December 4, 2018 Issue of JAMA

December 4, 2018, Vol 320, No. 21, Pages 2171-2280

This Week in JAMA

Highlights

Abstract Full Text

free access has audio

JAMA. 2018;320(21):2171-2173. doi:10.1001/jama.2017.12658

Podcast: Hypothermia for Severe TBI, RAS Inhibitors After TAVR, OAC-PPI Therapy and UGIB, and more

Original Investigation

Caring for the Critically Ill Patient

Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury: The POLAR Randomized Clinical Trial

D. James Cooper, MD; Alistair D. Nichol, MB, PhD; Michael Bailey, PhD; et al.

Abstract Full Text

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JAMA. 2018;320(21):2211-2220. doi:10.1001/jama.2018.17075

This randomized clinical trial compares the effects of prophylactic hypothermia targeted to a core temperature of 33掳C-35掳C vs usual normothermic emergency care on neurologic outcomes or independent living of adult patients with severe traumatic brain injury (TBI).

Video: Conference Presentation: Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury: A Randomized Trial

Editorial
Hypothermia After Traumatic Brain Injury
Annemarie Docherty, PhD, MBChB, FRCA; John Emelifeonwu, MBChB, MRCS; Peter J. D. Andrews, MD, MBChB, FRCA

JAMA

Association of Oral Anticoagulants and Proton Pump Inhibitor Cotherapy With Hospitalization for Upper Gastrointestinal Tract Bleeding

Wayne A. Ray, PhD; Cecilia P. Chung, MD, MPH; Katherine T. Murray, MD; et al.

Abstract Full Text

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JAMA. 2018;320(21):2221-2230. doi:10.1001/jama.2018.17242

This pharmacoepidemiology study examines the association between oral anticoagulants (warfarin, apixaban, dabigatran, and rivaroxaban), cotherapy with proton pump inhibitors (PPIs), and upper gastrointestinal (UGI) tract bleeding in Medicare beneficiaries.

Association of Renin-Angiotensin Inhibitor Treatment With Mortality and Heart Failure Readmission in Patients With Transcatheter Aortic Valve Replacement

Taku Inohara, MD, PhD; Pratik Manandhar, MS; Andrzej S. Kosinski, PhD; et al.

Abstract Full Text

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JAMA. 2018;320(21):2231-2241. doi:10.1001/jama.2018.18077

This cohort study uses registry and Medicare claims data to investigate associations between prescription for a renin-angiotensin system (RAS) inhibitor at hospital discharge after transcatheter aortic valve replacement (TAVR) and 1-year all-cause mortality and heart failure readmissions.

Association of Medicaid Expansion With 1-Year Mortality Among Patients With End-Stage Renal Disease

Shailender Swaminathan, PhD; Benjamin D. Sommers, MD, PhD; Rebecca Thorsness, BA; et al.

Abstract Full Text

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JAMA. 2018;320(21):2242-2250. doi:10.1001/jama.2018.16504

This before-after study examines changes in 1-year mortality among nonelderly patients initiating dialysis in states that did vs did not participate in Medicaid expansion under the Affordable Care Act in 2014.

Editorial
Did Medicaid Expansion Reduce Mortality Among Patients Initiating Dialysis for Irreversible Kidney Failure?
Kevin F. Erickson, MD, MS; Vivian Ho, PhD; Wolfgang C. Winkelmayer, MD, ScD

JAMA

Research Letter

Proportion of Non鈥揢S-Born and Noncitizen Health Care Professionals in the United States in 2016

Yash M. Patel, BA; Dan P. Ly, MD; Tanner Hicks, BS; et al.

Abstract Full Text

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JAMA. 2018;320(21):2265-2267. doi:10.1001/jama.2018.14270

This national survey study uses US Census Bureau data to estimate the proportion of non鈥揢S-born and noncitizen health care professionals in the United States in 2016.

Association Between the Liaison Committee on Medical Education鈥檚 Diversity Standards and Changes in Percentage of Medical Student Sex, Race, and Ethnicity

Dowin H. Boatright, MD, MBA, MHS; Elizabeth A. Samuels, MD, MPH, MHS; Laura Cramer, PhD, ScM; et al.

Abstract Full Text

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JAMA. 2018;320(21):2267-2269. doi:10.1001/jama.2018.13705

This study examines the change in matriculant sex, race, and ethnicity in US medical schools after the 2009 implementation of diversity standards from the Liaison Committee on Medical Education (LCME) meant to broaden diversity among qualified applicants.

Special Communication

Caring for the Critically Ill Patient

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome and Posterior Probability of Mortality Benefit in a Post Hoc Bayesian Analysis of a Randomized Clinical Trial

Ewan C. Goligher, MD, PhD; George Tomlinson, PhD; David Hajage, MD, PhD; et al.

Abstract Full Text

has multimedia has audio

JAMA. 2018;320(21):2251-2259. doi:10.1001/jama.2018.14276

This Special Communication describes a Bayesian reanalysis of a randomized clinical trial comparing the effects on mortality of venovenous extracorporeal membrane oxygenation (ECMO) vs conventional mechanical ventilation among patients with severe acute respiratory distress syndrome, performed because of divergence between the clinical vs statistical significance of the trial鈥檚 findings and continued controversy over the benefit of ECMO.

Video: Conference Presentation: Extracorporeal Membrane Oxygenation (ECMO) for Severe Acute Respiratory Distress Syndrome (ARDS) and Posterior Probability of Mortality Benefit in a Post Hoc Bayesian Analysis of a Randomized Clinical Trial
Video: Conference Commentary: Extracorporeal Membrane Oxygenation (ECMO) for Severe Acute Respiratory Distress Syndrome (ARDS) and Posterior Probability of Mortality Benefit in a Post Hoc Bayesian Analysis of a Randomized Clinical Trial

Podcast: Bayes for Clinicians Who Need to Know but Don鈥檛 Like Math

Editorial
Time for Clinicians to Embrace Their Inner Bayesian?Reanalysis of Results of a Clinical Trial of Extracorporeal Membrane Oxygenation
Roger J. Lewis, MD, PhD; Derek C. Angus, MD, MPH, FRCP

JAMA
- Podcast: Bayes for Clinicians Who Need to Know but Don鈥檛 Like Math

Viewpoint

Evolving Issues in Oncology

Vaccines as an Integral Component of Cancer Immunotherapy

Jeffrey Schlom, PhD; James L. Gulley, MD, PhD

Abstract Full Text

JAMA. 2018;320(21):2195-2196. doi:10.1001/jama.2018.9511

This Viewpoint reviews recent preclinical developments in the use of therapeutic cancer vaccines to induce immune responses to tumor-associated antigens, alone or in combination with other therapies, such as tumor checkpoint inhibitor monoclonal antibodies, to render resistant (cold) tumor cells susceptible to T-cell antitumor activity.

Editorial
Oncology in Transition: Changes, Challenges, and Opportunities
Deborah Schrag, MD, MPH; Ethan Basch, MD, MSc

JAMA

Redistributing Investment in Health and Social Services鈥擳he Evolving Role of Managed Care

William H. Shrank, MD, MSHS; Donna J. Keyser, PhD, MBA; John G. Lovelace, MS, MSIS

Abstract Full Text

JAMA. 2018;320(21):2197-2198. doi:10.1001/jama.2018.14987

This Viewpoint discusses the increasing investments managed care organizations are making in social services to improve members鈥� health and decrease costs, and argues that the trend could free up resources for investment in the health of groups not covered by managed care plans.

Clinical Decision Support in the Era of Artificial Intelligence

Edward H. Shortliffe, MD, PhD; Martin J. Sepúlveda, MD, ScD

Abstract Full Text

JAMA. 2018;320(21):2199-2200. doi:10.1001/jama.2018.17163

This Viewpoint discusses the potential capabilities and challenges of decision support systems that are designed to be used interactively by clinicians.

A Piece of My Mind

Pain Management: Assembling a Tool Kit, Building a Life

Kevin F. Boehnke, PhD

Abstract Full Text

JAMA. 2018;320(21):2201-2202. doi:10.1001/jama.2018.17722

In this narrative medicine essay, the author shares how he assembled the tools to help him manage his pain from fibromyalgia and argues for reuniting pain medicine with compassion.

Editorial

Oncology in Transition: Changes, Challenges, and Opportunities

Deborah Schrag, MD, MPH; Ethan Basch, MD, MSc

Abstract Full Text

JAMA. 2018;320(21):2203-2204. doi:10.1001/jama.2018.17057

Hypothermia After Traumatic Brain Injury

Annemarie Docherty, PhD, MBChB, FRCA; John Emelifeonwu, MBChB, MRCS; Peter J. D. Andrews, MD, MBChB, FRCA

Abstract Full Text

JAMA. 2018;320(21):2204-2206. doi:10.1001/jama.2018.17121

Did Medicaid Expansion Reduce Mortality Among Patients Initiating Dialysis for Irreversible Kidney Failure?

Kevin F. Erickson, MD, MS; Vivian Ho, PhD; Wolfgang C. Winkelmayer, MD, ScD

Abstract Full Text

JAMA. 2018;320(21):2206-2208. doi:10.1001/jama.2018.14291

Time for Clinicians to Embrace Their Inner Bayesian?Reanalysis of Results of a Clinical Trial of Extracorporeal Membrane Oxygenation

Roger J. Lewis, MD, PhD; Derek C. Angus, MD, MPH, FRCP

Abstract Full Text

has audio

JAMA. 2018;320(21):2208-2210. doi:10.1001/jama.2018.16916

Podcast: Bayes for Clinicians Who Need to Know but Don鈥檛 Like Math

JAMA Clinical Guidelines Synopsis

Incidental Pulmonary Nodules Detected on CT Images

Irsk J. Anderson, MD; Andrew M. Davis, MD, MPH

Abstract Full Text

JAMA. 2018;320(21):2260-2261. doi:10.1001/jama.2018.16336

This JAMA Clinical Guidelines Synopsis summarizes the 2017 Fleischner Society guidelines on management of incidental pulmonary nodules detected on computed tomography (CT) imaging.

From The Medical Letter on Drugs and Therapeutics

Two New Intra-Articular Injections for Knee Osteoarthritis

Abstract Full Text

JAMA. 2018;320(21):2262-2263. doi:10.1001/jama.2018.13134

This Medical Letter review summarizes doses and formulations of 2 recently approved treatments for osteoarthritic knee pain, a single-injection hyaluronic acid gel (Durolane) and an extended-release formulation of triamcinolone acetonide (Zilretta).

Medical News & Perspectives