We Can Heal From Hate Crimes by Practicing Solidarity
This essay describes the author ’s experience of systemic racism in medicine. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

Assessing the Association Between Social Gatherings and COVID-19 Risk Using Birthdays
This cross-sectional study uses administrative health care data on 2.9 million households from the first 45 weeks of 2020 to assess the association between social gatherings and SARS-CoV-2 transmission by studying whether COVID-19 rates increase after birthdays in a household. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

External Validation of a Widely Implemented Sepsis Prediction Model in Hospitalized Patients
This cohort study externally validates the Epic Sepsis Model in the prediction of sepsis and evaluates its potential clinical impact compared with usual care. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

Fishing for an Association With Sudden Cardiac Death —Reply
In Reply We thank Siegel and Tseng for their response to our article. We refer the authors to our previous PURE publications where we provided definitions of individual cardiovascular disease (CVD) events, including sudden cardiac death (SCD) (eg, see appendices in Dehghan et al and Jenkins et al). Briefly, in PURE, SCD was defined as death that occurred suddenly and unexpectedly in which the death was witnessed, or the person was resuscitated from cardiac arrest who later died, and occurred in persons with known cardiovascular disease or with diabetes plus prespecified major cardiovascular risk factors. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

Fishing for an Association With Sudden Cardiac Death
To the Editor We read with interest the article by Mohan et al, which reports that in the ORIGIN study, higher fish intake is associated with lower risk of sudden cardiac death (SCD) among patients with vascular disease, but not in general populations. The authors assert that possible “selective antiarrhythmic effects” of fish consumption may protect against SCD.(p642) However, this article discusses neither how SCD was defined nor how cases were ascertained. In fact, none of the 4 contributing cohort studies clearly defines SCD. Rather, a variety of related terms are used, i ncluding “death from arrhythm...
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

FDA Approval of High-risk Therapeutic Devices Not Meeting Pivotal Primary End Points, 2016-2020
This cross-sectional study explores the frequency of, and rationale for, US Food and Drug Administration approval of high-risk therapeutic medical devices not meeting pivotal study primary end points from 2016 through 2020. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

Levothyroxine Use in the United States, 2008-2018
This cross-sectional study assesses national data for commercially insured and Medicare Advantage enrollees to analyze the use of levothyroxine in the US over time. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

Association of Changes in Seasonal Respiratory Virus Activity and Ambulatory Antibiotic Prescriptions With the COVID-19 Pandemic
This pre-post study examines the association between respiratory virus incidence and ambulatory antibiotic orders and the COVID-19 pandemic. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

Importance of External Validation in Sepsis
Sepsis accounts for nearly 1 million hospitalizations annually and is a major contributor to hospital length of stay, health care expenditures, and in-hospital mortality (ranging from 12.5%-15%). Early sepsis identification allows care teams to promptly implement goal-directed therapy to mitigate clinical deterioration. In this issue of JAMA Internal Medicine, Wong et al report on their external validation of the Epic Sepsis Model (ESM), a prediction tool available within the Epic electronic health record that is designed to generate automated alerts that warn clinicians that patients may be developing sepsis. Based on the...
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

Overuse of Levothyroxine in Patients With Subclinical Hypothyroidism
Recent clinical trials and a meta-analysis demonstrate no symptomatic benefit from treatment with levothyroxine among nonpregnant adults with subclinical hypothyroidism (defined as an elevated thyrotropin level with normal serum thyroid hormone levels). Contemporary evidence-based clinical practice guidelines strongly advise against levothyroxine supplementation for subclinical hypothyroidism. Older guidelines from professional societies generally do not recommend treatment for subclinical hypothyroidism with a thyrotropin level less than 10 mIU/L, except in special circumstances. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

Acute Myocardial Infarction With Diffuse ST-Segment Elevation
This case report describes the electrocardiographic results of a patient with severe substernal chest pain. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 21, 2021 Category: Internal Medicine Source Type: research

Active Surveillance as a Management Option for Low-risk Basal Cell Carcinoma
This Viewpoint proposes that active surveillance should be evaluated as a management option for selected patients with low-risk and asymptomatic basal cell carcinoma. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 14, 2021 Category: Internal Medicine Source Type: research

Smoking Cessation Intervention vs Brief Advice Alone for Expectant Fathers
This randomized clinical trial evaluates the outcomes of a tobacco control intervention at 3 and 6 months after intervention initiation for the cigarette-smoking male partners of nonsmoking pregnant women. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 14, 2021 Category: Internal Medicine Source Type: research

The Importance of Considering Frailty in Research on Older Adults —Reply
In Reply We thank Liu et al for their letter in response to our article and for highlighting the importance of frailty and the heterogeneity of health status among older adults. Liu et al hypothesize that there may be a subgroup of fit older adults with prediabetes in the Atherosclerosis Risk in Communities (ARIC) study who were more likely to receive preventive lifestyle and/or pharmacologic interventions, which may have influenced our results. Unfortunately, we do not have information on whether participants were referred by their health care professional to receive preventive lifestyle interventions during the 6 years o...
Source: JAMA Internal Medicine - June 14, 2021 Category: Internal Medicine Source Type: research

The Importance of Considering Frailty in Research on Older Adults
To the Editor We read the excellent cohort study by Rooney et al with great enthusiasm and appreciation, considering that there are few clinical trials designed to guide clinical decision-making among older adults with prediabetes and diabetes. The authors followed the Atherosclerosis Risk in Communities (ARIC) cohort and found that participants between 71 and 90 years old with prediabetes were more likely to regress to normoglycemia or die than progress to diabetes. This is an important study that may revolutionize the way we define and manage prediabetes in older adults; however, several limitations should be noted. (Sou...
Source: JAMA Internal Medicine - June 14, 2021 Category: Internal Medicine Source Type: research

Early Hospital Compliance With Federal Requirements for Price Transparency
This cross-sectional study assesses compliance within a random sample of hospitals with a federal rule requiring hospitals to disclose the prices they negotiate with insurers. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 14, 2021 Category: Internal Medicine Source Type: research

Administration of Standardized Screening Questions in Federally Qualified Health Centers
This quality improvement study assesses the frequency of standardized screenings tied to performance metrics within a national network of federally qualified health centers. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 14, 2021 Category: Internal Medicine Source Type: research

A Response to Excessive Screening Questions
Recently, JAMA Internal Medicine published a firsthand account of a trauma survivor who had disclosed over a series of years on multiple self-administered screenings that she had experienced trauma, yet none of her health care clinicians had ever followed up with her or provided any support or resources. In reading her account, I wondered how many of her clinicians had even seen the screening questionnaires she completed. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 14, 2021 Category: Internal Medicine Source Type: research

Paroxysmal Atrioventricular Block
This case report presents electrocardiographic findings in a patient in their mid-80s with intermittent confusion and falls. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 14, 2021 Category: Internal Medicine Source Type: research

Gender, Race/Ethnicity, and Sexual Orientation of Editors at Leading Medical and Scientific Journals
This survey study assesses the diversity of editors at leading medical and scientific journals. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 11, 2021 Category: Internal Medicine Source Type: research

Are SARS-CoV-2 Human Challenge Trials Ethical?
This Viewpoint explores the ethics of a UK SARS-CoV-2 human challenge trial. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 7, 2021 Category: Internal Medicine Source Type: research

Risk of Subsequent Fractures in Postmenopausal Women After Nontraumatic vs Traumatic Fractures
This cohort study examines how future fracture risk in postmenopausal women varies according to whether an initial fracture is traumatic or nontraumatic. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 7, 2021 Category: Internal Medicine Source Type: research

Necessity of Coronary CT Scans —Reply
In Reply We appreciate the Letter to the Editor from Greenland et al providing feedback on our Patient Page about coronary computed tomography (CT) scans. The authors first take issue with the statement that traditional atherosclerotic cardiovascular disease (ASCVD) risk estimators such as the Framingham Risk Score and pooled cohort equations are more accurate than coronary artery calcium (CAC) scoring in predicting risk of heart attack, referring to the United States Preventive Services Task Force (USPSTF) conclusion that tests such as CAC scoring “may improve calibration, discrimination and reclassification” ...
Source: JAMA Internal Medicine - June 7, 2021 Category: Internal Medicine Source Type: research

Necessity of Coronary CT Scans
To the Editor The Patient Page on coronary computed tomography (CT) scans paints a negative and incorrect picture. The best answer to the question, “Should I get a coronary CT scan?” is that it depends. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 7, 2021 Category: Internal Medicine Source Type: research

Spread of Misinformation About Face Masks and COVID-19 by Automated Software on Facebook
This cross-sectional study examines the spread of misinformation regarding the Danish Study to Assess Face Masks for the Protection Against COVID-19 Infection on Facebook. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 7, 2021 Category: Internal Medicine Source Type: research

Use of High-Sensitivity Cardiac Troponin in Patients With Kidney Impairment
This randomized clinical trial examines the use of high-sensitivity cardiac troponin testing for patients with kidney impairment. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 7, 2021 Category: Internal Medicine Source Type: research

High-Sensitivity Cardiac Troponin Assays in Patients With Kidney Impairment
High-sensitivity cardiac troponin (hs-cTn) assay was approved by the US Food and Drug Administration in 2017, and its appropriate use is currently being investigated. In this issue of JAMA Internal Medicine, Gallacher et al examine the use of hs-cTn assays in patients with kidney impairment in a prespecified secondary analysis of a randomized clinical trial of patients with suspected acute coronary syndrome (ACS). Their major finding is that while the frequency of elevated levels of hs-cTn increases as kidney function deteriorates, two-thirds of patients with kidney impairment and elevated hs-cTn concentrations do not have...
Source: JAMA Internal Medicine - June 7, 2021 Category: Internal Medicine Source Type: research

A Distinction Without a Difference —Does It Matter Whether Fractures Are Nontraumatic or Traumatic?
“A 54-year-old woman presents with a hip fracture after a fall from standing.” (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 7, 2021 Category: Internal Medicine Source Type: research

Pathologic U Waves Secondary to Severe Hypophosphatemia During Refeeding Syndrome
This case report presents electrocardiographic findings in a young patient with palpitations and weakness and a recent history of depression and weight loss. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 7, 2021 Category: Internal Medicine Source Type: research

Equity and the JAMA Network
The key objective of JAMA is “To promote the science and art of medicine and the betterment of the public health”; similar objectives and mission statements are supported by all 12 JAMA Network Journals. Together this family of journals is committed to publishing the best research, reviews, and opinion articles to advance m edical science, promote public health, and improve patient care. The ultimate goal is to promulgate truth in science and medicine. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 3, 2021 Category: Internal Medicine Source Type: research

JAMA Internal Medicine
Mission Statement: To promote the art and science of medicine and the betterment of public health by publishing manuscripts of interest and relevance to internists practicing as generalists or as medical subspecialists. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 1, 2021 Category: Internal Medicine Source Type: research

A Clinical Approach to Preventing Death on the Streets
This Viewpoint offers a novel framework to empower clinicians to assess a person in need on the street and prevent avoidable death. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 28, 2021 Category: Internal Medicine Source Type: research

Socioeconomic Inequality in Respiratory Health in the US From 1959 to 2018
This cross-sectional study examines long-term trends in socioeconomic disparities in respiratory disease prevalence, pulmonary symptoms, and pulmonary function (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 28, 2021 Category: Internal Medicine Source Type: research

Association of Low-Value Care Exposures With Health Care Experience Ratings
This quality improvement study assesses associations between rates of low-value service provision to a primary care professional patient panel and patients ’ ratings of their health care experiences. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 28, 2021 Category: Internal Medicine Source Type: research

Social Connectedness Among Medicare Beneficiaries Following the Onset of the COVID-19 Pandemic
This cross-sectional study examines social connectedness among Medicare beneficiaries during the COVID-19 pandemic. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 28, 2021 Category: Internal Medicine Source Type: research

Lung Health Disparities in Time
In this issue of JAMA Internal Medicine, Gaffney and colleagues explore the associations between socioeconomic status (SES) and respiratory health over nearly 6 decades using US National Health and Nutrition Examination Survey (NHANES) data. With alignment of outcomes to accommodate secular changes in questionnaires, the authors demonstrate disparities by education and family income in clinically relevant lung health outcomes and tobacco exposure. Specifically, poorer and less educated adults reported higher rates of respiratory symptoms (problem cough, wheeze, dyspnea on exertion), and the gap between symptom prevalence i...
Source: JAMA Internal Medicine - May 28, 2021 Category: Internal Medicine Source Type: research

Updated Website Address Throughout Article
In the Special Article titled “Assessing Risk Factors as Potential Screening Tests: A Simple Assessment Tool,” published on February 28, 2011, the website address reported in the text and Figures is no longer valid. The correct address is https://www.medicalscreeningsociety.com/rsc.asp. The article has been corrected online. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 28, 2021 Category: Internal Medicine Source Type: research

Beat-to-Beat Variation in QRS Morphology Following Transcatheter Aortic Valve Replacement
This case report describes beat-to-beat variation in QRS morphology occurring in a patient who has undergone transcatheter aortic valve replacement. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 28, 2021 Category: Internal Medicine Source Type: research

Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy
This cohort study examines the rate of SARS-CoV-2 reinfection among people in Lombardy, Italy, who previously recovered from COVID-19. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 28, 2021 Category: Internal Medicine Source Type: research

Protection Because of Prior SARS-CoV-2 Infection
How much protection against future infections does prior infection with SARS-CoV-2 infection provide? This is an important question for advising individual patients, as well as for projecting future outbreaks of SARS-CoV-2. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 28, 2021 Category: Internal Medicine Source Type: research

Factors Associated With Liver Transplant Outcomes in Veterans With End-Stage Liver Disease
This cohort study uses data from the United Network of Organ Sharing to assess the factors associated with referral, wait-listing, and receipt of liver allografts in veterans with end-stage liver disease. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 24, 2021 Category: Internal Medicine Source Type: research

Lipoprotein(a) Measurement in Clinical Practice —Reply
Less is More (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 24, 2021 Category: Internal Medicine Source Type: research

Lipoprotein(a) Measurement in Clinical Practice
To the Editor With great interest we read the Teachable Moment by Furlan et al regarding the usefulness of lipoprotein(a) (Lp[a]) measurement in clinical practice. The authors describe a patient at very low risk of cardiovascular disease (CVD) with an Lp(a) concentration of 110 mg/dL, concluding that statin therapy should not be recommended in view of the low risk. The authors argue that Lp(a) is a biomarker of unknown clinical significance, in absence of either approved drugs lowering Lp(a) or randomized clinical trials showing that reduction in Lp(a) results in CVD risk reduction. We feel that these conclusions merit a w...
Source: JAMA Internal Medicine - May 24, 2021 Category: Internal Medicine Source Type: research

Effectiveness of Tocilizumab in Patients Hospitalized With COVID-19
This follow-up study of the CORIMUNO-TOCI-1 randomized clinical trial examines the association between survival and C-reactive protein levels in patients hospitalized with COVID-19 who were treated with tocilizumab. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 24, 2021 Category: Internal Medicine Source Type: research

Evaluation of Compliance With the FDA Amendments Act of 2007
This cross-sectional study evaluates clinical trials ’ rates of compliance with the legal requirements of the US Food and Drug Administration’s Amendments Act of 2007 for timely registration of clinical trials, data verification, delayed reporting, and trial document submission. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 24, 2021 Category: Internal Medicine Source Type: research

Trial Reporting and the Clinical Trials Enterprise
Health Care Policy (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 24, 2021 Category: Internal Medicine Source Type: research

Taking Time With the RP Interval in Narrow Complex Tachycardia
This case report describes the electrocardiographic findings in a man in his 80s without prior history of arrhythmia who presented with cough and shortness of breath during the COVID-19 pandemic. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 24, 2021 Category: Internal Medicine Source Type: research

Integrating New Effectiveness Data Into US Food and Drug Administration –Approved Drug Labeling
This Viewpoint assesses US Food and Drug Administration policies regarding drug label changes. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 17, 2021 Category: Internal Medicine Source Type: research

Hospital Responses to Incentives in Episode-Based Payment for Joint Surgery
This controlled population-based study investigates the response of hospitals to changing incentives in Medicare ’s Comprehensive Care for Joint Replacement program, an episode-based payment model. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 17, 2021 Category: Internal Medicine Source Type: research

Effectiveness of a Vaping Cessation Text Message Program Among Young Adult e-Cigarette Users
This randomized clinical trial determines the effectiveness of a text message program for vaping cessation among young adults aged 18 to 24 years vs assessment-only control. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 17, 2021 Category: Internal Medicine Source Type: research