August 20, 2019, Vol 322, No. 7, Pages 589-702

In This Issue of JAMA

Highlights

Abstract Full Text

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JAMA. 2019;322(7):589-591. doi:10.1001/jama.2018.15465

Audio Summary: Effect of Maintenance Olanzapine vs Placebo on Psychotic Depression Relapse, Abnormal TFTs and Preterm Birth, USPSTF BRCA Testing Guidelines, and more

Original Investigation

Effect of Continuing Olanzapine vs Placebo on Relapse Among Patients With Psychotic Depression in Remission: The STOP-PD II Randomized Clinical Trial

Alastair J. Flint, MB; Barnett S. Meyers, MD; Anthony J. Rothschild, MD; et al.

Abstract Full Text

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JAMA. 2019;322(7):622-631. doi:10.1001/jama.2019.10517

This randomized clinical trial compares the effect on relapse of continuing olanzapine vs placebo among patients with psychotic depression who achieved remission of psychosis and depressive symptoms while taking olanzapine and sertraline.

Editorial
Maintenance Treatment for Psychotic Depressive Disorders: Progress and Remaining Challenges
William H. Coryell, MD

Association of Thyroid Function Test Abnormalities and Thyroid Autoimmunity With Preterm Birth: A Systematic Review and Meta-analysis

The Consortium on Thyroid and Pregnancy—Study Group on Preterm Birth

Abstract Full Text

JAMA. 2019;322(7):632-641. doi:10.1001/jama.2019.10931

This individual participant data meta-analysis pooled data from 19 cohort studies to assess whether maternal thyroid function test abnormalities and thyroid autoimmunity are risk factors for preterm birth among pregnant women without overt thyroid disease.

Editorial
Thyroid Function Test Abnormalities During Pregnancy
Anne R. Cappola, MD, ScM; Brian M. Casey, MD

Association of Smoking Cessation With Subsequent Risk of Cardiovascular Disease

Meredith S. Duncan, MA; Matthew S. Freiberg, MD, MSc; Robert A. Greevy Jr, PhD; et al.

Abstract Full Text

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JAMA. 2019;322(7):642-650. doi:10.1001/jama.2019.10298

This cohort study uses Framingham Heart Study data to assess the association between years since smoking cessation and incident cardiovascular disease (CVD), compared with current and never smoking, among participants without baseline CVD over a median follow-up of 26 years.

Editor's Note
Smoking Cessation and Reduction of Cardiovascular Disease Risk
Thomas B. Cole, MD, MPH

Research Letter

Prevalence and Characteristics of Virginia Hospitals Suing Patients and Garnishing Wages for Unpaid Medical Bills

William E. Bruhn, BS; Lainie Rutkow, JD, PhD, MPH; Peiqi Wang, MD, MPH; et al.

Abstract Full Text

JAMA. 2019;322(7):691-692. doi:10.1001/jama.2019.9144

This study uses 2017 court records to characterize how frequently Virginia hospitals take legal action to garnish patients’ wages to recover unpaid medical expenses, and the characteristics of hospitals and patient employers associated with the actions.

US Preventive Services Task Force

Recommendation Statement

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: US Preventive Services Task Force Recommendation Statement

US Preventive Services Task Force

Abstract Full Text

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JAMA. 2019;322(7):652-665. doi:10.1001/jama.2019.10987

This 2019 Recommendation Statement from the US Preventive Services Task Force recommends that women with a family or personal history associated with increased risk for harmful mutations in the BRCA1/2 genes and with a positive result on a brief familial risk assessment tool should receive genetic counseling and, if indicated, genetic testing (B recommendation) and recommends against routine risk assessment, genetic counseling, or genetic testing for women whose personal or family history is not associated with potentially harmful BRCA1/2 gene mutations (D recommendation).

Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer

Editorial
US Preventive Services Task Force Breast Cancer Recommendation Statement on Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer
Lisa Newman, MD, MPH
- Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer
Hereditary Cancer Evaluation in 2019—a Rapidly Evolving Landscape
Rachel L. Yung, MD; Larissa A. Korde, MD, MPH
- Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer
Broadening Criteria for BRCA1/2 Evaluation: Placing the USPSTF Recommendation in Context
Susan Domchek, MD; Mark Robson, MD
- Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer
USPSTF Recommendations for BRCA1 and BRCA2 Testing in the Context of a Transformative National Cancer Control Plan
Padma Sheila Rajagopal, MD, MPH; Sarah Nielsen, MS, CGC; Olufunmilayo I. Olopade, MD

Evidence Report

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer in Women: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Heidi D. Nelson, MD, MPH, MACP, FRCP; Miranda Pappas, MA; Amy Cantor, MD, MPH; et al.

Abstract Full Text

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JAMA. 2019;322(7):666-685. doi:10.1001/jama.2019.8430

This systematic review to support the 2019 US Preventive Services Task Force Recommendation Statement on risk assessment, genetic counseling, and genetic testing for BRCA-related cancer summarizes published evidence on the benefits and harms of assessment, counseling, and testing in women without recently diagnosed BRCA1/2-related cancer.

Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer

Editorial
US Preventive Services Task Force Breast Cancer Recommendation Statement on Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer
Lisa Newman, MD, MPH
- Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer
Hereditary Cancer Evaluation in 2019—a Rapidly Evolving Landscape
Rachel L. Yung, MD; Larissa A. Korde, MD, MPH
- Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer
Broadening Criteria for BRCA1/2 Evaluation: Placing the USPSTF Recommendation in Context
Susan Domchek, MD; Mark Robson, MD
- Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer
USPSTF Recommendations for BRCA1 and BRCA2 Testing in the Context of a Transformative National Cancer Control Plan
Padma Sheila Rajagopal, MD, MPH; Sarah Nielsen, MS, CGC; Olufunmilayo I. Olopade, MD

Viewpoint

The Conundrum of the United States Medical Licensing Examination Score Reporting Structure

Jennifer L. Swails, MD; Omowunmi Aibana, MD, MPH; Barbara J. Stoll, MD

Abstract Full Text

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JAMA. 2019;322(7):605-606. doi:10.1001/jama.2019.9669

In the context of joint preliminary recommendations from the Federation of State Medical Boards and the National Board of Medical Examiners to consider moving the USMLE examination to pass-fail score reporting, this Viewpoint discusses how the current 3-digit score reporting structure is used by residency program directors and medical schools, how it may distract students from developing qualities of innovation and humanism important to medicine, and how it may facilitate workforce underrepresentation of some student groups.

Audio Interview: Implications of the United States Medical Licensing Examination (USMLE) Score Reporting Structure

A New Supreme Court Ruling on Drug Liability

Mitchell C. Johnston; Marcia M. Boumil, JD, LLM; Gregory Curfman, MD

Abstract Full Text

JAMA. 2019;322(7):607-608. doi:10.1001/jama.2019.8515

In May 2019 the US Supreme Court sent back to lower courts the question of whether Merck Sharpe & Dohme Corp was liable for atypical fractures from its osteoporosis drug alendronate because it did not identify the adverse effect in the product’s label. This Viewpoint discusses the legal questions of liability raised by the case and the implication of the decision for the pharmaceutical industry and for patients alleging harmed from prescription drugs.

Protecting Pregnant Women With Substance Use Disorders and Their Neonates Participating in Research

Jonathan M. Davis, MD; Lynne Yao, MD; Barbara E. Bierer, MD

Abstract Full Text

JAMA. 2019;322(7):609-610. doi:10.1001/jama.2019.9002

This Viewpoint discusses the potential risks faced by pregnant women with substance use disorders who participate in clinical research, including criminal prosecution for drug use while pregnant and custody loss of their children, and proposes changes to research procedures and disclosure provisions to encourage their participation so the evidence base informing their care and addressing the opioid epidemic more generally can advance.

Electronic Fetal Monitoring to Prevent Fetal Brain Injury: A Ubiquitous Yet Flawed Tool

Emmet Hirsch, MD

Abstract Full Text

JAMA. 2019;322(7):611-612. doi:10.1001/jama.2019.8918

This Viewpoint argues that the near-universal adoption of electronic fetal monitoring (EFM) in labor and delivery units has occurred without evidence that it has reduced adverse neurological events and has contributed to an increase in US cesarean delivery rates, and calls for the education of physicians and the public about EFM’s demonstrated reliability and value.

A Piece of My Mind

A Tale of Two Lungs

Matthew K. Hensley, MD, MPH

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JAMA. 2019;322(7):613-614. doi:10.1001/jama.2019.11287

In this narrative medicine essay, a critical care physician works through lessons he learned from his experience with a man with end-stage lung disease going into terminal respiratory failure who consented to intubation only if he had a chance for a lung transplant and considers how to balance patient autonomy with medical paternalism when good outcomes are unlikely and the best decisions are uncertain.

Editorial

Maintenance Treatment for Psychotic Depressive Disorders: Progress and Remaining Challenges

William H. Coryell, MD

Abstract Full Text

JAMA. 2019;322(7):615-617. doi:10.1001/jama.2019.9682

Thyroid Function Test Abnormalities During Pregnancy

Anne R. Cappola, MD, ScM; Brian M. Casey, MD

Abstract Full Text

JAMA. 2019;322(7):617-619. doi:10.1001/jama.2019.10159

Broadening Criteria for BRCA1/2 Evaluation: Placing the USPSTF Recommendation in Context

Susan Domchek, MD; Mark Robson, MD

Abstract Full Text

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JAMA. 2019;322(7):619-621. doi:10.1001/jama.2019.9688

Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer

Editorial
US Preventive Services Task Force Breast Cancer Recommendation Statement on Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer
Lisa Newman, MD, MPH
- Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer
Hereditary Cancer Evaluation in 2019—a Rapidly Evolving Landscape
Rachel L. Yung, MD; Larissa A. Korde, MD, MPH
- Audio Interview: USPSTF Recommendation: Assessment, Counseling, and Testing for BRCA-Related Cancer
USPSTF Recommendations for BRCA1 and BRCA2 Testing in the Context of a Transformative National Cancer Control Plan
Padma Sheila Rajagopal, MD, MPH; Sarah Nielsen, MS, CGC; Olufunmilayo I. Olopade, MD

JAMA Insights

Catheter Ablation for Atrial Fibrillation in 2019

Gaurav A. Upadhyay, MD; Francis J. Alenghat, MD, PhD

Abstract Full Text

JAMA. 2019;322(7):686-687. doi:10.1001/jama.2019.10929

This JAMA Insights Clinical Update reviews management approaches to atrial fibrillation (AF), including assessment of the need for anticoagulation, and controversies over the need for rhythm control and the role of catheter ablation for maintaining sinus rhythm and reducing AF-associated symptoms.

Editorial
Catheter Ablation for Atrial Fibrillation: Lessons Learned From CABANA
Christine M. Albert, MD, MPH; Deepak L. Bhatt, MD, MPH

JAMA Clinical Challenge

Electrocardiographic Diagnosis of Atrial Arrhythmias

Elsayed Z. Soliman, MD, MSc, MS; Prashant D. Bhave, MD; Lin Y. Chen, MD, MS

Abstract Full Text

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JAMA. 2019;322(7):688-689. doi:10.1001/jama.2019.10925

This Clinical Challenge reviews ways to distinguish atrial ectopy, AV block, multifocal atrial tachycardia, and other supraventricular tachycardias from atrial fibrillation in patients with absent P waves, irregularly irregular R-R intervals, and f waves on electrocardiography.

Editor's Note

Smoking Cessation and Reduction of Cardiovascular Disease Risk

Thomas B. Cole, MD, MPH

Abstract Full Text

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JAMA. 2019;322(7):651. doi:10.1001/jama.2019.11166

Medical News & Perspectives

Weighing the Risks and Rewards of Peanut Oral Immunotherapy

Jennifer Abbasi

Abstract Full Text

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JAMA. 2019;322(7):596-598. doi:10.1001/jama.2019.9142

This Medical News article discusses a recent meta-analysis of oral immunotherapy trials for people with peanut allergies.

Getting Social: Physicians Can Counteract Misinformation With an Online Presence

Rita Rubin, MA

Abstract Full Text

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JAMA. 2019;322(7):598-600. doi:10.1001/jama.2019.10779

This Medical News interview discusses the value of social media for health care.

Audio: Getting Social: Physicians Need to Counteract Misinformation Online

News From the Food and Drug Administration

Ventilator Recall

Feyza Sancar, PhD

Abstract Full Text

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JAMA. 2019;322(7):604. doi:10.1001/jama.2019.11803

Another Option for Hypoactive Sexual Desire

Feyza Sancar, PhD

Abstract Full Text

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JAMA. 2019;322(7):604. doi:10.1001/jama.2019.11515

First Treatment for Rare Autoimmune Neuromyelitis

Feyza Sancar, PhD

Abstract Full Text

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JAMA. 2019;322(7):604. doi:10.1001/jama.2019.11804

The JAMA Forum

Averting Alert Fatigue to Prevent Adverse Drug Reactions

Aaron E. Carroll, MD

Abstract Full Text

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JAMA. 2019;322(7):601. doi:10.1001/jama.2019.11710

Global Health

Gag Rule May Increase Abortions

Bridget Kuehn, MSJ

Abstract Full Text

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JAMA. 2019;322(7):603. doi:10.1001/jama.2019.11062

Viruses Drive Children’s Pneumonia

Bridget Kuehn, MSJ

Abstract Full Text

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JAMA. 2019;322(7):603. doi:10.1001/jama.2019.11801

Fighting Epilepsy Stigma

Bridget Kuehn, MSJ

Abstract Full Text

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JAMA. 2019;322(7):603. doi:10.1001/jama.2019.11802

JAMA Infographic

Prevalence and Treatment of Chronic Obstructive Pulmonary Disease (COPD) in the United States

Adam I. Biener, PhD; Sandra L. Decker, PhD; Frederick Rohde, MA

Abstract Full Text

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JAMA. 2019;322(7):602. doi:10.1001/jama.2019.10241

Poetry and Medicine

Playing Word Games

Susan Frances Martinello

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JAMA. 2019;322(7):698. doi:10.1001/jama.2019.5687

JAMA Revisited

The Relation of Pathology to Practice: Francis Carter Wood, M.D., New York

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JAMA. 2019;322(7):699. doi:10.1001/jama.2018.15473

JAMA Patient Page

Should I Be Tested for BRCA Mutations?

Jill Jin, MD, MPH

Abstract Full Text

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JAMA. 2019;322(7):702. doi:10.1001/jama.2019.11251

This JAMA Patient Page describes the US Preventive Services Task Force’s recently published recommendations on risk assessment and genetic counseling and testing for BRCA mutations and BRCA-related cancers.