November 7, 2017 Issue of JAMA

November 7, 2017, Vol 318, No. 17, Pages 1625-1728

This Week in JAMA

Highlights

Abstract Full Text

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JAMA. 2017;318(17):1625-1627. doi:10.1001/jama.2016.13377

Podcast: Pain meds in the ED, TNF inhibitors and lymphoma, fall prevention, and more.

Original Investigation

Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department: A Randomized Clinical Trial

Andrew K. Chang, MD, MS; Polly E. Bijur, PhD; David Esses, MD; et al.

Abstract Full Text

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JAMA. 2017;318(17):1661-1667. doi:10.1001/jama.2017.16190

This randomized clinical trial compares the efficacy of 4 oral combination analgesics among adult patients treated for moderate to severe acute extremity pain at 2 urban emergency departments in the United States.

Editorial
Opioid vs Nonopioid Acute Pain Management in the Emergency Department
Demetrios N. Kyriacou, MD, PhD

JAMA

Factors Associated With Increases in US Health Care Spending, 1996-2013

Joseph L. Dieleman, PhD; Ellen Squires, MPH; Anthony L. Bui, MPH; et al.

Abstract Full Text

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JAMA. 2017;318(17):1668-1678. doi:10.1001/jama.2017.15927

This study uses data from the 2013 US Disease Expenditure project and the 2015 Global Burden of Disease study to evaluate associations between population, disease, and service utilization and price variables and changes in health care spending between 1996 and 2013.

Editorial
Factors Associated With Increased US Health Care Spending: Implications for Controlling Health Care Costs
Patrick H. Conway, MD, MSc

JAMA

Association Between Use of Thiopurines or Tumor Necrosis Factor Antagonists Alone or in Combination and Risk of Lymphoma in Patients With Inflammatory Bowel Disease

Magali Lemaitre, PhD; Julien Kirchgesner, MD, MSc; Annie Rudnichi, MD; et al.

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JAMA. 2017;318(17):1679-1686. doi:10.1001/jama.2017.16071

This pharmacoepidemiology study conducted in France assesses the risk of lymphoma associated with thiopurines and anti鈥搕umor necrosis factor agents, used alone or in combination, for treatment of inflammatory bowel disease.

Comparisons of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis

Andrea C. Tricco, PhD; Sonia M. Thomas, MSc; Areti Angeliki Veroniki, PhD; et al.

Abstract Full Text

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JAMA. 2017;318(17):1687-1699. doi:10.1001/jama.2017.15006

This network meta-analysis of trials comparing fall-prevention interventions for older adults provides summary estimates of the effects of exercise and vision and environmental assessments for reducing fall-related injury and hospitalization.

Editorial
Evidence Supports Action to Prevent Injurious Falls in Older Adults
Eric B. Larson, MD, MPH

JAMA

Research Letter

Labeling Accuracy of Cannabidiol Extracts Sold Online

Marcel O. Bonn-Miller, PhD; Mallory J. E. Loflin, PhD; Brian F. Thomas, PhD; et al.

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JAMA. 2017;318(17):1708-1709. doi:10.1001/jama.2017.11909

This study compares ingredients listed on the labels of cannabidiol products sold online to actual product constituents determined by laboratory analysis.

Association of Trial Registration With Reporting of Primary Outcomes in Protocols and Publications

An-Wen Chan, MD, DPhil; Annukka Pello, MD; Jessica Kitchen, MSc; et al.

Abstract Full Text

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JAMA. 2017;318(17):1709-1711. doi:10.1001/jama.2017.13001

This study characterizes discrepancies between primary outcomes specified in trial protocols, registrations, and publications, and the association between prospective registration and consistency of published outcomes.

Viewpoint

Potential Health Implications Related to Fracking

Russell A. Wilke, MD, PhD; Jerome W. Freeman, MD

Abstract Full Text

JAMA. 2017;318(17):1645-1646. doi:10.1001/jama.2017.14239

This Viewpoint reviews the potential health risks associated with fracking in the United States, including effects on air quality and consequences of exposure to fracking fluids, and proposes policy and public health safeguards to prevent harms.

Targeting Immune Checkpoints in Cancer Therapy

Suzanne L. Topalian, MD

Abstract Full Text

JAMA. 2017;318(17):1647-1648. doi:10.1001/jama.2017.14155

This Viewpoint reviews the development of immune checkpoint inhibitors as a new drug class for treating cancer, and discusses future directions including development of commercial assays for identifying response-to-treatment biomarkers and the use of combination regimens to improve response.

Knowledge for Precision Medicine: Mechanistic Reasoning and Methodological Pluralism

Mark R. Tonelli, MD, MA; Brian H. Shirts, MD, PhD

Abstract Full Text

JAMA. 2017;318(17):1649-1650. doi:10.1001/jama.2017.11914

This Viewpoint discusses how precision medicine demands case-based reasoning, in which the relevant particulars of the individual patient are elucidated and incorporated into clinical assessments and decisions, and the challenge of expanding individualized knowledge.

Vaccination Challenges in Confronting the Resurgent Threat From Yellow Fever

Lin H. Chen, MD; Davidson H. Hamer, MD

Abstract Full Text

JAMA. 2017;318(17):1651-1652. doi:10.1001/jama.2017.14258

This Viewpoint examines strategies for vaccinating travelers against yellow fever given recent vaccine shortages and global yellow fever outbreaks.

A Piece of My Mind

Despite My Best Intentions

James S. Kahn, MD

Abstract Full Text

JAMA. 2017;318(17):1653-1654. doi:10.1001/jama.2017.6123

Editorial

Opioid vs Nonopioid Acute Pain Management in the Emergency Department

Demetrios N. Kyriacou, MD, PhD

Abstract Full Text

JAMA. 2017;318(17):1655-1656. doi:10.1001/jama.2017.16725

Factors Associated With Increased US Health Care Spending: Implications for Controlling Health Care Costs

Patrick H. Conway, MD, MSc

Abstract Full Text

JAMA. 2017;318(17):1657-1658. doi:10.1001/jama.2017.16802

Evidence Supports Action to Prevent Injurious Falls in Older Adults

Eric B. Larson, MD, MPH

Abstract Full Text

JAMA. 2017;318(17):1659-1660. doi:10.1001/jama.2017.15098

JAMA Clinical Evidence Synopsis

Maternal Use of Antiepileptic Agents During Pregnancy and Major Congenital Malformations in Children

Rebecca L. Bromley, PhD; Jennifer Weston, CPsychol; Anthony G. Marson, MB, ChB, MD

Abstract Full Text

JAMA. 2017;318(17):1700-1701. doi:10.1001/jama.2017.14485

This Clinical Evidence Synopsis summarizes a Cochrane review summarizing associations between maternal use of antiepileptic drugs during pregnancy and major congenital malformations in children.

JAMA Clinical Guidelines Synopsis

Screening for Chronic Obstructive Pulmonary Disease

Valerie G. Press, MD, MPH; Adam S. Cifu, MD; Steven R. White, MD

Abstract Full Text

JAMA. 2017;318(17):1702-1703. doi:10.1001/jama.2017.15782

This JAMA Clinical Guidelines Synopsis summarizes the 2017 Global Initiative for Chronic Obstructive Lung Disease guideline on screening for chronic obstructive pulmonary disorder.

JAMA Diagnostic Test Interpretation

Interpretation of Urine Drug Screens: Metabolites and Impurities

Geeta Nagpal, MD; Heather Heiman, MD; Shannon Haymond, PhD

Abstract Full Text

JAMA. 2017;318(17):1704-1705. doi:10.1001/jama.2017.10910

A comprehensive urine drug screen for a 50-year-old woman taking daily methadone, immediate-release morphine, gabapentin, duloxetine, and celecoxib for pain was positive for methadone and morphine but also codeine and hydromorphone. How do you interpret the results?

Medical News & Perspectives

Bioethics Panels Open Door Slightly to Germline Gene Editing

Jeff Lyon

Abstract Full Text

JAMA. 2017;318(17):1639-1640. doi:10.1001/jama.2017.13962

This Medical News article explores the prospects for gene editing in humans.

News From the Food and Drug Administration

First Biosimilar to Treat Cancer

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2017;318(17):1644. doi:10.1001/jama.2017.15839

Duodenoscope Design Aimed at Infection Prevention

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2017;318(17):1644. doi:10.1001/jama.2017.16043

Intravenous Lymphoma Drug Approved

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2017;318(17):1644. doi:10.1001/jama.2017.16047

The JAMA Forum

Republicans Will Own Whatever Happens to the ACA and Health Care Reform

Gail Wilensky, PhD

Abstract Full Text

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JAMA. 2017;318(17):1642-1643. doi:10.1001/jama.2017.15727

Bench to Bedside

Gene Editing Provides Clues to Why Cancer Immunotherapy Often Fails

Tracy Hampton, PhD

Abstract Full Text

JAMA. 2017;318(17):1641-1642. doi:10.1001/jama.2017.15507

The Arts and Medicine

Portraits in Health Policy

Theresa BrownGold

Abstract Full Text

JAMA. 2017;318(17):1634-1636. doi:10.1001/jama.2017.11556

This Arts and Medicine essay features portrait paintings of individuals whose health care stories represent the challenges of navigating the fragmented US health care and insurance system.

Poetry and Medicine