April 9, 2019 Issue of JAMA

April 9, 2019, Vol 321, No. 14, Pages 1325-1418

This Week in JAMA

Highlights

Abstract Full Text

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JAMA. 2019;321(14):1325-1327. doi:10.1001/jama.2018.15278

Podcast: Effect of Vitamin D on GI Cancer Survival, HIV PrEP and STIs, Tumor Genomics and NSCLC Outcomes, and more

Original Investigation

Effect of Vitamin D Supplementation on Relapse-Free Survival Among Patients With Digestive Tract Cancers: The AMATERASU Randomized Clinical Trial

Mitsuyoshi Urashima, MD; Hironori Ohdaira, MD; Taisuke Akutsu, MD; et al.

Abstract Full Text

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JAMA. 2019;321(14):1361-1369. doi:10.1001/jama.2019.2210

This randomized clinical trial compares the effects of vitamin D supplementation vs placebo on 5-year relapse-free survival after surgical resection of stage I-III esophageal, gastric, small bowel, and colorectal cancers.

Video: Effects of Vitamin D Supplementation On Outcomes In Patients With Gastrointestinal (GI) Cancer

Editorial
Vitamin D as Cancer Therapy?Insights From 2 New Trials
Elizabeth L. Barry, PhD; Michael N. Passarelli, PhD; John A. Baron, MD, MS, MSc

JAMA
- Video: Effects of Vitamin D Supplementation On Outcomes In Patients With Gastrointestinal (GI) Cancer
- Conversations with Dr Bauchner: Insights From 2 New Trials on Vitamin D as Cancer Therapy

Effect of High-Dose vs Standard-Dose Vitamin D₃ Supplementation on Progression-Free Survival Among Patients With Advanced or Metastatic Colorectal Cancer: The SUNSHINE Randomized Clinical Trial

Kimmie Ng, MD, MPH; Halla S. Nimeiri, MD; Nadine J. McCleary, MD, MPH; et al.

Abstract Full Text

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JAMA. 2019;321(14):1370-1379. doi:10.1001/jama.2019.2402

This phase 2 randomized clinical trial compares the effects of high-dose vs standard-dose vitamin D₃ added to standard chemotherapy on progression-free survival among patients with metastatic colorectal cancer.

Video: Effects of Vitamin D Supplementation On Outcomes In Patients With Gastrointestinal (GI) Cancer

Editorial
Vitamin D as Cancer Therapy?Insights From 2 New Trials
Elizabeth L. Barry, PhD; Michael N. Passarelli, PhD; John A. Baron, MD, MS, MSc

JAMA
- Video: Effects of Vitamin D Supplementation On Outcomes In Patients With Gastrointestinal (GI) Cancer
- Conversations with Dr Bauchner: Insights From 2 New Trials on Vitamin D as Cancer Therapy

Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection

Michael W. Traeger, MSc; Vincent J. Cornelisse, MBBS, PhD; Jason Asselin, BSc; et al.

Abstract Full Text

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JAMA. 2019;321(14):1380-1390. doi:10.1001/jama.2019.2947

To evaluate the possibility that HIV preexposure prophylaxis (PrEP) might lead to behavioral changes that increase risk of non-HIV sexually transmitted infections (STIs), this cohort study investigates the incidence of chlamydia, gonorrhea, and syphilis among a population of Australian gay and bisexual men before and after initiation of HIV PrEP.

Editorial
Addressing the Sexually Transmitted Infection and HIV Syndemic
Monica Gandhi, MD, MPH; Matthew A. Spinelli, MD; Kenneth H. Mayer, MD

JAMA

Association of Patient Characteristics and Tumor Genomics With Clinical Outcomes Among Patients With Non鈥揝mall Cell Lung Cancer Using a Clinicogenomic Database

Gaurav Singal, MD; Peter G. Miller, MD, PhD; Vineeta Agarwala, MD, PhD; et al.

Abstract Full Text

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JAMA. 2019;321(14):1391-1399. doi:10.1001/jama.2019.3241

This cancer epidemiology study links electronic health record (EHR) data with comprehensive genomic profiling to identify patient characteristics and gene alterations associated with overall survival, response to targeted and immune therapies, and other clinical outcomes in patients non鈥搒mall cell lung cancer (NSCLC).

Editorial
The Evolving Uses of 鈥淩eal-World鈥� Data
Ethan Basch, MD, MSc; Deborah Schrag, MD, MPH

JAMA

Research Letter

Nurse Practitioner and Physician Assistant Waivers to Prescribe Buprenorphine and State Scope of Practice Restrictions

Joanne Spetz, PhD; Christopher Toretsky, MPH; Susan Chapman, PhD, RN; et al.

Abstract Full Text

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JAMA. 2019;321(14):1407-1408. doi:10.1001/jama.2019.0834

This study uses SAMHSA data to describe the proportions of nurse practitioners and physician assistants with waivers to prescribe buprenorphine for treating opioid use disorder and associations with state regulations restricting their scope of practice.

Viewpoint

Trust in Health Care

Physicians鈥� Trust in One Another

Richard M. Frankel, PhD; Virginia P. Tilden, PhD; Anthony Suchman, MD, MA

Abstract Full Text

JAMA. 2019;321(14):1345-1346. doi:10.1001/jama.2018.20569

This Viewpoint discusses the importance of trust between physicians for ensuring quality care and reducing physician burnout; shares physicians鈥� stories about trust and mistrust of their peers and colleagues; and proposes a set of initial principles intended to foster physician-physician trust.

Editorial
Trust in Health Care
Howard Bauchner, MD

JAMA
Building Trust in Health Care鈥擶hy, Where, and How
Dhruv Khullar, MD, MPP

JAMA

Trust in Health Care

Why Physicians Should Trust in Patients

Rachel Grob, PhD; Gwen Darien, BA; David Meyers, MD

Abstract Full Text

JAMA. 2019;321(14):1347-1348. doi:10.1001/jama.2019.1500

This Viewpoint discusses the importance of reciprocal trust between patients and physicians, identifies reasons physicians may not trust their patients, and proposes ways physicians can communicate their trust directly to patients.

Editorial
Trust in Health Care
Howard Bauchner, MD

JAMA
Building Trust in Health Care鈥擶hy, Where, and How
Dhruv Khullar, MD, MPP

JAMA

Obesity Treatment, Beyond the Guidelines: Practical Suggestions for Clinical Practice

Scott Kahan, MD, MPH; JoAnn E. Manson, MD, DrPH

Abstract Full Text

JAMA. 2019;321(14):1349-1350. doi:10.1001/jama.2019.2352

This Viewpoint proposes a guideline-based approach to weight management counseling in primary care, emphasizing the need to avoid stigmatizing overweight and obesity, and the need for physician persistence in offering patients their attention, support, and individualized treatment.

Nutrition Education in Medical School, Residency Training, and Practice

Stephen Devries, MD; Walter Willett, MD, DrPH; Robert O. Bonow, MD, MS

Abstract Full Text

JAMA. 2019;321(14):1351-1352. doi:10.1001/jama.2019.1581

This Viewpoint discusses the lack of nutrition education offered to medical students, despite the important role that physicians can and should play in advising patients on the topic, and proposes ways to integrate meaningful nutrition instruction into all phases of medical training.

A Piece of My Mind

Having the Conversation I Encourage Others to Have

Kate Lally, MD

Abstract Full Text

JAMA. 2019;321(14):1353. doi:10.1001/jama.2019.3166

In this narrative medicine essay, a palliative care physician with breast cancer talks about the end-of-life conversations she and her husband have, recalling how her priorities have changed through life stages and how she uses her experiences to inform her interactions with her own cancer patients.

Editorial

Vitamin D as Cancer Therapy?Insights From 2 New Trials

Elizabeth L. Barry, PhD; Michael N. Passarelli, PhD; John A. Baron, MD, MS, MSc

Abstract Full Text

has multimedia has audio

JAMA. 2019;321(14):1354-1355. doi:10.1001/jama.2019.2589

Video: Effects of Vitamin D Supplementation On Outcomes In Patients With Gastrointestinal (GI) Cancer

Conversations with Dr Bauchner: Insights From 2 New Trials on Vitamin D as Cancer Therapy

Addressing the Sexually Transmitted Infection and HIV Syndemic

Monica Gandhi, MD, MPH; Matthew A. Spinelli, MD; Kenneth H. Mayer, MD

Abstract Full Text

JAMA. 2019;321(14):1356-1358. doi:10.1001/jama.2019.2945

The Evolving Uses of 鈥淩eal-World鈥� Data

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

Abstract Full Text

JAMA. 2019;321(14):1359-1360. doi:10.1001/jama.2019.4064

JAMA Guide to Statistics and Methods

Overview of Cost-effectiveness Analysis

Gillian D. Sanders, PhD; Matthew L. Maciejewski, PhD; Anirban Basu, PhD

Abstract Full Text

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JAMA. 2019;321(14):1400-1401. doi:10.1001/jama.2019.1265

This JAMA Guide to Statistics and Methods reviews the use of cost-effectiveness analysis to quantify the tradeoffs in costs, harms, and benefits of new health care interventions compared with existing interventions.

Podcast: JAMA Guide to Statistics and Methods
Podcast: Cost-effectiveness Analysis for Clinicians

JAMA Performance Improvement

Reducing Emergency Department Length of Stay

Mary P. Mercer, MD, MPH; Malini K. Singh, MD, MPH; Hemal K. Kanzaria, MD, MS

Abstract Full Text

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JAMA. 2019;321(14):1402-1403. doi:10.1001/jama.2018.21812

This JAMA Performance Improvement article uses the case of a patient who presented to the emergency department but left after waiting 4 hours without being seen to discuss interdisciplinary improvement efforts for reducing system inefficiencies and improving access to care in emergency departments.

Podcast: How to Reduce Emergency Department Dwell Time

JAMA Diagnostic Test Interpretation

Evaluating the Erythrocyte Sedimentation Rate

Andrew J. Hale, MD; Daniel N. Ricotta, MD; Jason A. Freed, MD

Abstract Full Text

JAMA. 2019;321(14):1404-1405. doi:10.1001/jama.2019.1178

A 65-year-old woman presented with 2 days of throbbing, bilateral temporal headache and bilateral blurred vision, an erythrocyte sedimentation rate (ESR) of 110 mm/h, and total protein of 10.4 g/dL. Results of a temporal artery biopsy showed a normal caliber lumen without infiltrating inflammatory cells. What is the diagnosis, and what would you do next?

Medical News & Perspectives

Mesh Implants for Women: Scandal or Standard of Care?

Rita Rubin, MA

Abstract Full Text

JAMA. 2019;321(14):1338-1340. doi:10.1001/jama.2019.0940

This Medical News story examines the controversy over the safety and effectiveness of mesh implants used to treat pelvic organ prolapse and stress urinary incontinence.

Quick Uptakes: Taking the Uncertainty Out of Interpreting BRCA Variants

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2019;321(14):1340-1341. doi:10.1001/jama.2019.0967

This Medical News feature provides highlights of a comprehensive international database that can help clinicians and patients clarify the meaning of BRCA1 and BRCA2 genetic variants.

The JAMA Forum

Deprescribing Policies: Time for a Fresh Approach

Ashish K. Jha, MD, MPH

Abstract Full Text

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JAMA. 2019;321(14):1341-1342. doi:10.1001/jama.2019.2939

News From the Centers for Disease Control and Prevention

Measles Vaccine Exemptions

Bridget Kuehn, MSJ

Abstract Full Text

JAMA. 2019;321(14):1344. doi:10.1001/jama.2019.3063

Vaping and Pregnancy

Bridget Kuehn, MSJ

Abstract Full Text

JAMA. 2019;321(14):1344. doi:10.1001/jama.2019.3424

Biotech Innovations

Better Cholera Counts Through Machine Learning Models

Jennifer Abbasi

Abstract Full Text

JAMA. 2019;321(14):1343. doi:10.1001/jama.2019.3459

Wireless Vital Signs Monitoring for the NICU

Jennifer Abbasi

Abstract Full Text

JAMA. 2019;321(14):1343. doi:10.1001/jama.2019.3243

HIV Remission After Hematopoietic Stem Cell Transplant

Jennifer Abbasi

Abstract Full Text

JAMA. 2019;321(14):1343. doi:10.1001/jama.2019.3460

The Arts and Medicine

Clinical Role-Play in Autonomous Sensory Meridian Response (ASMR) Videos: Performance and Placebo in the Digital Era

Amisha Ahuja, MD; Nitin Kumar Ahuja, MD, MS

Abstract Full Text

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JAMA. 2019;321(14):1336-1337. doi:10.1001/jama.2019.2302

This Arts and Medicine essay describes the growth of clinical role-play ASMR videos online, reviews what little is known about the ASMR phenomenon, and discusses it in the context of placebo response research.