April 10, 2018 Issue of JAMA

April 10, 2018, Vol 319, No. 14, Pages 1415-1520

This Week in JAMA

Highlights

Abstract Full Text

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JAMA. 2018;319(14):1415-1417. doi:10.1001/jama.2017.12317

Podcast: US Burden of Disease, LABAs and LAMAs for Asthma, Tumor DNA Sequencing to Guide Cancer Management, and more

Original Investigation

The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States

The US Burden of Disease Collaborators

Abstract Full Text

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JAMA. 2018;319(14):1444-1472. doi:10.1001/jama.2018.0158

In this study, Global Burden of Disease investigators characterize trends in mortality, life expectancy, and prevalence associated with most common diseases and disease and mortality risk factors in the United States between 1990 and 2016.

Podcast: US Burden of Diseases, Injuries, and Disease Risk Factors, 1990-2016

Editorial
Toward a United States of Health: Implications of Understanding the US Burden of Disease
Howard K. Koh, MD, MPH; Anand K. Parekh, MD, MPH

JAMA

Association of Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists With Asthma Control in Patients With Uncontrolled, Persistent Asthma: A Systematic Review and Meta-analysis

Diana M. Sobieraj, PharmD; William L. Baker, PharmD; Elaine Nguyen, PharmD, MPH; et al.

Abstract Full Text

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JAMA. 2018;319(14):1473-1484. doi:10.1001/jama.2018.2757

This systematic review and meta-analysis assesses the effects of long-acting muscarinic antagonist vs placebo or vs other controllers as an add-on therapy to inhaled corticosteroids and the use of triple therapy vs inhaled corticosteroids and long-acting 尾-agonists in patients with uncontrolled, persistent asthma.

Editorial
Time to Converge FDA Decisions and Evidence Syntheses for Long-Acting Muscarinic Antagonists and SMART in Guidelines for the Treatment of Asthma
Jerry A. Krishnan, MD, PhD; David H. Au, MD, MS

JAMA

Association of Inhaled Corticosteroids and Long-Acting 尾-Agonists as Controller and Quick Relief Therapy With Exacerbations and Symptom Control in Persistent Asthma: A Systematic Review and Meta-analysis

Diana M. Sobieraj, PharmD; Erin R. Weeda, PharmD; Elaine Nguyen, PharmD, MPH; et al.

Abstract Full Text

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JAMA. 2018;319(14):1485-1496. doi:10.1001/jama.2018.2769

This systematic review and meta-analysis of randomized trials compares the efficacy of combined use of inhaled corticosteroids and long-acting 尾-agonists (LABAs) as the controller and the quick relief therapy (SMART) vs the same or higher doses of inhaled corticosteroids with or without a LABA used as the controller therapy and short-acting 尾-agonists as the relief therapy in patients with persistent asthma.

Editorial
Time to Converge FDA Decisions and Evidence Syntheses for Long-Acting Muscarinic Antagonists and SMART in Guidelines for the Treatment of Asthma
Jerry A. Krishnan, MD, PhD; David H. Au, MD, MS

JAMA

Research Letter

Acute Malnutrition and Anemia Among Rohingya Children in Kutupalong Camp, Bangladesh

Eva Leidman, MSPH; Alexa Humphreys, MS; Blanche Greene Cramer, DrPH; et al.

Abstract Full Text

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JAMA. 2018;319(14):1505-1506. doi:10.1001/jama.2018.2405

This survey study assesses the health and nutritional status of Rohingya children aged 6 to 59 months in the Kutupalong refugee camp in Bangladesh.

Viewpoint

The Proposal to Lower P Value Thresholds to .005

John P. A. Ioannidis, MD, DSc

Abstract Full Text

JAMA. 2018;319(14):1429-1430. doi:10.1001/jama.2018.1536

In this Viewpoint, John Ioannidis discusses the potential effects on clinical research of a 2017 proposal to lower the default P value threshold for statistical significance from .05 to .005 as a means to reduce false-positive findings and reviews alternative solutions for improving the accuracy and relevance of statistical inference.

Editorial
The Enduring Evolution of the P Value
Demetrios N. Kyriacou, MD, PhD

JAMA

Novel Vaccine Technologies: Essential Components of an Adequate Response to Emerging Viral Diseases

Barney S. Graham, MD, PhD; John R. Mascola, MD; Anthony S. Fauci, MD

Abstract Full Text

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JAMA. 2018;319(14):1431-1432. doi:10.1001/jama.2018.0345

In this Viewpoint, Anthony Fauci and colleagues review modern technological advances that facilitate acceleration of vaccine development in response to new and emerging viral disease threats, and argue for investment in surveillance in developing countries to expedite pathogen identification and jump-start the vaccine development process.

Driving Under the Influence of Cannabis: An Increasing Public Health Concern

Johannes G. Ramaekers, PhD

Abstract Full Text

JAMA. 2018;319(14):1433-1434. doi:10.1001/jama.2018.1334

This Viewpoint reviews evidence that cannabis use impairs driving performance and emphasizes the importance of developing policies and legislation to address the resulting safety risks.

Editorial
Driving After Marijuana Use: The Changing Face of 鈥淚mpaired鈥� Driving
Mark Asbridge, PhD

JAMA Pediatr

Enforcing Federal Drug Laws in States Where Medical Marijuana Is Lawful

Lawrence O. Gostin, JD; James G. Hodge Jr, JD, LLM; Sarah A. Wetter, JD

Abstract Full Text

JAMA. 2018;319(14):1435-1436. doi:10.1001/jama.2018.1083

This Viewpoint describes the 2018 rescission of federal limits on enforcement of medical marijuana and discusses its possible consequences on state laws, medical research, and legal risks for physicians prescribing and patients using medical marijuana.

Editorial
Medical Marijuana Laws and Cannabis Use: Intersections of Health and Policy
Wilson M. Compton, MD, MPE; Nora D. Volkow, MD; Marsha F. Lopez, PhD, MHS

JAMA Psychiatry

A Piece of My Mind

A Third Option

Sumit D. Agarwal, MD

Abstract Full Text

JAMA. 2018;319(14):1437. doi:10.1001/jama.2018.3169

In this narrative medical essay, the author recounts a patient鈥檚 brave decision to refuse a face mask and mechanical ventilation while deoxygenating from spontaenous pneumothorax and interstitial lung disease, a care choice none of the physicians considered.

Editorial

Toward a United States of Health: Implications of Understanding the US Burden of Disease

Howard K. Koh, MD, MPH; Anand K. Parekh, MD, MPH

Abstract Full Text

JAMA. 2018;319(14):1438-1440. doi:10.1001/jama.2018.0157

Time to Converge FDA Decisions and Evidence Syntheses for Long-Acting Muscarinic Antagonists and SMART in Guidelines for the Treatment of Asthma

Jerry A. Krishnan, MD, PhD; David H. Au, MD, MS

Abstract Full Text

JAMA. 2018;319(14):1441-1443. doi:10.1001/jama.2018.2029

JAMA Insights

Genomics and Precision Health

Sequencing of Tumor DNA to Guide Cancer Risk Assessment and Therapy

David H. Spencer, MD, PhD; Timothy J. Ley, MD

Abstract Full Text

JAMA. 2018;319(14):1497-1498. doi:10.1001/jama.2018.2281

This Genomics and Precision Health article reviews clinical applications of tumor DNA sequencing to direct treatment of melanoma and of myeloid, lung, and colorectal cancers.

JAMA Clinical Challenge

A 58-Year-Old Man With a Macerated Rash of the Neck and Axilla

Christopher Haley, MD; Uyen Ngoc Mui, MD; Stephen K. Tyring, MD, PhD

Abstract Full Text

JAMA. 2018;319(14):1499-1500. doi:10.1001/jama.2018.2285

An African American man presented with a 5-year history of a pruritic and painful rash of the right lateral area of the neck and right axilla that worsened in the summer and sometimes blistered. A sister had a similar rash. What would you do next?

From The Medical Letter on Drugs and Therapeutics

Benralizumab (Fasenra) for Severe Eosinophilic Asthma

Abstract Full Text

JAMA. 2018;319(14):1501-1502. doi:10.1001/jama.2018.3609

This Medical Letter review summarizes the mechanism of action, results from clinical studies, and adverse effects of benralizumab, a humanized monoclonal antibody selective for the interleukin-5 receptor, for add-on maintenance treatment of severe asthma among patients aged 12 years or older with an eosinophilic phenotype .

Medical News & Perspectives

A Day in the Life: Facing the Opioid Epidemic in Huntington, West Virginia

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2018;319(14):1423-1424. doi:10.1001/jama.2018.1353

This Medical News article profiles Beth Toppins, an emergency physician on the front lines of the opioid epidemic in Huntington, West Virginia. It is part of an ongoing JAMA News series profiling the daily routine of health care professionals making a difference in their communities.

Did a Sugar Called Trehalose Contribute to the Clostridium difficile Epidemic?

Jennifer Abbasi

Abstract Full Text

JAMA. 2018;319(14):1425-1426. doi:10.1001/jama.2018.0888

This Medical News article discusses whether trehalose, a sugar manufactured from cornstarch used to sweeten and texturize foods, has contributed to the emergence of epidemic strains of Clostridium difficile infection (CDI).

News From the Centers for Disease Control and Prevention