This JAMA issue focuses on important contemporary issues in ethics and medical research and is anchored by 2 Special Communications with their accompanying Viewpoints and Editorials.
Research that is scientifically and ethically sound should gain institutional review board (IRB) approval without difficulty. Yet investigators seeking to address important questions through research conducted in the context of clinical care, including comparative effectiveness research and implementation science studies, often struggle with IRB review even when proposed research poses little risk. To facilitate approval, investigators sometimes feel compelled to make compromises that weaken the science (eg... Читать дальше...
This study assesses artemisinin partial resistance, Pfkelch13 variations, and malaria recrudescence in Ugandan children with complicated malaria.
One of the greatest threats to the control of malaria is the emergence of artemisinin partial resistance (ART-R) in Plasmodium falciparum, the most virulent human malaria parasite, in multiple countries in Africa. Artemisinins are rapid-acting antimalarial therapeutic agents that are the key components of artemisinin-based combination therapy, which combines an artemisinin derivative with a longer-acting partner drug to treat uncomplicated falciparum malaria. Artemisinin-based combination therapies are the standard of care for this indication. Читать дальше...
This study aims to characterize the individual-level agreement of polygenic risk scores for coronary heart disease that perform similarly at the population level.
Risk prediction to inform strategies for the primary prevention of cardiovascular disease is universally recommended by clinical practice guidelines in the US and worldwide. A risk-based prevention paradigm matches the intensity of the prevention effort with the absolute risk of the individual. Because the absolute risk reduction is directly proportional to the absolute risk of the individual (ie, individuals at higher predicted risk will experience greater benefit than those with a lower predicted risk from a given therapy)... Читать дальше...
This randomized clinical trial compares different text messaging strategies (generic refill reminders, behavioral nudge refill reminders, behavioral nudge refill reminders plus a fixed-message chatbot) with usual care to improve medication refill adherence among adult US patients nonadherent to cardiovascular medications.
This study analyzes how prices negotiated by Medicare in the US compare with net prices before negotiation, ceiling prices, and list prices in 6 other high-income countries.
This study compares the efficacy of 2% perioperative intravenous lidocaine infusion vs 0.9% saline placebo on return of gut function after elective minimally invasive colon resection.
In Reply In September 2024, a US appeals court struck down California’s prohibition on firearms in health care settings, citing the Supreme Court’s new requirement that modern gun laws be evaluated based on whether they are consistent with historical tradition rather than their ability to address the threat and reality of gun violence. Under this “originalist” approach, whether hospitals qualify as “sensitive places” where guns can be prohibited turns on whether judges believe hospitals to be sufficiently... Читать дальше...
To the Editor In their article, Mr Romero and colleagues discussed the consequences of recent Supreme Court decisions on the possession of firearms, especially the possibility that declaring hospitals a firearm-free domain breaches Second Amendment rights. If that is true, then it applies to hospital staff as well as patients and their relatives. How will patients feel about their physician having an AR-15 on their desk during an examination?
In Reply We agree with Dr Xie and colleagues that SSIs are caused by multiple contributing factors. This underlines the need for cluster-randomized trials (like our own), as contributing noncontrolled factors here are randomly distributed between groups. Of note, our study had an even distribution of allocations between the study sites and surgical specialties.
To the Editor A recent study in JAMA comparing povidone iodine with chlorhexidine gluconate for preoperative skin antisepsis effectively informed the clinical decision-making process in surgical settings to prevent SSIs. However, while the study addressed the primary objective, several ancillary considerations relevant to the surgical community warrant further exploration.
This Medical News article is an interview with K. Casey Lion, MD, MPH, about the need for greater equity in health care for those with language barriers and how artificial intelligence translation tools may help bridge the gap.
This Medical News article discusses a new program to enroll underrepresented communities in decentralized clinical trials.
The Centers for Disease Control and Prevention (CDC) lowered the recommended age for the 1-time vaccine against pneumonia. Previously recommended for those aged 65 years or older, the agency now advises the pneumococcal vaccination starting at age 50 years.
Between 1980 and 1998, the triplet and higher-order multiple birth rate in the US soared from 37 to about 194 births per 100 000—a rise associated with older maternal age and a spike in the use of fertility treatments. But from 1998 to 2023, this rate dropped to 74 births per 100 000, a decline of 62%, according to a National Center for Health Statistics data brief.
People around the world face record-breaking health threats because of climate change and the worsening effects of “persistent inaction,” the latest Lancet report on health and climate change attests.
The prospect of avoiding an invasive colonoscopy has helped fuel interest around new less-invasive alternatives to colorectal cancer screenings, such as stool-based tests and cell-free blood-based DNA tests, which received approval from the US Food and Drug Administration (FDA) this past July. But traditional colonoscopies remain the best method for catching colorectal cancer early, according to a study published in the Annals of Internal Medicine.
Tuberculosis (TB) is once again the leading global cause of death from infectious disease, surpassing COVID-19. In 2023, about 8.2 million people were newly diagnosed with TB, the highest number recorded since the World Health Organization (WHO) began monitoring the disease in 1995.
Patients with obesity and knee osteoarthritis may experience substantial pain relief with semaglutide, according to the results of an international trial published in the New England Journal of Medicine.
New research suggests that a combination of cognitive remediation and noninvasive brain stimulation using low-level electrical currents may slow the decline of mental capabilities in older adults with major depression, a risk factor for dementia including Alzheimer disease.
The Centers for Disease Control and Prevention (CDC) recommended a second dose of the 2024-2025 COVID-19 vaccine, administered 6 months after the first dose, for people aged 65 years or older and individuals who are immunocompromised.
I like the idea of a river yawning: its mouth a vast open width, just a symptom of fatigue. I think of how it wraps its length around itself, serpentine and sure; how its waves rock back and forth, a cradle on an unsteady floor. on days like today, when the spring fog has melted into my bones, or when time seems to stop or slow, I think of my spine as that river and curl into myself like the letter “c.” breath floating downstream, body swaying like the currents of the sea.
This JAMA Insights discusses allogenic stem cell donation, including the donation process and the effects of stem cell donation on donors.