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How Does Long-Term Quality of Life, Patient Satisfaction Compare For Appendicitis Treatments?
JAMA Surgery
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 19, 2020
Media advisory: To contact corresponding author Paulina Salminen, M.D., Ph.D., email paulina.salminen@tyks.fi. The full study and commentary are linked to this news release.
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Bottom Line: Researchers compared long-term quality of life and patient satisfaction among those patients who were treated with antibiotics or who had their appendix removed for uncomplicated acute appendicitis. Evidence in recent years has indicated antibiotic treatment is a safe and efficient alternative to appendectomy. This study was a seven-year follow-up of a randomized clinical trial in Finland of patients with uncomplicated acute appendicitis who underwent appendectomy or who received antibiotics. The follow-up included 423 patients who completed questionnaires regarding quality of life and their level of satisfaction with the treatment received. Researchers found no difference between treatment groups in patient-rated quality of life or in satisfaction with the treatment if it was successful. Patients taking antibiotics who later had an appendectomy were less satisfied than patients with successful antibiotic or appendectomy treatments. Limitations of the study include use in the initial trial of an open surgical approach for appendectomy since laparoscopic appendectomy is the current standard associated with shorter hospital stays and less postoperative pain.
Authors: Paulina Salminen, M.D., Ph.D., of Turku University Hospital, Turku, Finland, and coauthors
(doi:10.1001/jamasurg.2019.6028)
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Charity Care Provided by Nonprofit Hospitals
JAMA Internal Medicine
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 17, 2020
Media advisory: The full study is linked to this news release.
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What The Study Did: Researchers looked at the net income of nonprofit hospitals in the U.S. and examined how their financial status was associated with the level of charity care they provided in 2017 for uninsured and insured patients.
Authors: Ge Bai, Ph.D., C.P.A., of the Johns Hopkins Carey Business School in Baltimore, is the corresponding author.
(doi:10.1001/jamainternmed.2019.7415)
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Examining How Often Care, ICU Admissions Were Consistent With Treatment-Limiting Orders Near End of Life
JAMA
EMBARGOED FOR RELEASE: 2 P.M. (ET), SUNDAY, FEBRUARY 16, 2020
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What The Study Did: Patients with chronic life-limiting illnesses often have medical orders with treatment limitations in place regarding medical interventions and intensive care unit admissions near the end of their lives. This observational study included about 1,800 patients with such orders who were hospitalized within six months of their death to examine how often care was consistent with those orders.
Authors: Robert Y. Lee, M.D., M.S., of the University of Washington in Seattle, is the corresponding author.
(doi:10.1001/jama.2019.22523)
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Factors Associated With Health-Related Quality of Life in Patients With Facial Palsy
JAMA Otolaryngology-Head & Neck Surgery
EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, FEBRUARY 13, 2020
Media advisory: The full study and commentary are linked to this news release.
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What The Study Did: Patients with facial palsy completed questionnaires to help identify socioeconomic, personality and mental health factors associated with their health-related quality of life, information that may be beneficial in interpreting treatment outcomes.
Authors: Tessa E. Bruins, B.Sc., of the University Medical Center Groningen, in Groningen, the Netherlands, is the corresponding author.
(doi:10.1001/jamaoto.2019.4559)
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Feasibility of Using Cells From Fat Tissue to Treat Scarred Vocal Cords
JAMA Otolaryngology-Head & Neck Surgery
EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, FEBRUARY 13, 2020
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What The Study Did: This small trial examined the feasibility and effectiveness of injecting cells with regenerative properties that are from a patient’s fat tissue into scarred vocal cords of patients who had difficulty speaking.
Authors: Alexia Mattei, M.D., of La Conception University Hospital in Marseille, France, is the corresponding author.
(doi:10.1001/jamaoto.2019.4328)
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Clinical Trial Examines Subconcussive Head Impacts From Soccer
JAMA Ophthalmology
EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, FEBRUARY 13, 2020
Media advisory: To contact corresponding author Keisuke Kawata, Ph.D., email Charles Conner-Rondot at crondot@indiana.edu. The full study and commentary are linked to this news release.
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Bottom Line: Subconcussive head impacts from sports are those that don’t cause symptoms of a concussion. This randomized clinical trial evaluated whether such subconcussive head impacts from soccer-ball headings impaired brain circuitry linking eye and cognitive functions in adult soccer players compared with a control group of players that only kicked the soccer ball. Neuro-ophthalmologic function was measured with a test of eye movement and brain functions such as attention, language and concentration. The study included 78 soccer players, of whom 40 players did 10 soccer-ball headings. Researchers report the kicking control group performed better on the test of neuro-ophthalmologic function at all points over 24 hours after the intervention than the heading group of players. The findings suggest subconcussive head impacts may affect neuro-eye function, at least in the short term. Limitations of the study include an inability to determine the observed effects beyond 24 hours and it is unknown whether prior exposure to soccer-ball heading affected the players’ responses to 10 headings as part of the trial intervention.
Authors: Keisuke Kawata, Ph.D., Indiana University School of Public Health, Bloomington, and coauthors.
(doi:10.1001/jamaophthalmol.2019.6128)
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Evaluating Skin Cancer History by Sexual Orientation, Gender Identity
JAMA Dermatology
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 12, 2020
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Association Between Sexual Orientation and Lifetime Prevalence of Skin Cancer in the United States https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2019.4196?guestAccessKey=b853325d-c507-49b8-8434-b967fae3000a&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=021220
Gender Identity and Lifetime Prevalence of Skin Cancer in the United States https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2019.4197?guestAccessKey=62ee7daa-9c1f-4a56-a0b8-0caec9285cd4&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=021220
What The Studies Did: These two related studies and editorial examined the association of sexual orientation and gender identity with a history of self-reported skin cancer.
Authors: Arash Mostaghimi, M.D., M.P.A., M.P.H., of Brigham and Women’s Hospital and Harvard Medical School in Boston, is the corresponding author of both studies.
(doi:10.1001/jamadermatol.2019.4196 and 10.1001/jamadermatol.2019.4197)
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Analysis of Melanoma in US by Age Groups
JAMA Dermatology
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, NOVEMBER 13, 2019
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What The Study Did: This study used registry data to determine annual rates of melanoma in pediatric, adolescent, young adult and adult age groups, and the findings suggest an apparent decrease among adolescent and young adults between 2006 and 2015 but increases in older adults.
Authors: Jennifer M. Gardner M.D., of the Seattle Cancer Care Alliance, is the corresponding author.
(doi:10.1001/jamadermatol.2019.3353)
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Palliative vs Standard Care for Parkinson Disease
JAMA Neurology
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 10, 2020
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What The Study Did: This randomized clinical trial that included 210 patients with Parkinson disease and related disorders and 175 caregivers examined whether outpatient palliative care was associated with better patient or caregiver outcomes compared with standard care.
Authors: Benzi M. Kluger, M.D., of the University of Rochester Medical Center in Rochester, New York, is the corresponding author.
(doi:10.1001/jamaneurol.2019.4992)
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Heroin Use in US
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, FEBRUARY 11, 2020
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What The Study Did: Survey responses from a nationally representative group of 800,000 U.S. adults were used to examine changes in heroin use, heroin injection and heroin use disorder from 2002 to 2018.
Authors: Beth Han, M.D., Ph.D., M.P.H., of the Substance Abuse and Mental Health Services Administration in Rockville, Maryland, is the corresponding author.
(doi:10.1001/jama.2019.20844)
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‘Surprise’ Out-Of-Network Bills After In-Network Elective Surgery
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, FEBRUARY 11, 2020
Media advisory: To contact corresponding author Karan R. Chhabra, M.D., M.Sc., email Kara Gavin at kegavin@med.umich.edu. The full study and related articles are linked to this news release.
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Bottom Line: Claims data from a large health insurer were used to examine how often patients unexpectedly receive out-of-network bills after having in-network elective surgery. These “surprise bills” typically occur when a patient receives care from a clinician, such as an anesthesiologist or surgical assistant, who doesn’t participate in that patient’s insurance network. This analysis included nearly 350,000 commercially insured patients who underwent elective surgery at in-network facilities with in-network primary surgeons between 2012 and 2017. The authors report that approximately 1 in 5 of these procedures resulted in an out-of-network bill, with an average potential balance of $2,011. Out-of-network bills were associated with anesthesiologists and surgical assistants in 37% of these surgeries. A limitation of the study is that claims data came from only one insurer.
Authors: Karan R. Chhabra, M.D., M.Sc., University of Michigan, Ann Arbor, and coauthors.
(doi:10.1001/jama.2019.21463)
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Are There Racial/Ethnic Disparities in Treatment for Acne?
JAMA Dermatology
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 5, 2020
Media advisory: The full study is linked to this news release.
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What The Study Did: Whether there are differences in treatment of acne by race/ethnicity, sex and type of insurance was the focus of this observational study that analyzed treatment and prescribing patterns for acne for nearly 30,000 patients.
Authors: Junko Takeshita, M.D., Ph.D., M.S.C.E., of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, is the corresponding author.
(doi:10.1001/jamadermatol.2019.4818)
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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Association of Parent, Family Stressors With Screen Exposure Among Toddlers
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 5, 2020
Media advisory: The full study is linked to this news release.
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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.
What The Study Did: This population-based study explored associations between parent and family stressors, such as parenting stress and lower household income, with child screen exposure and screen use paired with feeding in toddlers.
Authors: Katherine Tombeau Cost, Ph.D., of the Hospital for Sick Children in Toronto, is the corresponding author.
(10.1001/jamanetworkopen.2019.20557)
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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Examining Patterns After Shift to Reference Pricing for Drugs
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, FEBRUARY 5, 2020
Media advisory: The full study and commentary are linked to this news release.
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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.
What The Study Did: An economic evaluation of 3.3 million drug insurance claims looked at whether implementing reference pricing was associated with physicians and patients adjusting to using the least expensive alternative within a drug class.
Authors: James C. Robinson, Ph.D., University of California, Berkeley, School of Public Health, is the corresponding author.
(10.1001/jamanetworkopen.2019.20544)
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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Health Insurance Concerns of Adults Approaching Retirement
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, FEBRUARY 7 2020
Media advisory: The full study and commentary are linked to this news release.
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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.
What The Study Did: An online survey study was conducted to gauge the perspectives of adults who are nearing retirement (ages 50 to 64) about their confidence in affording heath insurance, keeping a job or delaying retirement to have employer-sponsored health insurance; their concerns about potential changes to to health insurance because of changes to federal policies; and the avoidance of medical care or medications because of cost.
Authors: Renuka Tipirneni, M.D., M.Sc., of the University of Michigan in Ann Arbor, is the corresponding author.
(10.1001/jamanetworkopen.2019.20647)
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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Examining Consumption of Processed Meat, Unprocessed Red Meat, Poultry or Fish With Risk of CVD, Death
JAMA Internal Medicine
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 3, 2020
Media advisory: The full study is linked to this news release.
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What The Study Did: Data for nearly 30,000 adults from six study groups in the U.S. were used to investigate associations between eating processed meat, unprocessed red meat, poultry or fish and the risk of cardiovascular disease and death from any cause.
Authors: Victor W. Zhong, Ph.D., of Cornell University in Ithaca, New York, is the corresponding author.
(doi:10.1001/jamainternmed.2019.6969)
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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Homicide Among Pregnant, Postpartum Women in Louisiana
JAMA Pediatrics
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 3, 2020
Media advisory: The full study is linked to this news release.
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What The Study Did: Researchers examined how often homicide was the cause of death among women in Louisiana who were pregnant or up to one year postpartum compared with other causes.
Authors: Maeve E. Wallace, Ph.D., of the Tulane University School of Public Health and Tropical Medicine in New Orleans, is the corresponding author.
(doi:10.1001/jamapediatrics.2019.5853)
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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Changes in the Cost Over Time of HIV Antiretroviral Therapy in US
JAMA Internal Medicine
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, FEBRUARY 3, 2020
Media advisory: The full study is linked to this news release.
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What The Study Did: Researchers calculated the average cost of recommended initial HIV antiretroviral therapy (ART) regimens in the U.S. from 2012 to 2018 and analyzed how this cost has changed over the years. High ART costs are one of the factors that can lead to poor HIV treatment and outcomes in the U.S.
Authors: Rochelle P. Walensky, M.D., M.P.H., of Massachusetts General Hospital in Boston, is the corresponding author.
(doi:10.1001/jamainternmed.2019.7108)
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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Are Neurological Disorders Associated With Increased Risk of Suicide?
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, FEBRUARY 4, 2020
Media advisory: The full study is linked to this news release.
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What The Study Did: Nearly 40 years of registry data for 7.3 million people living in Denmark were used to examine whether people diagnosed with neurological disorders, including dementia, stroke, epilepsy, Parkinson disease and multiple sclerosis, die by suicide more often than others.
Authors: Annette Erlangsen, Ph.D., of the Danish Research Institute for Suicide Prevention in Copenhagen, Denmark, is the corresponding author.
(doi:10.1001/jama.2019.21834)
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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Do State Regulations Affect Adult Use of E-Cigarettes?
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JANUARY 31, 2020
Media advisory: The full study is linked to this news release.
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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.
What The Study Did: National data from 895,000 adults were used to examine how state regulations regarding electronic cigarettes were associated with their use among U.S. adults.
Authors: Wei Bao, Ph.D., of the University of Iowa College of Public Health in Iowa City, is the corresponding author.
(10.1001/jamanetworkopen.2019.20255)
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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Rates of New Colorectal Cancer Cases as People Turn 50, Historically Begin Screening
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JANUARY 31, 2020
Media advisory: The full study is linked to this news release.
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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.
What The Study Did: Cancer registries representing about 28% of the U.S. population were used to examine how new cases of colorectal cancer increased from age 49 to 50, the age when many people of average risk for the disease historically began screening, although screening age recommendations vary.
Authors: Jordan J. Karlitz, M.D., of the Southeast Louisiana Veterans Health Care System and Tulane University School of Medicine in New Orleans, is the corresponding author.
(10.1001/jamanetworkopen.2019.20407)
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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Effect of State Law Allowing Pharmacists to Dispense Naloxone Without Rx
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JANUARY 31, 2020
Media advisory: The full study is linked to this news release.
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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.
What The Study Did: Naloxone is a medication used to reverse an opioid overdose, and this study looked at how an Ohio law that allowed pharmacists to dispense naloxone without a prescription was associated with dispensing rates.
Authors: Pamela C. Heaton, Ph.D., of the University of Cincinnati in Ohio, is the corresponding author.
(10.1001/jamanetworkopen.2019.20310)
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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Suicidal Thoughts Among US Army Soldiers Deployed to Afghanistan
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUARY 29, 2020
Media advisory: To contact corresponding author Robert J. Ursano, M.D., email email Sarah Marshall at sarah.marshall@usuhs.edu. The full study is linked to this news release.
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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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: Among nearly 4,000 U.S. Army soldiers deployed in Afghanistan, 11.7% reported suicidal thoughts at some point in their lives, 3.0% within the past year and 1.9% within the past 30 days on questionnaires completed at the midpoint of their deployment in 2012. This observational study used the questionnaires to analyze how common suicidal ideation and mental health disorders were during combat deployment and to examine the associated risk factors. The study is unique in its assessment of soldiers’ self-reported suicidal ideation and mental health disorders at the midpoint of deployment, a period when risk for suicide attempts appears to peak. The authors report risk factors associated with recent suicidal thoughts during deployment included being white, past noncombat trauma and past major depressive disorder. Limitations of the study include self-reported data and findings that may not generalize to other soldiers or civilians. The authors suggest major depressive disorder and noncombat trauma are important factors for identifying risk of suicidal thoughts during combat deployments.
Authors: Robert J. Ursano, M.D., Uniformed Services University of the Health Sciences, Bethesda, Maryland, and coauthors
(doi:10.1001/jamanetworkopen.2019.19935)
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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Associations Between Work Environment and Rushed, Missed Care Tasks in Nursing Homes
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUARY 29, 2020
Media advisory: The full study and commentary are linked to this news release.
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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.
What The Study Did: Associations between work environment (including staffing, culture and leadership) and self-reported missed or rushed tasks by care aides in nursing homes in Canada were analyzed in this observational study.
Authors: Yuting Song, Ph.D., of the University of Alberta in Edmonton, Canada, is the corresponding author.
(10.1001/jamanetworkopen.2019.20092)
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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Self-Reported Secondhand Exposure to e-Cigarette Aerosol Among US Youth
JAMA Pediatrics
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JANUARY 27, 2020
Media Advisory: The full study is linked to this news release.
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What The Study Did: This research letter reports on self-reported secondhand aerosol from electronic cigarettes using survey data from U.S. middle and high school students.
Author: Hongying Dai, Ph.D., of the University of Nebraska Medical Center in Omaha, is the corresponding author.
(doi:10.1001/jamapediatrics.2019.5665)
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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Diabetes Screening in Barbershops to Identify Undiagnosed Black Men
JAMA Internal Medicine
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JANUARY 27, 2020
Media Advisory: The full study is linked to this news release.
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What The Study Did: This research letter reports on diabetes screening in barbershops to identify undiagnosed black men.
Authors: David C. Lee, M.D., of the NYU Grossman School of Medicine in New York, is the corresponding author.
(doi:10.1001/jamainternmed.2019.6867)
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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Study Examines Poverty, Suicide Associations Among US Youth
JAMA Pediatrics
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JANUARY 27, 2020
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What The Study Did: Associations between county-level concentrations of poverty in the United States and suicide rates among children and adolescents (ages 5 to 19) were explored in this observational study.
Authors: Jennifer A. Hoffman, M.D., of the Ann & Robert H. Lurie Children’s Hospital of Chicago, is the corresponding author.
(doi:10.1001/jamapediatrics.2019.5678)
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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Unmet Need for Physicians, Services Among US Adults
JAMA Internal Medicine
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JANUARY 27, 2020
Media Advisory: To contact corresponding author Laura Hawks, M.D., email David Cecere at dcecere@challiance.org. The full study, commentary and podcast are linked to this news release.
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Bottom Line: Twenty years of survey data from the Centers for Disease Control and Prevention were used to examine the unmet need to see a physician and for services among insured and uninsured adults from 1998 to 2017, a time of change in the U.S. health care system that included passage of the Affordable Care Act (ACA). The proportion of adults who reported being unable to see a physician because of cost increased, with worsening access among insured adults whose numbers increased over time. The proportion of adults with chronic medical conditions unable to see a physician because of cost also increased for most conditions. A bigger share of adults received guideline-recommended cholesterol tests and flu shots but the proportion of women receiving mammograms decreased. A limitation of the study was the use of self-reported data.
Authors: Laura Hawks, M.D., Cambridge Health Alliance, Cambridge, Massachusetts, and coauthors.
(doi:10.1001/jamainternmed.2019.6538)
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Study Assesses Absorption, Blood Levels of Active Ingredients in Sunscreen
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JANUARY 21, 2020
Media advisory: To contact corresponding author David G. Strauss, M.D., Ph.D., email Amanda Turney at Amanda.Turney@fda.hhs.gov and Brittney Manchester at brittney.manchester@fda.hhs.gov. The full study and editorial are linked to this news release. A visual abstract is below.
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Bottom Line: A randomized clinical trial with 48 healthy volunteers assessed the absorption of six active ingredients (avobenzone, oxybenzone, octocrylene, homosalate, octisalate and octinoxate) in four sunscreen products formulated as lotion and sprays (aerosol, nonaerosol and pump). This study builds on a prior trial from Food and Drug Administration (FDA) researchers published by JAMA in 2019. In this trial, all six tested active ingredients administered in four different sunscreen formulations were absorbed and had blood concentrations that surpassed the FDA threshold for potentially waiving some of the additional safety studies for sunscreens. Researchers emphasize the findings don’t mean people should refrain from using sunscreen, which can help to prevent skin cancer and protect the skin. More research is needed to determine the effect of exposure to sunscreen ingredients. This study was conducted indoors in a clinical research setting and participants weren’t exposed to direct sunlight during the seven days they remained at the clinic. A change in study design from an indoor to an outdoor setting would better represent real-life sunscreen application. The study also wasn’t designed to assess the absorption difference by formulation or skin types.
Authors: David G. Strauss, M.D., Ph.D., U.S. Food and Drug Administration, Silver Spring, Maryland, and coauthors.
Visual Abstract:
(doi:10.1001/jama.2019.20747)
Editor’s Note: The study was funded by the FDA. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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Examining Low-Carbohydrate, Low-Fat Diets, Risk of Death
JAMA Internal Medicine
EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JANUARY 21, 2020
Media Advisory: The full study is linked to this news release.
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What The Study Did: An analysis of self-reported national dietary data from more than 37,000 U.S. adults suggests associations between low-carbohydrate and low-fat diets and the risk of death may depend on the quality and food sources of the carbohydrates, proteins and fats people eat. The diet scores in this observational study don’t mimic particular versions of diets so the results cannot be used to assess the health benefits or risks of popular diets. Researchers report overall low-carbohydrate-diet and low-fat-diet scores weren’t associated with risk of total mortality but unhealthy low-carbohydrate-diet and low-fat-diet scores were associated with higher total mortality and healthy low-carbohydrate-diet and low-fat-diet scores were associated with lower total mortality.
Authors: Zhilei Shan, M.D., Ph.D., of the Harvard T.H. Chan School of Public Health in Boston, is the corresponding author.
(doi:10.1001/jamainternmed.2019.6980)
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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PEPTIC Trial Comparing Strategies to Prevent Stress Ulcers in ICU Patients Needing Mechanical Ventilation
JAMA
EMBARGOED FOR RELEASE: 4:30 A.M. (ET), FRIDAY, JANUARY 17, 2020
Media advisory: The full study and editorial are linked to this news release. A visual abstract is below. The study is being released to coincide with presentation at the Critical Care Reviews Meeting 2020 in Belfast, Northern Ireland. The live presentation can be viewed here https://vimeo.com/383968980.
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What The Study Did: Researchers report on a randomized clinical trial that compared two strategies (proton pump inhibitors vs. histamine-2 receptor blockers) to prevent stress ulcers among adult patients in intensive care units who needed mechanical ventilation. The trial was conducted at 50 ICUs in five countries to compare in-hospital death rates using the two strategies. The study is being released to coincide with presentation at the Critical Care Reviews Meeting 2020 in Belfast, Northern Ireland.
Authors: Paul J. Young, Ph.D., of the Medical Research Institute of New Zealand in Wellington, is the corresponding author.
Visual Abstract
(doi:10.1001/jama.2019.22190)
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VITAMINS Trial Report on Vitamin C, Hydrocortisone, Thiamine for Septic Shock
JAMA
EMBARGOED FOR RELEASE: 6:30 A.M. (ET), FRIDAY, JANUARY 17, 2020
Media advisory: The full study and editorial are linked to this news release. A visual abstract is below. The study is being released to coincide with presentation at the Critical Care Reviews Meeting 2020 and the live presentation can be viewed here https://vimeo.com/383969217.
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What The Study Did: In this randomized clinical trial of about 200 patients with septic shock, combination treatment with intravenous vitamin C, hydrocortisone and thiamine compared with intravenous hydrocortisone alone didn’t significantly improve the amount of time patients were alive and free of medicines that raise blood pressure (vasopressors) over seven days. The study findings are being released to coincide with presentation at the Critical Care Reviews Meeting 2020 in Belfast, Northern Ireland.
Authors: Rinaldo Bellomo, M.D., Ph.D., of Monash University in Melbourne, Australia, is the corresponding author.
Visual Abstract
(doi:10.1001/jama.2019.22176)
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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Observational Study Explores Fish Oil Supplements, Testicular Function in Healthy Young Men
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JANUARY 17, 2020
Media advisory: The full study, commentary and podcast are linked to this news release.
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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Wednesday and 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.
What The Study Did: An observational study of nearly 1,700 young healthy Danish men looked at how fish oil supplements were associated with testicular function as measured by semen quality and reproductive hormone levels. Limitations of this study include a lack of information on the actual concentration of omega-3 fatty acids in the fish oil supplements self-reported by the men. Researchers suggest randomized clinical trials are needed.
Author: Tina Kaid Jensen, Ph.D., University of Southern Denmark, Odense, and coauthors.
(10.1001/jamanetworkopen.2019.19462)
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Head/Neck Cancer Diagnosis, Time to Treatment After ACA Medicaid Expansions
JAMA Otolaryngology-Head & Neck Surgery
EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JANUARY 16, 2020
Media advisory: To contact corresponding author Evan M. Graboyes, M.D., email Montez Seabrook at seabromo@musc.edu. The full study is linked to this news release.
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Bottom Line: Researchers for this observational study examined the association between the expansion of Medicaid coverage in some states after the Patient Protection and Affordable Care Act (ACA) was passed and the diagnosis and treatment of patients with head and neck squamous cell carcinoma (HNSCC). The analysis included nearly 91,000 adults with newly diagnosed HNSCC who were identified from the National Cancer Database. Researchers report that between the pre-ACA (2010-2013) and post-ACA (2014-1026) periods, the percentage of uninsured patients with HNSCC decreased but those decreases didn’t differ significantly between expansion and nonexpansion states. The percentage of patients diagnosed with localized (stage I or II) HNSCC decreased from the pre-ACA to post-ACA periods in both expansion and nonexpansion states but the decreases were smaller in Medicaid expansion states so that resulted in a small relative increase in patients diagnosed with localized disease in Medicaid expansion states. The average time to beginning treatment didn’t differ overall between expansion and nonexpansion states but was improved for patients with nonoropharyngeal HNSCC in expansion states relative to nonexpansion states. Limitations of the study include possible misclassification of insurance coverage.
Authors: Evan M. Graboyes, M.D., Medical University of South Carolina, Charleston, and coauthors.
(doi:10.1001/jamaoto.2019.4310)
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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Blood Pressure Changes Throughout Life
JAMA Cardiology
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUARY 15, 2020
Media advisory: The full study, editorial and podcast are linked to this news release.
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What The Study Did: This observational study reports on patterns of blood pressure changes over time and how they differ between women and men.
Authors: Susan Cheng, M.D., M.P.H., M.M.Sc., of Cedars-Sinai Medical Center in Los Angeles, is the corresponding author.
(doi:10.1001/jamacardio.2019.5306)
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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How Common Are Operations, Hospitalizations After Weight-Loss Surgery?
JAMA Surgery
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUARY 15, 2020
Media advisory: The full study and commentary are linked to this news release.
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What The Study Did: Data on about 33,000 adults who had the common weight-loss procedures of gastric bypass or sleeve gastrectomy were analyzed to examine the risks of operations, interventions, hospitalizations or death associated with the procedures up to five years later.
Authors: Anita Courcoulas, M.D., of the University of Pittsburgh Medical Center, is the corresponding author.
(doi:10.1001/jamasurg.2019.5470)
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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Did Increasing Vegetable Consumption Reduce the Risk of Prostate Cancer Progression?
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JANUARY 14, 2020
Media advisory: To contact corresponding author J. Kellogg Parsons, M.D., M.H.S., email Yadira Galindo at ygalindo@health.ucsd.edu. The full study and related study are linked to this news release. A visual abstract is below.
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Bottom Line: This randomized clinical trial among more than 400 men with early-stage prostate cancer looked at whether a telephone-based program encouraging increased vegetable consumption would decrease cancer progression over two years. The authors report no significant decrease in the risk of prostate cancer progression among men in the intervention program compared with those who received only written information about diet and prostate cancer. The study may have been underpowered to identify a clinically important difference.
Authors: J. Kellogg Parsons, M.D., M.H.S., UC San Diego Moores Comprehensive Cancer Center and VA San Diego Healthcare System, La Jolla, California, and coauthors.
Visual Abstract
(doi:10.1001/jama.2019.20207)
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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