tbuckley/cabot-search huggingface dataset:
Medical and Surgical Episodes Among Hospital Participants in the Bundled Payments for Care Improvement–Advanced Program
Authors: Keenan J. Robbins, Jie Zheng, R. J. Waken, E. John Orav, Arnold M. Epstein, Karen E. Joynt Maddox
Journal: JAMA Network Open (2024)

Importance Hospital participation in the Bundled Payments for Care Improvement–Advanced (BPCI-A) initiative has been associated with modest savings and stable clinical outcomes overall, but it is unknown whether the program performs differently for medical and surgical or procedural (henceforth, surgical) episodes. Objective To assess the association of BPCI-A participation with Medicare spending and clinical outcomes for medical and surgical episodes. Design, Setting, and Participants This retrospective difference-in-differences cohort study utilized 100% Medicare fee-for-service inpatient claims for episodes initiated between January 1, 2017, and September 30, 2019, and included 90 days of follow-up. The setting was hospitals participating in BPCI-A and matched nonparticipant hospitals. Participants included Medicare beneficiaries admitted for medical or surgical episodes. Exposure BPCI-A participation, beginning in 2018. Main Outcomes and Measures Changes in 90-day Medicare payments and clinical outcomes (readmissions, mortality, healthy days at home). Results The final sample included 2 895 878 episodes; 1 618 172 (55.9%) were female, 324 186 (11.2%) people under age 65 years, 1 354 246 (46.8%) between 65 and 80 years of age, and 1 217 446 (42.0%) over 80 years of age. Patient characteristics at BPCI-A and comparison hospitals were similar. BPCI-A participation was associated with a decrease in payments for medical episodes (−$882 per episode; 95% CI −$1004 to −$760) and surgical episodes (−$587; 95% CI −$850 to −$324) compared with nonparticipant hospitals (absolute difference between change in medical and surgical episodes, −$295; 95% CI −$584 to −$5). BPCI-A participation was associated with a greater increase in healthy days at home and a greater decrease in both skilled nursing facility (SNF) admissions and SNF length of stay overall, but there were no significant differences between medical and surgical episodes in terms of the association of BPCI-A with changes in these outcomes. Conclusions and Relevance In this cohort study analyzing the outcomes of the BPCI-A program for medical and surgical episodes, BPCI-A participation was associated with modestly decreased payments for both medical and surgical episodes compared with nonparticipants. Improvements in clinical outcomes associated with BPCI-A participation were also modest for both types of episodes; this study does not support a hypothesis that either medical or surgical episodes are better-suited for episode-based payments.
Dental Clinic Deserts in the US: Spatial Accessibility Analysis
Authors: Md. Shahinoor Rahman, Jeffrey C. Blossom, Ichiro Kawachi, Renuka Tipirneni, Hawazin W. Elani
Journal: JAMA Network Open (2024)

IMPORTANCE Little is known about the spatial accessibility to dental clinics across the US. OBJECTIVE To map the spatial accessibility of dental clinics nationally and to examine the characteristics of counties and US Census block groups with dental care shortage areas. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study of US dental clinics in 2023 using data from the IQVIA national practitioners’ database, which includes 205 762 active dentists. Data were analyzed from November 2023 to April 2024. EXPOSURES Socioeconomic characteristics of block groups and counties including rurality, area deprivation, racial and ethnic segregation, and uninsured population. MAIN OUTCOMES AND MEASURES Enhanced 2-step floating catchment area method with a 30-minute drive time impedance was used to calculate the accessibility score to dental clinics at the block group level. The outcomes were dental clinic shortage areas and inequality in access to dental clinics. RESULTS Nearly 1.7 million people in the US (0.5%) lacked access to dental clinics within a 30-minute drive. This included 0.9 million male (52.2%), 1.2 million White (71.0%), 52 636 Black (3.0%), and 176 885 Hispanic (10.2%) individuals. Approximately 24.7 million people (7.5%) lived in dental care shortage areas (defined as &amp;amp;lt;1 dentist per 5000 population). There was a significant difference in spatial accessibility scores between rural and urban areas, with 1 dentist for every 3850 people in rural areas and 1 dentist for every 1470 people in urban areas. Additionally, there were 387 counties with significant disparities in access to dental clinics. Rural block groups (23.9 percentage points [pp]; 95% CI, 23.6-24.3), block groups with higher levels of Black (1.5 pp; 95% CI, 1.3-1.7) and Hispanic (4.5 pp; 95% CI, 4.3-4.8) segregation, and block groups with the highest levels of area deprivation (5.5 pp; 95% CI, 5.1-5.9) were more likely to experience dental care shortages compared with urban block groups and those with lower levels of segregation and area deprivation. Moreover, rural counties (11.3 pp; 95% CI, 8.9-13.7), counties with a high uninsured population (3.0 pp; 95% CI, 1.5-4.4), and counties with high levels of deprivation (5.8 pp; 95% CI, 2.1-9.5) were more likely to have inequality in access to dental clinics. CONCLUSIONS AND RELEVANCE In this cross-sectional study of US dental clinics, there was geographic shortage and maldistribution of the dental workforce. These findings can support dental workforce planning efforts at the federal and state levels to encourage dentists to practice in underserved areas to reduce disparities in access to dental care.
Anterior Gastropexy for Paraesophageal Hernia Repair
Authors: Clayton C. Petro, Ryan C. Ellis, Sara M. Maskal, Sam J. Zolin, Chao Tu, Adele Costanzo, Lucas R. A. Beffa, David M. Krpata, Diya Alaedeen, Ajita S. Prabhu, Benjamin T. Miller, Kevin F. Baier, Alisan Fathalizadeh, John Rodriguez, Michael J. Rosen
Journal: JAMA Surgery (2024)

Paraesophageal hernias can cause severe limitations in quality of life and life-threatening complications. Even though minimally invasive paraesophageal hernia repair (MIS-PEHR) is safe and effective, anatomic recurrence rates remain notoriously high. Retrospective data suggest that suturing the stomach to the anterior abdominal wall after repair-an anterior gastropexy-may reduce recurrence, but this adjunct is currently not the standard of care.
Hospital Assets and Private Equity Acquisition
Authors: Shaun Larkin
Journal: JAMA (2024)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors JAMA+ AI Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Not Time to Abandon Cholecystectomy for Symptomatic Cholelithiasis—Reply
Authors: Daan J. Comes, Philip R. de Reuver
Journal: JAMA Surgery (2024)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast JAMA+ AI Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Unseen Impacts of Team-Based Documentation—Reply
Authors: Nate C. Apathy, A. Jay Holmgren, Dori A. Cross
Journal: JAMA Internal Medicine (2024)

In Reply We thank the authors for their Letter and the opportunity to further discuss the current interpretation and promising extensions of our recent publication.1 We will summarize and discuss 4 key points of interest, beginning each by paraphrasing the question posed.
Jessner Lymphocytic Infiltrate in Anti-HMGCR Myopathy
Authors: Joshua Prenner, Esther Choi, Yoo Jung Kim, Lida Zheng, Cuong V. Nguyen
Journal: JAMA Dermatology (2024)

This case report describes a man in his 50s with type 2 diabetes and hyperlipidemia who was admitted for rash and proximal muscle weakness, pain, and unintentional 15-pound weight loss associated with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) myopathy.
US Veterans’ Experiences With VA and Non-VA Health Care
Authors: Terrence Liu, Brittani Garlick, Nora Metzger, Erica Paulos, Brady T. West, Megan E. Vanneman, Tanner J. Caverly, Eve A. Kerr, Jane H. Forman, Angela Fagerlin, Jeffrey T. Kullgren
Journal: JAMA Internal Medicine (2024)

This survey study reports veterans’ perception of the timeliness, patient-centeredness, affordability, and quality of the care, services, and facilities they receive across the US.
Gestational Hypertension, Preeclampsia, and Eclampsia and Future Neurological Disorders
Authors: Therese Friis, Lina Bergman, Susanne Hesselman, Linda Lindström, Katja Junus, Catherine Cluver, Carlos Escudero, Anna-Karin Wikström
Journal: JAMA Neurology (2024)

Importance Gestational hypertension, preeclampsia, and eclampsia are established risk factors for stroke and dementia later in life. Whether these pregnancy complications are associated with an increased risk of new-onset neurological disorders within months to years after giving birth is not known. Objective To explore whether gestational hypertension, preeclampsia, and eclampsia are associated with new-onset migraine, headache, epilepsy, sleep disorder, or mental fatigue within months to years after giving birth. Design, Setting, and Participants In this register-based cohort study, exposures were identified in the Swedish Medical Birth Register from 2005 to 2018. Follow-up was conducted using the National Patient Register, containing diagnoses from specialized inpatient and outpatient care. Follow-up started 42 days after delivery and continued until the first event, death, emigration, or the end of the follow-up period (2019). The risk was calculated with Cox regression analysis and expressed as adjusted hazard ratio (aHR) with a 95% CI. Through the Swedish Medical Birth Register, 659 188 primiparous women with singleton pregnancies between 2005 and 2018 were identified. Women with a diagnosis of chronic hypertension (n = 4271) or a prepregnancy neurological disorder (n = 6532) were excluded. The final study population included 648 385 women. Data analyses were conducted in 2023. Exposures Gestational hypertension, preeclampsia, and eclampsia. Main outcome The primary outcome was a composite neurological outcome of migraine, headache, epilepsy, sleep disorder, or mental fatigue. Results The study included 648 385 women with a mean age of 28.5 (SD, 5.0) years at the time of their first pregnancy. Women with gestational hypertension (n = 11 133), preeclampsia (n = 26 797), and eclampsia (n = 625) all had an association with increased risk for a new-onset neurological disorder compared with women with normotensive pregnancies. The aHR for gestational hypertension was 1.27 (95% CI, 1.12-1.45), 1.32 (95% CI, 1.22-1.42) for preeclampsia, and 1.70 (95% CI, 1.16-2.50) for eclampsia. When exploring individual outcomes, women with eclampsia were associated with more than a 5 times increased risk of epilepsy (aHR, 5.31; 95% CI, 2.85-9.89). Conclusion and Relevance In this study, gestational hypertension, preeclampsia, and eclampsia were associated with an increased risk of new-onset migraine, headache, epilepsy, sleep disorder, or mental fatigue within months to years after giving birth. Guidelines recommend follow-up after delivery for women with gestational hypertension and preeclampsia for their increased risk of cardiovascular disease. At these visits, caregivers should also pay attention to persisting or new-onset of neurological symptoms, since this group of women appears to be vulnerable to developing or experiencing neurological disorders.
Methotrexate and Interstitial Lung Disease
Authors: Anna Brinks, Carli Needle, Kristen Lo Sicco
Journal: JAMA Dermatology (2024)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast JAMA+ AI Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2025 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal
Intravascular Sympathetic Stimulation to Facilitate Catheter Ablation of Premature Ventricular Complexes
Authors: Timothy M. Markman, Cory M. Tschabrunn, David Callans, Francis E. Marchlinski, Saman Nazarian
Journal: JAMA Cardiology (2024)

Importance Infrequent intraprocedural premature ventricular complexes (PVCs) limit the efficacy of catheter ablation. Intravascular stimulation of sympathetic nerves via vertebral veins (VVs) has been used to activate cardiac sympathetic tone and may promote PVCs. Objective To characterize the ability of direct electrical sympathetic stimulation via VVs to induce PVCs at the time of catheter ablation. Design, Setting, and Participants This prospective case series involved adult patients undergoing catheter ablation of PVCs, with rare or absent PVCs despite standard provocation, at the Hospital of the University of Pennsylvania between 2022 and 2024. Stimulation was performed via the left VV (20 Hz, up to 25 mA). Main Outcomes and Measures The primary outcome was PVC frequency, assessed before, during, and after stimulation. A multilevel mixed-effects Poisson regression was used to compare the rate of PVCs during the procedure. Results Fifteen patients (mean [SD] age, 60 [17] years; 10 male [71%]) had a mean (SD) preprocedure PVC burden of 16.3% (8.6%) (median [IQR], 17.0% [11.5%-21.5%]), and 7 of 15 had undergone at least 1 prior unsuccessful ablation. Provocation of PVCs was attempted with isoproterenol, atrial and ventricular burst pacing, and minimal sedation in all patients before VV stimulation. Throughout the 10-minute period before VV stimulation, patients had a mean (SD) of 1.3 (1.4) PVCs (median [IQR], 1.0 [0.0-2.5] PVCs). During VV stimulation, PVCs were noted in all patients (mean [SD], 8.2 [5.7] PVCs per minute; median [IQR], 6.0 [4.5-13.0] PVCs per minute). In the 10-minute period after VV stimulation, patients had a mean (SD) of 5.1 (6.6) PVCs per minute (median [IQR], 3.0 [0.5-6.5] PVCs per minute). After VV stimulation, ablation was guided by activation mapping in 7 patients and by pace mapping alone in the remaining patients. Postablation monitoring demonstrated a mean (SD) 1.3% (2.3%) burden of PVCs (median [IQR], 0.0% [0.0%-2.5%]), with 9 of 15 patients having less than 1% burden of PVCs. There were no adverse events related to VV stimulation. Conclusions and Relevance These findings suggest that intravascular sympathetic stimulation via the VV can be used to safely provoke PVCs during catheter ablation.
Variation in Emergency Department Physician Admitting Practices and Subsequent Mortality
Authors: Stephen Coussens, Dan P. Ly
Journal: JAMA Internal Medicine (2024)

An emergency department (ED) physician's decision to admit a patient to the hospital plays a pivotal role in determining the type and intensity of care that patient will receive. ED physicians vary widely in their propensity to admit patients to the hospital, but it is unknown whether higher admission propensities result in lower subsequent mortality rates.
It Is Time to Get Political for Children—Reply
Authors: Alison A. Galbraith, Aaron M. Milstone, Susan L. Rosenthal
Journal: JAMA Pediatrics (2024)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast JAMA+ AI Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Methotrexate and Interstitial Lung Disease
Authors: Anuradha Bishnoi, Surender Singh, Davinder Parsad
Journal: JAMA Dermatology (2024)

To the Editor We commend Shah et al1 for their recent study, which highlights that treating dermatomyositis with methotrexate does not significantly increase the risk of incident interstitial lung disease (ILD).
Immune Checkpoint Inhibitor–Induced Vitiligo-Like Depigmentation
Authors: Michela Starace, Stephano Cedirian, Luca Rapparini, Alessandro Pileri, Cristina Carrera, Priscila Giavedoni, M. Teresa Alonso de Leon, Lukas Kraehenbuehl, Yannick S. Elshot, Zoe Apalla, Chryssoula Papegeorgiou, Vasiliki Nikolaou, Tatjana Radevic, Zsuzsanna Lengyel, Pietro Sollena, Ketty Peris, Ernesto Rossi, Davide Fattore, Dimitra Koumaki, Aram Boada, Ana-Maria Forsea, Sonia Segura, Azael Freites-Martinez, Julia Riganti, Emily Avitan-Hersh, Nada Saffuri, Lucie Peuvrel, Frédéric Dezoteux, Bianca Maria Piraccini, Vincent Sibaud
Journal: JAMA Dermatology (2024)

This retrospective case series compares vitiligo resulting from immune checkpoint inhibitor (ICI) therapy vs preexisting vitiligo among patients receiving ICI treatment for cancer.
Trends in Buprenorphine Dispensing Among Adolescents and Young Adults in the US
Authors: Eileen Lee, S. Michaela Rikard, Gery Guy, Andrew Terranella
Journal: JAMA (2024)

This study examines trends in buprenorphine dispensing from retail pharmacies to adolescents and young adults aged 10 to 24 years in the US from 2020 to 2023.
Representation of Women Among Cardiology Grand Rounds Speakers in the United States
Authors: Ersilia M. DeFilippis, Supriya Muppala, Gurleen Kaur, Jessica H. Huston, Robert A. Harrington, Quinn Capers, Pamela S. Douglas, Nadim Mahmud, Nosheen Reza
Journal: JAMA Cardiology (2024)

Importance Women are underrepresented in leadership positions in cardiology. Institutional grand rounds (GR) are platforms through which faculty can gain professional exposure and access to career development opportunities. The gender diversity of invited cardiology GR speakers has not been investigated. Objective To examine the representation of women among cardiology GR speakers in the United States. Design, Setting, and Participants This cross-sectional study reviewed all 626 internal medicine residency training program websites in the American Medical Association’s FRIEDA directory to identify publicly available records of cardiology GR. Grand rounds from September 1997 through December 2022 were included; GR with more than 1 speaker and trainee-led case conferences were excluded. Exposures Grand rounds speaker gender. Main Outcomes and Measures Data on GR topic focus, speaker gender, and academic rank were collected. Results A total of 3806 GR lectures at 42 institutions were included; 799 (21%) were delivered by women and 3007 (79%) by men. The proportion of women GR speakers increased by 1% per year and increased for each topic over time with the exception of electrophysiology and basic/translational science. Women were most likely to speak on women’s cardiovascular health (80 lectures [10.0%] vs 17 [0.6%] for men; P &amp;amp;lt; .001). Conclusions and Relevance Women compose about 1 in 5 cardiology GR speakers with modest growth in representation over time but remain underrepresented as GR speakers for procedural cardiology and basic/translational science topics.