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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.
Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2019.4818?guestAccessKey=e154760d-041f-43fb-9081-da57ba4eca89&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=020520
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.
Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2019.21834?guestAccessKey=d5649cd4-8b2b-4f8b-9694-3ec2845cb59e&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=020420
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.
Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.19935?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=012920
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.
Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2019.5665?guestAccessKey=f57b4f65-70a2-457c-b00e-97041b1ae677&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=012720
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
Media advisory: The full study is linked to this news release.
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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)
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 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)
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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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)
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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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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Examining Changes to FDA Approval, Regulation of Pharmaceuticals Over 4 Decades
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JANUARY 14, 2020
Media advisory: To contact corresponding author Jonathan J. Darrow, S.J.D., J.D., M.B.A., email Elaine St. Peter at estpeter@bwh.harvard.edu. The full study and editorial are linked to this news release.
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Bottom Line: Publicly available and Food and Drug Administration (FDA) data were used in this observational study to describe the number and types of prescription drugs approved from 1983 to 2018 and how the approval process and regulation of drugs changed during this period. Approvals of new generic drugs and biologics increased over this time, as the median annual number of generic drugs approved was 284 from 1985 to 2012 and 588 from 2013 to 2018. The authors report that the average annual number of new drug approvals, including biologics, was 34 from 1990-1999, decreasing to 25 from 2000-2009, and increasing to 41 from 2010-2018. There has been an expansion in the number of expedited development and approval programs since 1983, while the amount of evidence used for approvals has decreased. The proportion of new approvals supported by at least two pivotal trials declined from 81% in 1995-1997 to 53% in 2015-2017. The amount of industry-paid user fees collected, funds used to accelerate review times, have increased to an annual average of $820 million in 2013-2017. FDA drug review times declined from more than three years in 1983 to less than one year in 2017. A limitation of the study is the difficulty in comparing the size of the clinical benefit of drugs across different indications and populations.
Authors: Jonathan J. Darrow, S.J.D., J.D., M.B.A., of Brigham and Women’s Hospital, Harvard Medical School, Boston, and coauthors.
(doi:10.1001/jama.2019.20288)
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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Views of Rural US Adults on Serious Health, Economic Issues in Their Communities
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUARY 8, 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: Nationally representative surveys from 2018 and 2019 were used to examine the views of adults in the rural U.S. on the serious health and economic problems facing their communities, including the cost and access to health care and addiction to opioids.
Author: Mary G. Findling, Ph.D., Sc.M., of the Harvard T.H. Chan School of Public Health in Boston, is the corresponding author.
(10.1001/jamanetworkopen.2019.18745)
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Public Opinion on Proposals in California to Prevent Firearm Violence
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUARY 8, 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 survey study assessed public opinion in California (overall and by firearm ownership status) on two proposals to prevent firearm injuries: an amnesty program that would allow individuals to turn in ammunition magazines that hold more than 10 bullets, no questions asked; and a law that prevents someone from buying a gun for five years if they have had two or more driving under the influence of alcohol or drugs convictions in five years. It is illegal in California to buy or sell ammunition magazines that hold more than 10 bullets; it may soon be illegal to have them.
Author: Rocco Pallin, M.P.H., of the University of California, Davis, is the corresponding author.
(10.1001/jamanetworkopen.2019.18786)
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Are There Shared Genetic Factors Between Weight and Major Psychiatric Disorders?
JAMA Psychiatry
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUAURY 8, 2020
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What The Study Did: Data from 1.3 million people were used to investigate genetic overlap between body mass index and major psychiatric disorders such as schizophrenia, bipolar disorder and major depression. Obesity is a risk factor for cardiovascular disease and a shorter life expectancy among people with major psychiatric disorders is mainly due to coexisting cardiovascular diseases.
Authors: Shahram Bahrami, Ph.D., and Ole A. Andreassen, M.D., Ph.D., of the University of Oslo in Norway, are the corresponding authors.
(10.1001/jamapsychiatry.2019.4188)
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Electric Scooter Injuries, Hospital Admissions in US
JAMA Surgery
EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JANUAURY 8, 2020
Media advisory: The full study is linked to this news release.
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What The Study Did: Electric scooters are increasingly used as fast and convenient transportation in the United States. This observational study reports on injuries and hospital admissions related to electric scooters from 2014 to 2018 using national data.
Authors: Benjamin N. Breyer, M.D., M.A.S., of the University of California, San Francisco, is the corresponding author.
(doi:10.1001/jamasurg.2019.5423)
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Pooled Data Used to Examine Powder Use by Women in Genital Area, Ovarian Cancer Risk
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JANUARY 7, 2020
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What The Study Did: Researchers pooled data from four large study groups with 250,000 women to estimate the association between using body powder in the genital area and risk of ovarian cancer.
Authors: Katie M. O’Brien, of the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina, is the corresponding author.
(doi:10.1001/jama.2019.20079)
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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Trial Examines Effect of Folic Acid, Zinc Supplementation in Male Partners of Couples Seeking Infertility Treatment
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JANUARY 7, 2020
Media advisory: The full study is linked to this news release. A visual abstract is below.
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What The Study Did: This randomized clinical trial examined the effects of daily folic acid and zinc supplementation in men on semen quality and live births among 2,300 couples planning infertility treatment.
Authors: Enrique F. Schisterman, Ph.D., of the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Maryland, is the corresponding author.
Visual Abstract
(doi:10.1001/jama.2019.18714)
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Cesarean Delivery Rates in China
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, JANUARY 7, 2020
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What The Study Did: This study assessed changes between 2008 and 2018 in the rate of cesarean deliveries in China.
Authors: Jian-meng Liu, Ph.D., of the Peking University Health Science Center in Beijing, is the corresponding author.
(doi:10.1001/jama.2019.17595)
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How Plant Closures Are Associated With Opioid Overdose Deaths
JAMA Internal Medicine
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, DECEMBER 30, 2019
Media Advisory: The full study is linked to this news release.
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What The Study Did: Prior studies have reported mixed findings about an association between economic factors, such as unemployment and income, and opioid overdose deaths. This study estimated how automotive assembly plant closures were associated with opioid overdose mortality rates among adults of working age from 1999 through 2016.
Authors: Atheendar S. Venkataramani, M.D., Ph.D., of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, is the corresponding author.
(doi:10.1001/jamainternmed.2019.5686)
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Operating Room Reproductive Hazards for Female Surgeons
JAMA Surgery
EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JANUARY 2, 2020
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What The Study Did: Researchers in this review article discuss occupational reproductive hazards for female surgeons in the operating room, including radiation exposure, surgical smoke, working conditions and physical demands, sharps injuries, anesthetic gases and the use of toxic agents.
Authors: Matilda Anderson, M.B.B.S., M.P.H., of the Western Health Surgical Department, in Victoria, Australia, and Rose H. Goldman, M.D., M.P.H., of Harvard Medical School in Boston, are the authors.
(doi:10.1001/jamasurg.2019.5420)
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Study Examines Insecticide Exposure With Risk of Death
JAMA Internal Medicine
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, DECEMBER 30, 2019
Media Advisory: The full study and commentary are linked to this news release.
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What The Study Did: Pyrethroid insecticides are a commonly-used class of insecticides used in agriculture, residential pest control and numerous consumer products. In this observational study, data from a nationally representative sample of about 2,100 adults were used to examine associations of pyrethroid exposure, as measured by a biomarker in urine samples, with risk of death over about 14 years.
Authors: Wei Bao, M.D., Ph.D., of the University of Iowa in Iowa City, is the corresponding author.
(doi:10.1001/jamainternmed.2019.6019)
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Examining Antiepileptic Drug Exposure in Infants Breastfed by Mothers With Epilepsy
JAMA Neurology
EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, DECEMBER 30, 2019
Media Advisory: The full study is linked to this news release.
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What The Study Did: This observational study examined blood concentrations of antiepileptic drugs to report the extent of drug exposure from breastfeeding in infants whose mothers had epilepsy.
Authors: Angela K. Birnbaum, Ph.D., of the University of Minnesota in Minneapolis, is the corresponding author.
(doi:10.1001/jamaneurol.2019.4443)
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Patient Views on Religious Affiliations of Health Care Facilities
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, DECEMBER 27, 2019
Media advisory: To contact corresponding author Maryam Guiahi, M.D., M.Sc., email David Kelly at david.kelly@cuanschutz.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: A survey of U.S. adults suggests most don’t consider an institution’s religious affiliation when selecting a health care facility. The survey, delivered on the phone or via the internet, was completed by 1,446 participants, most of whom were white and the most common religion was Protestant. Only 6.4% of adults reported that they considered religious affiliation when selecting a health care facility. However, most participants (71.4%), especially women, agreed their personal health decisions should take priority over an institution’s religious values in the provision of services. Federal protections allow health facilities to limit options to patients on the basis of religious values. Limitations of the study include a low response rate and a large proportion of individuals who were white and who had higher education and higher income.
Authors: Maryam Guiahi, M.D., M.Sc., University of Colorado School of Medicine in Aurora, and and coauthors
(doi:10.1001/jamanetworkopen.2019.17008)
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Imaging to Examine Brain Architecture Association With Mood, Attentional Symptoms
JAMA Psychiatry
EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, DECEMBER 26, 2019
Media advisory: The full study is linked to this news release.
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What The Study Did: Researchers looked at whether certain patterns of connectivity between specific regions of the brain in children at age 7 (measured by magnetic resonance imaging) were associated with later development of symptoms related to attention-deficit/hyperactivity disorder and major depressive disorder.
Authors: Susan Whitfield-Gabrieli, Ph.D., of the University of California at Berkeley, is the corresponding author.
(doi:10.1001/jamapsychiatry.2019.4208)
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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State Opioid Prescribing Limits
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, DECEMBER 27, 2019
Media advisory: To contact corresponding author Sunil Agarwal, M.D., email Nicole Rouech at MichiganOPEN@umich.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: Many states have passed laws restricting the duration of opioid prescriptions for acute pain. This analysis focused on Massachusetts and Connecticut, the first states to implement limits after the Centers for Disease Control and Prevention published opioid prescribing guidelines in March 2016, to examine the association of opioid prescribing duration limits and postoperative opioid prescribing in those two states. The states implemented limits of seven days on initial opioid prescriptions in 2016 with exceptions for some patients and leeway for clinicians to override the limits based on their medical judgment. After analyzing data for 16,281 adults not using opioids but who filled an initial prescription within 3 days of surgery between mid 2014 and late 2017, investigators report opioid duration prescribing limits were associated in Massachusetts with decreases in average prescription size filed, the duration supplied and prescribing more than a seven-day supply, although the changes were small. Prescribing limits weren’t associated with changes in Connecticut. Limitations of the study include that it captured only opioid prescriptions reimbursed through employer-based health insurance and it didn’t include all surgical procedures performed in Massachusetts and Connecticut.
Authors: Sunil Agarwal, M.D., of the Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan, and coauthors
(doi:10.1001/jamanetworkopen.2019.18361)
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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Imaging of Mummified Remains of Ancient Inuit People Suggests Vascular Calcifications
JAMA Network Open
EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, DECEMBER 27, 2019
Media advisory: To contact corresponding author L. Samuel Wann, M.D., and senior author Gregory Thomas, M.D., email Nick Ragone at Nick.Ragone@ascension.org and Rhoda Weiss at reweiss@memorialcare.org. The full study is linked to this news release. An image of the mummified remains is below.
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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: Computed tomography (CT) imaging of mummified remains of three young Inuit people living 500 years ago in Greenland shows calcifications in remnants of their arteries that resemble atherosclerosis (a hardening and narrowing of the arteries) seen in living humans and other mummies. In an effort to better understand the early human history of atherosclerosis, researchers examined the remains of the mummies from the Peabody Museum of Archaeology and Ethnology in Cambridge, Massachusetts, because the ancient Inuit were hunter-gatherer people who ate a marine-based diet, which is rich in omega-3 fatty acids. While this case series presents evidence of calcified plaques in the mummified remains, an incomplete visualization of the arteries means the authors can’t determine the severity of the vascular calcifications or evaluate clinical disease.
Authors: L. Samuel Wann, M.D., of Ascension Healthcare, in Milwaukee, and coauthors
(doi:10.1001/jamanetworkopen.2019.18270)
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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Eye Changes From Spaceflight Compared to Simulated Weightlessness
JAMA Ophthalmology
EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, DECEMBER 26, 2019
Media advisory: The full study and commentary are linked to this news release.
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What The Study Did: Some astronauts who fly long missions to the International Space Station experience eye changes. This study investigated whether the eye changes from the traditional spaceflight analog (an experience on earth meant to mimic spaceflight) of simulated weightlessness from 30 days of bed rest with head tilted down were similar to those experienced by astronauts during spaceflight.
Authors: Steven S. Laurie, Ph.D., of KBR in Houston, is the corresponding author.
(doi:10.1001/jamaophthalmol.2019.5261)
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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Thyroid Cancer Rates in US
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, DECEMBER 20, 2019
Media advisory: To contact corresponding author Jennifer L. Marti, M.D., email Grace Naugle at gen4001@med.cornell.edu. The full study is linked to this news release.
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Bottom Line: An analysis suggests rates of thyroid cancer in the U.S. appear to have plateaued in recent years after decades on the rise. That increase was mostly attributed to more screening and imaging over the last three decades that detected many small thyroid cancers. Researchers in this observational study used cancer surveillance registry data to examine changes in rates of new cases of thyroid cancer in the U.S. from 1992 to 2016. Authors report the rate increased from 5.7 to 13.8 per 100,000 between 1992 and 2009, with the greatest annual percentage change (6.6%) from 1998 to 2009. The rate of increase slowed from 2009 to 2014 (13.8 to 14.7 per 100,000) and the rate has been stable since 2014 (from 14.7 to 14.1 per 100,000). The rate changes possibly may be due to a decline in the occurrence of thyroid cancer but the changes happened when there was a greater understanding about overdiagnosis of thyroid cancer and practice guidelines changed so a less intensive workup of thyroid nodules is a more likely explanation. Limitations of the study include that observational analyses like these cannot determine causality and the results may not be generalizable to other areas of the U.S. beyond the regions included in the registry data.
Authors: Jennifer L. Marti, M.D., Weill Cornell Medicine, New York, and coauthors.
(doi:10.1001/jama.2019.18528)
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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How Common is Diabetes Among Racial/Ethnic Groups?
JAMA
EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, DECEMBER 20, 2019
Media advisory: To contact corresponding author Yiling J. Cheng, M.D., Ph.D., email Alaina Robertson at ifs2@cdc.gov. The full study and editorial are linked to this news release.
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Bottom Line: Estimating how common diabetes (both diagnosed and undiagnosed) was among U.S. adults by racial and ethnic groups was the objective of this observational study. A group of 7,575 adults 20 and older who participated in the National Health and Nutrition Examination Surveys between 2011-2016 were included. Among them, 2,266 people had diagnosed diabetes, and 377 had undiagnosed diabetes. The age-sex-adjusted proportion of adults with diabetes (diagnosed and undiagnosed) was 12.1% non-Hispanic white, 20.4% non-Hispanic black, 22.1% Hispanic, and 19.1% non-Hispanic Asian. The results also show that among selected Hispanic and non-Hispanic Asian subpopulations, there were noteworthy differences in how common diabetes was. The age-sex-adjusted proportion of adults with undiagnosed diabetes was 3.9% non-Hispanic white, 5.2% non-Hispanic black, 7.5% Hispanic, and 7.5% non-Hispanic Asian. Limitations of the study include diagnosed diabetes was self-reported, and there was a small sample of adults in some subgroups used for estimates.
Authors: Yiling J. Cheng, M.D., Ph.D., Centers for Disease Control and Prevention, Atlanta, and coauthors.
(doi:10.1001/jama.2019.19365)
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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