Late-Stage Cancer End Points to Speed Cancer Screening Clinical Trials —Not So Fast
In this issue of JAMA, Feng et al studied whether late-stage cancer (ie, stage III or stage IV cancer), rather than cancer-specific mortality, was an acceptable alternative end point in clinical trials of cancer screening. The authors analyzed 41 clinical trials conducted in Europe, North America, and Asia, combining the data overall and according to cancer type. They evaluated the association between incidence of stage III-IV cancer and cancer-specific mortality in and across the selected studies. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 7, 2024 Category: General Medicine Source Type: research

Cancer Stage Compared With Mortality as End Points in Randomized Clinical Trials of Cancer Screening
This meta-analysis of 41 randomized clinical trials of cancer screening compares cancer-specific mortality with stage III-IV cancer as end points. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 7, 2024 Category: General Medicine Source Type: research

Prostate-Specific Antigen Screening and 15-Year Prostate Cancer Mortality
This secondary analysis of a randomized clinical trial assesses whether screening for prostate-specific antigen reduces prostate cancer mortality at 15-year follow-up. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 6, 2024 Category: General Medicine Source Type: research

A Pragmatic Approach to Prostate Cancer Screening
The introduction of prostate-specific antigen (PSA) –based screening for prostate cancer in the early 1990s was followed by a nearly 2-decade long decline in prostate cancer metastasis and mortality. However, clinical trial data revealed that screening was associated with substantial harms. Under the traditional clinical approach in which elevated serum PSA triggered prostate biopsy, roughly 1 in 5 screened men underwent biopsies, with more than 75% found to be negative and a majority of positive biopsies harboring low-grade, clinically insignificant cancers. Prostate biopsies are uncomfortable for patients and carry a r...
Source: JAMA - Journal of the American Medical Association - April 6, 2024 Category: General Medicine Source Type: research

Prostate Cancer Screening With PSA, Kallikrein Panel, and MRI
This preliminary descriptive report compares the rates of detecting high- and low-grade prostate cancer in men invited for prostate cancer screening vs those not invited to undergo prostate cancer screening. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 6, 2024 Category: General Medicine Source Type: research

Meta-Analysis: “Limited” Benefits to Rapid Viral Tests in EDs
Observational studies have suggested that rapid viral testing for respiratory viruses is tied to lower use of antibiotics. Now, a meta-analysis published in JAMA Internal Medicine suggests that may not be the case, based on results from 11 randomized clinical trials involving about 6100 participants. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 5, 2024 Category: General Medicine Source Type: research

WHO Documents Rising Resistance to First-Line HIV Drug
Currently, the World Health Organization (WHO) recommends using dolutegravir, an integrase strand transfer inhibitor approved by the US Food and Drug Administration in 2013, as a first- and second-line drug for treating people with HIV. But resistance to the treatment is on the rise. About 4% to as many as about 20% of people in 4 countries reporting data —Malawi, Mozambique, Uganda, and Ukraine—who had not achieved viral suppression exhibited resistance while taking the drug as part of their antiretroviral therapy, a recent report by the WHO found. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 5, 2024 Category: General Medicine Source Type: research

Less Sleep Tied to Increased Risk of Diabetes Despite Healthy Diet
People who slept 5 or fewer hours each night had a higher risk of being diagnosed with type 2 diabetes than those who slept 7 to 8 hours, even if they followed a healthy diet, a cohort study published in JAMA Network Open found. Sleeping 5 hours or 3 to 4 hours per day was linked with a 16% and 41% increased risk of type 2 diabetes, respectively. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 5, 2024 Category: General Medicine Source Type: research

Deaths From Excessive Drinking Rose in the US During Pandemic
Deaths associated with excessive alcohol use have been rising over the past 20 years. But during 2020-2021 they went up dramatically —from an average of about 138 000 deaths during 2016-2017 to more than 178 000 deaths during the COVID-19 pandemic. The change represents a 29% increase in lives lost, according to results published in the MMWR. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 5, 2024 Category: General Medicine Source Type: research

How Generative AI Done Right Could Help Democratize Health Care
This Medical News article is an interview with JAMA Editor in Chief Kirsten Bibbins-Domingo and Virologist Davey Smith, head of the Division of Infectious Diseases and Global Public Health at the University of California, San Diego. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 5, 2024 Category: General Medicine Source Type: research

Introducing the JAMA Summit
Over the past year, JAMA editors have been developing the concept of the JAMA Summit —forums for catalyzing discussion and action on pressing issues in science, medicine, and public health. Over its more than 140-year history, JAMA has been a leader in publishing on critical issues related to health. As a forum for eliciting new ideas, facilitating cross-sector dialogue, and ident ifying opportunities for progress that inspire discussion and action, the JAMA Summit represents the latest iteration of this long tradition of furthering our mission to advance the science and art of medicine and the betterment of public healt...
Source: JAMA - Journal of the American Medical Association - April 4, 2024 Category: General Medicine Source Type: research

Reported Political Participation by Physicians vs Nonphysicians
This study uses survey data to compare rates of political participation between US physicians and nonphysicians from 2017 to 2021. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 4, 2024 Category: General Medicine Source Type: research

Prevalence of Type 1 Diabetes Among US Children and Adults by Age, Sex, Race, and Ethnicity
This study uses data from the 2019 to 2022 cycles of the National Health Interview Survey to estimate the prevalence of type 1 diabetes among US youths and adults. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 4, 2024 Category: General Medicine Source Type: research

Noninvasive Airway Management of Comatose Patients With Acute Poisoning
To the Editor A recent study suggested clinical benefits of noninvasive airway management in comatose patients with acute poisoning. An accompanying editorial lauded the study as a practice-changing trial providing rigorous evidence. Although we have recommended against indiscriminate intubation of patients based on a low Glasgow Coma Scale (GCS) score, we are concerned about the ability of this study to provide conclusive evidence allowing a paradigm shift in clinical practice. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 4, 2024 Category: General Medicine Source Type: research

Noninvasive Airway Management of Comatose Patients With Acute Poisoning
To the Editor We read with interest the recent article that reported among comatose patients with suspected acute poisoning, a conservative strategy of withholding intubation was associated with a greater clinical benefit for the composite end point of in-hospital death, length of ICU stay, and length of hospital stay. We think that some methodological issues about this study deserve consideration. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - April 4, 2024 Category: General Medicine Source Type: research