December 14, 2021 Issue of JAMA

December 14, 2021, Vol 326, No. 22, Pages 2239-2339

This Week in JAMA

Audio Highlights

Abstract Full Text

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JAMA. 2021;326(22):e2018265. doi:10.1001/jama.2020.18265

Podcast: Intravenous or Intraosseous Calcium for Out-of-Hospital Cardiac Arrest, Closure of Patent Foramen Ovale After Stroke, Clinical Outcomes in Preserved Ratio Impaired Spirometry, and more

Original Investigation

Effect of Intravenous or Intraosseous Calcium vs Saline on Return of Spontaneous Circulation in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial

Mikael Fink Vallentin, MD; Asger Granfeldt, MD, PhD, DMSc; Carsten Meilandt, BSc; et al.

Abstract Full Text

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JAMA. 2021;326(22):2268-2276. doi:10.1001/jama.2021.20929

This placebo-controlled randomized clinical trial compares administration of calcium vs saline during out-of-hospital cardiac arrest for sustained return of spontaneous circulation in adults.

Video: Effect of Intravenous or Intraosseous Calcium vs Saline on Return of Spontaneous Circulation in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial

Heterogeneity of Treatment Effects in an Analysis of Pooled Individual Patient Data From Randomized Trials of Device Closure of Patent Foramen Ovale After Stroke

David M. Kent, MD, MS; Jeffrey L. Saver, MD; Scott E. Kasner, MD; et al.

Abstract Full Text

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JAMA. 2021;326(22):2277-2286. doi:10.1001/jama.2021.20956

This study evaluates heterogeneity of treatment effect (HTE) of patent foramen ovale (PFO) closure on stroke recurrence based on the Risk of Paradoxical Embolism and PFO-Associated Stroke Causal Likelihood scoring systems using individual patient data pooled from 6 randomized clinical trials (RCTs) that compared PFO closure plus medical therapy vs medical therapy alone in patients with PFO-associated stroke.

Editorial
Patent Foramen Ovale Closure鈥擧arnessing Clinical Trial Evidence to Inform Individualized Treatment Decisions
Robert W. Yeh, MD, MSc; Doreen DeFaria Yeh, MD

JAMA

Association Between Preserved Ratio Impaired Spirometry and Clinical Outcomes in US Adults

Emily S. Wan, MD, MPH; Pallavi Balte, MBBS, PhD; Joseph E. Schwartz, PhD; et al.

Abstract Full Text

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JAMA. 2021;326(22):2287-2298. doi:10.1001/jama.2021.20939

This study of pooled data from 9 US population-based cohorts assessed mortality risk and adverse cardiovascular and respiratory outcomes for chronic lung diseases among adults with normal spirometry vs preserved ratio impaired spirometry.

Research Letter

Association of Social Risk Factors With Home Dialysis and Kidney Transplant Rates in Dialysis Facilities

Rebecca Thorsness, PhD; Virginia Wang, PhD; Rachel E. Patzer, PhD, MPH; et al.

Abstract Full Text

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JAMA. 2021;326(22):2323-2325. doi:10.1001/jama.2021.18372

This study examines rates of home dialysis and transplant at dialysis facilities that serve patients with high social risk to understand how they fare under the End-Stage Renal Disease Treatment Choices Model.

Frequency and Duration of Boarding for Pediatric Mental Health Conditions at Acute Care Hospitals in the US

JoAnna K. Leyenaar, MD, PhD, MPH; Seneca D. Freyleue, MS; Amy Bordogna, MPH; et al.

Abstract Full Text

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JAMA. 2021;326(22):2326-2328. doi:10.1001/jama.2021.18377

This study estimates the frequency and duration of boarding for pediatric mental health conditions at US acute care hospitals and describes hospital resources available to support youths during boarding.

Viewpoint

Pediatric COVID-19 Vaccines: What Parents, Practitioners, and Policy Makers Need to Know

William J. Moss, MD, MPH; Lawrence O. Gostin, JD; Jennifer B. Nuzzo, DrPH, SM

Abstract Full Text

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JAMA. 2021;326(22):2257-2258. doi:10.1001/jama.2021.20734

This Viewpoint discusses the Food and Drug Administration granting Emergency Use Authorization of the mRNA COVID-19 vaccine BNT162b2 for children aged 5 to 11 years and the role that will play in keeping children, schools, and communities safe.

Incentivizing a New Culture of Data Stewardship: The NIH Policy for Data Management and Sharing

Lyric A. Jorgenson, PhD; Carrie D. Wolinetz, PhD; Francis S. Collins, MD, PhD

Abstract Full Text

JAMA. 2021;326(22):2259-2260. doi:10.1001/jama.2021.20489

This Viewpoint cites the data collaboration during the COVID-19 pandemic as an example of unprecedented vaccine results and points to the NIH鈥檚 Policy for Data Management and Sharing to foster shared data as a routine part of grant applications.

Contextualizing Risk Among Patients With Heart Failure

Stephen J. Greene, MD; Javed Butler, MD, MPH, MBA; Gregg C. Fonarow, MD

Abstract Full Text

JAMA. 2021;326(22):2261-2262. doi:10.1001/jama.2021.20739

This Viewpoint frames the clinical event risk for heart failure in the context of the approach used in the 2018 ACC/AHA cholesterol guidelines.

A Piece of My Mind

The Hardest Thing

Vidya Bhavani Viswanathan, MD

Abstract Full Text

JAMA. 2021;326(22):2263-2264. doi:10.1001/jama.2021.21545

In this narrative medicine essay, a pediatrician who learned the hard secrets of breastfeeding after the birth of her twins shares how her experience transformed her approach to new parents by acknowledging the difficulty and helping them find support.

Editorial

Patent Foramen Ovale Closure鈥擧arnessing Clinical Trial Evidence to Inform Individualized Treatment Decisions

Robert W. Yeh, MD, MSc; Doreen DeFaria Yeh, MD

Abstract Full Text

JAMA. 2021;326(22):2265-2267. doi:10.1001/jama.2021.21317

Review

Diagnosis and Management of Acute Appendicitis in Adults: A Review

Dimitrios Moris, MD, MSc, PhD; Erik Karl Paulson, MD; Theodore N. Pappas, MD

Abstract Full Text

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JAMA. 2021;326(22):2299-2311. doi:10.1001/jama.2021.20502

This narrative review summarizes current understanding of the pathophysiology, diagnosis, and management of acute appendicitis, especially comparing antibiotics-only vs surgical approaches to management.

Podcast: Current Management of Acute Appendicitis: Antibiotics or Surgical Intervention

JAMA Guide to Statistics and Methods

Heterogeneity of Treatment Effect: Estimating How the Effects of Interventions Vary Across Individuals

Derek C. Angus, MD, MPH; Chung-Chou H. Chang, PhD

Abstract Full Text

JAMA. 2021;326(22):2312-2313. doi:10.1001/jama.2021.20552

This Guide to Statistics and Methods discusses the various approaches to estimating variability in treatment effects, including heterogeneity of treatment effect, which was used to assess the association between surgery to close patent foramen ovale and risk of recurrent stroke in patients who presented with a stroke in a related JAMA article.

JAMA Clinical Challenge

Erythematous Papules and Hemorrhagic Vesicles in a Woman With Arthralgias and Eye Pain

Lindsey West, MD; Sung Kyung Cho, BA; Cristina Thomas, MD

Abstract Full Text

JAMA. 2021;326(22):2314-2315. doi:10.1001/jama.2021.18708

A 48-year-old woman with diet-controlled diabetes had extremity arthralgias, a purpuric rash and foot paresthesias, and eye pain and redness. Vital signs and results of laboratory testing including direct immunofluorescence were unremarkable; skin biopsy showed leukocytoclasia, erythrocytic extravasation, and fibrin in small blood vessel walls. What is the diagnosis and what would you do next?

Medical News & Perspectives

COVID-19 Vaccine Makers Plan for Annual Boosters, but It鈥檚 Not Clear They鈥檒l Be Needed

Rita Rubin, MA

Abstract Full Text

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JAMA. 2021;326(22):2247-2249. doi:10.1001/jama.2021.21291

This Medical News feature examines whether it鈥檚 likely that repeated COVID-19 vaccine boosters will be needed to maintain protection against SARS-CoV-2.

Podcast: December 2021 Medical News Summary

News From the Centers for Disease Control and Prevention

Cancer Care Creates Substantial Costs for US Patients

Bridget M. Kuehn, MSJ

Abstract Full Text

JAMA. 2021;326(22):2251. doi:10.1001/jama.2021.21119

Delta Variant Wasn鈥檛 Linked With More Severe Disease

Bridget M. Kuehn, MSJ

Abstract Full Text

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JAMA. 2021;326(22):2251. doi:10.1001/jama.2021.21803

Biotech Innovations

Data Emerge From the UK鈥檚 COVID-19 Vaccine Extended Dosing Interval

Jennifer Abbasi

Abstract Full Text

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JAMA. 2021;326(22):2250. doi:10.1001/jama.2021.21963

COVID-19 Vaccine Combination Was Superior in Real-world Study

Jennifer Abbasi

Abstract Full Text

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JAMA. 2021;326(22):2250. doi:10.1001/jama.2021.21715

Immunocompromised Patients With COVID-19 Receive Interferon Gamma

Jennifer Abbasi

Abstract Full Text

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JAMA. 2021;326(22):2250. doi:10.1001/jama.2021.21964

The Arts and Medicine

The Legacy of James McCune Smith, MD鈥擳he First US Black Physician

Neil Krishan Aggarwal, MD, MBA

Abstract Full Text

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JAMA. 2021;326(22):2245-2246. doi:10.1001/jama.2021.18511

This Arts and Medicine feature surveys the life and scholarship of James McCune Smith, MD, a 19th-century New York physician who cared for poor individuals, debunked pseudoscience justifying racism, and published broadly in medicine and public health.

Poetry and Medicine