June 1, 2023 Issue of JAMA Internal Medicine

June 2023, Vol 183, No. 6, Pages 504-628

Perspective

When Oral Therapy Can Replace Intravenous Antibiotics鈥擟hanging Practice as New Data Emerge

Astrid Heppenstall Heger, MD; Rachel Baden, MD; Brad Spellberg, MD

Abstract Full Text

JAMA Intern Med. 2023;183(6):505-506. doi:10.1001/jamainternmed.2023.0923

This essay describes a physician-patient鈥檚 experience with unchanged practice patterns despite the publication of new data challenging those patterns.

Medicine in the Era of Artificial Intelligence: Hey Chatbot, Write Me an H&P

Teva D. Brender, MD

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JAMA Intern Med. 2023;183(6):507-508. doi:10.1001/jamainternmed.2023.1832

This Perspective envisions a world where artificial intelligence is integrated into health care.

Original Investigation

Less Is More

Frequency of Use and Outcomes of Colonoscopy in Individuals Older Than 75 Years

Jessica El Halabi, MD, MBI; Carol A. Burke, MD; Essa Hariri, MD, MSc; et al.

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JAMA Intern Med. 2023;183(6):513-519. doi:10.1001/jamainternmed.2023.0435

This cross-sectional study with a nested cohort assesses the number of screening colonoscopies done in patients older than 75 years with a life expectancy of fewer than 10 years.

Effects of Standard-Dose Prophylactic, High-Dose Prophylactic, and Therapeutic Anticoagulation in Patients With Hypoxemic COVID-19 Pneumonia: The ANTICOVID Randomized Clinical Trial

Vincent Labbé, MD; Damien Contou, MD; Nicholas Heming, MD, PhD; et al.

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JAMA Intern Med. 2023;183(6):520-531. doi:10.1001/jamainternmed.2023.0456

This randomized clinical trial compares the effects of high-dose, standard-dose, and therapeutic anticoagulation on mortality and/or disease duration among patients with hypoxemic COVID-19 pneumonia in 23 hospitals in France.

Health Care Policy and Law

Racial and Ethnic Disparities in Health Care Use and Access Associated With Loss of Medicaid Supplemental Insurance Eligibility Above the Federal Poverty Level

Eric T. Roberts, PhD; Youngmin Kwon, BA; Alexandra G. Hames, BA; et al.

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JAMA Intern Med. 2023;183(6):534-543. doi:10.1001/jamainternmed.2023.0512

This cross-sectional study examines whether exceeding the income threshold for Medicaid, which results in an abrupt loss of Medicaid eligibility, is associated with greater racial and ethnic disparities in access to and use of care.

Effect of a Coaching Intervention to Improve Cardiologist Communication: A Randomized Clinical Trial

Kathryn I. Pollak, PhD; Maren K. Olsen, PhD; Hongqiu Yang, PhD; et al.

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JAMA Intern Med. 2023;183(6):544-553. doi:10.1001/jamainternmed.2023.0629

This randomized clinical trial assesses the effect of a communication coaching intervention to teach evidence-based communication skills to cardiologists.

Association of Treatment With Nirmatrelvir and the Risk of Post鈥揅OVID-19 Condition

Yan Xie, PhD; Taeyoung Choi, MPH; Ziyad Al-Aly, MD

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JAMA Intern Med. 2023;183(6):554-564. doi:10.1001/jamainternmed.2023.0743

This cohort study examines the association of treatment with nirmatrelvir in the acute phase of COVID-19 and risk of post鈥揅OVID-19 condition.

Editor's Note
While Waiting for a Randomized Clinical Trial of Nirmatrelvir for Prevention of Post鈥揅OVID-19 Condition
Mitchell H. Katz, MD

JAMA Intern Med

Risk Factors Associated With Post鈭扖OVID-19 Condition: A Systematic Review and Meta-analysis

Vasiliki Tsampasian, MD, MSc; Hussein Elghazaly, MBBS; Rahul Chattopadhyay, MBBS, MSc; et al.

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JAMA Intern Med. 2023;183(6):566-580. doi:10.1001/jamainternmed.2023.0750

This systematic review and meta-analysis evaluates the findings of 41 studies with a total of 860鈥�783 patients to identify risk factors associated with post鈭扖OVID-19 condition.

Editor's Note
While Waiting for a Randomized Clinical Trial of Nirmatrelvir for Prevention of Post鈥揅OVID-19 Condition
Mitchell H. Katz, MD

JAMA Intern Med

Health Care Policy and Law

Examining Opportunities to Increase Savings From Medicare Price Negotiations

Marissa B. Reitsma, BS; Stacie B. Dusetzina, PhD; Jeromie M. Ballreich, PhD; et al.

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JAMA Intern Med. 2023;183(6):581-588. doi:10.1001/jamainternmed.2023.0763

This cross-sectional study examines estimated savings from Medicare price negotiation under the Inflation Reduction Act (IRA) and opportunities to increase savings.

Podcast: Examining Opportunities to Increase Savings from Medicare Price Negotiations

Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum

John W. Ayers, PhD, MA; Adam Poliak, PhD; Mark Dredze, PhD; et al.

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JAMA Intern Med. 2023;183(6):589-596. doi:10.1001/jamainternmed.2023.1838

This cross-sectional study evaluates the ability of an artificial intelligence chatbot to provide quality and empathetic responses to patient questions.

Editor's Note
鈥淗yperesthetic Neuralgia鈥� and 鈥淐rawly Skin鈥�: Poetry and Empathy in Medicine
Rafael Campo, MD, MA

JAMA

Editorial

Insufficient Evidence for Screening Reinforces Need for Primary Prevention of Skin Cancer

Isabella de Vere Hunt, MD; Jenna Lester, MD; Eleni Linos, MD, MPH, DrPH

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JAMA Intern Med. 2023;183(6):509-511. doi:10.1001/jamainternmed.2023.0927

Editorial
Skin Cancer Screening: The Importance of Identifying High-risk Subgroups and the Need for US-Based Population Research
Maryam M. Asgari, MD, MPH; Lori A. Crane, PhD, MPH

JAMA
- Podcast: USPSTF Recommendation: Screening for Skin Cancer

Health Care Policy and Law

Private Equity in US Health Care鈥擭ow Cradle to Grave?

Francis J. Crosson, MD; Isabel R. Ostrer, MD; Cary P. Gross, MD

Abstract Full Text

JAMA Intern Med. 2023;183(6):511-512. doi:10.1001/jamainternmed.2023.0324

Invited Commentary

Anticoagulation in Patients With COVID-19 Pneumonia鈥擶hat Is the Optimal Intensity?

Richard C. Becker, MD; Thomas L. Ortel, MD, PhD

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JAMA Intern Med. 2023;183(6):532-533. doi:10.1001/jamainternmed.2023.0625

How Chatbots and Large Language Model Artificial Intelligence Systems Will Reshape Modern Medicine: Fountain of Creativity or Pandora鈥檚 Box?

Ron Li, MD; Andre Kumar, MD, MEd; Jonathan H. Chen, MD, PhD

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JAMA Intern Med. 2023;183(6):596-597. doi:10.1001/jamainternmed.2023.1835

Use of Sepsis Clinical Prediction Models to Improve Patient Care

Murtaza Mogri, PhD; Richard W. Grant, MD, MPH; Vincent X. Liu, MD, MS

Abstract Full Text

JAMA Intern Med. 2023;183(6):612-615. doi:10.1001/jamainternmed.2022.7164

Editor's Note

While Waiting for a Randomized Clinical Trial of Nirmatrelvir for Prevention of Post鈥揅OVID-19 Condition

Mitchell H. Katz, MD

Abstract Full Text

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JAMA Intern Med. 2023;183(6):565. doi:10.1001/jamainternmed.2023.0760

Research Letter

Use of Active Surveillance vs Definitive Treatment Among Men With Low- and Favorable Intermediate鈥揜isk Prostate Cancer in the US Between 2010 and 2018

Bashir Al Hussein Al Awamlh, MD; Daniel A. Barocas, MD, MPH; Alec Zhu, MD; et al.

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JAMA Intern Med. 2023;183(6):608-611. doi:10.1001/jamainternmed.2022.7100

This cross-sectional study of data from the Surveillance, Epidemiology and End Results database assesses temporal trends in the use of active surveillance and watchful waiting vs definitive treatment in men with low- and favorable intermediate鈥搑isk prostate cancer in the US between 2010 and 2018.

Factors Associated With Variability in the Performance of a Proprietary Sepsis Prediction Model Across 9 Networked Hospitals in the US

Patrick G. Lyons, MD, MSc; Mackenzie R. Hofford, MD; Sean C. Yu, PhD; et al.

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JAMA Intern Med. 2023;183(6):611-612. doi:10.1001/jamainternmed.2022.7182

This cohort study uses data from electronic health records to assess variability in a sepsis prediction model across 9 hospitals.

Daratumumab for a Patient With Refractory Antineutrophil Cytoplasmatic Antibody鈥揂ssociated Vasculitis

Torben M. Rixecker, MD; Philipp M. Lepper, MD; Sebastian Mang, MD; et al.

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JAMA Intern Med. 2023;183(6):615-618. doi:10.1001/jamainternmed.2023.0152

This case reports on a patient with antineutrophil cytoplasmatic antibody鈥揳ssociated vasculitis and severe pulmonary and cutaneous involvement who received conventional therapy that failed and who was rescued by daratumumab therapy.

Novel Estimates of Mortality Associated With Poverty in the US

David Brady, PhD; Ulrich Kohler, PhD; Hui Zheng, PhD

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JAMA Intern Med. 2023;183(6):618-619. doi:10.1001/jamainternmed.2023.0276

This cohort study estimated association between poverty and mortality and quantified the proportion and number of deaths associated with poverty.

Internal Medicine Resident Perspectives on Virtual Recruitment

Alec B. O鈥機onnor, MD, MPH; Kelly McGarry, MD; Kathleen M. Finn, MD, MPhil; et al.

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JAMA Intern Med. 2023;183(6):619-621. doi:10.1001/jamainternmed.2023.0281

This survey study describes the perceived implications of virtual-only recruitment and the preferred application process for residents and fellows.

Health Care Policy and Law

Private Equity Acquisition of Oncology Clinics in the US From 2003 to 2022

Kevin Tyan, BA; Miranda B. Lam, MD, MBA; Michael Milligan, MD, MBA

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JAMA Intern Med. 2023;183(6):621-623. doi:10.1001/jamainternmed.2023.0334

This cross-sectional study examines private equity鈥揵acked acquisitions of medical and radiation oncology clinics in the US from 2003 to 2022 using financial databases and publicly available data.

Editorial
Private Equity in US Health Care鈥擭ow Cradle to Grave?
Francis J. Crosson, MD; Isabel R. Ostrer, MD; Cary P. Gross, MD

JAMA Intern Med

Challenges in Clinical Electrocardiography

Chest Pain, Paced Rhythm, and 2 Missed Indications for Emergent Reperfusion

Jesse T. T. McLaren, MD; H. Pendell Meyers, MD; Stephen W. Smith, MD

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JAMA Intern Med. 2023;183(6):598-599. doi:10.1001/jamainternmed.2023.0096

This case report describes a 70-year-old patient with intermittent chest pain that developed into constant chest pain, sweating, and shortness of breath.

Chest Pain and Wide QRS Tachycardia

János Tomcsányi, MD, PhD; Péter Arányi, MD, PhD

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JAMA Intern Med. 2023;183(6):600-601. doi:10.1001/jamainternmed.2023.0287

This case report presents the electrocardiogram findings of a patient in their 70s with diabetes who presented with 3 hours of chest pain.

An Unusual Cause of ST-Segment Elevation in the Right Precordial Leads鈥擜 Clue From the Humble Waves

Yan Chen, MD; Gujiang Chen, MD; Yuan Zhang, MD

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JAMA Intern Med. 2023;183(6):602-603. doi:10.1001/jamainternmed.2023.0294

This case report describes a patient in their late teens who presented to the outpatient department stating that they had felt the implanted cardioverter defibrillator deliver a shock 3 times within the past 6 months.

Less Is More

An Unusual Tracing

Sameer Kassem, MD, PhD; Jochanan E. Naschitz, MD

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JAMA Intern Med. 2023;183(6):604-605. doi:10.1001/jamainternmed.2023.0298

This case report presents the electrocardiogram findings of a patient in their 90s with end-stage dementia, pressure ulcers, extrapyramidal syndrome, paroxysmal atrial fibrillation, and hypothyroidism who experienced a massive aspiration of gastric content.

Serial Electrocardiograms鈥擜n Unsung Hero

Maha Nadir, MBBS; Muhammad Talha Bin Nazir, MBBS, MRCP (UK), CCDS, CEPS-A

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JAMA Intern Med. 2023;183(6):606-607. doi:10.1001/jamainternmed.2023.0342

This case report describes a patient in their 60s with diabetes and hypertension who presented to the emergency department with retrosternal chest pain.

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