Return of Research Results to Study Participants
This Viewpoint encourages the development of approaches to share the results of research with study participants to reinforce the value of patient participation, to incentivize engagement in research, and to honor the belief that individuals have a right to their own data. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 21, 2018 Category: General Medicine Source Type: research

How HIPAA Harms Care, and How to Stop It
In this Viewpoint, Don Berwick reviews common misconceptions about Health Insurance Portability and Accountability Act (HIPAA) requirements regarding personal health information and proposes steps the Department of Health and Human Services (DHHS) can take to better balance privacy protections with the need to ensure health information is available for clinical care in reasonable time at reasonable expense. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 20, 2018 Category: General Medicine Source Type: research

Health Data and Privacy in the Era of Social Media
This Viewpoint discusses personal health information on social media and other sites and ways in which this information can and should be protected. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 20, 2018 Category: General Medicine Source Type: research

Philip Morris International Foundation and Tobacco Control
This Viewpoint discusses the Philip Morris International –funded Foundation for a Smoke-Free World, whose stated mission is to end cigarette smoking within a generation, and explains why the effort is likely a distraction from true evidence-based tobacco control. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 18, 2018 Category: General Medicine Source Type: research

New Foundation Revives Debate About Health Research Funded by Big Tobacco
This Medical News story examines the controversy surrounding Philip Morris International ’s funding of a foundation whose stated purpose is to reduce the use of conventional cigarettes. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 18, 2018 Category: General Medicine Source Type: research

Supporting the Next Generation of Biomedical Researchers
This Viewpoint summarizes a 2018 National Academies of Sciences, Engineering, and Medicine (NASEM) report that details challenges to support of biomedical scientists in the United States and proposes solutions, including public-private partnerships and a dedicated line of Congressional funding to support next-generation researchers and innovation. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 14, 2018 Category: General Medicine Source Type: research

Why Merkel Cell Cancer Is Garnering More Attention
This Medical News story discusses the growing incidence of basal cell carcinoma and promising treatments for the disease. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 13, 2018 Category: General Medicine Source Type: research

Adam Gazzaley, MD, PhD: Developing Prescribable Video Games
This Medical News article discusses a video game-based therapy for pediatric attention-deficit/hyperactivity disorder. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 13, 2018 Category: General Medicine Source Type: research

NIH Helping to End Addiction Over the Long-term Initiative
This Viewpoint discusses the National Institutes of Health ’s Helping to End Addiction Long-term, an interdisciplinary program aimed at advancing addiction and pain research in the United States. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 12, 2018 Category: General Medicine Source Type: research

Progress in Prevention and Treatment of Acute Kidney Injury
This Viewpoint discusses progress in the recognition and management of acute kidney injury (AKI) since publication in 2012 of KDIGO clinical practice guidelines to improve AKI outcomes, and proposes next steps in management, including use of biomarkers, risk alerts, and care bundles, to improve AKI prevention and outcomes. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 11, 2018 Category: General Medicine Source Type: research

Type 2 Myocardial Infarction —Diagnosis, Prognosis, and Treatment
This Viewpoint reviews what is known about myocardial infarction (MI) caused by oxygen supply-and-demand mismatch (type 2 MI) and differences from MI caused by coronary artery disease, as well as proposes areas for further investigation to identify optimal management strategies. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 11, 2018 Category: General Medicine Source Type: research

The 50-Year Legacy of the Harvard Report on Brain Death
This Viewpoint discusses the the ethical challenge of defining death in persons with irreversible coma, legalization of the definition of brain death in the 1981 Uniform Determination of Death Act, and current implications of the definition for decisions about life support, organ transplantation, and newer genetic technologies. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 7, 2018 Category: General Medicine Source Type: research

Addressing Patients ’ Concerns About Bisphosphonates
This Medical News article discusses how fears of rare adverse effects associated with osteoporosis medications are driving a treatment crisis. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 6, 2018 Category: General Medicine Source Type: research

Why Do US Infants Still Die in Their Sleep?
This Medical News story examines why US infants continue to die because of unsafe sleep conditions. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 6, 2018 Category: General Medicine Source Type: research

Transition to the ICD-10 in the United States
This Viewpoint proposes strategies to manage code linkage gaps and other sources of error in the transition in the United States from use of theInternational Classification of Diseases, Ninth Revision (ICD-9) to theInternational Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 4, 2018 Category: General Medicine Source Type: research

CMS Requirements for Mandatory Shared Decision Making for Cardiac Procedures and Other Tests
This Viewpoint discusses Centers for Medicare& Medicaid Services (CMS) policies requiring physicians to engage patients in shared decision making prior to implantation of an implantable cardioverter-defibrillator, lung cancer screening, and left atrial appendage closure for stroke prevention in atrial fibrillation, and argues that better guidance is needed if the requirements are to promote meaningful shared decisions. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 4, 2018 Category: General Medicine Source Type: research

Antithrombotic Therapy for Peripheral Artery Disease in 2018
This JAMA Clinical Update reviews CVD risk stratification of patients with peripheral artery disease (PAD) and current standards of practice for use of antiplatelet and anticoagulant therapies. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 1, 2018 Category: General Medicine Source Type: research

Sustaining Health-Protective Behaviors Such as Physical Activity and Healthy Eating
This Viewpoint discusses the importance of how microtimescale influences fluctuations in mood or motivation on a minute-to-minute or day-to-day basis, influences people ’s ability to sustain lifestyle behaviors over a lifetime, and envisions development of just-in-time interventions as needed to facilitate daily healthy choices. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 31, 2018 Category: General Medicine Source Type: research

Explaining the Rise in Fatalities From Preventable Injury in Teenagers and Young Adults
This Viewpoint reviews CDC injury statistics documenting a rise in preventable fatalities in young people related to opioids, motor vehicle crashes, and firearms, and calls for policies aimed at reversing the trend. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 31, 2018 Category: General Medicine Source Type: research

For Patients With Type 2 Diabetes, What ’s the Best Target Hemoglobin A 1C ?
This Medical News article discusses new clinical guidance for blood glucose targets. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 30, 2018 Category: General Medicine Source Type: research

A Day in the Life: Physician Cares for HIV-Positive Patients in Jail
This Medical News story describes a day in the life of an infectious disease specialist caring for incarcerated individuals living with HIV. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 30, 2018 Category: General Medicine Source Type: research

Resolving the Productivity Paradox of Health Information Technology
In this Viewpoint, Robert Wachter and Michael Howell from Google discuss the prospects that medicine is finally poised to realize improvements in quality, safety, and productivity from investments in health information technology and digitization, and from growing competencies in systems thinking and population health (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 29, 2018 Category: General Medicine Source Type: research

Big Data and Predictive Analytics
This Viewpoint describes 4 major barriers to useful risk prediction that may not be easily overcome by new methods in machine learning and, in some instances, may be more difficult to overcome in the era of big data. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 29, 2018 Category: General Medicine Source Type: research

QALYs in 2018 —Advantages and Concerns
This Viewpoint reviews the rationale for measuring health outcomes using quality-adjusted life-years (QALYs) and discusses the advantages and limitations of the measure and its role in attempts to define and promote the practice of high-value medicine. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 24, 2018 Category: General Medicine Source Type: research

HIPAA and Protecting Health Information in the 21st Century
This Viewpoint posits that HIPAA no longer fully protects health information in today ’s big data era in which health data are collected and exchanged in nonclinical settings, such as social media, apps, and search engines, and proposes principles around which reform of health information privacy protections should be organized. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 24, 2018 Category: General Medicine Source Type: research

Framingham at 70: What We ’ve Learned About Women and Heart Disease
In this Medical News article, the Framingham Heart Study ’s director, Daniel Levy, MD, discusses women’s participation during the study’s 70-year history. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 23, 2018 Category: General Medicine Source Type: research

Global Budgets in Maryland
This Viewpoint discusses the unique approach to health care reform implemented in Maryland, which has a diverse population served by rural, suburban, and urban hospitals including 2 major academic health centers. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 21, 2018 Category: General Medicine Source Type: research

Health Care Reforms in India
This Viewpoint discusses the efforts India has been taking as it works toward establishing universal health coverage. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 21, 2018 Category: General Medicine Source Type: research

Association of the qSOFA Score With Hospital Mortality in Low- and Middle-Income Countries
This pooled cohort analysis assesses the association of quick Sequential (Sepsis-Related Organ Failure Assessment (qSOFA) score with excess hospital death among patients with suspected infection in low- to middle-income countries and compares the mortality association using qSOFA vs systemic inflammatory response syndrome (SIRS) criteria. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 20, 2018 Category: General Medicine Source Type: research

qSOFA Score for Patients With Sepsis in Low- and Middle-Income Countries
In the past 2 years, sepsis has received considerable attention from the global community. In 2017, the World Health Assembly passed a resolution urging all 194 UN Member States to implement actions to reduce the burden of sepsis, and for the World Health Organization to report on the public health implications of sepsis and its global consequences. It has become clear that early resuscitation targeted to hemodynamic goals is more expensive and no more effective than routine care in high-income countries. In Zambia, a protocolized resuscitation strategy actually increased mortality. These data and other studies continue to...
Source: JAMA - Journal of the American Medical Association - May 20, 2018 Category: General Medicine Source Type: research

Recombinant Human Pentraxin 2 vs Placebo and Lung Function in Idiopathic Pulmonary Fibrosis
This randomized clinical trial compares the effects of recombinant human pentraxin 2, a monocyte differentiation inhibitor, vs placebo on changes in percent predicted forced vital capacity after 28 weeks in patients with idiopathic pulmonary fibrosis. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 20, 2018 Category: General Medicine Source Type: research

Feasibility of Airway Transplantation Using a Bioengineered Stented Aortic Allograft
This case series describes 90-day mortality of patients who required tracheal, bronchial, or carinal reconstruction using stented aortic allografts supported by muscle flaps for treatment of inoperable airway disease including lung cancer, tracheal stenosis, or tracheomalacia. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 20, 2018 Category: General Medicine Source Type: research

The Body ’s Largest Artery Aids in Building a Better Trachea
In this medical news article, the author of a study reporting outcomes of tracheal replacement surgery explains how he and his colleagues developed their techniques. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 20, 2018 Category: General Medicine Source Type: research

Clinical Trials in Idiopathic Pulmonary Fibrosis in the “Posttreatment Era”
The “treatment era” for idiopathic pulmonary fibrosis (IPF) in the United States and other countries was inaugurated in November 2014 following the Food and Drug Administration’s (FDA’s) approval of pirfenidone and nintedanib as treatments for IPF. Even the most optimistic pulmonologists may hav e doubted that such a day would ever arrive, let alone a day when a practicing clinician would have not 1, but 2 medications to treat IPF. The FDA approved pirfenidone and nintedanib on the basis of published studies that showed these therapies slowed the rate of deterioration of forced vital capaci ty (FVC)...
Source: JAMA - Journal of the American Medical Association - May 20, 2018 Category: General Medicine Source Type: research

Reconstruction of the Central Airways: From the Aorta to the Trachea
In this issue ofJAMA, Martinod and colleagues report the results of a prospective, single-institution safety and feasibility trial of airway transplantation to reconstruct long-segment defects of the trachea and central bronchi. Over 6.5 years, 13 of 20 patients with end-stage tracheal lesions or proximal lung tumors requiring a pneumonectomy were enrolled in the study and underwent airway reconstruction with cryopreserved aortic allografts following definitive resection. Custom-made stents to support the allografts were used initially to prevent airway collapse but were removed at a postoperative mean duration of 18 month...
Source: JAMA - Journal of the American Medical Association - May 20, 2018 Category: General Medicine Source Type: research

Banning Abortion in Cases of Down Syndrome
This Viewpoint discusses legal and ethical issues raised by the 2017 Ohio law prohibiting physicians from performing abortions if the pregnant woman ’s decision was influenced by her belief that the fetus has Down syndrome. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 18, 2018 Category: General Medicine Source Type: research

Direct-to-Consumer Genetic Testing for BRCA Mutations
This Viewpoint discusses the implications of the US FDA ’s 2018 marketing authorization permitting 23and Me to marketBRCA mutation testing to the general public, including concern about overtesting, false assurance, and the ability of accessible testing to improve population health outcomes. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 18, 2018 Category: General Medicine Source Type: research

The President ’s 2018 Plan to Address High Drug Prices
This Viewpoint discusses missed opportunities in the 2018 White House blueprint to reduce prescription drug prices, including a proposal that would require CMS to negotiate prices with manufacturers and that would ban unfair practices companies use to extend brand exclusivity. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 17, 2018 Category: General Medicine Source Type: research

Treating Opioid Use Disorder in the Emergency Department
This Medical News story describes the growing trend of emergency departments initiating medication-assisted treatment with buprenorphine to patients with opioid use disorder. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 16, 2018 Category: General Medicine Source Type: research

Comparison of Intubation Techniques in Patients With Difficult Airways
This randomized clinical trial compares the effect on first-attempt success of intubation using a tracheal tube bougie introducer vs endotracheal tube with stylet in patients with difficult airway characteristics requiring emergency intubation. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 16, 2018 Category: General Medicine Source Type: research

Conservative Management of Low-Risk Prostate Cancer in the VA System, 2005-2015
This study uses US Department of Veterans Affairs (VA) data to characterize trends in the use of watchful waiting and active surveillance as strategies for managing low-risk prostate cancer in US veterans from 2005 through 2015. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 15, 2018 Category: General Medicine Source Type: research

The Microbiome and Risk for Atherosclerosis
This Viewpoint discusses the role the human gut microbiome may play in the development and progression of atherosclerosis, both by influencing risk factors and by direct effects on the inflammation and vulnerability of endovascular plaques. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 14, 2018 Category: General Medicine Source Type: research

Private Sector Involvement in Physician-Scientist Training
In this Viewpoint, Insel and colleagues discuss the roles that private sector companies and foundations might play and the advantages of public-private partnerships in nurturing new and early-career physician-investigators given an always-challenging funding environment and ever-increasing hurdles young physicians must overcome to establish a research career. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 10, 2018 Category: General Medicine Source Type: research

Management Reasoning
This Viewpoint discusses management reasoning, ways in which it differs from diagnostic reasoning, and areas that require further research. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 10, 2018 Category: General Medicine Source Type: research

Antitrust, Market Exclusivity, and Transparency in the Pharmaceutical Industry
This Viewpoint uses 3 recent legal antitrust cases filed by pharmaceutical companies against each other to identify mechanisms by which companies suppress competition and keep drug prices inflated, and emphasizes the role of antitrust law as a potentially positive means to open markets and increase access to affordable drugs. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 7, 2018 Category: General Medicine Source Type: research

The Ethics of Medicaid ’s Work Requirements and Other Personal Responsibility Policies
This Viewpoint discusses the possible harms of controversial state-mandated work requirements for Medicaid beneficiaries and proposes safeguards the Centers for Medicare& Medicaid Services might put in place to minimize health risks to patients. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 7, 2018 Category: General Medicine Source Type: research

Value-Based Pricing and Patient Access for Specialty Drugs
This Viewpoint discusses the challenges of high prices for payers and high access barriers for patients for specialty drugs and how these can be addressed by value-based pricing and value-based patient access. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 3, 2018 Category: General Medicine Source Type: research

The Importance of Oral Health in Comprehensive Health Care
This Viewpoint discusses the importance of oral medicine to overall patient health, and argues for dedicated screening and assessment of oral and dental health among nondentist health practitioners. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 3, 2018 Category: General Medicine Source Type: research

Taking a Closer Look at the Biomarker Test for Mild Traumatic Brain Injury
In this Medical News article, experts discuss the benefits and limitations of a blood test recently approved to evaluate patients with mild traumatic brain injury. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 2, 2018 Category: General Medicine Source Type: research

Is Direct Primary Care a Game Changer?
This Medical News story discusses the pros and cons of direct primary care, whose practitioners don ’t accept insurance and instead charge a membership fee to cover services. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - May 2, 2018 Category: General Medicine Source Type: research