August 21, 2018 Issue of JAMA

August 21, 2018, Vol 320, No. 7, Pages 615-733

This Week in JAMA

Highlights

Abstract Full Text

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JAMA. 2018;320(7):615-617. doi:10.1001/jama.2017.12504

Podcast: Brand vs Generic Drug Spending, CV Health and Dementia, Cervical Cancer Screening Guideline, and more

Original Investigation

Medicare Spending on Brand-name Combination Medications vs Their Generic Constituents

Chana A. Sacks, MD, MPH; ChangWon C. Lee; Aaron S. Kesselheim, MD, JD, MPH; et al.

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JAMA. 2018;320(7):650-656. doi:10.1001/jama.2018.11439

This retrospective analysis estimates the additional cost to Medicare of prescribing brand-name combination medications instead of generic constituents by using the Medicare data set of Part D beneficiaries prescribed any of the 1500 medications that accounted for highest total spending in 2015.

Association of Cardiovascular Health Level in Older Age With Cognitive Decline and Incident Dementia

Cécilia Samieri, PhD; Marie-Cécile Perier, MSc; Bamba Gaye, PhD; et al.

Abstract Full Text

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JAMA. 2018;320(7):657-664. doi:10.1001/jama.2018.11499

This cohort study assesses the association between cardiovascular (CV) health, defined by measures of healthy lifestyle and controlled CV risk factors, and risk of cognitive decline and dementia in community-dwelling people in France aged 65 years or older.

Editorial
Striving for Ideal Cardiovascular and Brain Health: It Is Never Too Early or Too Late
Jeffrey L. Saver, MD; Mary Cushman, MD, MSc

JAMA

Preliminary Communication

Association of Cardiovascular Risk Factors With MRI Indices of Cerebrovascular Structure and Function and White Matter Hyperintensities in Young Adults

Wilby Williamson, MSc, MRCP; Adam J. Lewandowski, DPhil; Nils D. Forkert, PhD; et al.

Abstract Full Text

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JAMA. 2018;320(7):665-673. doi:10.1001/jama.2018.11498

This cross-sectional study examines associations between modifiable cardiovascular risk factors鈥攕uch as BMI, cholesterol and glucose levels, smoking, and alcohol use鈥攁nd MRI measures of cerebrovascular structure, function, and white matter integrity in adults aged 18 to 40.

Editorial
Striving for Ideal Cardiovascular and Brain Health: It Is Never Too Early or Too Late
Jeffrey L. Saver, MD; Mary Cushman, MD, MSc

JAMA

Research Letter

Accuracy of Pulse Oximetry-Based Home Baby Monitors

Christopher P. Bonafide, MD, MSCE; A. Russell Localio, PhD; Daria F. Ferro, MD; et al.

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JAMA. 2018;320(7):717-719. doi:10.1001/jama.2018.9018

This study uses an US Food and Drug Administration鈥揷leared oximeter to measure the accuracy of the pulse oximetry-based consumer baby monitors Owlet Smart Sock 2 and Baby Vida.

US Preventive Services Task Force

Recommendation Statement

Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement

US Preventive Services Task Force

Abstract Full Text

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JAMA. 2018;320(7):674-686. doi:10.1001/jama.2018.10897

This 2018 Recommendation Statement from the US Preventive Services Task Force makes recommendations regarding use of cervical cytology alone, high-risk HPV testing alone, and both in combination to screen for cervical cancer.

Podcast: USPSTF Recommendation: Screening for Cervical Cancer

Editorial
Screening for Cervical Cancer: New Tools and New Opportunities
Lee A. Learman, MD, PhD; Francisco A. R. Garcia, MD, MPH

JAMA
Cervical Cancer Screening鈥擬oving From the Value of Evidence to the Evidence of Value
George F. Sawaya, MD

JAMA Intern Med

Evidence Report

Screening for Cervical Cancer With High-Risk Human Papillomavirus Testing: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Joy Melnikow, MD, MPH; Jillian T. Henderson, PhD; Brittany U. Burda, DHSc, MPH; et al.

Abstract Full Text

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JAMA. 2018;320(7):687-705. doi:10.1001/jama.2018.10400

This systematic review to support the 2018 US Preventive Services Task Force Recommendation Statement on screening for cervical cancer summarizes published evidence on the benefits and harms of using high-risk human papillomavirus (hrHPV) testing alone, hrHPV testing with cytology, or cytology alone for cervical cancer screening.

Editorial
Screening for Cervical Cancer: New Tools and New Opportunities
Lee A. Learman, MD, PhD; Francisco A. R. Garcia, MD, MPH

JAMA
Cervical Cancer Screening鈥擬oving From the Value of Evidence to the Evidence of Value
George F. Sawaya, MD

JAMA Intern Med

Modeling Study

Screening for Cervical Cancer in Primary Care: A Decision Analysis for the US Preventive Services Task Force

Jane J. Kim, PhD; Emily A. Burger, PhD; Catherine Regan, BA; et al.

Abstract Full Text

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JAMA. 2018;320(7):706-714. doi:10.1001/jama.2017.19872

This modeling study uses a microsimulation model of a hypothetical cohort to model the benefits, burden, and harms of cervical cancer screening strategies to inform the 2018 US Preventive Services Task Force Recommendation Statement on screening for cervical cancer in primary care.

Editorial
Screening for Cervical Cancer: New Tools and New Opportunities
Lee A. Learman, MD, PhD; Francisco A. R. Garcia, MD, MPH

JAMA
Cervical Cancer Screening鈥擬oving From the Value of Evidence to the Evidence of Value
George F. Sawaya, MD

JAMA Intern Med

Viewpoint

Lyme Disease in 2018: What Is New (and What Is Not)

Eugene D. Shapiro, MD; Gary P. Wormser, MD

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JAMA. 2018;320(7):635-636. doi:10.1001/jama.2018.10974

This Viewpoint provides a clinical update on Lyme disease, reviewing information on the epidemiology, diagnosis, and treatment of the infection, and discussing the role of Lyme testing in the evaluation of chronic pain and fatigue.

Podcast: Treating Lyme Disease in 2018, Part 2
Podcast: Treating Lyme Disease in 2018, Part 1

Direct Primary Care: One Step Forward, Two Steps Back

Eli Y. Adashi, MD, MS; Ryan P. Clodfelter, BA; Paul George, MD, MHPE

Abstract Full Text

JAMA. 2018;320(7):637-638. doi:10.1001/jama.2018.8405

This Viewpoint argues that direct primary care, in which patients contract directly with a primary care physician to pay a recurring out-of-pocket fee for a defined set of benefits, is unlikely to drive improvements in outcomes and reduction in costs because of adverse patient selection and the absence of incentives for physicians to deliver value.

Sustaining Health-Protective Behaviors Such as Physical Activity and Healthy Eating

Genevieve F. Dunton, PhD, MPH

Abstract Full Text

JAMA. 2018;320(7):639-640. doi:10.1001/jama.2018.6621

This Viewpoint discusses the importance of understanding how microtimescale influences鈥攆luctuations in mood or motivation on a minute-to-minute or day-to-day basis鈥攁ffect people鈥檚 ability to sustain lifestyle behaviors over a lifetime and envisions development of just-in-time interventions as needed to facilitate daily healthy choices.

Mandatory Shared Decision Making by the Centers for Medicare & Medicaid Services for Cardiovascular Procedures and Other Tests

Faisal M. Merchant, MD; Neal W. Dickert Jr, MD, PhD; David H. Howard, PhD

Abstract Full Text

JAMA. 2018;320(7):641-642. doi:10.1001/jama.2018.6617

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.

A Piece of My Mind

Blinded by Sight

Sheridan Lam, MD

Abstract Full Text

JAMA. 2018;320(7):643-644. doi:10.1001/jama.2018.11125

In this narrative medicine essay, an opthalmalogist recounts the unexpected results of a cataract removal from a patient who had been blind since she was a teenager following a severe infection that had permanently scarred her corneas.

Editorial

Striving for Ideal Cardiovascular and Brain Health: It Is Never Too Early or Too Late

Jeffrey L. Saver, MD; Mary Cushman, MD, MSc

Abstract Full Text

JAMA. 2018;320(7):645-647. doi:10.1001/jama.2018.11002

Screening for Cervical Cancer: New Tools and New Opportunities

Lee A. Learman, MD, PhD; Francisco A. R. Garcia, MD, MPH

Abstract Full Text

JAMA. 2018;320(7):647-649. doi:10.1001/jama.2018.11004

Editorial
Cervical Cancer Screening鈥擬oving From the Value of Evidence to the Evidence of Value
George F. Sawaya, MD

JAMA Intern Med

Medical News & Perspectives

Hurricane Maria and Puerto Rico: A Physician Looks Back at the Storm

Jennifer Abbasi

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JAMA. 2018;320(7):629-630. doi:10.1001/jama.2018.8244

In this Medical News article, an endocrinologist in Puerto Rico recounts her experiences treating patients during and after last year鈥檚 major hurricane.