Preventing and Responding to COVID-19 on College Campuses
This Viewpoint from CDC officials discusses late summer and early fall increases in COVID-19 cases among college-age students when they were returning to campus, and reiterates public health measures that could reduce outbreaks and the need for university-community partnership to reduce SARS-CoV-2 transmission. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 29, 2020 Category: General Medicine Source Type: research

Sophisticated Purchasing of Pharmaceuticals —Learning From Other Countries
In 2019 and early 2020, drug pricing in the United States was a top concern of the public and therefore of politicians. President Trump, the moderate Democrats, the progressive Democrats, and some Republicans competed to denounce louder and regulate more substantially the manner by which pharmaceutical firms set their prices. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 28, 2020 Category: General Medicine Source Type: research

Worst-Rank Score Methods —A Nonparametric Approach to Informatively Missing Data
This JAMA Guide to Statistics and Methods explains worst-rank score methods, a nonparametric statistical technique that assigns worst-case outcomes for patients with missing data to account for missingness that may reflect an adverse change in patient status (informative rather than random missingness). (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 28, 2020 Category: General Medicine Source Type: research

The 2020 Lasker Awards and the COVID-19 Pandemic
In this Viewpoint, the chair of the 2020 Lasker Medical Research Awards reflects on the history of the award program and its recipients as a stand-in for the 2020 awards, which are not being given because of the coronavirus disease 2019 (COVID-19) pandemic, and anticipates the most important research leading to COVID-19 treatment and control will be candidates for future recognition. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 25, 2020 Category: General Medicine Source Type: research

Managing Minimally Abnormal Cervical Cancer Screening Results
This JAMA Insights review summarizes 2020 consensus guidelines on management of minimally abnormal cervical cancer screening results, including no abnormal pathology, atypical squamous cells of undetermined significance (ASCUS), and low-grade squamous intraepithelial lesion (LSIL) with and without positive high-risk HPV testing. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 25, 2020 Category: General Medicine Source Type: research

Gastrointestinal Complications in Critically Ill Patients With and Without COVID-19
This study compares the incidence of gastrointestinal complications of critically ill patients with COVID-19 –induced acute respiratory distress syndrome (ARDS) vs comparably ill patients with non–COVID-19 ARDS using propensity score analysis. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 24, 2020 Category: General Medicine Source Type: research

Revisiting the Roles of Primary Care Clinicians in Genetic Medicine
This Viewpoint describes 4 approaches for primary care clinicians to incorporate genetics care into their practices, and the systems-level interventions needed to operationalize them, including collecting a family history, initiating genomic testing and diagnostic workup, referral to genetics subspecialists, and monitoring disease surveillance. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 24, 2020 Category: General Medicine Source Type: research

Coronary Computed Tomography Angiography
A 56-year-old woman with a history of CAD, hypertension controlled with medication, and a recent negative stress ECG for atypical chest pain underwent coronary CTA for persistent symptoms, which showed no stenosis or plaque. How would you follow up on the negative imaging result? (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 23, 2020 Category: General Medicine Source Type: research

Association of SARS-CoV-2 Test Status and Pregnancy Outcomes
This study examines the pregnancy outcomes of individuals infected with SARS-CoV-2 and those uninfected at a hospital in Sweden. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 23, 2020 Category: General Medicine Source Type: research

As Their Numbers Grow, COVID-19 “Long Haulers” Stump Experts
This Medical News article discusses the puzzling phenomenon of “long-haulers,” patients who haven’t returned to full health weeks or even months after what sometimes is a mild case of COVID-19. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 23, 2020 Category: General Medicine Source Type: research

Protecting the Editorial Independence of the CDC From Politics
In this Viewpoint, 3 former editors of CDC ’s Morbidity and Mortality Weekly Report (MMWR) respond to reports that political appointees have altered the timing and/or language of the publication to influence perceptions of the COVID-19 pandemic and suggest measures to preserve MMWR’s editorial independence and prevent future political in terference. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 22, 2020 Category: General Medicine Source Type: research

Hormonal Contraception in Women With Hypertension
This JAMA Insights article proposes an algorithm to guide the choice of oral contraceptives (OCs) for individuals with hypertension given the risk of elevated blood pressure and attendant complications of hypertension with OCs. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 21, 2020 Category: General Medicine Source Type: research

Camping Alone —Recovering From COVID-19
In this narrative medicine essay a medical student describes similarities between a challenging high school wilderness isolation camping trip and her experience in isolation with and recovering from COVID-19 in the early months of the pandemic in New York. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 21, 2020 Category: General Medicine Source Type: research

Ensuring Adequate Palliative and Hospice Care During COVID-19 Surges
This Viewpoint discusses barriers to quality end-of-life care during the COVID-19 pandemic, including limited staffing, inadequate access to palliative medications, and restrictive visitation policies, and calls for proactive surge planning through organizational and policy reforms to facilitate symptom relief and comfort for patients dying in the pandemic. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 21, 2020 Category: General Medicine Source Type: research

The Opioid Epidemic During the COVID-19 Pandemic
Drug overdose deaths in the US increased in 2019, despite a slight decrease from 2017 to 2018; this increase was largely driven by illicitly manufactured fentanyl. The opioid epidemic has also been complicated by increasing use of methamphetamine in combination with opioids. It is likely that the emergence of coronavirus disease 2019 (COVID-19) and subsequent disruptions in health care and social safety nets combined with social and economic stressors will fuel the opioid epidemic. Reports from national, state, and local media suggest that opioid-related overdoses are increasing, but the absence of real-time national repor...
Source: JAMA - Journal of the American Medical Association - September 18, 2020 Category: General Medicine Source Type: research

Nonfatal Opioid Overdoses at an Urban Emergency Department During the COVID-19 Pandemic
This study compares the numbers of nonfatal, unintentional opioid-related opioid overdoses presenting to a US urban emergency department during the early months of the coronavirus disease 2019 (COVID-19) pandemic (March-June 2020) vs 2019, overall and by age, race/ethnicity, and insurance status. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 18, 2020 Category: General Medicine Source Type: research

Drug Test Results in US Before and After Declaration of a National Emergency Concerning COVID-19
This substance use epidemiology study uses a commercial urine drug testing (UDT) service ’s data to compare UDT results for cocaine, fentanyl, heroin, and methamphetamine before vs after US declaration of coronavirus disease 2019 (COVID-19) as a national emergency among patients diagnosed with or at risk of substance use disorders. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 18, 2020 Category: General Medicine Source Type: research

Extreme Wildfires —A Growing Population Health and Planetary Problem
This Viewpoint uses findings from a June 2019 National Academies of Sciences, Engineering, and Medicine (NASEM) workshop report and subsequent data to summarize known environmental and health effects of extreme wildfires, emphasizing their differential adverse effects on low-income, non –English-speaking, and other vulnerable communities. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 18, 2020 Category: General Medicine Source Type: research

Change in Antibodies to SARS-CoV-2 Among Health Care Personnel in Nashville, Tennessee
This study examines the duration of antibody response to SARS-CoV-2 in health care personnel over a 60-day period in Nashville, Tennessee. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 17, 2020 Category: General Medicine Source Type: research

Another Medical Malpractice Crisis Coming? Try Something New
This Viewpoint discusses the prospect of escalating malpractice claims and coverage costs in the wake of the COVID-19 pandemic, and proposes communication and resolution strategies focusing on patient safety, transparency, and proactive acknowledgement of error as an alternative to a defensive approach to claims and lawsuits. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 17, 2020 Category: General Medicine Source Type: research

The Science of Persuasion Offers Lessons for COVID-19 Prevention
In this Medical News article, science communications expert Dominique Brossard, PhD, discusses research-based strategies to encourage COVID-19-mitigating behaviors. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 16, 2020 Category: General Medicine Source Type: research

Is Blood Type Linked to COVID-19 Risk?
This Medical News Quick Uptake discusses research into whether blood type is linked to COVID-19 risk. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 16, 2020 Category: General Medicine Source Type: research

OSHA and Worker Safety During the COVID-19 Pandemic
This Viewpoint discusses the importance of preventive measures and supplies to reduce workplace COVID-19 transmission and calls for the US Occupational Safety and Health Administration (OSHA) to issue an enforceable requirement that employers implement standards and plans to minimize COVID-19 incidence among essential workers and spread to their families and communities. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 16, 2020 Category: General Medicine Source Type: research

Suboptimal US Response to COVID-19 Despite Robust Capabilities and Resources
This Viewpoint attempts to reconcile the US ’s high 2019 preparedness ranking on the Global Health Security Index, an international framework for benchmarking health security, and its faltering coronavirus disease 2019 (COVID-19) pandemic response, and explores lessons learned from other countries whose higher rankings and efficient respons es were more closely aligned. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 16, 2020 Category: General Medicine Source Type: research

Pruritus and Tense Bullae After Discontinuation of Pembrolizumab in a Patient With Renal Cell Carcinoma
A 53-year-old woman developed widespread tense bullae with pruritus and oral mucosal lesions recalcitrant to corticosteroids during a treatment with pembrolizumab for stage IV renal cell carcinoma that persisted after discontinuation of the drug. ESR and CRP levels were elevated and biopsy suggested an autoimmune bullous process, but direct immunofluorescence results were negative. What is the diagnosis and what would you do next? (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 14, 2020 Category: General Medicine Source Type: research

Change in Donor Characteristics and Antibodies to SARS-CoV-2 in Donated Blood in the US, June-August 2020
This study describes changes in blood donor demographics and seroreactivity after testing of blood donations for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies began and was publicized in the US in mid-June 2020. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 14, 2020 Category: General Medicine Source Type: research

Algorithmic Stewardship for Artificial Intelligence and Machine Learning Technologies
This Viewpoint proposes creation of algorithmic stewardship programs at health systems, tasked similar to antibiotic stewardship committees with oversight of artificial intelligence and machine learning technologies to ensure they are used safely, effectively, fairly, and to the benefit of diverse patient populations. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 14, 2020 Category: General Medicine Source Type: research

Radiology and Value-Based Health Care
This Viewpoint discusses the importance of transitioning radiology from a volume-based to a value-based practice and specialty, starting from within with an effort by radiologists to help define and create that value for referring clinicians and the patients and health care systems they serve. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 11, 2020 Category: General Medicine Source Type: research

COVID-19 and the Path to Immunity
This Viewpoint reviews what is known about acute and long-term B-cell, antibody, and T-cell responses to SARS-CoV-2 infection and explains how each are implicated in vaccine candidates likely to be effective and durably protective again COVID-19. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 11, 2020 Category: General Medicine Source Type: research

Reassuring the Public and Clinical Community About the Scientific Review and Approval of a COVID-19 Vaccine
Public perception of the review of medications and vaccines for coronavirus disease 2019 (COVID-19) has become enmeshed in politics. The pressure on the US Food and Drug Administration (FDA) and Commissioner Stephen Hahn, MD, to approve the broad use of a COVID-19 vaccine in the coming months will be immense. However, a lack of clarity about the agency ’s approach—coupled with a stream of announcements from various federal agencies and pharmaceutical companies—has led to confusion and concern. Greater clarity and transparency about the review process as well as the full engagement of the relevant federal ...
Source: JAMA - Journal of the American Medical Association - September 10, 2020 Category: General Medicine Source Type: research

Racial/Ethnic Variation in Nasal Transmembrane Serine Protease 2 ( TMPRSS2 ) Gene Expression Facilitating Coronavirus Entry
This cross-sectional study used nasal epithelium collected in 2015-2018 to compare expression of TMPRSS2, a facilitator of SARS-CoV-2 viral entry and spread, among Asian, Black, Latino, and White patients as well as patients of mixed race/ethnicity within a New York City health system. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 10, 2020 Category: General Medicine Source Type: research

Oral Health in Medicare —Considerations for 21st-Century Coverage
This Viewpoint discusses the need to expand Medicare benefits to include coverage for oral health services given the inextricable connection between diseases of the mouth, gums, and teeth and systemic disease, such as with stem cell transplants and immunosuppression, prosthetic heart valves, and bisphosphonate use. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 10, 2020 Category: General Medicine Source Type: research

Fairly Prioritizing Groups for Access to COVID-19 Vaccines
This Viewpoint proposes that ethical principles of preventing harm, helping disadvantaged populations, and achieving equal treatment should guide COVID-19 vaccine distribution, supporting initial allocation to health care workers, people in high-risk occupations and housing, and those with high-risk medical conditions. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 10, 2020 Category: General Medicine Source Type: research

Treatment and Control of Hypertension in 2020
The global burden of hypertension and diseases causally linked to it is substantial. In 2015, among 30 environmental, behavioral, and metabolic risk factors for diseases resulting in the highest levels of disability-adjusted life-years, high blood pressure ranked No. 1. Further analyses revealed that from 1990 to 2015, the worldwide rate of elevated systolic blood pressure levels increased substantially, as did deaths and disability-adjusted life-years related to high systolic blood pressure. Increasing risks of death and disability were observed even at systolic blood pressure levels of 110 mm Hg to 115 mm Hg. (Source: JA...
Source: JAMA - Journal of the American Medical Association - September 9, 2020 Category: General Medicine Source Type: research

Obesity and Hypertension in the Time of COVID-19
In this issue of JAMA, 2 reports present cross-sectional data on the prevalence and trends for obesity and controlled hypertension from 1999 through 2018 based on data from the National Health and Nutrition Examination Survey, a federal program of nationally representative surveys designed to monitor the health and nutrition of adults and children in the US. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 9, 2020 Category: General Medicine Source Type: research

Trends in Blood Pressure Control Among US Adults With Hypertension, 1999-2000 to 2017-2018
This study uses US National Health and Nutrition Examination Survey data to characterize changes in blood pressure control among adults with hypertension between 1999-2000 and 2017-2018 overall and by age, race, insurance type, and health care access. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 9, 2020 Category: General Medicine Source Type: research

Update to Conference Dates
This article was corrected online. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 8, 2020 Category: General Medicine Source Type: research

Prevalence of Third-Party Tracking on COVID-19 –Related Web Pages
This study uses webXray, an automated tool that detects tracking on websites, to describe the prevalence and characteristics of third-party data requests and cookies on the top 20 COVID-19 –related websites, including academic and government sites, from US-based search results in May 2020. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 8, 2020 Category: General Medicine Source Type: research

Upper Airway Surgery for Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse, hypoxemia, and sleep disruption; is strongly associated with cardiovascular disease; and is an important cause of excessive daytime sleepiness. In the US, the estimated prevalence in 2013 of moderate to severe sleep apnea was 10% to 17% in men and 3% to 9% in women, and the most common risk factors include advancing age, obesity, and male sex. Continuous positive airway pressure (CPAP) is highly effective at maintaining upper airway patency, and has been shown in randomized clinical trials to improve symptoms of OSA, such as daytime sleepin...
Source: JAMA - Journal of the American Medical Association - September 4, 2020 Category: General Medicine Source Type: research

Effect of Upper Airway Surgery vs Medical Management on Obstructive Sleep Apnea
This randomized clinical trial compares the effect of multilevel airway surgery (combined palatal and tongue surgery) vs ongoing medical management on apnea-hypopnea index (AHI) measures and daytime sleepiness symptoms in patients with obstructive sleep apnea (OSA) whose condition did not respond to CPAP treatment. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 4, 2020 Category: General Medicine Source Type: research

Running on Fumes
In this narrative medicine essay, a hospitalist charts his emotional journey from March by the once brightly colored signs that declared hospital workers as heroes have now faded by summer reflecting how the steady and intense work of helping patients with COVID-19 has seemingly become mundane. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 4, 2020 Category: General Medicine Source Type: research

Cytokine Levels in Critically Ill Patients With COVID-19 and Other Conditions
This study compares levels of tumor necrosis factor α, IL-6, and IL-8 in critically ill patients with coronavirus disease 2019 (COVID-19) vs those with other critical illness to better characterize the contribution of cytokine storm to COVID-19 pathophysiology. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 3, 2020 Category: General Medicine Source Type: research

COVID-19 and mRNA Vaccines —First Large Test for a New Approach
This Medical News article discusses the leading vaccine candidates against the novel coronavirus. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 3, 2020 Category: General Medicine Source Type: research

Corticosteroids in COVID-19 ARDS
Corticosteroids, such as hydrocortisone and dexamethasone, have anti-inflammatory, antifibrotic, and vasoconstrictive effects, which intensivists have been trying to leverage for decades to improve outcomes in patients with acute respiratory distress syndrome (ARDS) and septic shock. In the first description of ARDS in 1967, Ashbaugh and colleagues noted that “corticosteroids appeared to have value in the treatment of patients with fat-embolism and possibly viral pneumonia.” (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 2, 2020 Category: General Medicine Source Type: research

Effect of Hydrocortisone on Mortality or Respiratory Support Among Critically Ill COVID-19 Patients
This randomized clinical trial compares the effect of low-dose hydrocortisone vs placebo on treatment failure (death or persistent respiratory support dependency) at 21 days in critically ill patients with COVID-19 and acute respiratory failure in France. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 2, 2020 Category: General Medicine Source Type: research

Effect of Dexamethasone on Ventilator-Free Days in Patients With Moderate or Severe COVID-19 –Related ARDS
This open label clinical trial compares the effects of dexamethasone vs usual care on the number of days alive and free of mechanical ventilation at day 28 among COVID-19 patients in Brazil with moderate to severe acute respiratory distress syndrome (ARDS). (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 2, 2020 Category: General Medicine Source Type: research

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19
This open-label randomized trial compares the effects of fixed-dose vs shock-dependent vs no intravenous hydrocortisone on organ support –free days among patients with coronavirus disease 2019 (COVID-19) admitted to critical care units (ICU/CCUs) for respiratory or cardiovascular organ support. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 2, 2020 Category: General Medicine Source Type: research

Association Between Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19
This meta-analysis pools data from 7 randomized trials to estimate the association between administration of corticosteroids vs usual care or placebo and all-cause mortality at 28 days in patients with severe coronavirus disease 2019 (COVID-19). (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - September 2, 2020 Category: General Medicine Source Type: research

SARS-CoV-2 Testing and Community Health Center Primary Care Services During the COVID-19 Pandemic
This study uses electronic health record data to describe primary care services offered by US community health centers in March through May 2020, including SARS-CoV-2 testing, well-child visits, HbA1c testing, and cancer screening. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - August 31, 2020 Category: General Medicine Source Type: research

Emergency Use Authorizations During the COVID-19 Pandemic
This Viewpoint describes the FDA ’s Emergency Use Authorization (EUA) of hydroxychloroquine for treatment of COVID-19 and its subsequent revocation, and suggests improvements to the EUA process during development of COVID-19 vaccines and for future public health crises. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - August 31, 2020 Category: General Medicine Source Type: research