November 1, 2020 Issue of JAMA Internal Medicine

November 2020, Vol 180, No. 11, Pages 1412-1560

Viewpoint

Health Care Policy and Law

Tobacco Dependence Treatment Is Critical to Excellence in Health Care

Linda Sarna, RN, PhD; Michael C. Fiore, MD, MPH, MBA; Steven A. Schroeder, MD

Abstract Full Text

JAMA Intern Med. 2020;180(11):1413-1414. doi:10.1001/jamainternmed.2020.3972

This Viewpoint discusses the importance of including tobacco dependence treatment as a measure of excellence in the provision of health care.

Health Care Policy and Law

A Further Weakening of Contraceptive Coverage Under the Affordable Care Act

Erica S. Turret, JD; Katherine L. Kraschel, JD; Gregory Curfman, MD

Abstract Full Text

JAMA Intern Med. 2020;180(11):1415-1416. doi:10.1001/jamainternmed.2020.5533

This Viewpoint discusses how a recent US Supreme Court decision raises questions about whether an employer-based health care system can continue to best serve employees and the public at large.

Perspective

The Disappearance of the Primary Care Physical Examination鈥擫osing Touch

Paul Hyman, MD

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1417-1418. doi:10.1001/jamainternmed.2020.3546

This article assesses the loss of the physical examination amid telehealth visits during the coronavirus disease 2019 pandemic.

The Suffocating State of Physician Workforce Diversity: Why 鈥淚 Can鈥檛 Breathe鈥�

Curtiland Deville Jr, MD

Abstract Full Text

JAMA Intern Med. 2020;180(11):1418-1419. doi:10.1001/jamainternmed.2020.3815

This essay discusses the need for more diversity in the physician workforce to benefit patients and society.

Original Investigation

Assessment of Data Sources That Support US Food and Drug Administration Medical Devices Safety Communications

Noam Tau, MD; Daniel Shepshelovich, MD

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1420-1426. doi:10.1001/jamainternmed.2020.3514

This cross-sectional study assesses the sources of initial safety signals that trigger publication of Medical Device Safety Communications and the potential associations among Medical Device Safety Communication data source, type of safety issue, and subsequent action by the US Food and Drug Administration.

Changes in Hospital Income, Use, and Quality Associated With Private Equity Acquisition

Joseph D. Bruch, BA; Suhas Gondi, BA; Zirui Song, MD, PhD

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1428-1435. doi:10.1001/jamainternmed.2020.3552

This difference-in-differences analysis assesses whether an association exists between hospitals being acquired by private equity firms and hospital income, use, and quality in the United States.

Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US

Shruti Gupta, MD, MPH; Salim S. Hayek, MD; Wei Wang, PhD; et al.

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1436-1447. doi:10.1001/jamainternmed.2020.3596

This cohort study of adults with COVID-19 examines factors associated with death and interhospital variation in treatment and outcomes in the US.

Clinical Course and Molecular Viral Shedding Among Asymptomatic and Symptomatic Patients With SARS-CoV-2 Infection in a Community Treatment Center in the Republic of Korea

Seungjae Lee, MD; Tark Kim, MD; Eunjung Lee, MD; et al.

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1447-1452. doi:10.1001/jamainternmed.2020.3862

This cohort study quantitatively describes molecular viral shedding in asymptomatic and symptomatic patients with SARS-CoV-2 infection.

Experiences of Home Health Care Workers in New York City During the Coronavirus Disease 2019 Pandemic: A Qualitative Analysis

Madeline R. Sterling, MD, MPH, MS; Emily Tseng, MS; Anthony Poon, BS; et al.

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1453-1459. doi:10.1001/jamainternmed.2020.3930

This qualitative analysis using grounded theory describes the experiences of home health care workers caring for older adults and for patients with chronic illnesses in New York City during the coronavirus disease 2019 pandemic.

Podcast: Experiences of Home Health Care Workers during COVID-19 in New York City

Accuracy of Physicians鈥� Electrocardiogram Interpretations: A Systematic Review and Meta-analysis

David A. Cook, MD, MHPE; So-Young Oh, MS, MA; Martin V. Pusic, MD, PhD

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1461-1471. doi:10.1001/jamainternmed.2020.3989

This systematic review and meta-analysis identifies and summarizes published research on the accuracy of physicians鈥� interpretations of electrocardiograms.

Efficacy of Smartphone Applications for Smoking Cessation: A Randomized Clinical Trial

Jonathan B. Bricker, PhD; Noreen L. Watson, PhD; Kristin E. Mull, MS; et al.

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1472-1480. doi:10.1001/jamainternmed.2020.4055

This randomized clinical trial examines the efficacy of a smartphone application for smoking cessation based on acceptance and commitment therapy vs a National Cancer Institute smoking cessation application based on US clinical practice guidelines.

Effects of Counseling by Peer Human Advisors vs Computers to Increase Walking in Underserved Populations: The COMPASS Randomized Clinical Trial

Abby C. King, PhD; Maria Ines Campero, BA; Jylana L. Sheats, PhD; et al.

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1481-1490. doi:10.1001/jamainternmed.2020.4143

This randomized clinical trial examines changes in physical activity with virtual vs human advisors in Latino participants.

Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity: The TREAT Randomized Clinical Trial

Dylan A. Lowe, PhD; Nancy Wu, MS; Linnea Rohdin-Bibby, BA; et al.

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1491-1499. doi:10.1001/jamainternmed.2020.4153

This randomized clinical trial examines the effect of 16:8-hour time-restricted eating on weight loss and metabolic risk markers.

Invited Commentary

Identification and Market Removal of Risky Medical Devices

Madris Tomes, MBA

Abstract Full Text

JAMA Intern Med. 2020;180(11):1426-1427. doi:10.1001/jamainternmed.2020.3512

Extreme Vulnerability of Home Care Workers During the COVID-19 Pandemic鈥擜 Call to Action

Theresa A. Allison, MD, PhD; Anna Oh, PhD, MPH, RN; Krista L. Harrison, PhD

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1459-1460. doi:10.1001/jamainternmed.2020.3937

Podcast: Experiences of Home Health Care Workers during COVID-19 in New York City

Less Is More

A Solution for Guideline Overkill鈥擬ore Guidelines or Shared Understanding?

Raj Mehta, MD; Richard Lehman, BM, BCh

Abstract Full Text

JAMA Intern Med. 2020;180(11):1508-1509. doi:10.1001/jamainternmed.2020.3969

Prone Positioning in Awake, Nonintubated Patients With COVID-19: Necessity Is the Mother of Invention

Aartik Sarma, MD; Carolyn S. Calfee, MD, MAS

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1539-1540. doi:10.1001/jamainternmed.2020.3027

Private Equity, Women鈥檚 Health, and the Corporate Transformation of American Medicine

Lawrence P. Casalino, MD, PhD

Abstract Full Text

JAMA Intern Med. 2020;180(11):1545-1546. doi:10.1001/jamainternmed.2020.3564

Editor's Note

Inclusion Across the Lifespan in Cardiovascular Trials鈥擜 Long Road Ahead

Colette DeJong, MD; Kenneth Covinsky, MD

Abstract Full Text

JAMA Intern Med. 2020;180(11):1533-1534. doi:10.1001/jamainternmed.2020.2735

Less Is More

Two Remedies for Inappropriate Percutaneous Coronary Intervention鈥擟losing the Gap Between Evidence and Practice

James W. Salazar, MD, MAS; Rita F. Redberg, MD, MSc

Abstract Full Text

JAMA Intern Med. 2020;180(11):1536-1537. doi:10.1001/jamainternmed.2020.2801

Special Communication

Health Care Policy and Law

Drug Reimbursement Regulation in 6 Peer Countries

Ezekiel J. Emanuel, MD, PhD; Cathy Zhang, BA; Aaron Glickman, MPA; et al.

Abstract Full Text

JAMA Intern Med. 2020;180(11):1510-1517. doi:10.1001/jamainternmed.2020.4793

This study delineates drug coverage, price, and reimbursement regulations in 6 countries, emphasizing the relevance for US policy making.

Editorial
Sophisticated Purchasing of Pharmaceuticals: Learning From Other Countries
James C. Robinson, PhD, MPH

JAMA

Review

Less Is More

Identifying Recommendations for Stopping or Scaling Back Unnecessary Routine Services in Primary Care

Eve A. Kerr, MD, MPH; Mandi L. Klamerus, MPH; Adam A. Markovitz, BS; et al.

Abstract Full Text

JAMA Intern Med. 2020;180(11):1500-1508. doi:10.1001/jamainternmed.2020.4001

This systematic review describes recommendations made by an expert panel across internal medicine disciplines on decreasing the frequency of or discontinuing testing and therapy not deemed to be necessary.

Research Letter

Health Care Policy and Law

Cognition and Take-up of the Medicare Savings Programs

Eric T. Roberts, PhD; Brian E. McGarry, PhD; Alexandra Glynn, BA

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1529-1531. doi:10.1001/jamainternmed.2020.2783

This cross-sectional study examines the association between cognition and Medicare Savings Program enrollment among qualified elderly Medicare beneficiaries.

Representation of Older Adults in Cardiovascular Disease Trials Since the Inclusion Across the Lifespan Policy

Michael G. Nanna, MD; Sean T. Chen, MD; Adam J. Nelson, MBBS, PhD; et al.

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1531-1533. doi:10.1001/jamainternmed.2020.2750

This review compares representation of older adults in interventional cardiovascular disease studies in the US before and after implementation of the National Institutes of Health鈥檚 Inclusion Across the Lifespan Policy.

Editor's Note
Inclusion Across the Lifespan in Cardiovascular Trials鈥擜 Long Road Ahead
Colette DeJong, MD; Kenneth Covinsky, MD

JAMA Intern Med

Less Is More

US False Claims Act Investigations of Unnecessary Percutaneous Coronary Interventions

David H. Howard, PhD; Nihar R. Desai, MD, MPH

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1534-1536. doi:10.1001/jamainternmed.2020.2812

This case-control study assess the association of US False Claims Act investigations of the overuse of PCIs with PCI volumes.

Podcast: Percutaneous Coronary Intervention (PCI) For Stable Coronary Artery Disease - Reducing Inappropriate Use

Editor's Note
Two Remedies for Inappropriate Percutaneous Coronary Intervention鈥擟losing the Gap Between Evidence and Practice
James W. Salazar, MD, MAS; Rita F. Redberg, MD, MSc

JAMA Intern Med

Prone Positioning in Awake, Nonintubated Patients With COVID-19 Hypoxemic Respiratory Failure

Alison E. Thompson, MD; Benjamin L. Ranard, MD; Ying Wei, PhD; et al.

Abstract Full Text

open access

JAMA Intern Med. 2020;180(11):1537-1539. doi:10.1001/jamainternmed.2020.3030

This cohort study investigates whether the prone position is associated with improved oxygenation and decreased risk for intubation in spontaneously breathing patients with severe COVID-19 hypoxemic respiratory failure.

Less Is More

Potential Association of the ISCHEMIA Trial With the Appropriate Use Criteria Ratings for Percutaneous Coronary Intervention in Stable Ischemic Heart Disease

Ali O. Malik, MD, MSc; John A. Spertus, MD, MPH; Manesh R. Patel, MD; et al.

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1540-1542. doi:10.1001/jamainternmed.2020.3181

This cohort study examines the potential implications of the ISCHEMIA trial on the appropriateness of percutaneous coronary intervention in patients with stable ischemic heart disease.

Podcast: Percutaneous Coronary Intervention (PCI) For Stable Coronary Artery Disease - Reducing Inappropriate Use

Editor's Note
Two Remedies for Inappropriate Percutaneous Coronary Intervention鈥擟losing the Gap Between Evidence and Practice
James W. Salazar, MD, MAS; Rita F. Redberg, MD, MSc

JAMA Intern Med

Expansion of Private Equity Involvement in Women鈥檚 Health Care

Joseph D. Bruch, BA; Alexander Borsa, BA; Zirui Song, MD, PhD; et al.

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1542-1545. doi:10.1001/jamainternmed.2020.3567

This cross-sectional study examines the clinical and societal implications of the exansion of private equity in women鈥檚 health care.

The Exclusion of Older Persons From Vaccine and Treatment Trials for Coronavirus Disease 2019鈥擬issing the Target

Benjamin K. I. Helfand, MSc; Margaret Webb, BA; Sarah L. Gartaganis, MSW, MPH; et al.

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1546-1549. doi:10.1001/jamainternmed.2020.5084

This cross-sectional study evaluates the risk of exclusion for older adults in randomized clinical trials for treatment and vaccine interventions in coronavirus disease 2019.

Podcast: Nursing Homes and COVID-19

Challenges in Clinical Electrocardiography

An Atypical Case of Vasovagal Cardioinhibitory Syncope in a Young Male Soldier鈥擲tand Up, Be Counted

Elizabeth R. Doman, DO; Adam J. Kisling, MD; Emilio Fentanes, MD

Abstract Full Text

JAMA Intern Med. 2020;180(11):1518-1520. doi:10.1001/jamainternmed.2020.3023

This case report presents the electrocardiographic findings of a male soldier who experienced syncope while deployed overseas.

Influence of Prone Positioning on Electrocardiogram in a Patient With COVID-19

Hoang H. Nguyen, MD, MSc; Richard G. Trohman, MD; Henry D. Huang, MD

Abstract Full Text

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JAMA Intern Med. 2020;180(11):1521-1523. doi:10.1001/jamainternmed.2020.3818

This case report presents the electrocardiographic findings a woman in her 50s with COVID-19, fever, and shortness of breath, with comorbidities including morbid obesity and obstructive sleep apnea.

Troubleshooting a Transcutaneous Pacemaker

Emily R. Cedarbaum, MD, MPH; Rohit Mital, MD; Nora Goldschlager, MD

Abstract Full Text

JAMA Intern Med. 2020;180(11):1524-1525. doi:10.1001/jamainternmed.2020.3828

This case report presents the electrocardiographic findings of an older adult woman with altered mental status, weakness, slurred speech, emesis, and headache.