Did Public Education Campaign Improve Patient Response to TIA, Minor Stroke?

Posted June 28, 2018 by Deanna Bellandi

JAMA Neurology

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JULY 2, 2018

Media Advisory: To contact corresponding author Peter M. Rothwell, M.D., Ph.D., F.R.C.P., email peter.rothwell@ndcn.ox.ac.uk. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Links will be live at the embargo time: http://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/jamaneurol.2018.1603

Bottom Line: A study of more than 2,200 patients in the United Kingdom examined the association of a public education campaign with delays and failure to seek medical attention after a minor stroke or transient ischemic attack (TIA). The risk of major stroke is high after a TIA or minor stroke. Quick medical attention can substantially reduce that risk but patients often fail to recognize or act on their symptoms.

Authors: Peter M. Rothwell, M.D., Ph.D., F.R.C.P., of John Radcliffe Hospital, University of Oxford, United Kingdom, and coauthors

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

(doi:10.1001/jamaneurol.2018.1603)

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

# # #

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

Is Drinking More Coffee Associated With Lower Risk of Death?

Posted June 28, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JULY 2, 2018

Media advisory: To contact study author Erikka Loftfield, Ph.D., email National Cancer Institute press officers at ncipressofficers@mail.nih.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.2425

Bottom Line: Coffee is popular around the globe and studies have generally reported inverse associations (moving in opposite directions) between its consumption and the risk of chronic diseases and death. But what about heavy coffee drinking and people with genetic variations that can affect how they metabolize caffeine? A new study of nearly half a million people in the United Kingdom suggests a lower risk of death was associated with drinking more coffee, including among coffee drinkers who have eight or more cups per day, in both slow and fast metabolizers of caffeine, and in drinkers of ground, instant and decaffeinated coffee. The results come with a warning to interpret them with caution because they are based on observational data and cannot prove causation.

Authors: Erikka Loftfield, Ph.D., of the National Cancer Institute, National Institutes of Health, Rockville, Maryland, and coauthors.

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

(doi:10.1001/jamainternmed.2018.2425)

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

# # #

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

Visual Impairment Associated with a Decline in Cognitive Function

Posted June 26, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JUNE 28, 2018

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

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.2493

Bottom Line: Worsening vision and declining cognitive function are common conditions among older people. Understanding the association between them could help reduce age-related cognitive changes. A study of more than 2,500 adults aged 65 and older found rate of worsening vision was associated with rate of declining cognitive function. More importantly, vision has a stronger influence on cognition than the reverse. The study finding suggests maintaining good vision through the prevention and treatment of vision disorders in old persons may be a strategy to lessen age-related cognitive changes.

Authors: D. Diane Zheng, M.S., University of Miami Miller School of Medicine, Miami, Florida, and coauthors

Related material: The commentary, “Treating the Eyes to Help the Brain,” by Paul J. Foster, Ph.D., F.R.C.S., (Ed)., of Moorfields Eye Hospital, London, and coauthors is also available on the For The Media website.

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

(doi:10.1001/jamaophthalmol.2018.2493)

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

# # #

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

Are Hopes, Plans for Future Associated with Lower Odds of Perpetrating Weapon-Related Violence?

Posted June 28, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JULY 2, 2018

Media advisory: To contact corresponding author Alison J. Culyba, M.D., Ph.D., M.P.H., email Marc Lukasiak at marc.lukasiak@chp.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.1158

Bottom Line: Hopes and plans for the future were associated with lower odds of perpetrating weapon-related violence in a new study based on survey data from predominantly black/African American male youths in low-resource neighborhoods in Pittsburgh who were enrolled in a violence prevention trial.

Authors: Alison J. Culyba, M.D., Ph.D., M.P.H., of the Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pennsylvania, and coauthors

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

(doi:10.1001/jamapediatrics.2018.1315)

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

# # #

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

Listen to the Podcast: Health Care Spending Gone Wild – Using Expensive Insulin Analogs With Few Clinical Advantages

Posted June 22, 2018 by Jim Michalski

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

Is Cataract Surgery Associated with Reduced Risk of a Serious Traffic Accident?

Posted June 26, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JUNE 28, 2018

Media advisory: To contact corresponding author Matthew B. Schlenker, M.D., M.Sc., F.R.C.S.C., email Heidi Singer at Heidi.Singer@utoronto.ca. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.2510

Bottom Line: Cataract surgery was associated with a modest decrease in the risk of being involved in a serious traffic crash.

Why The Research Is Interesting: Cataracts are the most common cause of impaired vision worldwide and may increase a driver’s risk of a traffic accident. The potential benefits of cataract surgery for reducing a patient’s subsequent risk of an accident are uncertain.

Who and When: 559,546 patients 65 years and older who underwent cataract surgery; this population-based study was conducted from 2006 to 2016

What (Study Measures and Outcomes): First eye cataract surgery, although most have a second eye surgery soon after (exposure); emergency department visit for a traffic crash as a driver (outcomes)

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

Authors: Matthew B. Schlenker, M.D., M.Sc., F.R.C.S.C., University of Toronto, and coauthors

Results: The crash rate decreased from 2.36 to 2.14 per 1,000 patients per year after cataract surgery, representing a 9 percent reduction in serious traffic crashes.

Study Limitations: This was not a randomized trial testing the effects of cataract surgery; patients were aware of their diagnosis, mindful of their treatments and could alter their driving behaviors.

Study Conclusions:

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

(doi:10.1001/jamaophthalmol.2018.2510)

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

# # #

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

Is Risk for Endocrine Disease Higher in Survivors of Cancer in Adolescence, Young Adulthood?

Posted June 26, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JUNE 29, 2018

Media advisory: To contact corresponding study author Mette Vestergaard Jensen, M.D., email mettev87@gmail.com. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0349

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

Bottom Line: An increased risk of endocrine diseases, such as thyroid disease, testicular dysfunction and diabetes, was associated with people who survived cancer as adolescents and young adults.

Why The Research Is Interesting: Cancer survival rates have improved and it is necessary to explore the long-term consequences of cancer treatment.

What and When: 32,548 one-year cancer survivors who were diagnosed at ages 15 to 39 and identified in the Danish Cancer Registry, along with 188,728 people who were cancer-free a nd identified through the Danish Civil Registration system; study conducted from 1976 to 2009 with follow-up from 1977 to 2010

What (Study Measures and Outcomes): First primary cancer diagnosed at ages 15 to 39 and treated according to recommendations and guidelines at the time of diagnosis (exposures); all hospital contacts (hospital admission and outpatient visits) for endocrine disease were identified in the National Patient Register and statistical estimates of hospitalization rates and risk were calculated

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

Authors: Mette Vestergaard Jensen, M.D., of the Danish Cancer Society Research Center, Copenhagen, Denmark, and coauthors

Results:

Study Limitations: Lack of information on conditions diagnosed and treated by general practitioners; number of cases may be underestimated; cancer survivors more closely watched in the health care system and this could cause overestimation of risk estimates

Study Conclusions:

Related Material: The invited commentary, “Unmet Survivorship Care Needs of Adolescent and Young Adult Cancer Survivors,” by Stacey Marjerrison, M.D., M.Sc., F.R.C.P.C., of McMaster University, Ontario, Canada, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0349)

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

# # #

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

USPSTF Recommendation Statement on Screening for Osteoporosis to Prevent Fractures

Posted June 21, 2018 by Jim Michalski

JAMA

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

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

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

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

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

The USPSTF Concludes:

Related material

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

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

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

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

— JAMA editorial: Screening for Osteoporosis

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

— JAMA Patient Page: Screening for Osteoporosis to Prevent Fractures

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

(doi:10.1001/jama.2018.7498)

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

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

# # #

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

Risk of Autism Increased in Children of Mothers with Diabetes

Posted June 21, 2018 by Jim Michalski

JAMA

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

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

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

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

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

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

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

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

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

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

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

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

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

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

(doi:10.1001/jama.2018.7614)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

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

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

母亲患糖尿病会使儿童患自闭症的风险增加

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

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

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

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

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

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

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

研究局限：父亲的风险因素以及其它宫内和产后暴露因素未被评估。

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

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

Missed Opportunities for HIV Testing

Posted June 21, 2018 by Jim Michalski

JAMA

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

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

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

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

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

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

(doi:10.1001/jama.2018.7611)

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

# # #

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

What Does Fitness in Midlife Mean for Depression, Cardiovascular Disease Later in Life?

Posted June 25, 2018 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JUNE 27, 2018

Media Advisory: To contact corresponding author Benjamin L. Willis, M.D., M.P.H., email Amber Freeland at afreeland@coopinst.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.1467

Bottom Line: A high level of fitness in midlife was associated with a lower risk of depression after age 65 and a lower risk of cardiovascular death, including after a diagnosis of depression.

Why The Research Is Interesting: Fitness, a risk factor that can be changed, has an association with chronic diseases, cardiovascular disease events and death. How fitness in mid-life is associated with later-life depression and the risk of death from cardiovascular disease after a depression diagnosis is not well understood.

Who and When: 17,989 generally healthy men and women (average age 50); they visited a clinic for a preventive medicine exam at midlife (data were collected from 1971 through 2009) and they were eligible for Medicare from 1999 to 2010

What (Study Interventions and Outcomes): Midlife fitness estimated from treadmill exercise test results (exposures); depression diagnoses from Medicare claims files and CVD mortality from National Death Index records (outcomes)

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

Authors: Benjamin L. Willis, M.D., M.P.H., of the Cooper Institute, Dallas, Texas, and coauthors

Results:

Study Limitations: Diagnoses came from Medicare claims data; the severity of depression could not be determined; and authors cannot eliminate the possibility of depression and CVD leading to lower fitness levels

Study Conclusions: Health care professionals should consider fitness and physical activity as part of overall preventive care to promote healthy aging.

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

(doi:10.1001/ jamapsychiatry.2018.1467)

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

# # #

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

Do Abortion-Related Complications Differ Based on Facility Where Done?

Posted June 21, 2018 by Jim Michalski

JAMA

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

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

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

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

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

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

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

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

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

Results:

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

Study Conclusions:

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

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

(doi:10.1001/jama.2018.7675)

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

# # #

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

Medicare Patients Less Likely to Die in a Hospital

Posted June 21, 2018 by Jim Michalski

JAMA

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

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

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

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

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

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

(doi:10.1001/jama.2018.8981)

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

# # #

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

What Are Insurance Coverage Policies for Drug Treatments for Low Back Pain?

Posted June 19, 2018 by Jim Michalski

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JUNE 22, 2018

Media advisory: To contact corresponding study author G. Caleb Alexander, M.D., M.S., email Barbara Benham at bbenham1@jhu.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0235

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

Bottom Line: An analysis of prescription drug coverage policies for the treatment of low back pain suggests insurers could help to reduce opioid overuse by expanding access to opioid alternatives through coverage and reimbursement policies.

Why The Research Is Interesting: Little is known about medication coverage policies among U.S. insurers for the treatment of chronic noncancer pain.

Who, What and When: Health plan documents from 15 Medicaid, 15 Medicare Advantage and 20 commercial health plans in 2017 from 16 states representing more than half of the U.S. population; 20 interviews with more than 43 senior medical and pharmacy health plan executives from representative plans

What (Study Measures and Outcomes): Formulary coverage, utilization management and patient out-of-pocket costs

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

Authors: G. Caleb Alexander, M.D., M.S., Johns Hopkins Bloomberg School of Public Health, Baltimore, and coauthors

Results:

Study Limitations: Publicly available documents were not consistently available for all payers; some health systems and payers, such as the Veterans Health Administration and workers’ compensation plans, weren’t included.

Study Conclusions: The findings suggest opportunities for insurers to redesign coverage policies to improve pain management and reduce opioid-related injuries and deaths.

Related material: The commentary, “Opioid Prescribing for Low Back Pain,” by Jennifer F. Waljee, M.D., M.P.H., and Chad M. Brummett, M.D., of the University of Michigan, Ann Arbor is also available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0235)

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

# # #

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

Are Gestational Age at Birth and Symptoms of ADHD Associated?

Posted June 21, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JUNE 25, 2018

Media advisory: To contact corresponding author Helga Ask, Ph.D., email helga.ask@fhi.no. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.1315

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: Early premature birth at less than 34 weeks was associated with symptoms of attention-deficit/hyperactivity disorder (ADHD) in preschool-age children and inattention symptoms in school-age children.

Why The Research Is Interesting: Prior research suggests an association between prematurity and ADHD but it’s uncertain the extent to which that might be explained by genetic and environmental risk factors. This study, which investigated the association between gestational age at birth and symptoms of ADHD in preschool and school-age children, used sibling comparison to account for unmeasured genetic and environmental risk factors.

Who and When: 113,227 children, including 33,081 siblings

What (Study Measures and Outcomes): Children and siblings in different gestational age groups: early preterm (delivery at 22-33 weeks), late preterm (delivery at 34-36 weeks), early term (delivery at 37-38 weeks), deliver at week 39, a reference group (for comparison) with delivery at week 40, delivery at week 41, and late term (delivery after week 41) (exposures); ADHD symptoms in children at age 5 reported by mothers and symptoms of inattention and hyperactivity/impulsivity at age 8 (outcomes)

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

Authors: Helga Ask, Ph.D., of the Norwegian Institute of Public Health, Oslo, Norway, and coauthors

Results: Early premature birth was associated with increased risk of symptoms of ADHD in children at age 5 and symptoms of inattention at age 8, with the association at preschool age most pronounced among girls.

Study Limitations: Participation rate, attrition, and maternal reports of ADHD symptoms are among the limitations

Study Conclusions:

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

(doi:10.1001/jamapediatrics.2018.1315)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年6月25日，星期一，美国东部时间上午11点

媒体咨询：联系通讯作者Helga Ask, Ph.D.，请发电子邮件到helga.ask@fhi.no。

出生时的胎龄与ADHD症状有关联吗？

概要: 根据《美国医学会杂志-儿科学》(JAMA Pediatrics)发表的一项研究，学龄前儿童注意缺陷/多动障碍（ADHD）的症状以及学龄儿童的注意力不集中的症状与不足34周的早期早产有关联。

为何对该问题感兴趣：之前的研究表明，早产与ADHD之间存在关联，但不清楚在多大程度上该关联可以用遗传和环境风险因素来解释。这项研究调查了出生时的胎龄与学龄前和学龄儿童ADHD症状之间的相关性，并利用同胞（兄弟姐妹）比较来解释未测量的遗传和环境风险因素。

研究参与者及时间：113,227名儿童，其中包括33,081名兄弟姐妹

研究内容（研究手段及结果）：不同胎龄组的儿童和兄弟姐妹：早期早产（22-33周分娩），晚期早产（34-36周分娩），早期分娩（37-38周分娩），39周分娩， 40周分娩的参考组（用于比较），41周分娩，和晚期分娩（41周后分娩）（暴露）; 母亲报告的5岁儿童的ADHD症状以及8岁时注意力不集中和多动/冲动症状（结果）

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

作者：Helga Ask, Ph.D., 挪威公共卫生研究所，挪威奥斯陆，以及共同作者

研究结果：早期早产与5岁儿童ADHD症状以及8岁儿童注意力不集中的症状的风险增加有关联，在学龄前儿童中，女孩中的该关联性最高。

研究局限：参与率，减员以及ADHD症状的孕产妇报告都是其局限性

研究结论：

意义该发现显示了减少早产的潜在意义以及为早产婴儿提供专门护理以防止神经发育问题的重要性。

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

How Are Chronic Opioid Use, 2016 Presidential Voting Patterns Associated?

Posted June 19, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JUNE 22, 2018

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

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0450

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

Bottom Line: An analysis of Medicare claims data suggests chronic opioid use in U.S. counties corresponded with support for Republican Donald Trump in the 2016 presidential election, with much of the correlation explained by socioeconomic factors.

Why The Research Is Interesting: Similarities have been observed in maps showing the geographic distribution of the opioid epidemic and the results of the 2016 presidential election. This study examined the association at the county level between the rate of Medicare Part D enrollees receiving prescriptions for prolonged opioid use and the percentage of votes for President Trump 2016 to explore the extent to which demographic and economic factors might explain it.

What and When: A national sample of Medicare claims data for more than 3.7 million enrollees in the Medicare prescription drug benefit

What (Study Measures and Outcomes): Chronic opioid use by county rate for receiving a 90-day or more supply of opioids prescribed in 2015

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

Authors: James S. Goodwin, M.D., of the University of Texas Medical Branch, Galveston, and coauthors

Results: Support for Republican President Trump in 2016 explained about 18 percent of the variance in county rates of opioid use in 3,100 U.S. counties, with counties whose opioid prescription rates were above average having a higher average Republican vote than counties with opioid prescription rates below average. The association is related to underlying county socioeconomic characteristics related to income, disability, insurance coverage and unemployment.

Study Limitations: The 2016 county presidential vote would include all voters while information on prolonged opioid prescriptions from 2015 would include only Medicare Part D enrollees; the associations linking opioid use and voting are at the county, not individual, level.

Study Conclusions:

Featured Image:

What The Image Shows: (Right click “save image as” to download.) Two maps showing opioid use in U.S. counties and 2016 presidential voting patterns.

Related Material: The invited commentary, “The Opiates and the (Voting) Masses” by James Niels Rosenquist, M.D., Ph.D., of Massachusetts General Hospital, Harvard Medical School, Boston, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0450)

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

# # #

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

Patient Outcomes, Complication Rates of Postmastectomy Breast Reconstruction

Posted June 18, 2018 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JUNE 20, 2018

Media advisory: To contact corresponding author Andrea L. Pusic, M.D., M.H.S., email Elaine St. Peter at estpeter@bwh.harvard.edu. To contact corresponding author Edwin G. Wilkins, M.D., M.S., email Nicole Fawcett at nfawcett@umich.edu. The full studies are available on the For The Media website.

Bottom Line: Two studies, a commentary and podcast focus on patient outcomes after breast reconstruction surgery following mastectomy. One studied compared satisfaction and quality of life between patients who had breast reconstruction using implants or their own tissue, and a second study compared two-year complication rates across common breast reconstruction techniques.

What: Women who had breast reconstruction after mastectomy using their own tissue (autologous reconstruction) were more satisfied two years later with their breasts and had greater sexual and psychosocial well-being than patients who had reconstruction with implants.

Authors: Andrea L. Pusic, M.D., M.H.S., Brigham Health, Boston, and coauthors

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2018.1677

(doi:10.1001/jamasurg.2018.1677)

What: While nearly one-third of women undergoing breast reconstruction following mastectomy experienced complications, failure of the reconstruction occurred in only 5.4 percent. Patients having reconstruction with their own tissue (autologous) were more likely to develop complications but also had lower chances of failure compared with patients choosing implant techniques.

Authors: Edwin G. Wilkins, M.D., M.S., University of Michigan, Ann Arbor, and coauthors

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2018.1687

(doi:10.1001/jamasurg.2018.1687)

Related Material:

— A podcast with Drs. Pusic and Wilkins is available for listening and downloading on this page.

— The commentary, “Autologous vs Prosthetic Breast Reconstruction,” by Kenneth L. Fan, M.D., and David H. Song, M.D., M.B.A., MedStar Georgetown University Hospital, Washington, D.C., is also available on the For The Media website.

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

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

# # #

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

Is Increased BMI Associated With Reduced Risk of Premenopausal Breast Cancer?

Posted June 19, 2018 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JUNE 21, 2018

Media advisory: To contact corresponding author Minouk J. Schoemaker, Ph.D., email Jamie Lederhose at Jamie.Lederhose@breastcancernow.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.1771

Bottom Line: Higher body mass index (BMI), especially in early adulthood, may be associated with reduced risk for premenopausal breast cancer.

Why The Research Is Interesting: Breast cancer is the most commonly diagnosed cancer among women. Breast cancer’s origin is complex and it includes a wide range of factors, among them how much body fat a woman has, a measure often assessed by BMI (a calculation of weight in kilograms divided by height in meters squared). Previous research suggests increasing BMI may be associated with reduced risk for premenopausal breast cancer but increased risk after menopause. This study sought to undertake a more rigorous and systematic analysis of the association between BMI and risk of premenopausal breast cancer using pooled data from 19 studies.

Who and When: 758,592 premenopausal women from 19 studies (recruited from 1963 to 2013); there were 13,082 new cases of breast cancer over roughly nine years of follow-up per participant

What (Study Measures and Outcomes): BMI at ages 18 to 24, 25 to 34, 35 to 44 and 45 to 54 (exposures); invasive or noninvasive (in situ) premenopausal breast cancer

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

Authors: Premenopausal Breast Cancer Collaborative Group (Minouk J. Schoemaker, Ph.D., of the Institute of Cancer Research, London, United Kingdom, is the corresponding author)

Results: The analysis suggests an “inverse association” of breast cancer risk with BMI for women between the ages of 18 and 54, which means breast cancer risk decreased as BMI increased. The association was strongest for BMI in early adulthood between the ages of 18 and 24.

Limitations: The study used BMI as its measure but women with the same BMI can have different body fat distributions and overall levels of body fat; weight was often self-reported and some women over report or under report their weight

Study Conclusions: Study authors are not advocating weight gain as a way to reduce premenopausal breast cancer risk. Understanding the reasons for the association seen between BMI and premenopausal breast cancer risk could potentially help to identify risk factors that might be modified.

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

(doi:10.1001/jamaoncol.2018.1771)

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

# # #

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

Article Examines Guideline for Glycemic Control in Adults with Type 2 Diabetes

Posted June 14, 2018 by Jim Michalski

JAMA

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

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

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

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

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

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

(doi:10.1001/jama.2018.6798)

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

Related material

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

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

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

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

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

Video embed code:

<div style="display: block; position: relative; max-width: 300px;"><div style="padding-top: 50%;"><iframe src="//players.brightcove.net/864352215001/default_default/index.html?videoId=5794299530001" allowfullscreen webkitallowfullscreen mozallowfullscreen style="width: 100%; height: 100%; position: absolute; top: 0px; bottom: 0px; right: 0px; left: 0px;"></iframe></div></div>

Causes of Subsequent Death for Patients After Nonfatal Opioid Overdose

Posted June 18, 2018 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JUNE 20, 2018

Media Advisory: To contact corresponding author Mark Olfson, M.D., M.P.H., email Greg Flynn at Gregory.Flynn@nyspi.columbia.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.1471

Bottom Line: Adults who survive an opioid overdose are at high risk of dying during the year after the incident of substance use-associated diseases, suicide and other medical conditions.

Why The Research Is Interesting: There is interest in understanding the subsequent risk of death, not just from overdoses, in patients after a nonfatal opioid overdose because the number of those patients has increased.

Who and When: 76,325 Medicaid beneficiaries who experienced nonfatal opioid overdoses; there were 5,194 deaths in the first year after nonfatal opioid overdose

What (Study Interventions and Outcomes): Crude mortality rates in the first year after nonfatal opioid overdose and standardized mortality rate ratios for death from any cause and specific causes compared with the general population

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

Authors: Mark Olfson, M.D., M.P.H., of Columbia University, New York, and coauthors

Results: In the year after surviving an opioid overdose, the most common causes of death for adults were substance use-associated diseases, diseases of the circulatory system and cancer. These adults also were more likely than those in the general population to die of, especially, drug use-associated diseases, human immunodeficiency virus (HIV), chronic respiratory disease, viral hepatitis and suicide, particularly suicide among women.

Study Limitations: The study was based on data from 2001-2007. Since then, opioid use, naloxone reversal, medication-assisted treatment and other drug use patterns have changed, along with the composition of patients with opioid overdose, and that may have changed their subsequent risks of death.

Study Conclusions:

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

(doi:10.1001/ jamapsychiatry.2018.1471)

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

# # #

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

Having Stress-Related Disorder Associated With Increased Risk of Developing Autoimmune Disease

Posted June 14, 2018 by Jim Michalski

JAMA

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

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

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

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

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

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

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

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

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

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

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

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

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

(doi:10.1001/jama.2018.7028)

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

# # #

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

Dietary Supplement Use in Children, Adolescents

Posted June 14, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JUNE 18, 2018

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

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.1008

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: About one-third of children and adolescents in the United States use dietary supplements.

Why The Research Is Interesting: Data are lacking on the use of dietary supplements by children and adolescents, and dietary supplements are often implicated in preventable adverse drug events in this population.

Who and When: National Health and Nutrition Examination Survey (NHANES) data for 4,404 children and adolescents (up to age 19) from 2003 to 2014

What (Study Measures and Outcomes): Estimates of the frequency of dietary supplement use, including both nutritional products and alternative medicine products

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

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

Results:

Study Limitations: Estimates based on survey data

Study Conclusions: Many of the most commonly used supplements, including multivitamins, are implicated in preventable adverse drug events in children and adolescents.

Related Material: An editor article review podcast with Aaron E. Carroll, M.D., M.S., JAMA Pediatrics digital media editor, also is available on the For The Media website. The audio transcript is available here.

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

(doi:10.1001/jamapediatrics.2018.1008)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年6月18日，星期一，美国东部时间上午11点

媒体咨询：联系通讯作者Dima M. Qato, Pharm.D., M.P.H., Ph.D., 请发电子邮件到Jacqueline Carey jmcarey@uic.edu。

儿童及青少年膳食补充剂

概要: 根据《美国医学会杂志 -儿科学》(JAMA Pediatrics)发表的一项研究，美国约有三分之一的儿童和青少年使用膳食补充剂。

为何对该问题感兴趣：目前缺乏儿童和青少年使用膳食补充剂的数据，而该人群中的许多可预防的不良药物事件会涉及到膳食补充剂。

研究参与者及时间：2003年至2014年间，来自国家健康和营养调查（NHANES）所包括的4,404名儿童和青少年（19岁以下）的调查数据。

研究内容（研究手段及结果）：估计膳食补充剂的使用频率，包括营养品和替代性药品

研究设计：这是一项调查性研究。

作者：Dima M. Qato, Pharm.D., M.P.H., Ph.D., 芝加哥伊利诺伊大学，以及共同作者

研究结果：

同2003至2004年期间类似，在2013至2014年，2% 的儿童和青少年使用膳食补充剂
2003至2014年间的营养品使用没有变化
替代性药品补充剂的使用几乎增加了一倍，达到7%，（这主要是由于ω-3 脂肪酸补充剂的使用以及使用褪黑激素作为睡眠助剂造成的）
2003至2014年间最常用的儿童和青少年膳食补充剂为多种维生素补充剂

研究局限：研究中的估算是基于调查数据得来的

研究结论：许多最常用的补充剂，包括多种维生素，都提示与儿童和青少年可预防的不良药物事件有关。

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

Studies Examine Differences in Demographics, Urban vs Rural Rates of Obesity in U.S.

Posted June 14, 2018 by Jim Michalski

JAMA

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

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

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

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

(doi:10.1001/jama.2018.5158)

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

(doi:10.1001/jama.2018.7270)

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

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

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

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

# # #

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

What Are Rates of Legionnaires Disease Among VA Patients?

Posted June 12, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JUNE 15, 2018

Media advisory: To contact corresponding study author Shantini D. Gamage, Ph.D., M.P.H., email Michelle Spivak at Michelle.SpivakMelinger@va.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0230

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

Bottom Line: Rates of Legionnaires disease (LD) among U.S. Department of Veterans Affairs (VA) patients with overnight stays at a VA facility decreased from 2014 to 2016, even though overall rates of LD among VA patients increased in the same period; 91 percent of the 491 LD cases in the VA surveillance system had no VA exposure or only outpatient VA exposure.

Why The Research Is Interesting: Cases of LD have been increasing in the United States for decades. Health care facilities can transmit Legionella bacteria from building water systems to occupants. The VA has implemented prevention strategies at its medical facilities and has a national reporting system for LD cases, offering the first opportunity to look at LD rates in a U.S. healthcare system on a national level.

What and When: 491 LD cases in the VA surveillance system among patients from 2014 to 2016

What (Study Measures and Outcomes): Annual LD rates with cases categorized as VA or non-VA exposure

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

Authors: Shantini D. Gamage, Ph.D., M.P.H., of the VA National Infectious Diseases Service, Washington, D.C., and the University of Cincinnati College of Medicine, Cincinnati, Ohio, and coauthors.

Results: Total rates of LD increased from 1.5 to 2.0 per 100,000 VA enrollees from 2014 to 2016; 91 percent of the 491 LD cases had no VA exposure or outpatient-VA exposure; 44 cases of LD occurred in patients who had stayed at the VA overnight. The LD rate for the subset of VA patients who had an overnight stay significantly decreased between 2014 and 2016.

Study Limitations: Some cases of LD may have been missed, including cases in VA enrollees not diagnosed or treated at VA facilities; routine medical record reviews weren’t done

Study Conclusions:

Related Material: The invited commentary, “Prevention of Health Care-Associated Legionnaires Disease,” by Shawn J. Skerrett, M.D., of the University of Washington School of Medicine, Seattle, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0230)

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

# # #

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

Are Portable Music Players Associated With Hearing Loss in Children?

Posted June 12, 2018 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JUNE 14, 2018

Media advisory: To contact corresponding author Carlijn M. P. le Clercq, M.D., email c.leclercq@erasmusmc.nl. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2018.0646

Bottom Line: The effect of portable music players on the hearing of children is unclear. A new study found that about 1 in 7 children (9 to 11 years of age) showed signs of noise-induced hearing impairment, prior to exposure to known noise hazards such as club and concert attendance. Portable music players, used by 40 percent of 2,075 children in the study from the Netherlands, were associated with high-frequency hearing loss. Repeated measurements are needed to confirm this association.

Authors: Carlijn M. P. le Clercq, M.D., Erasmus University Medical Center, Rotterdam, the Netherlands, and coauthors

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

Related material: The commentary, “Can Your Smartphone Save Your Hearing?,” by Kevin H. Franck, Ph.D., M.B.A., C.C.C.-A., Massachusetts Eye and Ear, Harvard Medical School, Boston, is also available on the For The Media website.

(doi:10.1001/jamaoto.2018.0646)

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

# # #

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

Access to Investigational Medicines for Terminally Ill Through Expanded Access Programs

Posted June 12, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JUNE 15, 2018

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

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0283

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

Bottom Line: A new study identified investigational medicines made available through expanded access programs for patients with life-threatening illnesses prior to approval from the U.S. Food and Drug Administration to assess the timing and duration of investigational drug availability.

Authors: Joseph S. Ross, M.D., M.H.S., of Yale University School of Medicine, New Haven, Connecticut, and coauthors

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

(doi:10.1001/jamanetworkopen.2018.0283)

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

# # #

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

Certain Eye Conditions in Children May Affect Performance on Timed, Standardized Tests

Posted June 12, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JUNE 14, 2018

Media advisory: To contact corresponding author Krista R. Kelly, Ph.D., email Vanessa Peterson at vpeterson@retinafoundation.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.2295

Bottom Line: Children with eye conditions commonly referred to as lazy eye and crossed eyes were slower at marking answers on multiple-choice answer forms typically used in timed, standardized tests.

Why The Research Is Interesting: Impairment caused by lazy eye (amblyopia) or crossed eyes (strabismus) may affect the speed with which a child can mark answers with a pencil on a multiple-choice answer form.

Who and When: 85 school-age children (average age 10): 47 children with lazy eye, 18 children who had been treated for crossed eyes, and 20 children without these conditions for comparison; study conducted from May 2014 to November 2017

What (Study Measures and Outcomes): Children were asked to transfer the pre-marked correct answers from a standardized reading achievement test booklet to a multiple-choice answer form as quickly as possible without making mistakes or reading the text (exposures); time to complete the task (outcome)

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

Authors: Krista R. Kelly, Ph.D., Retina Foundation of the Southwest, Dallas, and coauthors

Results: Children with lazy eye or crossed eyes required approximately 28 percent more time to complete a 40 question multiple-choice answer sheet than children without eye conditions.

Study Limitations: The authors did not test children to determine whether they had dyslexia, relying on parental report regarding this criterion to be excluded from the study.

Study Conclusions:

Related material: The commentary, “Visuomotor Consequences of Abnormal Binocular Vision,” by Tina Y. Gao, B.Optom., Ph.D., of the University of Auckland, Auckland, New Zealand, is also available on the For The Media website.

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

(doi:10.1001/jamaophthalmol.2018.2295)

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

# # #

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

Listen to a Podcast: LDL-C by Martin/Hopkins, Friedewald, and Preparative Ultracentrifugation Methods

Posted June 11, 2018 by Jim Michalski

Listen to an interview with Seth Martin, M.D., M.H.S., co-author of the JAMA Cardiology study, “Comparison of LDL-C Assessment by Martin/Hopkins Estimation, Friedewald Estimation, and Preparative Ultracentrifugation: Insights From the FOURIER Trial, and Neil J. Stone, M.D., author of the commentary, “Measuring Low-Density Lipoprotein Cholesterol: When Is More Accurate Better?,” available for preview and download on this page.

Diet Quality Among Adults in SNAP Food Assistance Program

Posted June 12, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JUNE 15, 2018

Media advisory: To contact corresponding study author Fang Fang Zhang, M.D., Ph.D., email Siobhan Gallagher at Siobhan.gallagher@tufts.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0237

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

Bottom Line: Participants in the Supplemental Nutrition Assistance Program (SNAP) showed less improvement over time in an indicator of a healthful diet than both income-eligible individuals who didn’t participate in SNAP and higher-income individuals, although it is possible dietary trends among SNAP recipients may have been even worse if they didn’t participate in the program.

Why The Research Is Interesting: SNAP served 42.1 million people in fiscal year 2017 and the federal food assistance program has an annual budget of $70 billion. An unhealthful diet contributes to chronic diseases.

Who and When: Nationally representative study of 38,696 adults (age 20 or older): 6,162 SNAP participants, 6,692 income-eligible but nonparticipants in SNAP and 25,842 higher-income individuals from eight cycles of the National Health and Nutrition Examination Survey (NHANES) in 1999-2014; diet quality assessed by SNAP participation status

What (Study Measures and Outcomes): Average diet scores and proportion of U.S adults meeting poor, intermediate or ideal diet scores based on American Heart Association diet goals, including eight components (fruits and vegetables; whole grains; fish and shellfish; sugar-sweetened beverages; sodium; nuts, seeds and legumes; processed meats; and saturated fat)

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

Authors: Fang Fang Zhang, M.D., Ph.D., of the Friedman School of Nutrition Science and Policy at Tufts University, Boston, and coauthors

Results: SNAP participants had less improvement in diet scores than income-eligible nonparticipants in SNAP and higher-income individuals. Disparities persisted or worsened for SNAP participants for most dietary components compared with income-eligible nonparticipants in SNAP and higher-income individuals.

Study Limitations: Dietary intake was self-reported and subject to error.

Study Conclusions:

Related Material: The invited commentary, “Disparities in Diet Quality: No SNAPPY Solutions,” by Edgar R. Miller, III, Ph.D., M.D., and Deidra C. Crews, M.D., Sc.M., of Johns Hopkins University School of Medicine, Baltimore, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0237)

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

# # #

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

NIH Initiative Aims to Tackle Opioid Misuse, Addiction, Enhance Pain Management

Posted June 8, 2018 by Jim Michalski

JAMA

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

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

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

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

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

(doi:10.1001/jama.2018.8826)

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

# # #

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

Does Having a Blood Transfusion Before, During or After Surgery Increase the Risk for a Blood Clot?

Posted June 11, 2018 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JUNE 13, 2018

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

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2018.1565

Bottom Line: A transfusion of red blood cells before, during or after surgery was associated with an increased risk of blood clots for patients.

Why The Research Is Interesting: A blood clot that starts in a vein (venous thromboembolism or VTE) that is connected to time spent in a hospital is a major cause of illness and death. Studies have suggested red blood cell transfusions, which commonly occur when patients have surgery, may have a role in the development of blood clots.

Who and When: 750,937 patients who underwent a surgical procedure in 2014, of whom 47,410 received at least one red blood cell transfusion before, during or after surgery

What (Study Outcomes and Measures): Development of postoperative VTE within 30 days of surgery

How (Study Design): This was a registry study that used data from teaching and nonteaching hospitals in North America

Authors: Aaron A. R. Tobian, M.D., Ph.D., Johns Hopkins University, Baltimore, and coauthors

Results: VTE occurred in 0.8 percent of patients; transfusion of red blood cells before, during or after surgery was associated with increased risk.

Study Limitations: Authors could not evaluate the variation in outcomes by the hospital-wide practices in VTE prevention and guidelines adherence.

Study Conclusions:

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

(doi:10.1001/jamasurg.2018.1565)

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

# # #

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

Study Looks at Differences Between African Americans, Whites in Statin Therapy

Posted June 11, 2018 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JUNE 13, 2018

Media advisory: To contact corresponding author Michael G. Nanna, M.D., email Sarah Avery at sarah.avery@duke.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamacardiology/fullarticle/10.1001/jamacardio.2018.1511

Bottom Line: African American patients were less likely to receive guideline-appropriate statin therapy than white patients and the difference can be explained by a combination of demographic and clinical characteristics, socioeconomic status, patient beliefs and clinician factors.

Why The Research Is Interesting: African American individuals are at higher risk of hardening and narrowing of the arteries than white individuals, although reasons for this difference are unknown.

Who and When: 5,689 patients in a nationwide registry who were eligible for statin therapy and who have, or are at high risk for, atherosclerotic cardiovascular disease.

What (Study Measures and Outcomes): Use and dosing of statin therapy according to the 2013 American College of Cardiology/American Heart Association guideline by race (African American or white)

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

Authors: Michael G. Nanna, M.D., Duke University Medical Center, Durham, North Carolina, and coauthors

Results: African Americans patients were slightly less likely than white individuals to receive statins overall and less likely to receive statins at guideline-recommended intensity, although different perceptions and beliefs regarding statin therapy, demographics, clinical characteristics, socioeconomic status and lower frequency of care by cardiologists accounted for the differences.

Study Limitations: Researchers didn’t assess the reasoning behind clinician decisions to prescribe or not prescribe statin therapy; therefore, it is possible that there could have been contraindications to therapy in both African American and white participants or patient refusal.

Study Conclusions:

Related material: The Editor’s Note, “Addressing Cardiovascular Disease Disparities – Are We Getting Closer to the Truth?” by Clyde W. Yancy, M.D., M.Sc., Feinberg School of Medicine, Northwestern University, Chicago, and Deputy Editor, JAMA Cardiology, is also available on the For The Media website.

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

(doi:10.1001/jamacardio.2018.1511)

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

# # #

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

Metabolic Effects of Antipsychotic Medications in Youths

Posted June 11, 2018 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JUNE 13, 2018

Media Advisory: To contact corresponding author John W. Newcomer, M.D., email Gisele Galoustian at GGALOUST@fau.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.1088

Bottom Line: Increases in body fat and decreases in insulin sensitivity were observed in youths with disruptive behavior disorders who were treated for the first time with antipsychotic medications during a 12-week randomized clinical trial.

Why The Research Is Interesting: Treatment with antipsychotic medications has been associated with risks of weight gain, type 2 diabetes and related conditions. Antipsychotic medications are commonly prescribed off-label for children with attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders.

Who and When: 144 youths (ages 6 to 18) with distruptive behavior disorders (almost 56 percent had a primary diagnosis of ADHD with irritability and aggression that was insufficiently responsive to prior therapy) from the St. Louis metropolitan area; participants were enrolled in the trial from 2006-2010

What (Study Interventions and Outcomes): 12 weeks of treatment with oral aripiprazole (49 younths), olanzapine (46 youths) or risperidone (49 youths) (interventions); percentage total body fat and insulin sensitivity in muscle (primary outcomes), plus abdominal fat and other insulin sensitivity measures (secondary outcomes)

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

Authors: John W. Newcomer, M.D., of Florida Atlantic University, Boca Raton, Florida, Ginger E. Nicol, M.D., of Washington University in St. Louis, and coauthors

Results:

Study Limitations: The 12-week trial was shorter than the long-term treatment many patients receive; there was no placebo group for ethical and feasibility reasons

Study Conclusions:

Related Material: The editorial, “The Urgent Need for Optimal Monitoring of Metabolic Adverse Effects in Children and Youngsters Who Take On-Label or Off-Label Antipsychotic Medication,” by Marc De Hert, M.D., Ph.D., and Johan Detraux, M.Psy., of Katholieke Universiteit Leuven, Kortenberg, Belgium, also is available on the For The Media website.

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

(doi:10.1001/ jamapsychiatry.2018.1088)

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

# # #

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

How Physically Active Are Adolescents, Young Adults?

Posted June 7, 2018 by Deanna Bellandi

JAMA Pediatrics

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

Media advisory: To contact corresponding author Sarah Armstrong, M.D., email Sarah Avery at sarah.avery@duke.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.1273

Bottom Line: Adolescents girls and young adult females (ages 12 to 29) reported less physical activity than their male counterparts and physical activity dropped off sharply during the transition from adolescence to young adulthood, with disparities by race and income seen among some groups.

Why The Research Is Interesting: Physical activity is an important health behavior and this data analysis describes patterns and duration of physical activity among adolescents and young adults. The most recent guidelines recommend at least 60 minutes of moderate to vigorous activity for adolescents per day; for adults, 150 minutes per week of moderate physical activity or 75 minutes per week of vigorous physical activity or an equivalent mix of the two is recommended

Who and When: 9,472 adolescents and young adults between the ages of 12 and 29 who participated in the National Health and Nutrition Examination Survey from 2007 through 2016 and self-reported physical activity

What (Study Measures and Outcomes): Self-reported physical activity duration and exercise

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

Authors: Sarah Armstrong, M.D., Duke University, Durham, North Carolina, and cauthors

Results:

Study Limitations: Data describe only associations; data were self-reported; the data don’t provide enough detail to understand associations among poverty, employment and physical activity indicators

Study Conclusions:

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

(doi:10.1001/jamapediatrics.2018.1273)

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

# # #

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

Is Use of Prescription Medications With Depression as Possible Side Effect Common?

Posted June 7, 2018 by Jim Michalski

JAMA

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

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

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

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

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

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

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

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

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

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

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

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

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

(doi:10.1001/jama.2018.6741)

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

# # #

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

USPSTF Recommendation Statement on Screening for Cardiovascular Disease Risk with ECG

Posted June 7, 2018 by Jim Michalski

JAMA

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

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

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

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

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

The USPSTF Concludes:

Related material

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

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

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

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

— JAMA editorial: The Screening ECG and Cardiac Risks

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

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

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

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

(doi:10.1001/jama.2018.3710)

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

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

# # #

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

Does Cancer Increase Risk of Diabetes?

Posted June 5, 2018 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JUNE 7, 2018

Media advisory: To contact corresponding author Juhee Cho, Ph.D., email jcho@skku.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.1684

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: Developing cancer was associated with increased risk for later diabetes in a nationally representative sample of the Korean general population.

Why The Research Is Interesting: Diabetes is a risk factor for several types of cancer and some previous research suggests cancer increases the risk of developing new diabetes.

Who and When: 524,089 men and women (ages 20 to 70) in a nationally representative sample of the Korean general population who had no history of cancer and were followed for up to 10 years (2003-2013)

What (Measures and Outcomes): New cancer (exposure); new type 2 diabetes using insurance claim codes (outcome)

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

Authors: Juhee Cho, Ph.D., of Sungkyunkwan University, Samsung Medical Center, Seoul, Korea, and coauthors

Results: Cancer was associated with an increased risk of diabetes, even after taking into account precancer risk factors, and that increased risk was highest in the first two years after cancer diagnosis.

Limitations: No information on cancer stage, only limited information on cancer treatment and management; and outcomes based on claims data.

Study Conclusions:

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

(doi:10.1001/jamaoncol.2018.1684)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年6月7日，星期四，美国东部时间上午11点

媒体咨询：联系通讯作者Juhee Cho, Ph.D.，请发电子邮件到jcho@skku.edu。

癌症是否会增加糖尿病的风险？

概要: 根据《美国医学会杂志 – 肿瘤学》(JAMA Oncology)发表的一项研究，癌症的发展与韩国普通人口中全国代表性样本的后期糖尿病风险增加有关联。

为何对该问题感兴趣：糖尿病是几种类型癌症的风险因素，以前的一些研究表明癌症会增加发生糖尿病的风险。

研究参与者及时间：524,089名没有癌症病史的男性和女性（年龄在20岁至70岁之间）作为韩国普通人口中的全国代表性样本，随访时间长达10年（2003 至2013年）

研究内容（研究手段及结果）：新的癌症（暴露）；使用保险索赔代码的新2型糖尿病（结果）

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

作者：Juhee Cho, Ph.D., 成均馆大学，首尔，韩国，以及共同作者

研究结果：即使考虑到癌症的前期风险因素，癌症与糖尿病风险增加也有关联，并且在癌症诊断后的头两年风险增加最高。

研究局限：没有癌症阶段的信息，只有有限的癌症治疗和管理信息以及基于索赔数据的结果。

研究结论：

意义医生应当注意，与未患癌症的个体相比，癌症患者有更高的频率会患上糖尿病等其它疾病。因此应当考虑在这些患者中进行常规的糖尿病筛查。

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

Are There Long-Term Health Risks After Having Tonsils or Adenoids Removed in Childhood?

Posted June 5, 2018 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JUNE 7, 2018

Media advisory: To contact corresponding author Sean G. Byars, Ph.D., email sean.byars@unimelb.edu.au. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2018.0614

Bottom Line: Removing tonsils and adenoids in children in Denmark was associated with increased long-term risk of respiratory, infectious and allergic diseases.

Why The Research Is Interesting: Tonsils and adenoids are commonly removed in childhood to treat conditions such as chronic ear infections and obstructed breathing. They are part of the immune system and are usually removed at ages when the development of the immune system is sensitive. Not much is known about the long-term impact of those surgeries.

Who and When: Nearly 1.2 million children born in Denmark from 1979 to 1999

What (Study Measures): Tonsils or adenoids removed within a child’s first nine years (exposures); risk of disease up to age 30 (outcomes); all disease diagnoses in the national health registries of Denmark.

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

Authors: Sean G. Byars, Ph.D., University of Melbourne, Australia, and coauthors

Results:

Study Limitations: Did not address risks of diseases in people over 30; researchers did not have large enough samples for rarer diseases to obtain reliable risk estimates

Study Conclusions: Study results suggest it is important to consider long-term risks when deciding whether to remove a child’s tonsils or adenoids.

Related material: The commentary, “Old Barbers, Young Doctors, and Tonsillectomy,” by Richard M. Rosenfeld, M.D., SUNY Downstate Medical Center, Brooklyn, New York, is also available on the For The Media website.

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

(doi:10.1001/jamaoto.2018.0614)

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

# # #

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

Decrease in Eye Injuries to Children

Posted June 5, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, JUNE 7, 2018

Media advisory: To contact corresponding author Julie C. Leonard, M.D., M.P.H., email Alexis Shaw at Alexis.Shaw2@osumc.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.2062

Bottom Line: Eye injuries that sent children to emergency departments in the United States decreased from 2006 to 2014, and most eye injuries posed low risk for vision loss.

Why The Research Is Interesting: Understanding the frequency of eye injuries and the associated likelihood of vision loss may help guide prevention efforts.

Who and When: More than 300,000 children up to age 17 who received care for an eye injury at an emergency department from 2006 to 2014.

What (Study Measures): eye injury (exposure); changes over time in the incidence of eye injuries, risk of vision loss and causes of eye injury to children (outcomes)

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

Authors: Julie C. Leonard, M.D., M.P.H., Ohio State University College of Medicine, Columbus, and coauthors

Results:

Study Limitations: Data were gathered from emergency department billing data, which may not accurately indicate diagnosis codes.

Study Conclusions:

Related material: The commentary, “Uncovering Reasons Why Acute Ocular Injuries in Children May Be Declining,” by Lindsey B. De Lott, M.D., M.S., University of Michigan, Ann Arbor; and a podcast with author Julie C. Leonard, M.D., M.P.H, are also available on the For The Media website.

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

(doi:10.1001/jamaophthalmol.2018.2062)

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

# # #

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

Do Physicians Change Testing, Treatment Decisions for Coronary Artery Disease after Malpractice Reform?

Posted June 4, 2018 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, JUNE 6, 2018

Media advisory: To contact corresponding author Steven A. Farmer, M.D., Ph.D., email Lisa Anderson at lisama2@gwu.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamacardiology/fullarticle/10.1001/jamacardio.2018.1360

Bottom Line: Physician testing and treatment decisions for coronary artery disease changed after states where they practice adopted malpractice damage caps, suggesting physicians will tolerate more clinical uncertainty when they face lower malpractice risk.

Why The Research Is Interesting: Little evidence exists that malpractice reform affects overall health care spending but it may influence physician behavior when patient conditions involve clinical uncertainty.

Who and When: 36,647 physicians in nine states with malpractice damage caps adopted in 2002-2005 and 39,154 physicians in 20 states without caps in a before-and-after study to compare whether reducing malpractice risk was associated with clinical decisions for testing and treatment of coronary artery disease (CAD).

What (Study Measures and Outcomes): Changes in testing rates for possible CAD, type of initial testing (noninvasive stress testing or invasive coronary angiography), progression from stress test to angiography, and progression from testing to revascularization to treat a narrowed or blocked coronary artery

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

Authors: Steven A. Farmer, M.D., Ph.D., George Washington University, Washington, D.C., and coauthors

Results:

Study Limitations: A modest number of states with new malpractice damage caps

Study Conclusions:

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

(doi:10.1001/jamacardio.2018.1360)

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

# # #

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

Association of Food Allergy, Other Allergies With Autism Spectrum Disorder

Posted June 5, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JUNE 8, 2018

Media advisory: To contact corresponding study author Wei Bao email Dan McMillan at daniel-mcmillan@uiowa.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0279

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

Bottom Line: Food and other types of allergies are more likely to be reported in children with autism spectrum disorder (ASD) than in children without ASD but the underlying reasons for this association aren’t clear.

Why The Research Is Interesting: A diagnosis of ASD has become more common among U.S. children but it isn’t clear why or what causes ASD. Some studies have suggested immune system dysfunction may potentially play a role. Allergies are common medical conditions of immune dysfunction in children.

Who and When: Data from 199,520 children (ages 3 to 17) who participated in the National Health Interview Survey between 1997 and 2016; food, respiratory and skin allergies were based on a response on a questionnaire by a parent or guardian

What (Study Measures): Parent or guardian response on a questionnaire about whether a child had received a diagnosis of ASD from a physician or other health professional

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

Authors: Wei Bao, M.D., Ph.D., of College of Public Health at the University of Iowa, Iowa City, and coauthors

Results: Children with ASD, compared to children without ASD, were more likely reported to have:

Food allergy (11.25% vs. 4.25%)
Respiratory allergy (18.7% vs. 12%)
Skin allergy (16.8% vs. 9.8%)

Study Limitations: Parent or guardian reports about ASD or allergy diagnoses in children may have been incorrect. Some parents may over report or under report allergies in their children. Authors didn’t know the timing of the onset of allergies or the ASD diagnosis. The study could not determine which diagnosis (ASD or allergic conditions) came first.

Study Conclusions:

Related Material: The invited commentary, “Another Step Toward Defining an Immune-Mediated Subtype of Autism Spectrum Disorder ” by Christopher J. McDougle, M.D., Lurie Center for Autism, Massachusetts General Hospital, Boston, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0210)

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

# # #

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

Are Antibiotics Overused in Treatment of Outpatient Acute Respiratory Infections?

Posted June 5, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JUNE 8, 2018

Media advisory: To contact corresponding study author Fiona P. Havers, M.D., email Kristen Nordlund at hok4@cdc.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0243

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

Bottom Line: Antibiotics are most commonly prescribed for acute respiratory infections, although most of these infections are caused by viruses for which antibiotics aren’t effective. A new study found that among almost 15,000 outpatients with acute respiratory infections during flu seasons, 41 percent of outpatients were prescribed antibiotics and 41 percent of them had diagnoses for which antibiotics weren’t indicated. The results suggest antibiotic overuse remains widespread in the treatment of outpatient acute respiratory infections.

Authors: Fiona P. Havers, M.D., of the Centers for Disease Control and Prevention, Atlanta, Georgia, and coauthors

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

(doi:10.1001/jamanetworkopen.2018.0243)

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

# # #

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

Does Increased Supervision of Resident Physicians Reduce Medical Errors?

Posted May 31, 2018 by Jim Michalski

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JUNE 4, 2018

Media advisory: To contact corresponding author Kathleen M. Finn, M.D., email McKenzie Ridings at mridings@partners.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.1244

Bottom Line: Increased supervision of residents by attending physicians who joined patient rounds didn’t significantly reduce medical errors but residents reported decreased autonomy.

Why The Research Is Interesting: The relationship between resident work hours and patient safety has been studied extensively but less is known about the role of attending physician supervision on patient safety.

Who and When: 22 attending physicians participated in this randomized clinical trial performed on an inpatient general medical service at a large academic center with 188 internal medicine residents from September 2015 to June 2016

What (Study Interventions and Outcomes): Increased direct supervision where attending physicians joined patient work rounds on previously admitted patients or standard supervision when attending physicians were available for rounds but didn’t join (interventions); rate of medical errors (measures)

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

Authors: Kathleen M. Finn, M.D., Massachusetts General Hospital, Boston, and coauthors

Results:

Study Limitations: Conducted at a single medical center with a large academic residency program

Study Conclusions: Residency training programs should reconsider the appropriate level of attending physician supervision when designing rounds to balance patient safety, excellent care, the needs of residents who are there to learn, and resident autonomy.

Related material: The commentary, “Optimizing the Balance Between Supervision and Autonomy in Training,” by Brian E. Neubauer, M.D., of Walter Reed National Military Medical Center, Bethesda, and coauthors is also available on the For The Media website.

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

(doi:10.1001/jamainternmed.2018.1244)

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

# # #

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

Preschool Home Visiting Program Improves Academic Performance, Reduces Child’s Need for School Services

Posted May 31, 2018 by Jim Michalski

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, JUNE 4, 2018

Media advisory: To contact corresponding author Karen L. Bierman, Ph.D., email Katie Bohn at kej5009@psu.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.1029

Bottom Line: A program of home visits designed to help families enhance school readiness for their preschool children had by the third grade improved academic performance, eased the social-emotional adjustment to school, and reduced problems at home for the children.

Why The Research Is Interesting: Little research with long follow-up exists on home-visiting programs that are designed for older preschool children (4-5 years old) and emphasize the parenting practices needed to support school readiness skills in children.

Who and When: 200 4-year-old children from low-income families recruited for this randomized clinical trial in 2008-2009 and followed up in 2013-2014

What (Study Interventions and Outcomes): 95 families chosen to receive 10 home visits during preschool, six visits in kindergarten, parent coaching and home-learning materials as part of the Research-Based and Developmentally Informed-Parent home visiting program (intervention); 105 families served as a comparison group and received math home-learning games in the mail (control); assessment of academic performance, social-emotional adjustment and problems at home by the end of third grade (outcomes)

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

Authors: Karen L. Bierman, Ph.D., Pennsylvania State University, University Park, and coauthors

Results:

Study Limitations: Some parents invited to participate in the study declined to do so, likely contributing to a final group of motivated study participants.

Study Conclusions: The results of this study appear to support the value of preschool home visiting programs as a strategy to help close the gap in school readiness and child well-being associated with poverty.

Related material: An audio summary is available on this page. The transcript is available here.

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

(doi:10.1001/jamapediatrics.2018.1029)

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

# # #

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

Study Updates Global Burden of Cancer

Posted May 31, 2018 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 2:15 P.M. (ET), SATURDAY, JUNE 2, 2018

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

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.2706

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: Population aging and growth largely fueled an increase in cancer cases between 2006 and 2016, and large disparities continue to exist between countries in cancer incidence, deaths and the disease’s associated disability.

Why The Research Is Interesting: An assessment of the impact of cancer over time can help to frame policy discussions, resource allocation and research focus.

What and When: Cancer incidence, mortality and related disability evaluated for 195 countries and territories with a focus on changes in the last decade (2006-2016).

Study Design: This was a systematic analysis.

Authors: Christina Fitzmaurice, M.D., M.P.H., at the Institute for Health Metrics and Evaluation at the University of Washington, Seattle, and coauthors in the Global Burden of Disease Cancer Collaboration

Results:

Limitations: Estimations can vary widely; data collection would be improved through the expansion and creation of vital registration systems, cancer registries, health surveys and other data systems

Study Conclusions: Cancer control planning and implementation, along with strategic investments, are needed to fulfill global commitments for the control of cancer and noncommunicable diseases.

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

(doi:10.1001/jamaoncol.2018.2706)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年6月2日，星期六，美国东部时间上午11点

媒体咨询：联系通讯作者Christina Fitzmaurice, M.D., M.P.H.，请发电子邮件到Kelly Bienhoff kbien@uw.edu。

新研究结果更新全球癌症负担

概要: 根据《美国医学会杂志肿瘤学》(JAMA Oncology)发表的一项研究，人口老龄化以及增长在很大程度上推动了癌症病例在2006年至2016年间的增加，而各国之间在癌症发病率，死亡率和疾病相关残疾方面仍然存在巨大差距。

为何对该问题感兴趣：评估癌症随时间的影响可以帮助构建政策讨论，资源分配和确定研究重点。

研究参与者及时间：对195个国家和地区的癌症发病率，死亡率和相关残疾进行了评估，并且重点关注过去十年（2006 – 2016年）间的变化。

研究设计：这是一项系统分析。

作者：Christina Fitzmaurice, M.D., M.P.H., 华盛顿大学健康度量与评估研究所，以及来自全球癌症疾病负担协作组织的共同作者。

研究结果：

2016年全球共有1720万癌症病例，并有890万人死亡
2006至2016年癌症病例上升28％，而人口老龄化和增长是其主要驱动因素
前列腺癌是男性最常见的癌症
乳腺癌是女性最常见的癌症

研究局限：数据估计可能会有很大的差异；而通过扩大和建立生命（出生，死亡等）登记系统，癌症登记，健康调查和其他数据系统，数据收集将得到改善。

研究结论：需要对癌症控制进行规划，并针对规划实施措施，再加上战略投资，来履行控制癌症和非传染性疾病的全球承诺。

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

Is Exercise Associated With Lower Risk of Death for Adult Survivors of Childhood Cancer?

Posted May 31, 2018 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 10 A.M. (ET), SUNDAY, JUNE 3, 2018

Media advisory: To contact corresponding author Lee W. Jones, Ph.D., email Nicole McNamara at mcnamarn@mskcc.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.2254

Bottom Line: Vigorous exercise is associated with reductions in the risk of death among adult survivors of childhood cancer.

Why The Research Is Interesting: In the general population, a healthy lifestyle that includes regular exercise is associated with a reduced risk of death. It is unknown whether that applies to adult survivors of childhood cancer who have an elevated risk of death because of the late effects of cancer treatment.

Who and When: 15,450 adult survivors of cancer diagnosed before age 21 at hospitals in the United States and Canada between 1970 and 1999 and enrolled in the Childhood Cancer Survivor Study

What (Study Measures): Self-reported vigorous exercise in metabolic equivalent task (MET) hours per week (exposures); all cause-mortality (primary outcome)

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

Authors: Jessica M. Scott, Ph.D., and Lee W. Jones, Ph.D., of Memorial Sloan Kettering Cancer Center, New York, and coauthors

Results: Vigorous exercise for adult survivors of childhood cancer was associated with reductions in risk of death; in a subset of these survivors, increased exercise (an average of nearly 8 MET-hours per week) over an eight-year period was associated with a lower risk of death compared with maintaining a low level of exercise.

Limitations: Exercise was self-reported by a single item that evaluated only vigorous exercise

Study Conclusions:

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

(doi:10.1001/jamaoncol.2018.2254)

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

# # #

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

Study Examines Association of Abortion and Antidepressants

Posted May 29, 2018 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 30, 2018

Media Advisory: To contact corresponding author Julia R. Steinberg, Ph.D., email Kelly Blake at kellyb@umd.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.0849

Bottom Line: While women who had a first abortion were more likely to use an antidepressant for the first time than women who didn’t have an abortion, the findings of a new study suggest the increased use of antidepressants wasn’t due to the abortion but to differences in risk factors for depression.

Why The Research Is Interesting: The purported mental health effects of abortion have been used to justify state policies limiting access to abortion in the United States.

Who and When: 396,397 women born in Denmark between 1980 and 1994; of the women, 30,834 had a first-trimester first abortion and 85,592 had a first childbirth

What (Study Measures): First prescription for antidepressant considered as an indicator of mild to moderate depression or anxiety (outcome); 59,465 women (15 percent) had a first antidepressant use; a ratio measuring risk was used to compare women who had an abortion with those who didn’t and women who gave birth with those who didn’t

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

Authors: Julia R. Steinberg, Ph.D., of the University of Maryland, College Park, and coauthors

Results: Women who had a first abortion had a higher risk of first-time antidepressant use compared with women who didn’t have an abortion, but for women who had a first abortion, the risk for first-time antidepressant use was the same in the year before and the year after the abortion and that risk decreased as more time since the abortion passed. Childbirth was associated with an increased likelihood of women using antidepressants more than one year later.

The strongest risk factors associated with first-time antidepressant use were indicators of previous mental health problems, including prior psychiatric contact and previously obtained antipsychotic and antianxiety medication.

Study Limitations: Reasons for the antidepressant prescriptions were unknown.

Study Conclusions:

Related Material: The editorial, “More Evidence That Abortion is Not Associated With Increased Risk of Mental Illness,” by Nada L. Stotland, M.D., and Angela D. Shrestha, M.D., of the University of Illinois at Chicago, also is available on the For The Media website.

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

(doi:10.1001/ jamapsychiatry.2018.0849)

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

# # #

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

Intellectual Activities Associated with Lower Risk of Dementia in Older Adults in China

Posted May 29, 2018 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 30, 2018

Media Advisory: To contact corresponding author Linda C.W. Lam, M.D., email cwlam@cuhk.edu.hk. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.0657

Bottom Line: A study that included more than 15,000 older Chinese adults in Hong Kong free of dementia at baseline suggests late-life participation in intellectual activities, such as reading books, newspapers or magazines, playing board games, Mahjong or card games, and betting on horse racing was associated with a lower risk of dementia in later years.

Authors: Linda C.W. Lam, M.D., of the Chinese University of Hong King, China, and coauthors

Related Material: The invited commentary, “Brain Exercise and Brain Outcomes: Does Cognitive Activity Really Work to Maintain Your Brain?” by Deborah Blacker, M.D., Sc.D., of Massachusetts General Hospital and Harvard Medical School, Boston, and Jennifer Weuve, M.P.H., Sc.D., of the Boston University School of Public Health, also is available on the For The Media website.

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

(doi:10.1001/ jamapsychiatry.2018.0657)

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

# # #

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

Are Indoor Tanners More Likely to Have Skin Checks for Signs of Cancer?

Posted May 29, 2018 by Deanna Bellandi

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 30, 2018

Media Advisory: To contact corresponding author Kasey L. Morris, Ph.D., email National Cancer Institute Media Relations Branch at ncipressofficers@mail.nih.gov. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Link will be live at the embargo time http://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2018.1118

Bottom Line: Estimates from a recent national survey suggest indoor tanners were more likely to have checked their skin for signs of cancer and to have had a professional skin cancer exam than individuals who didn’t use indoor tanning beds.

Authors: Kasey L. Morris, Ph.D., of the National Cancer Institute, Bethesda, Maryland, and coauthors

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

(doi:10.1001/jamadermatol.2018.1118)

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

# # #

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

Studies Examine Vitamin D Supplementation in Pregnancy, For Infants, Children

Posted May 24, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 29, 2018

Media advisory: To contact the study authors email Sture Andersson, M.D., Ph.D., at sture.andersson@hus.fi and Shu Qin Wei, M.D., Ph.D., at shu.qin.wei@umontreal.ca. The full studies are available on the For The Media website.

Bottom Line: Vitamin D supplementation in pregnancy and for infants and children is the focus of two studies, an editorial and a patient page.

Why The Research Is Interesting: Vitamin D is essential for building and maintaining healthy bones and research suggests it may have other potential health benefits.

What: A randomized clinical trial of 975 healthy infants in Finland reports no difference in bone strength or incidence of infections at age 24 months when infants were given a higher daily dose of supplemental vitamin D (1,200 IU) compared with the standard dose (400 IU).

Authors: Sture Andersson, M.D., Ph.D., of the University of Helsinki and Helsinki University Hospital, Finland, and coauthors

Want to embed a link to this study in your story? Links will be live at the embargo time http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.0602

(doi:10.1001/jamapediatrics.2018.0602)

What: A systematic review and meta-analysis of 24 randomized clinical trials examined vitamin D supplementation during pregnancy on several infant outcomes including small for gestational age, fetal or neonatal death, and congenital abnormality.

Authors: Shu Qin Wie, M.D., Ph.D., of University of Montreal, Canada, and coauthors

Want to embed a link to this study in your story? Links will be live at the embargo time http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.0302

(doi:10.1001/jamapediatrics.2018.0302)

Related Material: The editorial, “Prenatal Vitamin D Supplementation to Improve Health in Offspring,” by Hans Bisgaard, M.D., D.M.Sc., of the Herlev and Gentofte Hospital, Gentofte, Denmark, the JAMA Pediatrics Patient Page, “Vitamin D and Your Child,” and a podcast also are available on the For The Media website.

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

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

# # #

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

About One-Third of U.S. Casualties in Iraq and Afghanistan Wars from Nonbattle Injuries

Posted May 29, 2018 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 30, 2018

Media advisory: To contact corresponding author Tuan D. Le, M.D., Dr.P.H., email Steven Galvan, D.B.A., at steven.galvan2.civ@mail.mil. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2018.1166

Bottom Line: About one-third of all injuries to U.S. military service members in the Iraq and Afghanistan wars, and 11.5 percent of deaths, were from nonbattle injuries, such as falls, motor vehicle crashes and equipment accidents.

Why The Research Is Interesting: Nonbattle injuries increase the burden on the military health care system and reduce the available fighting force. Data identifying specific deployment-related nonbattle injury (NBI) risks may be helpful for safety policies.

Who and When: 29,958 U.S. service members injured in Iraq and Afghanistan from 2003-2014

What (Study Measures): Injury incidence, patterns and severity were characterized by battle injury or NBI; proportion of NBIs and changes in NBI over time (outcomes).

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

Authors: Tuan D. Le, M.D., Dr.P.H., U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, and coauthors

Results In Iraq and Afghanistan from 2003-2014:

Study Limitations: The accuracy of data in a deployed combat setting is a significant challenge.

Study Conclusions:

Related material: The commentary, “Actionable Information to Reduce the Burden of Nonbattle Injury in Deployed U.S. Service Personnel,” by Todd E. Rasmussen, M.D., of the Uniformed Services University of the Health Sciences, Bethesda, Maryland, is also available on the For The Media website.

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

(doi:10.1001/jamasurg.2018.1166)

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

# # #

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

How Does Substance Use by American Indian Teens Compare to Other Adolescents?

Posted May 29, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 1:15 P.M. (ET), THURSDAY, MAY 31, 2018

Media advisory: To contact corresponding study author Randall C. Swaim, Ph.D., email Anne Manning at Anne.Manning@colostate.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0382

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

Bottom Line: American Indian teenagers living on or near reservations are more likely to use alcohol, marijuana and other drugs than other U.S. adolescents.

Why The Research Is Interesting: American Indian youth have historically reported higher levels of substance use. High rates of substance use by these young people are associated with increasing rates in later adulthood and the risk of substance use disorder and alcohol-related problems, including death. Tracking substance use among American Indian adolescents over time can help guide prevention and treatment efforts.

Who and When: 1,660 students in the 8th, 10th and 12th grades attending schools on or near reservations during the 2016-2017 school year.

What (Study Measures): Lifetime and past 30-day self-reported use of alcohol, marijuana or other drugs by American Indian youth compared with a nationally representative sample of U.S. adolescents

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

Authors: Randall C. Swaim, Ph.D., and Linda R. Stanley, Ph.D., of Colorado State University, Fort Collins

Results: American Indian teenagers reported higher lifetime and past 30-day substance use rates than other adolescents, with the biggest disparity in 8^th grade where American Indian youth were more likely to report using alcohol, marijuana and other illicit drugs.

Study Limitations: School participation in the survey was voluntary; student participation in the survey at each school was not 100 percent (87 percent); and the study likely underestimates substance use rates for adolescents in the 10th and 12th grades because there is a high dropout rate among American Indian youth.

Study Conclusions:

Related Material: The invited commentary, “Substance Use Among American Indian Youths Today: A Threat to Our Future,” by Spero M. Manson, Ph.D., of the University of Colorado Anschutz Medical Campus, Aurora, Colorado, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0382)

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

# # #

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

Are More Hospitals Requiring Flu Shots for Health Care Workers?

Posted May 29, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JUNE 1, 2018

Media advisory: To contact corresponding study author M. Todd Greene, Ph.D., M.P.H., email Michelle Spivak, M.A., at Michelle.SpivakMelinger@va.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0143

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

Bottom Line: A national survey study suggests the proportion of hospitals, both Veterans Affairs (VA) and non-VA hospitals, requiring flu shots for health care workers grew from 37.1 percent in 2013 to 61.4 percent in 2017, although the increase was driven primarily by non-VA hospitals and overall many hospitals still lack such a mandate.

Why The Research Is Interesting: Annual flu shots are recommended for all health care workers to limit its spread.

Authors: M. Todd Greene, Ph.D., M.P.H., of the Veterans Affairs Ann Arbor Healthcare System and the University of Michigan Medical School, Ann Arbor, Michigan, and coauthors

Related Material: The editorial, “Continuing to Move the Needle on Health Care Personnel Influenza Vaccination Rates,” by Hilary M. Babcock, M.D., M.P.H., of the Washington University School of Medicine, St. Louis, Missouri, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0143)

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

# # #

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

Studies, Editorial Examine Opioid-Related Deaths, Prescribing Patterns

Posted May 29, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, JUNE 1, 2018

Media advisory: To contact study author Tara Gomes, Ph.D., email Ana Gajic at GajicA@smh.ca and to contact Tamra E. Meyer, Ph.D., M.P.H., email Tara Rabin at tara.rabin@fda.hhs.gov. The full studies are available on the For The Media website.

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

Bottom Line: Opioid-related deaths in the United States and a description of prescribing patterns for two opioid formulations (immediate-release and extended-release) to manage chronic pain are the focus of two studies and an editorial.

Why The Research Is Interesting: Opioid prescribing and overdose are leading public health problems. Examining the impact of opioid-related deaths over time helps to quantify the public health burden. Opioid misuse, abuse and overdose has prompted some to reconsider prescribing practices for opioid analgesics.

What: Opioid-related deaths (where a prescription or illicit opioid contributed substantially to a person’s cause of death based on death certificates) increased in the United States between 2001 and 2016 from 33 to 130 deaths per 1 million population, and the proportion of all deaths attributable to opioids grew from 0.4 percent (1 in 255) to 1.5 percent (1 in 65) during that time.

Authors: Tara Gomes, Ph.D., of St. Michael’s Hospital, Toronto, Canada, and coauthors

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0217

(doi:10.1001/jamanetworkopen.2018.0217)

What: Most patients receiving opioid pain medication, whether for short-term or extended use, use immediate-release formulations, according to a study of 169 million people receiving opioid medications from most of the outpatient retail pharmacies in the United States from 2003 through 2014.

Authors: Tamra E. Meyer, Ph.D., M.P.H., of the U.S. Food and Drug Administration, Silver Spring, Maryland, and coauthors

Want to embed a link to this study in your story? Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0216

(doi:10.1001/jamanetworkopen.2018.0216)

Related Material: The editorial, “Suggested Paths to Fixing the Opioid Crists: Directions and Misdirections,” by Jeffrey H. Samet, M.D., M.A., M.P.H., of Boston Medical Center and Boston University School of Medicine, and Stefan G. Kertesz, M.D., M.Sc., Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham School of Medicine, als0 is available on the For The Media website.

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

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

# # #

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

Is Lower-Fat Diet Associated With Breast Cancer Overall Survival?

Posted May 22, 2018 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MAY 24, 2018

Media advisory: To contact corresponding author Rowan T. Chlebowski, M.D., Ph.D., email media relations at City of Hope at media@coh.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.1212

Bottom Line: Women diagnosed with breast cancer during the Women’s Health Initiative Dietary Modification trial who were following a lower-fat diet had increased breast cancer overall survival, although the increase was likely partly due to better survival from several causes of death.

Why The Research Is Interesting: This study helps address the issue of postdiagnosis dietary intervention influences by providing findings for breast cancer overall survival measured from breast cancer diagnosis because study participants with breast cancer continued to participate in dietary modification activities.

Who and When: 48,835 postmenopausal women with no previous breast cancer and dietary fat intake of more than 32 percent based on a food questionnaire

What (Study Interventions and Outcomes): 19,541 participants took part in a dietary intervention to reduce their fat intake to 20 percent of calories and increase the amount of fruits, vegetables and grains they were eating, while 29,294 participants served as a usual-diet comparison group (interventions); breast cancer overall survival for new breast cancers diagnosed during the 8.5 years of the dietary intervention and examined later after 11.5 years of postdiagnosis follow-up.

Study Design: This was a secondary analysis of the Women’s Health Initiative randomized clinical trial

Authors: Rowan T. Chlebowski, M.D., Ph.D., of City of Hope National Medical Center, Duarte, California, and coauthors

Results: 1,764 women diagnosed with breast cancer during the dietary intervention; breast cancer overall survival was higher for women in the lower-fat group than in the usual-diet group; and in the group where women ate less fat, there were fewer deaths from breast cancer, other cancers and cardiovascular disease

Limitations: Modest increases in vegetable, fruit and grain intake, the need for confirmatory trials and incomplete breast cancer therapy information.

Study Conclusions:

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

(doi:10.1001/jamaoncol.2018.1212)

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

# # #

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

Laws Allowing Denial of Services to Same-Sex Couples Associated with Increase in Sexual Minority Adults Reporting Mental Distress

Posted May 21, 2018 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 23, 2018

Media Advisory: To contact corresponding author Julia Raifman, Sc.D., email Michelle Samuels at msamu@bu.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.0757

Bottom Line: Laws that allow same-sex couples to be denied services are associated with an increase in sexual minority adults reporting mental distress.

Why The Research Is Interesting: Laws allowing the denial of services to same-sex couples exist in a dozen states and are under consideration by the U.S. Supreme Court.

Who and When: 109,089 adults from nine states; 37,514 adults from three states (Utah, Michigan and North Carolina) that passed laws permitting services to be denied to same-sex couples and 71,575 from six nearby states used for comparison (Idaho, Nevada, Ohio, Indiana, Virginia and Delaware); data from the Behavioral Risk Factor Surveillance System were from 2014 through 2016

What (Study Measures): Whether individuals identified as a sexual minority (defined as those who identified as gay, lesbian, bisexual or not sure of their sexual orientation) and lived in a state with a law permitting the denial of services to same-sex couples in 2015 (exposures); mental distress, which was defined as poor mental health on 14 or more the past 30 days (outcome)

How (Study Design): This was an observational study. Researchers evaluated changes in mental distress among sexual minority adults in states that passed the laws compared to changes in mental distress among heterosexual adults in the same states and among sexual minority adults in control states. They controlled for all state characteristics that did not change over the study period and for a number of individual characteristics of study participants.

Authors: Julia Raifman, Sc.D., of the Boston University School of Public Health, and coauthors

Results: Of the 109,089 participants, 4,656 (4.8 percent) identified as sexual minorities; the proportion of sexual minority adults reporting mental distress increased between 2014 and 2016 in states that passed laws permitting services to be denied to same-sex couples compared with control states.

Study Limitations: Analysis conducted only in states and years with data on sexual orientation; findings may not be generalizable to other states

Study Conclusions:

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

(doi:10.1001/ jamapsychiatry.2018.0757)

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

# # #

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

Is There Association Between Groundwater Lithium, Diagnoses of Bipolar Disorder, Dementia?

Posted May 21, 2018 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 23, 2018

Media Advisory: To contact corresponding author William F. Parker, M.D., the University of Chicago, email Matt Wood at Matthew.Wood@uchospitals.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.1020

Bottom Line: High groundwater concentration of lithium, a naturally occurring trace element, wasn’t associated with any benefit in diagnoses of bipolar disorder or dementia when accounting for local health care resources and demographics, two factors that can cause mental health diagnosis rates to vary.

Why The Research Is Interesting: Previous research has suggested lithium may be associated with lower rates of mental health disorders. Mental health diagnosis rates can vary widely based on local health care resources and demographics, and this study accounted for those variables.

Who and When: Health care claims data for more than 4.2 million adults living in 174 U.S counties, among them more than 404,000 patients (9.6 percent) living in 1 of 32 counties with high lithium groundwater concentration of more than 40 μg/L.

What (Study Measures): County groundwater lithium concentrations, diagnoses identified from claims data, and county-level health care resources and demographics; frequency of bipolar disorder and dementia (outcomes); the analysis was repeated for three negative control outcomes (major depressive disorder, myocardial infarction and prostate cancer) that have no known link to groundwater lithium

How (Study Design): This was a population epidemiology study. A population epidemiology study describes characteristics of health and disease in one or more large populations, typically without detailed information about underlying causes.

Authors: William F. Parker, M.D., of the University of Chicago, and coauthors

Results:

Study Conclusions: Therapeutic doses of lithium are larger than groundwater lithium concentrations, making a true causal relationship between groundwater lithium and mental health “biologically dubious.” The purported association of high-lithium concentrations in drinking water with mental health disorders is driven by unaccounted variation in demographics, health care resources and diagnosis practices.

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

(doi:10.1001/ jamapsychiatry.2018.1020)

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

# # #

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

Will Treating Sleep Apnea with CPAP Improve Sexual Quality of Life?

Posted May 22, 2018 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MAY 24, 2018

Media advisory: To contact corresponding author Sebastian M. Jara, M.D., email Brian Donohue at bdonohue@uw.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2018.0485

Bottom Line: Long-term use of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea was associated an improvement in sexual quality of life for women, but not men.

Why The Research Is Interesting: Obstructive sleep apnea reduces sexual quality of life (QOL) as a result of reduced libido and intimacy, erectile dysfunction and several other factors. Treatment for obstructive sleep apnea may improve sexual QOL.

Who and When: 182 patients with newly diagnosed obstructive sleep apnea who were prescribed CPAP treatment from September 2007 through June 2010.

What (Study Exposures and Outcomes): Use (more than 4 hours per night) or nonuse (fewer than 0.5 hours per night) of CPAP treatment (exposures); sexual QOL as determined by a survey (outcomes)

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

Authors: Sebastian M. Jara, M.D., University of Washington, Seattle, and coauthors

Results:

Study Limitations: The measurement of sexual QOL in this study was not from a dedicated sexual QOL survey, which may have been more sensitive for measuring sexual dysfunction.

Study Conclusions:

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

(doi:10.1001/jamaoto.2018.0485)

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

# # #

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

Opioid-Related Adverse Drug Events Common after Surgery, Associated With Worse Outcomes

Posted May 21, 2018 by Jim Michalski

JAMA Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 23, 2018

Media advisory: To contact corresponding author Shahid Shafi, M.D., M.B.A., M.P.H., email Deke Jones at Deke.Jones@BSWHealth.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2018.1039

Bottom Line: Opioid-related adverse drug events were common among patients undergoing surgery and endoscopy procedures in the hospital and they were associated with worse patient outcomes.

Why The Research Is Interesting: Short-term opioid use in the hospital is a known source of the growing opioid epidemic. Opioid-related adverse drug events (ORADEs) can range from mild dermatitis to severe events such as acute respiratory failure.

Who and When: 135,379 patients admitted to 21 acute care hospitals from 2013 to 2015 who had surgery or endoscopic procedures at a hospital and were given opioids.

What (Study Measures): Opioid use (exposure); opioid-related adverse drug events and their association with inpatient mortality, discharge to another care facility, length of stay, cost of hospitalization and 30-day readmission (outcomes)

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

Authors: Shahid Shafi, M.D., M.B.A., M.P.H., Baylor Scott & White Health, Dallas, and coauthors

Results:

Study Limitations: A lack of information on the timing of ORADEs relative to when opioids were given to patients made it not possible to determine if the adverse events were a direct consequence of the opioid use or to other causes or drugs.

Study Conclusions:

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

(doi:10.1001/jamasurg.2018.1039)

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

# # #

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

Listen to a Podcast: Association Between Exposure to Diethylstilbestrol During Pregnancy And Multigenerational Neurodevelopmental Deficits

Posted May 17, 2018 by Deanna Bellandi

An editor article review podcast with Aaron E. Carroll, M.D., M.S., JAMA Pediatrics digital media editor, accompanies “Association of Exposure to Diethylstilbestrol During Pregnancy With Multigenerational Neurodevelopmental Deficits” and is available on the For The Media website. The audio transcript is available here.

Is Topical Rapamycin Effective, Safe to Treat Facial Lesions?

Posted May 21, 2018 by Deanna Bellandi

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 23, 2018

Media Advisory: To contact corresponding author Mary Kay Koenig, M.D., email Robert Cahill at Robert.cahill@uth.tmc.edu. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Link will be live at the embargo time http://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2018.0464

Bottom Line: Facial angiofibromas are disfiguring growths and these lesions occur in most people with tuberous sclerosis complex, a genetic disorder where growths can appear throughout the body. Current treatments for these facial growths include laser surgery, cryotherapy, dermabrasion and other similar procedures that can be painful and cause scarring but can’t prevent recurrence of the lesions.The results of a clinical trial of 179 patients showed improvement in the appearance of these lesions with the use of topical rapamycin.

Authors: Mary Kay Koenig, M.D., of the University of Texas Health Science Center at Houston, and coauthors

Related Material: An author podcast also is available on the For The Media website.

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

(doi:10.1001/jamadermatol.2018.0465)

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

# # #

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

Effect of New Guideline on U.S. Adults Recommended for High Blood Pressure Treatment

Posted May 21, 2018 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 23, 2018

Media advisory: To contact corresponding author Jiang He, M.D., Ph.D., email Keith Brannon at kbrannon@tulane.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamacardiology/fullarticle/10.1001/jamacardio.2018.1240

Bottom Line: The number of U.S. adults with high blood pressure is estimated to grow by 31 million and the number of adults recommended for antihypertensive treatment would increase by 11 million under the 2017 American College of Cardiology/American Heart Association hypertension guideline.

Why The Research Is Interesting: The 2017 guideline defines high blood pressure as a blood pressure level greater than or equal to 130/80 mm Hg compared with a level greater than or equal to 140/90 mm Hg in a 2014 evidence-based guideline from a joint national committee.

Who and When: U.S. adults with hypertension or recommended for antihypertensive treatment under the 2014 and 2017 hypertension guidelines.

What (Study Measures): Estimates of the effects of the 2014 and 2017 hypertension guideline on proportions of adults defined as having high blood pressure or recommended for antihypertensive treatment, as well as reductions in CVD and deaths.

How (Study Design): An analysis of national data.

Authors: Jiang He, M.D., Ph.D., Tulane University School of Public Health and Tropical Medicine, New Orleans, and coauthors

Results:

Study Limitations: Insufficient sample size from National Health and Nutrition Examination Survey and other studies that were used to reliably estimate the effect of the new guideline within subgroups.

Study Conclusions:

Related material: The editorial, “Blood Pressure Control-Much Has Been Achieved, Much Remains to Be Done,” by Lawrence J. Fine, M.D., Dr.P.H., National Heart, Lung, and Blood Institute, Bethesda, Maryland, and coauthors, and the Editor’s Note, “The New Hypertension Guidelines,” by Clyde W.Yancy, M.D., M.Sc., and Gregg C. Fonarow, M.D., are also available on the For The Media website.

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

(doi:10.1001/jamacardio.2018.1240)

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

# # #

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

Age-Related Racial Disparity in Childhood Suicide

Posted May 17, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MAY 21, 2018

Media advisory: To contact study author Jeffrey A. Bridge, Ph.D., email Gina Bericchia at mediarelations@nationwidechildrens.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.0399

Bottom Line: Age-related racial disparity exists in suicide rates among U.S. youths.

Why The Research Is Interesting: Previous research doesn’t adequately describe the extent of age-related racial disparity in youth suicide.

Who and When: 1,661 suicide deaths among black youth and 13,341 suicide deaths among white youths in the United States from 2001 through 2015

What (Study Measures): Comparison of age-specific suicide rates between black and white youths from 2001 through 2015

Authors: Jeffrey A. Bridge, Ph.D., Center for Suicide Prevention and Research at the Research Institute at Nationwide Children’s Hospital and Ohio State University, Columbus, Ohio, and coauthors

Results:

Study Limitations: Data cannot shed light on potential reasons for the age-related racial differences

Study Conclusions: Understanding potential race-related differences in reasons for suicide among youths could help in the development of effective suicide prevention efforts for black children.

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

(doi:10.1001/jamapediatrics.2018.0399)

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

# # #

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

Introducing JAMA Network Open

Posted May 15, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MAY 18, 2018

Media advisory: To contact the authors email mediarelations@jamanetwork.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2680413

Bottom Line: Learn more about JAMA Network Open in an editorial about the new journal written by Frederick P. Rivara, M.D., M.P.H., the journal’s editor in chief, and Stephan D. Fihn, M.D., M.P.H., deputy editor.

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

# # #

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

Two Studies Examine Effect of Testing Frequency after Treatment, Surgery for Colorectal Cancer

Posted May 17, 2018 by Jim Michalski

JAMA

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

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

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

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

Who:

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

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

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

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

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

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

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

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

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

# # #

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

How Accurate is Breath Test for Diagnosis Esophagogastric Cancer?

Posted May 15, 2018 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MAY 17, 2018

Media advisory: To contact corresponding author George B. Hanna, Ph.D., email g.hanna@imperial.ac.uk. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.0991

Bottom Line: A breath analysis test to diagnose esophagogastric (esophagus or stomach) cancer showed good diagnostic accuracy in a study of 335 patients, including 172 patients already diagnosed with that cancer.

Why The Research Is Interesting: The test was used to establish the diagnostic accuracy of a previously identified set of volatile organic compounds in the breath that were abnormally regulated with the presence of esophagogastric cancer. Early esophagogastric cancer presents with nonspecific symptoms.

Authors: George B. Hanna, Ph.D., Imperial College London, England, and coauthors

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

(doi:10.1001/jamaoncol.2018.0991)

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

# # #

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

Does Vitamin D Reduce Likelihood of Wheezing in Preterm Black Infants?

Posted May 17, 2018 by Jim Michalski

JAMA

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

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

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

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

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

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

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

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

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

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

Results:

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

Study Conclusions:

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

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

(doi:10.1001/jama.2018.5729)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年5月22日，星期二，东部时间上午11点

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

维生素D是否会减少早产黑人婴儿患喘鸣的可能性？

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

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

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

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

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

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

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

研究局限：研究问卷有可能导致喘鸣分类错误。

研究结论：

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

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

Technique Shows Promise for Reconstruction of Airway Following Surgery

Posted May 17, 2018 by Jim Michalski

JAMA

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

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

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

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

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

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

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

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

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

Results:

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

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

Featured Image:

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

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

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

(doi:10.1001/jama.2018.4653)

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

# # #

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

What is Impact of Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement?

Posted May 22, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MAY 25, 2018

Media advisory: To contact corresponding study author Harindra C. Wijeysundera, M.D., Ph.D., email Katherine Nazimek at katherine.nazimek@sunnybrook.ca. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0088.

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

Bottom Line: The need for a patient to have a permanent pacemaker implanted while hospitalized after undergoing a transcatheter aortic valve replacement is a complication associated with worse survival and increased risk of more time spent in the hospital then and in the future.

Why The Research Is Interesting: Transcatheter aortic valve replacement (TAVR) is a common treatment for patients with severe narrowing of the aorta. Complications are a concern, in particular TAVR-related conduction disturbances and the need to have a permanent pacemaker implanted. Research on the impact of having a permanent pacemaker implanted has been inconsistent.

Authors: Harindra C. Wijeysundera, M.D., Ph.D., of Sunnybrook Health Sciences Centre, Toronto, Canada, and coauthors

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

(doi:10.1001/jamanetworkopen.2018.0088)

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

# # #

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

Is Wealth Late in Life Associated With Increased Dementia Risk?

Posted May 14, 2018 by Deanna Bellandi

JAMA Psychiatry

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 16, 2018

Media Advisory: To contact corresponding author Dorina Cadar Ph.D., email d.cadar@ucl.ac.uk. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/jamapsychiatry.2018.1012

Bottom Line: Levels of wealth in late life, independent of education, appeared to be associated with increased risk for dementia, suggesting that people with fewer financial resources were at higher risk, according to a study of a nationally representative sample of older English adults.

Why The Research Is Interesting: Dementia is a global health care and social challenge. Relatively few studies have used socioeconomic resources other than education to examine dementia risk. This study investigated the association of different socioeconomic markers.

Authors: Dorina Cadar, Ph.D., of University College London, and coauthors

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

(doi:10.1001/ jamapsychiatry.2018.1012)

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

# # #

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

Wide Variation in Rate of Death Between VA Hospitals for Patients with Heart Disease, Heart Failure

Posted May 14, 2018 by Jim Michalski

JAMA Cardiology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 16, 2018

Media advisory: To contact corresponding author Peter W. Groeneveld, M.D., M.S., email Jonathan Hodges at jonathan.hodges@va.gov. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamacardiology/fullarticle/10.1001/jamacardio.2018.1115

Bottom Line: Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Why The Research Is Interesting: Ischemic heart disease (IHD) and chronic heart failure (CHF) are common in the VA health care system. The risk of death is high for both conditions. Little is known about the variation between VA medical centers in outcomes of care for patients with chronic, high-risk cardiovascular conditions such as these.

Who and When: 930,079 veterans with IHD and 348,015 veterans with CHF who received inpatient or outpatient care between 2010 and 2014 at 138 VA medical centers.

What (Study Measures): Mortality rates for IHD and for CHF across the 138 medical centers (exposures); death from any cause (outcome)

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

Authors: Peter W. Groeneveld, M.D., M.S., Veterans Affairs Medical Center, Philadelphia, and coauthors

Results: Mortality rates varied across VA medical centers from 5.5 percent to 9.4 percent for IHD and 11.1 percent to 18.9 percent for CHF.

Study Limitations: Administrative data do not measure disease severity and it is possible differences in mortality rates across VA medical centers were partially caused by differences in disease severity and other factors.

Study Conclusions:

Related material: The editorial, “In Pursuit of Better Measures of Quality of Care,” by Paul Heidenreich, M.D., M.S., VA Palo Alto Health Care System, Palo Alto, California, is also available on the For The Media website.

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

(doi:10.1001/jamacardio.2018.1115)

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

# # #

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

Do Patients With TBI Receive Follow-Up Care After ED Discharge?

Posted May 22, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MAY 25, 2018

Media advisory: To contact corresponding study author Seth A. Seabury, Ph.D., email Emily Gersema at gersema@usc.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0201

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

Bottom Line: Many patients treated in the emergency department for mild traumatic brain injury (TBI) don’t receive educational materials at discharge or see clinicians for follow-up care.

Why The Research Is Interesting: Millions of people experience mild TBIs each year. While some recover completely, many have persistent symptoms that can interfere with their everyday life and may require additional medical care.

Who and When: 831 patients treated for mild TBI in emergency departments (EDs) at 11 large trauma centers; this study used data on patients enrolled from 2014 to 2016 in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study

What (Study Measures): Follow-up care was defined as hospitals providing TBI educational materials at discharge, hospitals calling patients to follow-up, and patients seeing a physician or other clinician within three months of injury

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

Authors: Seth A. Seabury, Ph.D., of the University of Southern California, Los Angeles, and coauthors

Results:

Study Limitations: Relatively small number of study sites and all were university-affiliated, which may limit generalizability of the findings; self-reported patient follow-up care

Study Conclusions:

Related Material: The invited commentary, “Mild Traumatic Brain Injury: A Clarion Call for Care of the Postconcussive Spectrum,” by Mary Iaccarino, M.D., of Harvard Medical School, Boston, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0210)

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

# # #

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

Changes in E-Cigarette Use Among U.S. Adults

Posted May 10, 2018 by Jim Michalski

JAMA

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

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

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

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

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

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

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

(doi:10.1001/jama.2018.4658)

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

# # #

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

Podcast: Outcomes of Multiple-Gene Sequencing After Diagnosis of Breast Cancer

Posted May 9, 2018 by Deanna Bellandi

Listen to an author podcast with Allison W. Kurian, M.D., M.Sc., of Stanford University, California

Chemotherapy-Induced Peripheral Neuropathy in Long-Term Survivors of Childhood Cancer

Posted May 10, 2018 by Deanna Bellandi

JAMA Neurology

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MAY 14, 2018

Media Advisory: To contact corresponding author Susanna B. Park, Ph.D., email susanna.park@sydney.edu.au. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Links will be live at the embargo time: http://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/jamaneurol.2018.0963

Bottom Line: A new study assesses chemotherapy-induced peripheral neuropathy in 121 long-term survivors of childhood cancer to detail clinical, functional, neurophysiological and patient-reported outcomes of the condition.

Why The Research Is Interesting: Childhood and adolescent cancer survival rates have improved and it’s important to understand the long-term effect of cancer treatment. Chemotherapy-induced peripheral neuropathy is a potentially long-lasting adverse effect of chemotherapy agents that can be toxic to peripheral nerves.

Authors: Susanna B. Park, Ph.D., of the University of Sydney, Australia, and coauthors

To read the full study, please visit the For The Media website.

(doi:10.1001/jamaneurol.2018.0963)

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

# # #

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

What are the Trends in Prescription Medication Use Among U.S. Children and Teens?

Posted May 10, 2018 by Jim Michalski

JAMA

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

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

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

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

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

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

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

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

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

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

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

Study Conclusions:

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

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

(doi:10.1001/jama.2018.5690)

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

# # #

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

Does Acupuncture Increase the Likelihood of a Birth in Women Undergoing In Vitro Fertilization?

Posted May 10, 2018 by Jim Michalski

JAMA

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

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

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

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

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

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

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

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

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

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

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

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

Study Conclusions:

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

(doi:10.1001/jama.2018.5336)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

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

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

针灸会增加正在接受体外受精治疗的妇女的生产几率吗？

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

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

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

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

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

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

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

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

研究结论：

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

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

Listen to a Podcast on the Association of HPV Status at Head and Neck Carcinoma Subsites with Overall Survival

Posted May 9, 2018 by Jim Michalski

An author podcast accompanies the JAMA Otolaryngology-Head & Neck Surgery study, “Association of Human Papillomavirus Status at Head and Neck Carcinoma Subsites with Overall Survival,” by Benjamin L. Judson, M.D., Yale University School of Medicine, New Haven, Connecticut, and coauthors, and is available for preview and download on this page.

Are Pharmaceutical Marketing Payments to Physicians for Opioids Associated With Prescribing?

Posted May 10, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MAY 14, 2018

Media advisory: To contact study author Scott E. Hadland, M.D., M.P.H., M.S., email Jenny Eriksen at jenny.eriksen@bmc.org. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.1999

Bottom Line: Pharmaceutical industry marketing of opioid products to physicians through nonresearch payments, which can include speaking fees and meals, was associated with greater opioid prescribing.

Why The Research Is Interesting: Many opioid-related overdose deaths involve prescription opioids, and prescription opioids can commonly be a person’s first encounter on a path to illicit use. Marketing by the pharmaceutical industry to physicians is widespread but marketing of opioids and its influence on prescribing is unclear.

What (Study Methods): Linking of two U.S databases to identify all nonresearch payments from the pharmaceutical industry to physicians marketing opioid products (excluding buprenorphine hydrochloride marketed for addiction treatment) and to gather information on all claims from physicians who wrote opioid prescriptions (initial or refill) filled for Medicare beneficiaries in 2015

Authors: Scott E. Hadland, M.D., M.P.H., M.S., of Boston Medical Center, and coauthors

Results:

Study Limitations: Possibility of reverse causation because physicians who receive industry payments may be inclined to prescribe opioids; study establishes association, not cause and effect

Study Conclusions:

Related Material: Two other studies, “Weekly and Monthly Subcutaneous Buprenorphine Depot Formulations vs. Daily Sublingual Buprenorphine with Naloxone for Treatment of Opioid Use Disorder: A Randomized Clinical Trial,” and “Association of an Opioid Standard of Practice Intervention with Intravenous Opioid Exposure in Hospitalized Patients,” also are available on the For The Media website.

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

(doi:10.1001/jamainternmed.2018.1999)

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

# # #

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

Majority of Premature Infants Still Exposed to Early Antibiotics

Posted May 22, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MAY 25, 2018

Media advisory: To contact corresponding study author Dustin D. Flannery, D.O., email Joey McCool at mccool@email.chop.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.0164

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

Bottom Line: Most premature infants, who are at risk for sepsis but who may not have a culture confirmation of infection, continue to receive early antibiotics in the first few days of life, a finding that suggests neonatal antibiotic stewardship efforts are needed to help clinicians identify infants at lowest risk for infection to avoid unnecessary antibiotic exposure.

Why The Research Is Interesting: Antibiotics are commonly used in neonatal intensive care units. Empirical (early, without culture confirmation) antibiotic therapy is frequently given to very low-birth-weight (less than 1,500 grams) infants when they are born because of their risk for sepsis combined with the clinical instability of premature infants. Previous studies suggest these antibiotics given to protect infants also are associated with potential risks.

Who and When: 40,364 very low-birth-weight infants, including 12,947 extremely low-birth-weight infants (less than 1,000 grams), who survived for at least a day at 297 hospitals between 2009-2015; the study used an administrative database

What and When (Study Measures): Antibiotics initiated within the first 3 days of age and subsequent antibiotics given for more than five days (exposures); trends over time in early antibiotic initiation and duration from 2009-2015.

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

Authors: Dustin D. Flannery, D.O., of Children’s Hospital of Philadelphia, and coauthors

Results: The majority of premature infants had early antibiotic initiation (78.6 percent of very low-birth-weight infants and 87 percent of extremely low-birth-weight infants) and rates of initiation of empirical early antibiotic therapy didn’t change over time.

Study Limitations: The database didn’t have information to compare the severity of infants’ early illness or information to identify infants with culture-confirmed infections; hospitals in the southern United States were over represented.

Study Conclusions:

Related Material: The invited commentary, “Avoiding Unnecessary Antibiotic Exposure in Premature Infants: Understanding When (Not) to Start and When to Stop,” by Matthew J. Bizzarro, M.D., of Yale University School of Medicine, New Haven, Connecticut, als0 is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0164)

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

# # #

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

Is Teledermoscopy Cost-Effective in Australia for Skin Cancer Referrals?

Posted May 7, 2018 by Deanna Bellandi

JAMA Dermatology

EMBARGOED FOR RELEASE: 11 A.M. (ET), WEDNESDAY, MAY 9, 2018

Media Advisory: To contact corresponding author Centaine L. Snoswell, B.Pharm, M.P.H., email centaine.snoswell@uqconnect.edu.au. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Link will be live at the embargo time http://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/jamadermatol.2018.0855

Bottom Line: An analysis estimates using teledermoscopy (dermatologist consultation over the internet using dermoscopic images and written information) in Australia for skin cancer referrals would cost extra per case but could achieve faster clinical resolution.

Why The Research Is Interesting: In Australia, melanoma accounts for more than 10 percent of all diagnosed and reported cancers. This study examined the cost-effectiveness of teledermoscopy for skin cancer consultations and referrals to determine its potential to improve the management of skin cancer in Australia.

Authors: Centaine L. Snoswell, B.Pharm., M.P.H., of the University of Queensland, Australia, and coauthors

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

(doi:10.1001/jamadermatol.2018.0855)

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

# # #

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

New Technique Using Computer Algorithm, 3-D Printing Shows Promise for Creating Prosthetic Nose

Posted May 8, 2018 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MAY 10, 2018

Media advisory: To contact corresponding author Christopher J. Rizzi, M.D., email Karen Warmkessel at kwarmkessel@umm.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2018.0360

Bottom Line: A computer algorithm and 3-D printer created prosthetic noses rated similar to those pictured in photographs, and the technology could be a low-cost option for temporary prostheses or models for reconstructive surgeons.

Why The Research Is Interesting: Having a prosthetic nose built can be expensive for patients who need nasal reconstruction.

Who and When: Five volunteers whose photos were processed by a computer algorithm to a create a nose model printed by a 3-D printer; 36 survey respondents with medical backgrounds who compared the nasal prostheses with photographs of volunteers’ noses in a study conducted from August to October 2016

What (Study Measures): Similarity between 3-D printed nose models and photographs of volunteers’ noses based on survey responses.

Authors: Christopher J. Rizzi, M.D., University of Maryland Medical System, Baltimore, and coauthors

Results: Nasal prostheses most often closely resembled photographs of human noses.

Study Limitations: Results are interesting but the applicability of the technique in clinical practice is unknown.

Study Conclusions:

Featured Image:

What The Image Shows: (Click on the image for a full-size version. Right click to “save image as” to download.) The use of the algorithm to create the 3-D nose model.

Related material: The commentary, “Three-Dimensional Printing of Nasal Prosthetics,” by Taha Z. Shipchandler, M.D., Indiana University School of Medicine, Indianapolis, and coauthors is also available on the For The Media website.

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

(doi:10.1001/jamaoto.2018.0360)

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

# # #

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

Free Eyeglasses Improve Student Math Scores

Posted May 8, 2018 by Deanna Bellandi

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MAY 10, 2018

Media advisory: To contact corresponding author Yaojiang Shi, Ph.D., email shiyaojiang7@gmail.com. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.1329

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: Providing free eyeglasses through a hospital-based vision center to students in rural China with poor vision helped to improve student math scores.

Why The Research Is Interesting: Many children in rural China with poor vision, mostly due to nearsightedness, don’t own or wear eyeglasses, largely because of a lack of access to vision care services.

Who and When: 2,613 children evaluated from 31 primary schools in Yongshou County, a nationally designated poor county in rural China; clinical trial conducted during 2014-2015

What (Study Interventions and Outcomes): A vision center was set up in the local government hospital of Yongshou; school-based vision screenings by teachers at the beginning of the school year identified 1,200 students with poor vision; those students received either early (in the middle of the school year) or late (at the end of school year) referral to the vision center for eye exams and free glasses as needed. All students were given a standardized math test at the beginning of the school year and the primary outcome was performance on an end-of-year math test.

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

Authors: Yaojiang Shi, PhD, Center for Experimental Economics in Education, Shaanxi Normal University, China, and colleagues.

Results: Students who got eyeglasses earlier in the school year did better on an end-of-year math test than children who got their eyeglasses later in the school year.

Study Limitations: The study included just one county in China and it did not calculate program costs or perform any other economic modeling.

Study Conclusions:

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

(doi:10.1001/jamaophthalmol.2018.1329)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年5月10日 星期四，美国东部时间上午11点

媒体咨询：联系通讯作者Yaojiang Shi, Ph.D.，请发电子邮件到shiyaojiang7@gmail.com。

免费眼镜能提高学生的数学成绩

概要: 根据《美国医学会杂志眼科学》(JAMA Ophthalmology)发表的一项研究称，通过医院眼科或视力中心为视力不佳的中国农村学生免费提供眼镜有助于提高这些学生的数学成绩。

为何对该问题感兴趣：在中国农村，有许多视力不佳的儿童，而视力不佳的原因大多是因为近视；这些儿童没有或者不戴眼镜，其主要原因是缺乏视力保健服务。

研究参与者及时间：国家认定的中国农村贫困县永寿县的31所小学的共2613名学生; 该临床试验是在2014-2015年期间进行的

研究什么（研究干预和结果）：永寿县当地政府医院设立了一个视力中心，在学年初，通过教师进行的以学校为基础的视力筛查确定了1,200名视力不佳的学生；这些学生在早期（在学年中）或后期（在学年结束时）被转诊到该视力中心进行眼科检查并根据需要免费获得了眼镜。在学年开始时，所有学生都接受了标准化的数学考试，该研究的主要结果为学年末数学考试成绩。

如何研究（研究设计）：这是一项随机临床试验（RCT）。 RCT允许对干预的真实效果做出最强有力的推论。然而，并非所有的临床试验结果都可以在现实世界中被重复，因为患者特征或其它变量可能异于其他研究的研究对象。

作者：Yue Ma, PhD, 陕西师范大学教育实验经济研究所，以及共同作者。

研究结果：与在学年后期获得眼镜的学生相比，在学年早期获得眼镜的学生在学年末数学考试中的成绩更好。

研究局限：该研究仅包括中国的一个县，而且没有计算上述计划的成本，也没有涉及任何其它经济模型。

研究结论：

研究意义 以县为基础的视力中心是解决中国农村视力保健问题以及提高学生成绩的一个有效途径。

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

Are Psychological Interventions Associated With Chronic Pain Outcomes?

Posted May 3, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MAY 7, 2018

Media advisory: To contact study author M. Carrington Reid, M.D., Ph.D., email Jennifer Gundersen at jeg2034@med.cornell.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.0756

Bottom Line: Psychological interventions to treat chronic pain in older adults were associated with some small benefits.

Why The Research Is Interesting: Chronic pain not caused by cancer is a common condition in older adults and its management is complicated by a number of factors, including age-related physiologic changes and coexisting conditions. An ongoing opioid crisis means there is increased attention on nonpharmacologic therapies for chronic pain that use cognitive behavioral therapy approaches.

Who and When: 22 studies with 2,608 participants; included studies used a randomized trial design and evaluated a psychological intervention that used cognitive behavioral approaches alone or in combination with another strategy

What (Study Measures): Pain intensity was the main outcome; other outcomes included catastrophizing beliefs and self-efficacy (the belief you can succeed) in managing pain, pain interference, depressive symptoms, anxiety, physical function and health.

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

Results:

Study Limitations: Limited to English-language studies; few studies evaluated outcomes more than six months after treatment was completed so long-term effects remain poorly understood

Study Conclusions: Efforts are needed to develop and test psychological interventions that have better and more sustainable treatment effects for managing chronic pain in older adults.

Related Material: An author podcast also is available on the For The Media website.

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

(doi:10.1001/jamainternmed.2018.0756)

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

# # #

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

Crowdfunding Campaigns for Unproven Stem Cell-Based Interventions often Underemphasize Risks, Exaggerate Effectiveness

Posted May 3, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 8, 2018

Media advisory: To contact corresponding author Jeremy Snyder, Ph.D., email Ian Bryce at ian_bryce@sfu.ca. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.3057

Bottom Line: Crowdfunding campaigns by patients to raise money to pay for unproven stem cell treatments not covered by insurance often underemphasize risks and exaggerate the effectiveness of these treatments.

Why The Research Is Interesting: Insurers typically won’t pay for unproven stem cell treatments so patients must pay out-of-pocket or fundraise to get the money, often turning to online social networks to solicit donations in crowdfunding. Crowdfunding raises questions about how benefits and risks of the treatment are depicted in solicitations for money.

What and When: 408 crowdfunding campaigns for stem cell interventions as of December 2017 on two charitable crowdfunding platforms

Study Measures: Amount of funding, donors, share on social media and statements about the perceived risks and effectiveness of these interventions.

Authors: Jeremy Snyder, Ph.D., Simon Fraser University, Burnaby, British Columbia, Canada and coauthors

Results: The 408 crowdfunding campaigns sought more than $7.4 million and received pledges of about $1.4 million from 13,050 donors.

Of the 408 campaigns:

Study Limitations: The study likely underestimated the number of crowdfunding campaigns for stem cell interventions

Study Conclusions:

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

(doi:10.1001/jama.2018.3057)

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

# # #

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

Is Dementia Risk Increased Among Veterans After Mild TBI Without Loss of Consciousness?

Posted May 3, 2018 by Deanna Bellandi

JAMA Neurology

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, MAY 7, 2018

Media Advisory: To contact author Kristine Yaffe, M.D., email Suzanne Leigh at Suzanne.Leigh@ucsf.edu. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Links will be live at the embargo time: http://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/jamaneurol.2018.0815

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: Traumatic brain injury (TBI), even mild TBI without a loss of consciousness, was associated with increased risk for dementia in a study of more than 350,000 U.S. veterans.

Why The Research Is Interesting: TBI is common among veterans and civilians. In the military, TBI can be caused by shock waves from blasts, as well as blunt force, and it may not result in a loss of consciousness. Moderate and severe TBIs have previously been associated in some studies with increased dementia risk but an association between dementia and mild TBI, especially without an accompanying loss of consciousness, has been unclear.

Who and When: 178,779 patients diagnosed with TBI in the Veterans Health Administration health care system from 2001 to 2014 and an equal number of veterans without TBI for comparison

What (Study Measures): Dementia diagnosis

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

Authors: Deborah Barnes, Ph.D., M.P.H., and Kristine Yaffe, M.D., of the Veterans Health Care System, San Francisco, and the University of California, San Francisco, and coauthors

Results:

Even after accounting for medical and psychiatric coexisting conditions, the risk for dementia was increased for mild TBI without a loss of consciousness (LOC), mild TBI with LOC, mild TBI when it was unknown if there was LOC, and for moderate to severe TBI.

Study Limitations: The study used medical record databases based on clinician diagnoses, which may not reflect consensus definitions for TBI or dementia.

Study Conclusions:

Related Material: The editorial, “Risk of Dementia Outcomes Associated With Traumatic Brain Injury During Military Service,” by Kimbra Kenney, M.D., of the Uniformed Services University of the Health Services, Bethesda, Maryland, and Ramon Diaz-Arrastia, M.D., Ph.D., of the University of Pennsylvania Perelman School of Medicine, Philadelphia, also is available on the For The Media website.

To read the full study, please visit the For The Media website.

(doi:10.1001/jamaneurol.2018.0347)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年5月7日 星期一，美国东部时间上午11点

媒体咨询：联系通讯作者Deborah Barnes, Ph.D., M.P.H.，请发电子邮件到Jeremy Profitt Jeremy.Profitt@va.gov。

遭受无意识丧失的轻度创伤性脑损伤的退伍军人患痴呆的风险会增加吗？

概要: 根据《美国医学会杂志神经学》(JAMA Neurology)发表的一项研究，在一项超过350,000名美国退伍军人参加的研究中，创伤性脑损伤（TBI），即使是没有意识丧失的轻度创伤性脑损伤，也与痴呆风险的增加有关联。

为何对该问题感兴趣：TBI在退伍军人和平民中很常见。在军队中，TBI可能是由爆炸产生的冲击波,而不是直接的冲击力,造成的，并且可能不会导致意识丧失。之前的一些研究显示中度和重度TBI与痴呆风险增加有关联，但目前尚不清楚痴呆是否与轻度TBI之间有关联，特别是当没有意识丧失时。

研究参与者及时间：从2001年到2014年，经退伍军人健康管理局的医疗保健系统诊断为TBI的178,779名患者，以及进行比较的同等数量的没有TBI的退伍军人

研究什么（研究内容）：痴呆诊断

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

作者：Deborah Barnes, Ph.D., M.P.H., 退伍军人医疗保健系统，旧金山，和加州大学旧金山分校，以及共同作者

研究结果：

TBI退伍军人与痴呆：10,835 (6.1%)
非TBI退伍军人与痴呆：4,698 (2.6%)

即使考虑到医学和精神疾病共存的情况，无意识丧失（LOC）的轻度TBI，伴有LOC的轻度TBI，LOC未知的轻度TBI，以及中度至重度TBI都会导致痴呆的风险增加。

研究局限：该研究使用基于临床医生诊断的医疗记录数据库，这可能与TBI或痴呆的共识的定义并不完全一致。

研究结论：

结论和相关性：在这个包括350，000退伍军人的定群研究中，即使无意识丧失（LOC）的轻度TBI也与高于2倍的痴呆风险的增加有关联。因此迫切的需要研究退伍军人中与TBI相关的痴呆的治病机理，预防以及治疗。

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

USPSTF Recommendation Statement on Screening for Prostate Cancer

Posted May 3, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 8, 2018

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

Want to embed a link to this report in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.3710

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) recommends that men 55 to 69 who are interested in screening talk to their doctors about potential benefits and harms of screening for prostate cancer before deciding whether to undergo periodic prostate-specific antigen (PSA)-based screening. The USPSTF recommends against PSA-based screening for men 70 and older.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. This latest statement is an update of the 2012 recommendation. Prostate cancer is one of the most common types of cancer that affects men. Many men with prostate cancer never experience symptoms and, without screening, would never know they have the disease.

The USPSTF Concludes:

Related material

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

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

— A podcast interview with Alex H. Krist, M.D., M.P.H., a member of the USPSTF and co-author of the recommendation statement. The transcript is available here.

— Screening for Prostate Cancer – US Preventive Services Task Force Recommendation Statement

— Prostate-Specific Antigen–Based Screening for Prostate Cancer – Evidence Report and Systematic Review for the US Preventive Services Task Force

— JAMA Oncology editorial: Prostate Cancer Screening—A New Recommendation for Meaningful Physician-Patient Conversations

— JAMA Surgery editorial: USPTF Prostate Cancer Screening Recommendations— A Step in the Right Direction

— JAMA Internal Medicine editorial: Implications of the New USPSTF Prostate Cancer Screening Recommendation—Attaining Equipoise

— JAMA editorial: Prostate-Specific Antigen (PSA) Screening for Prostate Cancer – Revisiting the Evidence

— JAMA Patient Page: Screening for Prostate Cancer

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

(doi:10.1001/jama.2018.3710)

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

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年5月8日 星期二，美国东部时间上午11点

媒体咨询：联系美国预防服务工作组（U.S. Preventive Services Task Force），请发电子邮件到媒体协调员Newsroom@USPSTF.net 或打电话（202-572-2044）联系。

USPSTF关于筛查前列腺癌的建议声明

概要: 美国预防服务工作组（USPSTF）建议有兴趣筛查的55至69岁的男性在决定是否接受基于前列腺特异性抗原（PSA）的定期筛查之前，与其医生讨论筛查前列腺癌的潜在的益处和危害。根据《美国医学会杂志》（JAMA）发表的一份报告，USPSTF建议不要对70岁及以上的男性进行基于PSA的筛查。

背景资料：USPSTF经常就各种预防保健服务的有效性提出建议。这一最新声明是对2012年建议的更新。前列腺癌是影响男性的最常见的癌症类型之一。许多患有前列腺癌的男性从未出现过症状，如果没有筛查，可能永远也不会知道自己患有这种疾病。

USPSTF结论：

对于55至69岁的男性，决定定期进行基于PSA的前列腺癌筛查应该是个人的决定，并且应该事先与临床医生讨论该筛查的潜在的益处和危害。筛查可能会为减少某些男性患前列腺癌的机会提供一个不大的潜在好处。然而，许多男性会经历该筛查的潜在危害，包括假阳性结果，其需要额外的测试和可能的前列腺活检; 过度诊断和过度治疗; 以及治疗并发症，如失禁和勃起功能障碍等。在确定该筛查是否适用于某个个体时，患者和临床医生应考虑其家族史，种族/民族，共存的疾病状况，病人对筛查的益处，危害以及治疗导致的结果的评价，以及其它健康需要等。临床医生不应该对没有筛查意愿的男性进行筛查（C建议）。USPSTF建议不要对70岁及以上的男性进行基于PSA的前列腺癌筛查（D建议）。

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

Video embed code:

<div style="display: block; position: relative; max-width: 300px;"><div style="padding-top: 50%;"><iframe src="//players.brightcove.net/864352215001/default_default/index.html?videoId=5756384697001" allowfullscreen webkitallowfullscreen mozallowfullscreen style="width: 100%; height: 100%; position: absolute; top: 0px; bottom: 0px; right: 0px; left: 0px;"></iframe></div></div>

Antithrombotic Therapy in Patients With Atrial Fibrillaton Before, After Stroke

Posted May 15, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MAY 18, 2018

Media advisory: To contact corresponding study author Anna Gundlund, M.D., email annagundlund@gmail.com. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2680419

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

Bottom Line: Oral anticoagulation therapy after stroke in patients with atrial fibrillation was associated with lower risk for recurrent blood vessel-blocking blood clots.

Why The Research Is Interesting: Patients with atrial fibrillation (abnormal heart rhythm) are at increased risk of ischemic stroke and oral anticoagulation therapy (OAC) can reduce that risk. Underse of OAC has been reported in both Europe and the United States.

Who and When: 30,626 Danish patients with atrial fibrillation admitted with ischemic stroke (when a blood clot blocks a blood vessel to the brain)

What (Study Measures): Patients who survived 100 days after discharge were divided into three groups according to poststroke antithrombotic therapy (OAC, antiplatelet therapy alone or no antithrombotic therapy) with data on hospital admission, prescription fillings and vital status coming from nationwide registries (exposures); thromboembolic events (blood vessel-blocking blood clots) and bleeding complications across the three groups (outcomes)

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

Authors: Anna Gundlund, M.D., of Herlev and Gentofte Hospital, Denmark, and coauthors

Results:

Study Limitations: Registries didn’t include factors such as alcohol consumption or fall tendency; possible misclassification of ischemic stroke; results may have been skewed by patient compliance with medications; all types of AF included in study, which could have influenced physician’s choice of antithrombotic therapy

Study Conclusions:

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

(doi:10.1001/jamanetworkopen.2018.0171)

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.

# # #

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

Is Prognosis Poor for Breast Cancer Diagnosed After Negative Screening Mammography?

Posted April 30, 2018 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, MAY 3, 2018

Media advisory: To contact corresponding author Anne Marie McCarthy, Ph.D., email Katie Marquedant at kmarquedant@mgh.harvard.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.0352

Bottom Line: A study of mammography data for more than 300,000 women suggests cases of breast cancer diagnosed after a negative screening mammogram were more likely to be associated with poor prognosis than those cancers diagnosed after a positive screening mammogram.

Why The Research Is Interesting: The rate of breast cancer after negative mammography results is small but the likelihood these cases can be associated with poor prognosis highlights the need for early detection.

Authors: Anne Marie McCarthy, Ph.D., of Massachusetts General Hospital and Harvard Medical School, Boston, and coauthors

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

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

(doi:10.1001/jamaoncol.2018.00)

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

# # #

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

Can an Algorithm Detect Signs of a Serious Eye Disease in Premature Infants Like Human Experts?

Posted April 30, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 10:30 P.M. (ET), WEDNESDAY, MAY 2, 2018

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

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.1934

Bottom Line: An algorithm could detect signs of a serious eye disease in images from premature infants with accuracy comparable to or better than human experts.

Why The Research Is Interesting: Retinopathy of prematurity (ROP) is a leading cause of childhood blindness worldwide. The decision to treat is primarily based on the presence of plus disease, which is when retinal vessels are dilated and twisted. However, clinical diagnosis of plus disease can be highly subjective and variable.

What and When: A machine learning algorithm was trained to diagnose plus disease using 5,511 retinal photographs. Data were collected from July 2011 to December 2016 and analyzed from December 2016 to September 2017.

Study Measures: The algorithm to detect plus disease was tested on an independent set of 100 images against eight ROP experts.

Authors: Michael F. Chiang, M.D., Oregon Health and Science University, Portland, Jayashree Kalpathy-Cramer, Ph.D., Massachusetts General Hospital, Boston, and coauthors

Results: The algorithm diagnosed plus disease with comparable or better accuracy than human ROP experts.

Study Limitations: Algorithms in artificial neural networks are only as good as the data on which they are trained. It is unknown how factors such as image quality, resolution, different camera systems and field of view may affect the output of these deep learning systems.

Study Conclusions:

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

(doi:10.1001/jamaophthalmol.2018.1934)

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

# # #

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

Psychiatric Diagnoses and Medication Use in Children Insured by Medicaid

Posted April 26, 2018 by Deanna Bellandi

JAMA Pediatrics

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 30, 2018

Media advisory: To contact study author Dinci Pennap, M.P.H., email Patricia Fanning at pfanning@umaryland.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2018.0240

Bottom Line: Young children insured by Medicaid with a psychiatric diagnosis had early and prolonged exposure to psychotropic medications.

Why The Research Is Interesting: Treated psychiatric diagnoses and the use of psychotropic medications has increased in the pediatric population amid concerns of off-label prescription of medication use (not approved by the U.S. Food and Drug Administration). The short- and long-term effects of early exposure to complex combinations of medications are unknown.

Who and When: Medicaid claims data for 35,244 children born in a mid-Atlantic state in 2007 and followed up through 2014

What (Study Measures): Mental health treatments from birth through age 7 (exposures); cumulative incidence (frequency over time) of a first psychiatric diagnosis and psychotropic medication use from birth through age 7 and duration of medication use (outcomes)

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

Authors: Dinci Pennap, M.P.H., and Julie Zito, Ph.D., of the University of Maryland, Baltimore, and coauthors

Results:

Study Limitations: Medicaid data from one state; study captured medication dispensed not consumed; but longitudinal (over time) analysis of one group of children assessed across eight years permitted a cumulative assessment of outcomes

Study Conclusions: The study highlights the need for safety and outcomes research after initiating psychotropic medication use in very young populations of children, particularly for health outcomes.

Related Material: An editor article review podcast with Aaron E. Carroll, M.D., M.S., JAMA Pediatrics digital media editor, also is available on the For The Media website. The transcript is available here.

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

(doi:10.1001/jamapediatrics.2018.0240)

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.

# # #

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

Do Women With Epilepsy Have Similar Likelihood of Pregnancy?

Posted April 26, 2018 by Deanna Bellandi

JAMA Neurology

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 30, 2018

Media Advisory: To contact corresponding author Page B. Pennell, M.D., email Johanna Younghans at jyoughans@bwh.harvard.edu. The full study is available on the For The Media website.

To place an electronic embedded link in your story: Links will be live at the embargo time: http://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/jamaneurol.2018.0646

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: Women with epilepsy without a history of infertility or related disorders who wanted to become pregnant were about as likely as their peers without epilepsy to become pregnant. In an observational study of 89 women with epilepsy and 108 without, 60.7 percent of the women with epilepsy achieved pregnancy compared with 60.2 percent of women without epilepsy. They also had similar pregnancy outcomes with regard to live births and low rates of miscarriages.

Why The Research Is Interesting: Previous research suggests lower birth rates for women with epilepsy but they don’t differentiate between the biological and social factors that might contribute.

Authors: Page B. Pennell, M.D., of Brigham and Women’s Hospital, Boston, and coauthors

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

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

(doi:10.1001/jamaneurol.2018.0646)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年4月30日 星期一，美国东部时间上午11点

媒体咨询：联系通讯作者Page B. Pennell, M.D.，请发电子邮件到Johanna Younghans jyoughans@bwh.harvard.edu。

患有癫痫的女性是否有类似的怀孕几率？

概要: 没有不孕或相关疾病历史而想要怀孕的、患有癫痫的女性与类似的、未患有癫痫的女性相比具有相同的怀孕几率。根据《美国医学会杂志神经学》(JAMA Neurology) 发表的一项研究，该对89名患有癫痫的女性以及108名未患有癫痫的女性进行的观察性研究显示，60.7％的患有癫痫的女性成功怀孕；60.2％未患癫痫的女性成功怀孕。

为何对该问题感兴趣：以前的研究显示患有癫痫的女性具有较低的出生率，但这些患有癫痫的女性在可能导致该现象的生物和社会因素上并没有差异。

作者：Page B. Pennell, M.D., 布里格姆妇女医院，波士顿，以及共同作者

研究设计：这是一项观察性研究。研究人员不会为研究目的而进行干预，研究人员不能控制可以用来解释研究结果的各种自然差异。

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

Coverage Gains After ACA for Asian Americans, Native Hawaiians and Pacific Islanders

Posted April 26, 2018 by Deanna Bellandi

JAMA Internal Medicine

EMBARGOED FOR RELEASE: 11 A.M. (ET), MONDAY, APRIL 30, 2018

Media advisory: To contact study author John J. Park, M.B.Ch.B., M.P.H., email Todd Datz at tdatz@hsph.harvard.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.1476

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: Health insurance coverage gains were associated with all major racial groups following the Affordable Care Act and coverage disparities between whites and Asian Americans, Native Hawaiians and Pacific Islanders were essentially eliminated, according to a research letter based on national survey data.

Why The Research Is Interesting: Research has documented coverage gains for most major racial/ethnic populations but little attention as been paid to Asian Americans, Native Hawaiians and Pacific Islanders, who represent more than 50 ethnicities and speak 100 languages.

Authors: John J. Park, M.B.Ch.B., M.P.H., of the Harvard T.H. Chan School of Public Health, Boston, and coauthors.

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

(doi:10.1001/jamainternmed.2018.1476)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年4月30日 星期一，美国东部时间上午11点

媒体咨询：联系研究作者John J. Park, M.B.Ch.B., M.P.H.，请发电子邮件到Todd Datz tdatz@hsph.harvard.edu。

亚裔美国人，夏威夷原住民和太平洋岛民在“平价医疗法案”ACA实施后保险覆盖率有所提高

概要: 根据《美国医学会杂志内科学》(JAMA Internal Medicine)发表的一个基于全国调查数据的研究文章，在“平价医疗法案”(the Affordable Care Act)实施后，所有主要种族群体的健康保险覆盖率均有所增加，而白人与亚裔美国人，夏威夷原住民与太平洋岛民之间的覆盖率差异被基本消除。

为何对该问题感兴趣：以前的研究记录了大多数主要种族/民族人群的覆盖率增加，但对代表50多个民族并使用近100种语言的亚裔美国人，夏威夷原住民和太平洋岛民的关注很少。

作者：John J. Park, M.B.Ch.B., M.P.H., 哈佛T.H. Chan公共卫生学院，波士顿，以及共同作者

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

Rapid Increase of Synthetic Opioids Involved in Drug Overdose Deaths

Posted April 26, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, MAY 1, 2018

Media advisory: To contact corresponding author Christopher M. Jones, Pharm.D., M.P.H., email Chris Garrett at Christopher.Garrett@samhsa.hhs.gov. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.2844

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

本篇新闻发布稿件备有翻译版本：以下内容为中文简体翻译版本

Bottom Line: Synthetic opioids (such as illicit fentanyl) overtook prescription opioids in 2016 as the most common drug class involved in overdose deaths in the United States.

Why The Research Is Interesting: Drug overdose deaths are at unprecedented levels in the United States. Prescription opioids have been the most common drug involved in overdose deaths, but heroin and synthetic opioids are increasingly involved in overdoses.

What and When: Mortality data based on death certificates for 2010-2016

Study Measures: Number of synthetic opioid-involved overdose deaths by year for 2010 through 2016; overdose deaths involving psychotherapeutic and illicit drugs in which synthetic opioids were involved in the death; and synthetic opioid overdose deaths in 2016 also involving drugs or alcohol

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

Authors: Christopher M. Jones, Pharm.D., M.P.H., Substance Abuse and Mental Health Services Administration, Rockville, Maryland, and coauthors

Results:

Study Limitations: An estimated 15 percent to 25 percent of death certificates didn’t specify the type of drug involved in the overdose so the numbers reported are likely underestimates.

Study Conclusions: A lack of awareness about the potency of synthetic opioids, their availability and the increasing adulteration of the illicit drug supply poses substantial risks to individual and public health.

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

(doi:10.1001/jama.2018.2844)

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

# # #

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

Translation in Simplified Chinese

中文简体翻译版本

禁止提前报道指令解除时间：2018年5月1日 星期二，美国东部时间上午11点

媒体咨询：联系通讯作者Christopher M. Jones, Pharm.D., M.P.H.，请发电子邮件到Chris Garrett Christopher.Garrett@samhsa.hhs.gov。

合成阿片类药物的快速增加与药物过量死亡有关

概要: 根据《美国医学会杂志》(JAMA)发表的一项研究，合成阿片类药物（如非法芬太尼）在2016年超过了处方阿片类药物成为导致美国药物过量服用死亡的最常见的药物类别。

为何对该问题感兴趣：美国的药物过量服用死亡人数空前高涨。处方阿片类药物是导致药物过量服用死亡的最常见的药物，但海洛因和合成阿片类药物所占比重越来越高。

研究项目及时间：2010 – 2016年间基于死亡证明的死亡率数据

研究内容：2010至2016年间的每年由合成阿片类药物导致的药物服用过量死亡人数；包括合成阿片类药物的由心理治疗药物和非法药物导致的药物过量服用死亡人数；以及2016年涉及药物或酒精的合成阿片类药物导致的药物服用过量死亡。

如何研究（研究设计）：这是一项数据分析研究。

作者：Christopher M. Jones, Pharm.D., M.P.H., 美国药物滥用及心理健康服务管理局，马里兰州罗克维尔，以及共同作者

研究结果：

在2016年与阿片类药物相关的42,249例药物过量服用死亡事件中，19,413例涉及合成阿片类药物，17,087例涉及处方类阿片，15,469例涉及海洛因
2016年合成阿片类药物与9％的阿片类药物相关死亡事件有关，而2010年仅为14.3％
2016年合成阿片类药物过量服用死亡人数中有7％还涉及另一种药物或酒精

研究局限：据估计，15％到25％的死亡证书没有明确所涉及的过量药物的类型，因此所报告的数字可能被低估。

研究结论：缺乏对合成阿片类药物效力的明确认识，以及其可获得性和非法药物供应的增加对个人和公共健康构成重大风险。

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

Clinical Trial Supports Chiropractic Care as Component of Care for Low Back Pain

Posted May 15, 2018 by Deanna Bellandi

JAMA Network Open

EMBARGOED FOR RELEASE: 11 A.M. (ET), FRIDAY, MAY 18, 2018

Media advisory: To contact corresponding study author Christine M. Goertz, D.C., Ph.D., email James O’Connor at james.oconnor@palmer.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Links will be live at the embargo time https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2680417

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

Bottom Line: U.S military personnel with low back pain who received usual medical care plus chiropractic care reported moderate improvement in their pain intensity and disability compared with patients who received usual medical care alone.

Why The Research Is Interesting: Low back pain is one of the most common reasons service members in the U.S. military seek medical care. Common therapies for low back pain include nonsteroidal anti-inflammatory drugs, opioids, spinal fusions and edpidural steroid injections. An opioid crisis in the United States has created an urgent need to evaluate cost-effective and low-risk nonpharmacological treatments for low back pain. One of those options is chiropractic care.

Who and When: 750 active-duty U.S. service members enrolled in a clinical trial at three military sites (250 at each site) conducted from September 2012 to February 2016

What (Study Interventions and Measures): Usual medical care (self-care, medications, physical therapy and pain clinic referral) or usual medical care plus chiropractic care (spinal manipulation in the low back and adjacent areas plus additional procedures such as rehabilitative exercise, cryotherapy, superficial heat and other manual therapies) over six weeks (interventions); low back pain intensity and disability scores (main outcomes)

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

Authors: Christine M. Goertz, D.C., Ph.D., formerly of Palmer College of Chiropractic and now with Spine IQ (The Spine Institute for Quality), Davenport, Iowa, and coauthors

Results:

Study Limitations: Differences in participant characteristics, treatments received and outcomes across sites, as well as a short follow-up

Study Conclusions: Changes in pain intensity and disability reported by U.S. military personnel in this clinical trial that supports usual medical care plus chiropractic care for low back pain are consistent with existing literature on spinal manipulation therapy in both military and civilian populations.

Related Material: The invited commentary, “Innovating to Improve Care for Low Back Pain in the Military: Chiropractic Care Passes Muster,” by Daniel C. Cherkin, M.A., Ph.D., emeritus senior scientific investigator, Kaiser Permanente Washington Health Research Institute, Seattle, also is available on the For The Media website.

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

(doi:10.1001/jamanetworkopen.2018.0105)

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

# # #

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

Hearing Aid Use Associated with Lower Likelihood of Hospitalization, Emergency Department Visit

Posted April 24, 2018 by Jim Michalski

JAMA Otolaryngology-Head & Neck Surgery

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, APRIL 26, 2018

Media advisory: To contact corresponding author Elham Mahmoudi, Ph.D., email Kara Gavin at kegavin@med.umich.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2018.0273

Bottom Line: Older adults with hearing loss who used hearing aids were less likely to be hospitalized or have an emergency department visit and they had lower total Medicare costs, although their out-of-pocket health care expenses were higher.

Why The Research Is Interesting: Hearing loss is estimated to affect two-thirds of adults older than 70 years and is associated with worse communication with health care professionals, which can adversely affect health outcomes. Hearing aids, while helpful, are not covered by Medicare.

Who and When: Data for 1,336 adults 65 years or older with hearing loss from 2013-2014

What (Study Measures): Use of a hearing aid (exposure); total health care, Medicare, and out-of-pocket spending; any emergency department (ED), inpatient, and office visit; and number of ED visits, nights in hospital, and office visits (outcomes)

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

Authors: Elham Mahmoudi, Ph.D., University of Michigan, Ann Arbor, and coauthors

Results: Use of a hearing aid (602 adults) was associated with:

Study Limitations: Study data were from a self-reported survey and researchers had no objective measure of individual hearing loss; researchers also could not control for the type and number of hearing aids people reported using or how consistently they were used

Study Conclusions:

Related material: The commentary, “Hearing Aid Use and Health Care Costs Among Older Adult,” by Margaret I. Wallhagen, Ph.D., G.N.P.-B.C., University of California, San Francisco is also available on the For The Media website.

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

(doi:10.1001/jamaoto.2018.0273)

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

# # #

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

2 Studies, Editorial Report on Cancer Risk for Firefighters at World Trade Center Disaster

Posted April 24, 2018 by Deanna Bellandi

JAMA Oncology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, APRIL 26, 2018

Media advisory: To contact corresponding author Ola Landgren, M.D., Ph.D., email Rebecca Williams at williamr@mskcc.org and to contact Rachel Zeig-Owens, Dr.P.H., email Frank Gribbon at Francis.Gribbon@fdny.nyc.gov. The full studies are available on the For The Media website.

Want to embed a link to these studies in your story? Links will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.0504 and http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.0509

Bottom Line: Two studies and a related editorial report on cancer risk for firefighters with the Fire Department of the City of New York (FDNY) exposed to the wreckage of the World Trade Center during rescue and recovery work following the attacks on September 11, 2001.

Why The Research Is Interesting: The wreckage of the World Trade Center created environmental exposures to known and suspected carcinogens.

Who:

Rachel Zeig-Owens, Dr.P.H., of the FDNY World Trade Center Health Program, New York, and coauthors report on the “Estimation of Future Cancer Burden Among Rescue and Recovery Workers Exposed to the World Trade Center Disaster.” This study projected new cancer cases over 20 years among a group of 14,474 FDNY rescue and recovery workers exposed to the World Trade Center disaster site. Estimates suggest 2,960 new cases of cancer (including more prostate, thyroid and melanoma cancers) among these rescue and recovery workers between 2012-2031, which is greater than would be expected in a population that is similar demographically. Among white men in the group, 2,714 new cancers were estimated compared with 2,596 in a comparison group.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.0504

Ola Landgren, M.D., Ph.D., of Memorial Sloan Kettering Cancer Center, New York, and coauthors report on “Multiple Myeloma and its Precursor Disease Among Firefighters Exposed to the World Trade Center Disaster.” In a case series, the authors describe firefighters exposed to the World Trade Center disaster site who were later diagnosed with the blood cancer multiple myeloma and they also conducted a screening study of precursor disease for multiple myeloma. There were 16 firefighters diagnosed with multiple myeloma among a group of 12,942 exposed firefighters; exposure to the World Trade Center disaster site appeared to be associated with precursor disease of multiple myeloma.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.0509

Otis W. Brawley, M.D., M.Sc., of the American Cancer Society and Emory University, Atlanta, wrote an accompanying editorial, “Some Thoughts on Exposure to the World Trade Center Wreckage and Cancer.” In it, Brawley writes: “The predicted increases in cancers of the prostate, thyroid, and myeloma are interesting. Excess incidence and mortality for these cancers have been previously reported in firefighters from other cities. Are the predicted increases due
to WTC [World Trade Center] exposure or a career as a firefighter?”

Want to embed a link to these studies in your story?: Links will be live at the embargo time http://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2018.0498

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

(doi:10.1001/jamaoncol.2018.0504 (Zeig-Owens); doi:10.1001/jamaoncol.2018.0097 (Landgren); doi:10.1001/jamaoncol.2018.0498 (Brawley)

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

# # #

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

Did Eating Dark Chocolate Improve Vision?

Posted April 24, 2018 by Jim Michalski

JAMA Ophthalmology

EMBARGOED FOR RELEASE: 11 A.M. (ET), THURSDAY, APRIL 26, 2018

Media advisory: To contact corresponding author Jeff C. Rabin, O.D., M.S., Ph.D., email Margaret Garcia at mlgarci2@uiwtx.edu. The full study is available on the For The Media website.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2018.0978

Bottom Line: A small study found slight improvement in vision after eating dark chocolate.

Why The Research Is Interesting: Eating dark chocolate has been associated with better blood flow, mood and cognition in the short term but little is known about its possible effects on vision.

Who and When: 30 participants; testing was conducted from June to August 2017

What (Study Interventions and Outcomes): Eating a dark or milk chocolate bar (intervention); visual acuity and the ability to read letters of different sizes and contrast (lighter vs. darker letters) were measured about two hours after eating chocolate (outcomes)

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

Authors: Jeff C. Rabin, O.D., M.S., Ph.D., University of the Incarnate Word Rosenberg School of Optometry, San Antonio, and coauthors

Results:

Study Limitations: How long the effect on vision might last is unknown.

Study Conclusions: Real-world effects on vision of eating chocolate need to be tested.

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

(doi:10.1001/jamaophthalmol.2018.0978)

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

# # #

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

Use of Two Anti-Clotting Medications Following Bypass Surgery Improves Outcomes for Grafted Veins

Posted April 19, 2018 by Jim Michalski

JAMA

EMBARGOED FOR RELEASE: 11 A.M. (ET), TUESDAY, APRIL 24, 2018

Media advisory: To contact corresponding author Qiang Zhao, M.D., Ph.D., email zq11607@rjh.com.cn. The full study is available on the For The Media website.

Want to embed a link to this report in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.3197

Bottom Line: Taking aspirin plus an anti-clotting medication for one year after heart bypass surgery resulted in less narrowing of the vein used to bypass a blocked artery than taking aspirin alone.

Why The Research Is Interesting: Previous data have shown that the rate of failure of a graft of a saphenous vein (a vein from the leg) was approximately 15% to 20% within one year after coronary artery bypass grafting (CABG) surgery and was associated with worse long-term outcomes. Antiplatelet (anti-clotting) therapy with aspirin improves vein graft patency (less narrowing, blockage of the vein). The effect of the anti-clotting drug ticagrelor with or without aspirin on grafted saphenous veins in patients undergoing CABG is unknown.

Who and When: 500 patients who underwent CABG were enrolled in a randomized clinical trial in 2014 and 2015, with final follow-up in early 2017.

What (Study Interventions and Outcomes): Within 24 hours after CABG, 168 patients received ticagrelor (twice daily) and aspirin (once daily); 166 patients received ticagrelor (twice daily); 166 patients received aspirin (once daily) (interventions); patency of the grafted vein (less than 50% narrowing) one year after CABG (outcome)

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

Authors: Qiang Zhao, M.D., Ph.D., Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China and coauthors

Results:

Study Limitations: The trial was designed specifically to examine saphenous vein graft patency so the results cannot be generalized to include arterial grafts. The trial was not equipped to identify a significant effect on the incidence of major adverse cardiac events or other secondary and bleeding outcomes.

Study Conclusions:

Related material: The editorial, “Ticagrelor Following Coronary Artery Bypass Grafting,” by John H. Alexander, M.D., M.H.S., of Duke University Medical Center, Durham, North Carolina, is also available on the For The Media website.

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

(doi:10.1001/jama.2018.3197)

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

# # #

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