What The Study Did: This study (called a systematic review and meta-analysis) combined the results of 21 studies with about 128,000 participants to quantify the association between electronic cigarette use and marijuana use among adolescents and young adults.
Author: Nicholas Chadi, M.D., M.P.H., of Boston Children’s Hospital and Harvard Medical School in Boston, is the corresponding author.
(doi:10.1001/jamapediatrics.2019.2574)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, AUGUST 13, 2019
Media advisory: To contact corresponding author R. Nick Bryan, M.D., Ph.D., email Shahreen Abedin at Shahreen.Abedin@austin.utexas.edu. The full study, editorial, related article and video are linked to this news release. The summary video can be viewed on this page and embedded on your website by copying and pasting the HTML code below.
Bottom Line: Intensive blood pressure control among adults with high blood pressure was associated with a smaller increase in brain white matter lesions (a marker of small vessel disease and a risk factor for dementia) compared to standard blood pressure control, although the difference was small. Hypertension is a risk factor for developing white matter lesions. This analysis is a substudy of a randomized clinical of 449 patients with high blood pressure who had initial brain magnetic resonance imaging (MRI) and a follow-up MRI after four years. Researchers report intensive systolic blood pressure control (goal of less than 120 mm Hg) was associated with a smaller increase in white matter lesion volume compared with standard treatment (goal of less than 140 mm Hg). There also was a greater decrease in total brain volume, although the difference was small and the significance of this finding is unclear. Limitations of the study include the relatively short duration of the intervention and follow-up. Given the limited size of this study, it’s also not possible to correlate changes in brain structure with dementia occurrence.
Authors: R. Nick Bryan, M.D., Ph.D., University of Texas at Austin, and coauthors
(doi:10.1001/jama.2019.10551)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, AUGUST 13, 2019
Media advisory: To contact corresponding author Daniel Agardh, M.D., Ph.D., email daniel.agardh@med.lu.se. The full study and editorial are linked to this news release.
Bottom Line: Consuming more gluten during the first five years of life was associated with increased risk of celiac disease and celiac disease autoimmunity (the presence of antibodies in the blood) among genetically predisposed children. It remains unclear whether the amount of gluten consumed can trigger celiac disease. This observational study included 6,605 children born between 2004 and 2010 in Finland, Germany, Sweden and the United States who had a genetic predisposition for celiac disease. Gluten intake was estimated from food records collected at ages 6, 9, and 12 months and then biannually until the age of 5. Of the 6,605 children, 18% developed celiac disease autoimmunity and 7% developed celiac disease. The incidence of both outcomes peaked at 2 to 3 years old. The authors report that for every 1-gram per day increase in gluten consumption there was an associated higher risk of celiac disease and celiac disease autoimmunity. If gluten intake was one gram per day higher than the average at age 2 (corresponding to a half slice of white bread), the absolute risk differences for celiac disease autoimmunity and celiac disease were 6% and 7% higher, respectively, by age 3. A limitation of the study is the uncertainty of the accuracy of the reported gluten intake. The authors suggest a randomized clinical trial be done of different amounts of gluten during early childhood in genetically at-risk children.
Authors: Daniel Agardh, M.D., Ph.D., Lund University, Malmo, Sweden and coauthors
(doi:10.1001/jama.2019.10329)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, AUGUST 12, 2019
Media advisory: To contact corresponding author Eric Sun, M.D., Ph.D., email Beth Duff-Brown at bethduff@stanford.edu. The full study, editorial and viewpoint are linked to this news release.
Bottom Line: An analysis of claims data for privately insured patients suggests out-of-network billing for inpatient admissions and emergency department (ED) visits to in-network hospitals has increased along with the patient financial liability associated with it. This study included 5.4 million inpatient admissions and nearly 13.6 million ED visits to in-network hospitals between 2010-2016. Of all the ED visits, 39.1% generated an out-of-network bill and 37% of all the inpatient admissions resulted in an out-of-network bill. The percentage of ED visits with an out-of-network bill increased from 32.3% to 42.8% during the study period and the percentage of inpatient admissions with an out-of-network bill increased from 26.3% to 42% during that same time. The potential patient financial responsibility associated with out-of-network bills increased too, from an average $220 to $628 for ED visits and from an average $804 to $2,040 for inpatient admissions. A common example of out-of-network billing was ambulance transport. This study has some limitations, including no information on what patients actually paid to settle out-of-network bills. Researchers suggest their findings support strengthening legislative protections against the surprise medical bills associated with out-of-network billing.
Authors: Eric Sun, M.D., Ph.D., of Stanford University Medical Center in Stanford, California, is the corresponding author.
(doi:10.1001/jamainternmed.2019.3451)
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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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: This observational study looked at whether extreme heat is associated with increased risk of hospitalization or death among the vulnerable population of patients with end-stage renal disease (ESRD). The study included 7,445 patients with ESRD who underwent long-term hemodialysis treatment at clinics in Boston, Philadelphia or New York from 2001 to 2012. During that time, 2,953 of the patients died. Researchers used historical weather data to identify extreme heat days and investigated if exposures to such extreme heat days increased risk of hospitalizations and deaths among the patients. Extreme heat was associated with increased risk of same-day hospital admission and same-day death, with the risk of death greater among patients living with congestive heart failure, chronic obstructive pulmonary disease or diabetes. Risk varied between cities and by race/ethnicity. Limitations of the study include a lack of data to verify indoor conditions for patients and the study didn’t account for multiple-day heat waves, which could present a more severe threat for patients with ESRD.
Authors: Amir Sapkota, Ph.D., University of Maryland School of Public Health, College Park, and coauthors
(doi:10.1001/jamanetworkopen.2019.8904)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, AUGUST 9, 2019
Media advisory: To contact corresponding author Charles D. Blanke, M.D., email Wendy Lawton at lawtonw@ohsu.edu. The full study and commentary are linked to this news release.
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: An examination of a combined 28 years of data finds similarities in the characteristics and illnesses of patients requesting medical aid in dying in Oregon and Washington. The study included 3,368 prescriptions written for medical aid in dying, with 2,558 patients dying by lethal ingestion of medication, in the two states from 1998 to 2017 in Oregon and from 2009 to 2017 in Washington. Most of the patients were insured, non-Hispanic white individuals with some level of college education, 65 or older, and diagnosed with cancer. Loss of autonomy, impaired quality of life and loss of dignity were the most common reasons for pursuing medical aid in dying. Limitations of the study include physicians, not patients, providing the underlying reasons for requesting medical aid in dying as part of a follow-up questionnaire.
Authors: Charles D. Blanke, M.D., Oregon Health & Science University, Portland, and coauthors
(doi:10.1001/jamanetworkopen.2019.8648)
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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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 randomized clinical trial compared a technology-enhanced community health nursing intervention that included text message medication reminders with standard care for female adolescents and young adults with pelvic inflammatory disease.
Authors: Maria Trent, M.D., M.P.H., of the Johns Hopkins University School of Medicine in Baltimore, is the corresponding author.
(doi:10.1001/jamanetworkopen.2019.8652)
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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What The Study Did: Sex disparities in ophthalmic research were analyzed in this study that evaluated the representation of female authorships in ophthalmologic journals from 2008 to 2018, with sex assigned according to first name.
Authors: Michael H. K. Bendels, M.D., Ph.D., of Goethe-University in Frankfurt, Germany, is the corresponding author.
(doi:10.1001/jamaophthalmol.2019.3095)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, AUGUST 8, 2019
Media advisory: To contact corresponding author Kao-Ping Chua, M.D., Ph.D., email Beata Mostafavi at bmostafa@med.umich.edu. The full study is linked to this news release.
Bottom Line: National private insurance claims data were used to examine opioid prescribing patterns in children after tonsillectomy and return visits for complications. Opioids are commonly used after tonsillectomy, although American Academy of Otolaryngology clinical practice guidelines recommend nonopioids such as NSAIDs. This analysis included 2016 and 2017 claims data coded for tonsillectomy for nearly 16,000 children; nearly 60 percent of whom had one or more prescription drug claims for opioids between seven days before to one day after tonsillectomy. Having one or more prescription fills wasn’t associated with return visits for pain or dehydration or bleeding compared with children not using opioids but it was associated with increased risk of return visits for constipation. The study authors suggest reducing opioid prescribing to children after tonsillectomy may be possible without increasing risk of complications. The study has several limitations, including that children may not use opioids even when prescriptions are filled.
Authors: Kao-Ping Chua, M.D., Ph.D., University of Michigan, Ann Arbor, and coauthors
(doi:10.1001/jamaoto.2019.2107)
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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What The Study Did: Giant cell arteritis is an inflammation of the blood vessels that typically occurs in adults over 50 and, if left untreated, can result in irreversible vision loss and death. This study examined whether occurrence of the disorder was associated with race.
Authors: Anna M. Gruener, B.M.B.S., M.Sc., F.R.C.Ophth, of the Nottingham University Hospitals National Health Service Trust in the United Kingdom, is the corresponding author.
(doi:10.1001/jamaophthalmol.2019.2919)
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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What The Study Did: This research letter uses survey data to report on perceived bullying by internal medicine residents during training.
Authors: Scott M. Wright, M.D., of the Johns Hopkins Bayview Medical Center in Baltimore, is the corresponding author.
(doi:10.1001/jama.2019.8616)
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.
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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What The Study Did: This observational study of Swedish national register data included nearly 87,000 people with attention-deficit/hyperactivity disorder (ADHD) and examined the association of coexisting psychiatric disorders with risk of death.
Authors: Shihua Sun, M.D., of the Karolinska Institutet in Stockholm, Sweden, is the corresponding author.
(doi:10.1001/jamapsychiatry.2019.1944)
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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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: A nationwide population-based study in Taiwan suggests attention-deficit/hyperactivity disorder (ADHD) may be associated with a higher risk of death from injury causes, including suicide, unintentional injury and homicide. Although the risk of suicide-related death was higher in patients with ADHD than in those without, the absolute risk of death was low and suicide deaths were rare, with natural-cause deaths and unintentional injury deaths accounting for a higher number of deaths than suicide in the group of patients with ADHD. This observational study used registry data and included nearly 276,000 patients (ranging in age from 4 to 44) first diagnosed with ADHD between 2000 and 2012 and nearly 2 million individuals without ADHD for comparison. There was no increased risk of natural-cause death between the two groups. More research is needed to understand the causes of injury deaths in patients with ADHD and identify ways to mitigate them. Limitations of the study include the findings may not generalizable to others, including people with ADHD who aren’t diagnosed and those in other international settings. The study also couldn’t analyze the effects of ADHD medications and other potential mitigating factors, such as family history and psychosocial stress.
Authors: Charles Tzu-Chi Lee, Ph.D., National Taiwan Normal University, Taipei, and coauthors
(doi:10.1001/jamanetworkopen.2019.8714)
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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What The Study Did: This study (called a systematic review and meta-analysis) combined the results of 103 studies with nearly 478,000 children (ages 2 to 13) to look at how common overweight and obesity are among children across Europe.
Author: Iván Cavero-Redondo, Ph.D., of the Universidad de Castilla-La Mancha, in Cuenca, Spain, is the corresponding author.
(doi:10.1001/jamapediatrics.2019.2430)
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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What The Study Did: Data from the Centers for Medicare & Medicaid Services were used to examine industry payments to physician directors of National Cancer Institute-designated cancer centers in this research letter.
Authors: David Carr, M.D., of the University of California, San Diego, is the corresponding author.
(doi:10.1001/jamainternmed.2019.3098)
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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What The Study Did: This study of 180 deceased former football players who had chronic traumatic encephalopathy (CTE) investigated the association of brain white matter pathologic changes and cerebrovascular disease with dementia.
Authors: Ann C. McKee, M.D., of Boston University, is the corresponding author.
(doi:10.1001/jamaneurol.2019.2244)
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.
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 study used survey responses from nearly 79,000 individuals to estimate how common sesame allergy is in the United States.
Authors: Ruchi S. Gupta, M.D., M.P.J., of the Northwestern University Feinberg School of Medicine and the Ann & Robert H. Lurie Children’s Hospital of Chicago, is the corresponding author.
(doi:10.1001/jamanetworkopen.2019.9144)
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.
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 study (called a systematic review and meta-analysis) combined the results of 46 observational studies involving nearly 121,000 nonfrail adults (60 or older from 28 countries) and estimated the rate of new cases of frailty and prefrailty, which is a high risk of progressing to frailty.
Authors: Danny Liew, M.B.B.S.(Hons), F.R.A.C.P., Ph.D., of Monash University in Melbourne, Australia, is the corresponding author.
(doi:10.1001/jamanetworkopen.2019.8398)
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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Bottom Line: This study compared outcomes after a cancer diagnosis in patients with and without HIV who were 65 or older, had similar stages of cancer, and had received stage-appropriate cancer treatment in the year following diagnosis.
Authors: Anna E. Coghill, Ph.D., M.P.H., of the H. Lee Moffitt Cancer Center & Research Institute, in Tampa, Florida, is the corresponding author.
(doi:10.1001/jamaoncol.2019.1742)
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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What The Study Did: With the use of a driving simulator, three commercially available yellow-lens night-driving glasses were compared with clear lenses to examine their ability to detect pedestrians or reduce the negative effects of headlight glare. The study included 22 participants.
Authors: Alex D. Hwang, Ph.D., of Harvard Medical School in Boston, is the corresponding author.
(doi:10.1001/jamaophthalmol.2019.2893)
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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What The Study Did: The financial and environmental costs of unused portions of drugs from cataract surgery at four surgical sites in the U.S was investigated in this study.
Authors: Cassandra L. Thiel, Ph.D., of the New York University School of Medicine in New York, is the corresponding author
(doi:10.1001/jamaophthalmol.2019.2901)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, AUGUST 6, 2019
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, related articles and a podcast are linked to this news release.
Bottom Line: The U.S. Preventive Services Task Force (USPSTF) still recommends against screening for pancreatic cancer in adults without symptoms. The USPSTF routinely makes recommendations about the effectiveness of preventive care services. In this statement, the USPSTF reaffirmed its 2004 recommendation against screening for asymptomatic adults. Pancreatic cancer is an uncommon cancer with a poor prognosis.
(doi:10.1001/jama.2019.10232)
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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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: A population-based study using data from the National Health Insurance Research Database of Taiwan suggests hearing loss is associated with risk of dementia. The study included 8,135 patients with newly diagnosed hearing loss and an equal number of individuals without hearing loss for comparison. Among the 16,270 study participants, 1,868 developed dementia. Patients with hearing loss had a higher risk of dementia, especially those 45 to 64 years old. Six coexisting conditions also were associated with dementia risk in the present study. The authors caution causal inferences cannot be drawn from their findings.
Authors:
Authors: Charles Tzu-Chi Lee, Ph.D., of the National Taiwan Normal University, and Chin-Mei Liu, Ph.D., of the Taiwan Centers for Disease Control, both in Taipei
(doi:10.1001/jamanetworkopen.2019.8112)
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What The Study Did: This randomized clinical trial with about 400 adults conducted in China investigated acupuncture as an added treatment to antianginal therapies in reducing the frequency of angina attacks in patients with chronic stable angina.
Authors: Fanrong Liang, M.D., of the Chengdu University of Traditional Chinese Medicine, Sichuan, China, is the corresponding author.
(doi:10.1001/jamainternmed.2019.2407)
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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What The Study Did: This randomized clinical trial and meta-analysis focused on intensive blood pressure control compared with a standard control regimen on the risk of stroke in patients who had had a previous stroke.
Authors: Kazuo Kitagawa, M.D., Ph.D., of the Tokyo Women’s Medical University, Shinjukuku, Tokyo, is the corresponding author.
(doi:10.1001/jamaneurol.2019.2167)
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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What The Study Did: Data from two long-term study groups including nearly 125,000 health professionals in the U.S. were used to evaluate the association between intake of vitamin A, through diet and supplementation, and risk of cutaneous squamous cell cancer during a follow-up period of more than 26 years.
Authors: Eunyoung Cho, Sc.D., of Warren Alpert Medical School of Brown University in Providence, Rhode Island, is the corresponding author
(doi:10.1001/jamadermatol.2019.1937)
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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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 study used national insurance claims data for about 988,000 women to look at the association between an opioid prescription after a vaginal or cesarean delivery and rates of new persistent opioid use among U.S. women.
Authors: Alex F. Peahl, M.D., of the University of Michigan in Ann Arbor, is the corresponding author.
(doi:10.1001/jamanetworkopen.2019.7863)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JULY 26, 2019
Media advisory: To contact corresponding author Thomas Astell-Burt, Ph.D., email thomasab@uow.edu.au. The full study and commentary are linked to this news release.
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: This observational study looked at how green space is associated with mental health. Some research has suggested living near more green space may be associated with benefits. This analysis included nearly 47,000 city-dwelling adults in Australia and examined how living near different kinds of green space (including tree canopy, grass and low-lying vegetation) may be associated with risk of psychological distress, self-reported physician-diagnosed depression or anxiety, and fair to poor self-reported general health. The three outcomes were examined at baseline and follow-up about six years later. The authors report exposure to more tree canopy was associated with a lower likelihood of psychological distress and better self-rated general health. No green space indicator was associated with depression or anxiety. Exposure to low-lying vegetation wasn’t consistently associated with any outcome. Exposure to more grass was associated with a higher likelihood of reporting fair to poor general health and prevalent psychological distress. Limitations of the study include self-reported health outcomes and green space availability that may have decreased in some areas over time, which may mean the results underestimate the associations.
Authors: Thomas Astell-Burt, Ph.D., and Xiaoqi Feng, Ph.D., of the University of Wollongong, Wollongong, New South Wales, Australia.
(doi:10.1001/jamanetworkopen.2019.8209)
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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What The Study Did: This observational study examined at what point an increasing number of operations to remove the thyroid performed annually by a surgeon is associated with a lower rate of complications among patients.
Authors: Charles Meltzer, M.D., of the Permanente Medical Group in Santa Rosa, California, is the corresponding author.
(doi:10.1001/jamaoto.2019.1752)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JULY 26, 2019
Media advisory: To contact corresponding author Wei Bao, M.D., Ph.D., email Tom Snee at Tom-snee@uiowa.edu. The full study and commentary are linked to this news release.
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: The proportion of U.S. adults adhering to the “Physical Activity Guidelines for Americans” from the U.S. Department of Health and Human Services didn’t significantly improve between 2007 and 2016 but time spent sitting increased. The first edition of the federal guidelines recommending types and duration of physical activity were released in 2008 and updated in 2018, including a recommendation to spend less time sitting. This study used nationally representative survey data from about 27,000 adults to examine adherence to the recommendations for aerobic activity, as well as sedentary behavior from 2007 to 2016. Study authors report 65.2% met the guidelines for aerobic activity in 2015-2016, compared with 63.2% in 2007-2008, while time spent sitting increased from 5.7 hours per day in 2007-2008 to 6.4 hours per day in 2015-2016. The proportion of people not meeting the recommendations for aerobic activity and sitting more than six hours a day increased from 16.1% to 18.8% during this same period. A limitation of the study is that the information on physical activity and sitting time was self-reported.
Authors: Wei Bao, M.D., Ph.D., University of Iowa, Iowa City, and coauthors
(doi:10.1001/jamanetworkopen.2019.7597)
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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What The Study Did: This observational study describes the scope of private equity-backed acquisitions of dermatology practices in the United States.
Authors: Arash Mostaghimi, M.D., M.P.A., M.P.H., of Brigham and Women’s Hospital in Boston and an associate editor of JAMA Dermatology, is the corresponding author.
(doi:10.1001/jamadermatol.2019.1634)
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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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: Researchers looked at rates of medical imaging (CT, MRI, conventional x-rays, angiography, fluoroscopy and nuclear medicine) during pregnancy in this observational study that included nearly 3.5 million pregnant women in the United States and Canada from 1996 to 2016.
Authors: Marilyn L. Kwan, Ph.D., of Kaiser Permanente Northern California in Oakland is the corresponding author.
(doi:10.1001/jamanetworkopen.2019.7249)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JULY 24, 2019
Media advisory: To contact corresponding author Wei Bao, M.D., Ph.D., email Tom Snee at Tom-snee@uiowa.edu. The full study and commentary are linked to this news release.
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: Postmenopausal women with normal weight (body mass index 18.5 to 24.9) and central obesity (waist circumference greater than 88 cm) are at higher risk of death compared to women with normal weight and no central obesity. Obesity prevention commonly focuses on BMI, which can’t distinguish body shape or body fat distribution. The high abdominal fat distribution that is central obesity is common in the general population. This observational study examined the associations of normal-weight central obesity with risk of death using data from nearly 157,000 postmenopausal women enrolled in the Women’s Health Initiative between 1993 and 1998. Normal-weight central obesity in women was associated with an increased risk of death that was comparable to that of women with obesity (BMI equal to or greater than 30) and central obesity. Limitations of the study include its focus on postmenopausal women so the findings may not be broadly generalizable to younger women or men. The study authors suggest that normal-weight central obesity in women may be an underrecognized high-risk subpopulation and that the prevention and control of central obesity should be included in clinical and public health guidelines, even for individuals of normal weight.
Authors: Wei Bao, M.D., Ph.D., University of Iowa, Iowa City, and coauthors
(doi:10.1001/jamanetworkopen.2019.7337)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JULY 25, 2019
Media advisory: To contact corresponding author Zhaoming Wang, Ph.D., email Katy Hobgood Ray at media@stjude.org. The full study is linked to this news release.
Bottom Line: This research letter reports on the association of BRCA2 gene mutations and potential risk for pediatric or adolescent lymphoma. The study used whole-genome sequencing data for 1,380 survivors of pediatric or adolescent lymphoma (815 survivors of Hodgkin lymphoma and 565 survivors of non-Hodgkin lymphoma), of which 13 survivors had BRCA2 mutations (five survivors of Hodgkin lymphoma and eight survivors of non-Hodgkin lymphoma). Compared with individuals without cancer, there was a statistically significant association between BRCA2 mutations and risk of non-Hodgkin lymphoma but not Hodgkin lymphoma. The findings support including childhood non-Hodgkin lymphoma in the spectrum of cancers associated with BRCA2 mutations.
Authors: Zhaoming Wang, Ph.D., St. Jude Children’s Research Hospital, Memphis, Tennessee, and coauthors
(doi:10.1001/jamaoncol.2019.2203)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JULY 31, 2019
Media advisory: To contact corresponding author Ninh T. Nguyen, M.D., email Tom Vasich at tmvasich@uci.edu. The full study and commentary are linked to this news release.
Bottom Line: This database analysis looked at whether U.S. News & World Report top-ranked hospitals for gastroenterology and gastrointestinal surgery were associated with improved patient outcomes for common advanced laparoscopic abdominal operations, including bariatric, colorectal and hiatal hernia procedures. The study included nearly 52,000 abdominal operations performed at 351 academic centers and their affiliated hospitals in the United States in 2017; 31.4% of the procedures were performed at 41 top-ranked hospitals and 68.6% of procedures were done at 310 nonranked hospitals. The annual volume of procedures was three times higher at top-ranked hospitals but there were no significant differences in serious complications or in-hospital death between top-ranked and nonranked hospitals. However, advanced laparoscopic abdominal operations at top-ranked hospitals cost more on average and were associated with longer average hospital stays. This study has several limitations associated with the use of database information such as coding errors and selection bias.
Author: Ninh T. Nguyen, M.D., University of California Irvine Medical Center, Orange, and coauthors
(doi:10.1001/jamasurg.2019.2327)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JULY 31, 2019
Media advisory: To contact corresponding author Darren R. Brenner, Ph.D., email Kelly Johnston at kelly.johnston2@ucalgary.ca. The full study is linked to this news release.
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: The incidence of colorectal cancer among younger adults increased in recent years in this analysis of data from Canadian national cancer registries that included about 688,000 new colorectal cancers diagnosed over more than 40 years. Among men younger than 50, there was an average annual percentage change of 3.47% from 2006 to 2015. Among women younger than 50, there was an average annual percentage change of 4.45% from 2010 to 2015. Because the study used registry data, authors didn’t have access to any demographic information other than age so they were unable to identify what other factors may be associated with the increases. Potential reasons to explain the increases are not well understood and the authors suggest that be investigated before any change in screening guidelines is pursued.
Authors: Darren R. Brenner, Ph.D., University of Calgary, Alberta, Canada, and coauthors
(doi:10.1001/jamanetworkopen.2019.8090)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JULY 29, 2019
Media advisory: To contact corresponding author Laura Widman, Ph.D., email Matt Shipman at matt_shipman@ncsu.edu. The full study is linked to this news release.
Bottom Line: This study (called a systematic review and meta-analysis) combined the results 31 randomized clinical trials with 12,464 adolescent participants to examine whether parent-based sexual health interventions were associated with three main outcomes: delayed sexual activity, improved condom use and parent-child sexual communication. The findings were generally modest but across the studies there was a significant association of parent-based interventions with improved condom use and parent-child sexual communication but no significant differences for delaying adolescents’ sexual activity. The current study has several limitations, including variation in how outcomes were measured in the studies pooled for this analysis.
Author: Laura Widman, Ph.D., of North Carolina State University, Raleigh, and coauthors
(doi:10.1001/jamapediatrics.2019.2324)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JULY 26, 2019
Media advisory: To contact corresponding author Liselotte Dyrbye, M.D., M.H.P.E., email Bob Nellis at newsbureau@mayo.edu. The full study and commentary are linked to this news release.
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: Symptoms of physician burnout appear to be associated with greater bias toward black people in this study of nearly 3,400 second-year resident physicians in the United States who identified as nonblack. Survey data from questionnaires that were part of another study were used. About 45% of physician residents had symptoms of burnout. Explicit bias was measured on a “feeling thermometer” with the lowest score meaning cold or unfavorable toward black people and the highest score meaning warm or favorable; implict bias was measured on a test that involved sorting pictures of white and black people and words to describe them including “good” and “bad.” Study authors suggest symptoms of burnout may be factors in care disparities. However, this observational study cannot determine if the suggested association between symptoms of burnout and bias toward black people is causal and the magnitude of the observed association was small to medium.
Authors: Liselotte Dyrbye, M.D., M.H.P.E., of the Mayo Clinic, Rochester, Minnesota, and coauthors
(doi:10.1001/jamanetworkopen.2019.7457)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JULY 22, 2019
Media advisory: To contact corresponding author Marc G. Weisskopf, Ph.D., Sc.D., email Chris Sweeney at csweeney@hsph.harvard.edu. The full study and commentary are linked to this news release.
Bottom Line: Major league baseball (MLB) players had lower death rates overall and from many underlying causes of death compared with men in the general U.S. population, differences that could be associated in part with the physical fitness required for their jobs. This research letter reports on an analysis of mortality rates among 10,451 baseball players who debuted in the MLB from 1906 through 2006, including differences in mortality rates by position and career length. Having a longer playing career was associated with a lower rate of cardiovascular-related death and an increased rate of cancer deaths. Limitations of the study include an inability to account for physical activity, head injuries and other environmental or genetic factors.
Authors: Marc G. Weisskopf, Ph.D., Sc.D., Harvard T.H. Chan School of Public Health, Boston, and coauthors
(doi:10.1001/jamainternmed.2019.1218)
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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What The Study Did: This observational study used a study group of children from the Netherlands to examine how common was the use of melatonin and its association with sleep patterns in school-age children.
Author: Henning Tiemeier, M.D., Ph.D., of the Harvard T.H. Chan School of Public Health in Boston, is the corresponding author.
(doi:10.1001/jamapediatrics.2019.2084)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JULY 22, 2019
Media advisory: To contact corresponding author Qi Sun, M.D., Sc.D., email Chris Sweeney at csweeney@hsph.harvard.edu. The full study is linked to this news release.
Bottom Line: This study (called a systematic review and meta-analysis) combined the results of nine studies and examined the association between adherence to plant-based eating habits and risk of type 2 diabetes in adults. The analysis included 307,099 adults with 23,544 cases of type 2 diabetes. The authors report higher adherence to plant-based eating habits was associated with lower risk of type 2 diabetes, especially when only healthy plant-based foods, such as fruits, vegetables, whole grains, legumes and nuts, were included in the definition of plant-based. Limitations include that all of the studies analyzed were observational and dietary habits were self-reported.
Authors: Qi Sun, M.D., Sc.D., of the Harvard T. H. Chan School of Public Health, Boston, and coauthors
(doi:10.1001/jamainternmed.2019.2195)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JULY 23, 2019
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, related articles and a podcast are linked to this news release.
Bottom Line: The U.S. Preventive Services Task Force (USPSTF) recommends screening for hepatitis B virus (HBV) infection in pregnant women at their first prenatal visit. The USPSTF routinely makes recommendations about the effectiveness of preventive care services and this statement is a reaffirmation of its 2009 recommendation. Screening for HBV infection during pregnancy identifies infants who are at risk of acquiring this infection from their mothers before or after birth. Children infected with HBV during infancy or childhood are more likely to develop chronic infection.
(doi:10.1001/jama.2019.9365)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JULY 23, 2019
Media advisory: To contact corresponding author Ragini Verma, Ph.D., email Lauren Ingeno at Lauren.Ingeno@Pennmedicine.upenn.edu. The full study and editor’s note are linked to this news release. Images of brain tissue volume differences between patients and controls are below.
Bottom Line: Imaging shows differences in the brains of U.S. government personnel who were potentially exposed to unusual audible and sensory phenomena (sound, pressure or vibration) while serving in Cuba when compared with brain images from a group of healthy individuals without such exposure, although the clinical importance of these brain differences is uncertain. A preliminary report published by JAMA in 2018 described neurological signs and symptoms experienced by some of these government workers. In this study, advanced magnetic resonance imaging (MRI) of the brain was done for 40 workers and 48 healthy individuals who were demographically similar for comparison to analyze three components (brain volume, microstructural tissue measures, and functional connectivity). Study authors report differences in whole brain white matter volume, regional gray and white matter volumes, cerebellar tissue microstructural integrity, and functional connectivity in the auditory and visuospatial subnetworks of the brain but not in the executive control subnetwork. There also were no significant differences in total whole brain gray matter volume. The findings suggest there may be differences in brain structure in several brain regions and in some functional brain networks. The current study has several limitations including that it cannot determine if the differences among patients are because of individual differences or differences in the level and degree of exposure to the reported sound, pressure or vibrations.
Authors: Ragini Verma, Ph.D., University of Pennsylvania, Philadelphia, and coauthors
Brain Tissue Volume Differences Between Patients and Controls (right click on image to copy). Please see description of figure 1, page 341.
(doi:10.1001/jama.2019.9269)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JULY 19, 2019
Media advisory: To contact corresponding author Alison Gemmill, Ph.D., email Barbara Benham at bbenham1@jhu.edu. The full study, commentary and podcast are linked to this news release.
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: A national population-based study suggests the 2016 U.S. presidential election may have been associated with an increase in preterm births among Latina women in the United States. The design of the study is used to evaluate whether policies or other population-level changes interrupt a trend in an outcome. Using data on birth counts from 2009 through July 2017 from the Centers for Disease Control and Prevention, researchers compared preterm births (less than 37 weeks) to Latina women after the 2016 presidential election with the number expected had the election not taken place. Among nearly 32.9 million live births recorded during the study period, 11% of males and 9.6% of female births to Latina women were preterm compared with 10.2% and 9.3%, respectively, to other women. In the nine-month period beginning in November 2016, an additional 1,342 male and 995 female preterm births to Latina women were found above the expected number of preterm births, which is about 3.2% to 3.6% more. This study cannot identify the reasons behind the findings and other limitations of the study include an inability to differentiate between native and nonnative Latina women in the U.S. The authors suggest future research look at the association of anti-immigration policies with population health.
Authors: Alison Gemmill, Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and coauthors
(doi:10.1001/jamanetworkopen.2019.7063)
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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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: Researchers in this study looked at whether a computing system that analyzed data from thousands of chest x-rays of smokers and nonsmokers and developed a risk score could predict long-term risk of death.
Authors: Michael T. Lu, M.D., M.P.H., of Massachusetts General Hospital and Harvard Medical School in Boston, is the corresponding author.
(doi:10.1001/jamanetworkopen.2019.7416)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JULY 19, 2019
Media advisory: To contact corresponding author Kelly C. Young-Wolff, Ph.D., M.P.H., email Kerry Sinclair at ksinclair@webershandwick.com or Jan Greene at Janice.x.greene@kp.org. The full study and commentary are linked to this news release.
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: An observational study of pregnant women in Northern California suggests marijuana use before and during pregnancy has increased over time. The study of nearly 277,000 women in Kaiser Permanente Northern California included 367,403 pregnancies from 2009 to 2017. The women reported marijuana use on questionnaires as part of standard prenatal care. The authors report marijuana use in the year before pregnancy increased from 6.8% of women in 2009 to 12.5% in 2017, and marijuana use during pregnancy increased from 1.95% to 3.38%. Daily use of marijuana in the year before pregnancy increased from 1.17% in 2009 to 3.05% in 2017, and daily use during pregnancy increased from 0.28% to 0.69%. A limitation of the study is that the results may not be generalizable to women outside of California or those without access to health care.
Authors: Kelly C. Young-Wolff, Ph.D., M.P.H., Kaiser Permanente Northern California, Oakland, and coauthors
(doi:10.1001/jamanetworkopen.2019.6471)
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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EMBARGOED FOR RELEASE: 12:30 P.M. (ET), WEDNESDAY, JULY 17, 2019
Media Advisory: This article is being released to coincide with the Alzheimer’s Association International Conference. The full study and related articles also being released to coincide with the event are linked to this news release.
What The Study Did: This multicenter study used in vivo β-amyloid cerebrospinal fluid, a biomarker of Alzheimer disease, and positron emission tomography findings to track progression of Alzheimer disease over six years among study participants.
Authors: Niklas Mattsson, M.D., Ph.D., and Oskar Hansson, M.D., Ph.D., of Lund University in Malmo, Sweden, are the corresponding authors.
(doi:10.1001/jamaneurol.2019.2214)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JULY 15, 2019
Media Advisory: This article is being released to coincide with the Alzheimer’s Association International Conference. The full study and related articles also being released to coincide with the event are linked to this news release.
What The Study Did: Blood samples taken over several years from cognitively normal study participants who developed Alzheimer disease were analyzed along with samples from individuals who did not develop the disease to evaluate whether there is an association between neuronal-enriched extracellular vesicle biomarkers (particles shed by all cells and found in blood) and Alzheimer disease.
Authors: Dimitrios Kapogiannis, M.D., of the National Institutes of Health in Baltimore is the corresponding author.
(doi:10.1001/jamaneurol.2019.2462)
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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EMBARGOED FOR RELEASE: 12:30 P.M. (ET), SUNDAY, JULY 14, 2019
Media Advisory: This article is being released to coincide with the Alzheimer’s Association International Conference. The full study and related articles also being released to coincide with the event are linked to this news release.
What The Study Did: This study of 1,600 older adults free of dementia at baseline examined whether accumulation over a lifetime of cognitive and social activities was associated with a slower rate of memory loss and a reduced risk of dementia, taking into account brain pathologies.
Authors: Xiuying Qi, Ph.D., and Weili Xu, M.D., Ph.D., of Tianjin Medical University, Tianjin, China, are the corresponding authors.
(doi:10.1001/jamaneurol.2019.2455)
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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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 observational study included 46,000 injured workers in Tennessee who weren’t taking opioids at the time of their injury and looked at how common long-term opioid use was and what factors were associated with it.
Authors: Zoe Durand, Ph.D., of the Tennessee Department of Health in Nashville, is the corresponding author.
(doi:10.1001/jamanetworkopen.2019.7222)
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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What The Study Did: Photographs of 24 men before and after facial cosmetic surgery were part of this survey study to examine whether surgery was associated with perceived changes in attractiveness, masculinity and a variety of personality traits.
Authors: Michael J. Reilly, M.D., of the Georgetown University School of Medicine in Washington, D.C., is the corresponding author.
(doi:10.1001/jamafacial.2019.0463)
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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What The Study Did: In this secondary analysis of a randomized clinical trial, researchers examined the association of age with the benefit of intensive treatment to lower lipid levels with a combination therapy of simvastatin and ezetimibe compared to treatment with simvastatin alone after acute coronary syndrome in older patients.
Authors: Richard G. Bach, M.D., of Washington University School of Medicine in St. Louis, is the corresponding author.
(doi:10.1001/jamacardio.2019.2306)
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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What The Study Did: National registry data from five countries (Denmark, Finland, Sweden, Israel and Western Australia) were used to estimate the contribution of various genetic and nongenetic factors on the risk of autism spectrum disorder in this population-based study.
Authors: Sven Sandin, Ph.D., of the Karolinska Institutet in Stockholm, Sweden, is the corresponding author.
(doi:10.1001/jamapsychiatry.2019.1411)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), SUNDAY, JULY 14, 2019
Media advisory: To contact corresponding author David J. Llewellyn, Ph.D., email Louise Vennells at L.Vennells@exeter.ac.uk . This article is being released to coincide with the Alzheimer’s Association International Conference. The full study and related articles also being released to coincide with the event are linked to this news release.
Bottom Line: This observational study looked at whether a healthy lifestyle was associated with a lower risk of dementia regardless of genetic risk. Genetic factors are associated with increased risk of dementia but to what extent these might be offset by lifestyle factors is unknown. Genetic information from the UK Biobank was available for the 196,383 adults in this study who were of European ancestry, at least 60 years old and without dementia at the study baseline. Scores reflecting genetic risk and lifestyle were compiled based on genetic variants associated with Alzheimer disease and dementia and questionnaires about smoking, physical activity, diet and alcohol consumption. Over eight years of follow-up, there were 1,769 new cases of dementia. Both an unfavorable (the least healthy) lifestyle and high genetic risk were associated with higher dementia risk compared with low genetic risk and a favorable (the most healthy) lifestyle score. A favorable lifestyle was associated with lower dementia risk regardless of genetic risk, indicating that genetic risk and healthy lifestyle are independently associated with risk of dementia. The study has a number of limitations including that it cannot show causality, lifestyle factors were self-reported and the study was restricted to adults of European ancestry so it may not be generalizable to other populations.
Authors: David J. Llewellyn, Ph.D., University of Exeter Medical School, Exeter, United Kingdom, and coauthors
(doi:10.1001/jama.2019.9879)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JULY 15, 2019
Media advisory: To contact corresponding author Angélica Meinhofer, Ph.D., email Jen Gundersen at jeg2034@med.cornell.edu. The full study is linked to this news release.
Bottom Line: A research letter analyzed federally mandated data on children in foster care in the United States to examine how many children entered foster care because of parental drug use during the 2000 to 2017 fiscal years. There were nearly 5 million foster care entries during this period, of which nearly 1.2 million (about 23%) were home removals because of parental drug use. The number of foster care entries because of parental drug use rose from 39,130 of 269,382 removals (14.5%) in 2000 to 96,672 of 266,583 removals (36.3%) in 2017. These findings coincide with increasing trends in opioid use and overdose deaths nationwide during this period. However, the authors acknowledge factors other than drug use may have influenced foster care entries for parental drug use.
Author: Angélica Meinhofer, Ph.D., of Weill Cornell Medical College, New York, and Yohanis Angleró-Díaxm M.D., of Boston Children’s Hospital, Harvard Medical School, Boston
(doi:10.1001/jamapediatrics.2019.1738)
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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EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JULY 10, 2019
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Bottom Line: The 1978 novel “The House of God” is a fictional account of the internship experience of Samuel Shem, the pen name of Stephen Bergman, at Beth Israel Hospital in 1973-1974. Funny, angry, honest, and absurd, the book spotlighted the injustices of medical training and the patient care of that era and was pilloried by establishment medicine for years after publication for its razor-sharp version of the truth. This short documentary, produced on the 40th anniversary of the novel’s debut, details the book’s origins and the people and events that inspired its stories.
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EMBARGOED FOR RELEASE: 7:15 P.M. (ET), TUESDAY, JULY 16, 2019
Media Advisory: This article is being released to coincide with the Alzheimer’s Association International Conference. The full study and related articles also being released to coincide with the event are linked to this news release.
What The Study Did: Researchers in this observational study looked at whether physical activity moderates the association of β-amyloid levels, a biomarker of Alzheimer disease, with cognitive decline and neurodegeneration over time in clinically normal older adults.
Author: Jasmeer P. Chhatwal, M.D., Ph.D., of Massachusetts General Hospital, Harvard Medical School in Boston, is the corresponding author.
(doi:10.1001/jamaneurol.2019.1879)
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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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.
Visual Abstract
(doi:10.1001/jamanetworkopen.2019.6716)
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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What The Study Did: Hospital discharge data was used to examine the association between New York state sepsis regulations and the outcomes of patients hospitalized with sepsis.
Authors: Jeremy M. Kahn, M.D., M.S., of the University of Pittsburgh, is the corresponding author.
(doi:10.1001/jama.2019.9021)
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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What The Study Did: An observational study based on a group of smokers and former smokers in France looked at whether electronic cigarette use was associated with changes in the number of cigarettes smoked, with smoking cessation rates among smokers, and with smoking relapse among former smokers.
Authors: Ramchandar Gomajee, M.Sc., of the Sorbonne Université in Paris, is the corresponding author.
(doi:10.1001/jamainternmed.2019.1483)
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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What The Study Did: Veterans Affairs data for 355,121 patients undergoing ambulatory, elective, noncardiac surgery were used to compare the risk of death and complications in patients with and without heart failure.
Authors: Sherry M. Wren, M.D., of the Stanford University School of Medicine in Palo Alto, California, is the corresponding author.
(doi:10.1001/jamasurg.2019.2110)
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 emailmediarelations
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: Called a systematic review and meta-analysis, this study combined the results of 26 studies to examine the cognitive and motor development of infants and children exposed to opioids prenatally.
Authors: Ju Lee Oei, M.B.B.S., F.R.A.C.P, M.D., of The Royal Hospital for Children in Sydney, Australia, is the corresponding author.
(doi:10.1001/jamanetworkopen.2019.7025)
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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What The Study Did: A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.
Author: Peter Huppke, M.D., of Georg August University in Göttingen, German, is the corresponding author.
(doi:10.1001/jamaneurol.2019.1997)
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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What The Study Did: A group of 329,237 men and women of white Bristish ancestry with genetic data in the UK Biobank and blood pressure measurements were included in a study that examined the association between systolic blood pressure and risk of major valvular heart disease.
Authors: Kazem Rahimi, M.D., F.R.C.P., of the University of Oxford in Oxford, United Kingdom, is the corresponding author.
(doi:10.1001/jamacardio.2019.2202)
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.
# # #
For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or emailmediarelations
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 study (called a systematic review and meta-analysis) combined the results of 21 studies to summarize the overall association between being born preterm or low birth weight and later social outcomes as adults, such as ever having a romantic partnership, having sex or becoming a parent, as well as the quality of romantic partnerships and friendships.
Authors: Dieter Wolke, Ph.D., of the University of Warwick in the United Kingdom, is the corresponding author.
(doi:10.1001/jamanetworkopen.2019.6961)
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 emailmediarelations
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 observational study of nearly 5,700 hospital employees who used the workplace cafeteria reports on whether food placement and traffic light labeling (green for healthy, yellow for less healthy and red for least healthy) was associated with a reduction in calories in the food purchased by employees.
Authors: Anne N. Thorndike, M.D., M.P.H., of the Massachusetts General Hospital in Boston, is the corresponding author.
(doi:10.1001/jamanetworkopen.2019.6789)
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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What The Study Did: This randomized clinical trial of 143 men tested a short-term treatment for internet and computer game addiction.
Authors: Klaus Wölfling, Ph.D., of the University Medical Center of the Johannes Gutenberg-University Mainz in Germany, is the corresponding author
(doi:10.1001/jamapsychiatry.2019.1676)
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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What The Study Did: This observational study used data from a survey of behavioral health that included students from 10 Los Angeles-area high schools to examine whether nonmedical prescription opioid use was associated with later risk of heroin use in adolescents.
Author: Adam M. Leventhal, Ph.D., of the University of Southern California in Los Angeles, is the corresponding author.
(doi:10.1001/jamapediatrics.2019.1750)
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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