leiden University Medical Center, Leiden, the Netherlands, and coauthors, and is available for listening and download on this page.

How Common Among U.S. Adults is the Perception of a Phantom Odor?

Posted August 14, 2018 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, AUGUST 16, 2018

Media advisory: To contact corresponding author Kathleen E. Bainbridge, Ph.D., M.P.H., email news@nidcd.nih.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2018.1446

Bottom Line: The perception of phantom odors is a condition in which individuals think they smell odors that don’t actually exist. Anecdotal reports suggest it can be a debilitating condition, with the odors often described as foul, rotten or chemical. A new observational study estimates 6.5 percent of U.S. adults 40 and older perceive phantom smells. The study included about 7,400 adults who participated in the National Health and Nutrition Examination Survey. Prevalence was greater among women than men and among younger age groups. Only 11 percent of those affected had discussed a smell or taste problem with a clinician, which suggests increased awareness of the condition may help people seeking help or treatment.

Authors: Kathleen E. Bainbridge, Ph.D., M.P.H., National Institutes of Health, Bethesda, Maryland, and coauthors.

Related material: The commentary, “Prevalence and Risk Factors for Olfactory Hallucinations The Phantom Menace,” by David W. Hsu, M.D., Jeffrey D. Suh, M.D., University of California, Los Angeles School of Medicine, 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/jamaoto.2018.1446)

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.

Visual Abstract and Summary Video: Effect of Cell-Free DNA Screening on Miscarriage in Women With Pregnancies at High Risk of Trisomy 21

Posted August 9, 2018 by Jim Michalski

A Visual Abstract and Summary Video are available for the August 14 JAMA study, “Effect of Cell-Free DNA Screening vs Direct Invasive Diagnosis on Miscarriage Rates in Women With Pregnancies at High Risk of Trisomy 21,” by Laurent J. Salomon, M.D., Ph.D., Paris Descartes University, Paris, France, and coauthors.

The 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.

Visual Abstract: This is the link to the abstract when the embargo lifts.

Video embed code:

<div style="display: block; position: relative; max-width: 300px;"><div style="padding-top: 50%;"><iframe src="//players.brightcove.net/864352215001/default_default/index.html?videoId=5813824067001" allowfullscreen webkitallowfullscreen mozallowfullscreen style="width: 100%; height: 100%; position: absolute; top: 0px; bottom: 0px; right: 0px; left: 0px;"></iframe></div></div>

Quality of YouTube Videos for Facial Plastics Information

Posted August 14, 2018 by Deanna Bellandi

JAMA Facial Plastic Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, AUGUST 16, 2018

Media Advisory: To contact corresponding author Boris Paskhover, M.D., email Tiffany Cody at tcody@njms.rutgers.edu. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Links will be live at the embargo time: https://jamanetwork.com/journals/jamafacialplasticsurgery/fullarticle/10.1001/jamafacial.2018.0822

Bottom Line: YouTube videos are a popular resource for facial plastics information. However, a new research letter that evaluated the quality of some of those videos suggests they can present biased information, offer an unbalanced assessment of risks and benefits, and be unclear about the qualifications of the practitioners featured.

Authors: Boris Paskhover, M.D., Rutgers New Jersey Medical School, Newark, New Jersey, and coauthors

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

(doi:10.1001/jamafacial.2018.0822)

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.

Patient Motivations Behind Cosmetic Procedures

Posted August 13, 2018 by Deanna Bellandi

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, AUGUST 15, 2018

Media Advisory: To contact corresponding author Murad Alam, M.D., M.S.C.I., M.B.A., email Marla Paul at marla-paul@northwestern.edu. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Link will be live at the embargo time https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2018.2357

Bottom Line: What motivates patients to seek minimally invasive cosmetic procedures? Most patients want the procedures to please themselves, not others, and, apart from aesthetic appearance to look younger and fresher, patient motivations ranged from physical health and psychological well-being to looking good at work and increasing self-confidence. Those were among the findings of a new observational study that included 511 patients who competed a survey.

Authors: Murad Alam, M.D., M.S.C.I., M.B.A., of the Feinberg School of Medicine at Northwestern University, Chicago, Illinois, and coauthors

To Learn More: The full study is 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/jamadermatol.2018.2357)

Editor’s Note: The study includes conflict of interest and funding/support disclosures. 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.

Intervention for Young Transgender Women to Reduce Risk of HIV

Posted August 9, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, AUGUST 13, 2018

Media advisory: To contact corresponding author Robert Garofalo, M.D., M.P.H., email Julie Pesch at JPesch@luriechildrens.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.2334

Bottom Line: Young transgender women who took part in an intervention to reduce HIV transmission and acquisition had a greater reduction in condomless sex acts than young transgender women who received standard preventive care with testing for HIV/sexually transmitted infections and counseling in a randomized clinical trial.

Why The Research Is Interesting: HIV is high among transgender women in the United States, including among young transgender women between the ages of 16 and 29. Condomless sex acts are a risk for acquiring and transmitting HIV. This clinical trial evaluated the Project LifeSkills intervention for reducing condomless sex acts among young transgender women through sharing information about HIV, motivating people to protect themselves and promoting skills such as condom use and sexual partner communication and negotiation.

Who and When: 190 young transgender women in a clinical trial conducted between March 2012 and August 2016 in Boston and Chicago; participants were between the ages of 16 and 29 and were assigned male sex at birth but now self-identify as female, transgender women or on the transfeminine spectrum; 21 percent had HIV at the baseline assessment

What (Study Measures and Outcomes): Primary outcome was change in the number of self-reported condomless anal or vaginal sex acts in the four months before a baseline assessment and reported later at interval visits through 12 months

How (Study Design): This was a randomized clinical trial (RCT). RCTs allow 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: Robert Garofalo, M.D., M.P.H., of the Ann & Robert H. Lurie Children’s Hospital and Feinberg School of Medicine, Northwestern University, Chicago, Illinois, and coauthors

Results: A greater reduction in condomless sex acts among young transgender women in the intervention suggests the intervention is both feasible and effective.

Study Limitations: Conducted only in two cities; the intervention included content on the process of medical gender transition, which may not resonate with some women who have either completed the transition or who don’t plan to start it.

Study Conclusions:

Related Material: The editorial, “Challenges and Successes in Evaluating HIV Prevention
for Young Transgender Women—Building Skills, Maintaining Trust,” by Brittany J. Allen, M.D., of the University of Wisconsin School of Medicine and Public Health, Madison, also is 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/jamapediatrics.2018.2334)

Editor’s Note: The article contains funding/support disclosures. 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.

Prescriptions for Opioid Use Disorder Treatment, Opioid Pain Relievers After ACA Medicaid Expansion

Posted August 14, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, AUGUST 17, 2018

Media advisory: To contact corresponding study author Brendan Saloner, Ph.D., email Barbara Benham at bbenham1@jhu.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.1588

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Bottom Line: Medicaid expansion under the Affordable Care Act (ACA) was associated with an overall increase in people filling prescriptions for buprenorphine with naloxone, which is a treatment for opioid use disorder, as well as an increase in people filling prescriptions for opioid pain relievers (OPRs) paid for by Medicaid in a data analysis from five states.

Why The Research Is Interesting: Opponents of the ACA have suggested Medicaid expansion worsened the opioid crisis because insurance let people access cheap opioid pain relievers. However, the insurance expansion under the ACA also could help to lessen the opioid crisis by increasing access to medication to treat opioid use disorder. This study used pharmacy claims data for five states (three that expanded Medicaid and two that didn’t) to examine changes in prescriptions filled for buprenorphine with naloxone and for opioid pain relievers after the ACA’s Medicaid expansion.

Who and When: 11.9 million individuals who filled two or more prescriptions for opioids during at least one year between 2010 and 2015 from California, Maryland, and Washington (Medicaid expansion states) and Florida and Georgia (nonexpansion states)

What (Study Measures and Outcomes): Medicaid expansion (exposure); rates per 100,000 county residents were calculated for buprenorphine with naloxone and for opioid pain reliever prescriptions overall and by different payment sources (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: Brendan Saloner, Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and co-authors

Results: In the five states where data were analyzed, Medicaid expansion was:

Study Limitations: Data included from only five states; unobserved differences between states may be associated with the outcomes; and alternative explanations independent of the ACA could be driving prescription rates

Study Conclusions:

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

(doi:10.1001/jamanetworkopen.2018.1588)

Editor’s Note: The article contains conflict of interest and funding/support disclosures. 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 emailmediarelations@jamanetwork.org.

Traumatic Brain Injury May Be Associated with Increased Risk of Suicide

Posted August 9, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, AUGUST 14, 2018

Media advisory: To contact corresponding author Trine Madsen, Ph.D., email trine.madsen@regionh.dk. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.10211

Bottom Line: An increased risk of suicide was associated with those residents of Denmark who sought medical attention for traumatic brain injury (TBI) compared with the general population without TBI in a study that used data from Danish national registers. A history of TBI has been associated with higher rates of self-harm, suicide and death than the general population. This observational study included nearly 35,000 deaths by suicide over 35 years, of which 3,536 (10.2 percent) had medical contact for TBI recorded as mild TBI (concussion), skull fracture without documented TBI, and severe TBI (head injuries with evidence of structural brain injury). The risk for suicide was higher among people with severe TBI, numerous medical contacts for TBI and longer hospital stays, with these patients at highest risk for suicide in the the first six months after hospital discharge. The study has several limitations, including no information on treatment received by patients with TBI and some people may not have sought medical treatment for TBI.

Authors: Trine Madsen, Ph.D., Danish Research Institute of Suicide Prevention, Psychiatric Center Copenhagen, Copenhagen, Denmark and coauthors

Related material: The editorial, “Traumatic Brain Injury and Risk of Suicide,” by Lee Goldstein, M.D., Ph.D., Boston University School of Medicine, Boston, and Ramon Diaz-Arrastia, M.D., Ph.D., University of Pennsylvania Perelman School of Medicine, Philadelphia, 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.2018.10211)

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.

Can Combining Low Doses of 3 High Blood Pressure Medications into One Pill Improve Blood Pressure Control?

Posted August 9, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, AUGUST 14, 2018

Media advisory: To contact corresponding author Ruth Webster, Ph.D., email rwebster@georgeinstitute.org.au. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.10359

Bottom Line: Poorly controlled high blood pressure is a leading global public health problem requiring new treatment strategies. In most instances, inadequate blood pressure treatment can be mainly attributed to use of one medication, which has modest effectiveness. In a randomized clinical trial that included 700 patients in Sri Lanka with mild to moderate high blood pressure who were not receiving treatment or who were taking one medication, the daily use of a pill that contained low doses of three antihypertensive drugs for six months resulted in a greater percentage of patients achieving their target blood pressure goal.

Authors: Ruth Webster, Ph.D., The George Institute for Global Health, University of New South Wales, Sydney, Australia, and coauthors

Visual Abstract: This is the link to the abstract when the embargo lifts.

Related material:

— The editorial, “Low-Dose Combination Blood Pressure Pharmacotherapy to Improve Treatment Effectiveness, Safety, and Efficiency” by Mark D. Huffman, M.D., M.P.H., Northwestern University Feinberg School of Medicine, Chicago, and coauthors is also 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.

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

(doi:10.1001/jama.2018.10359)

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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