tbuckley/cabot-search huggingface dataset:
Reducing Wasteful Spending on Discarded Lecanemab in the US Medicare Program
Authors: Frank F. Zhou, Chi-Hong Tseng, Mei Leng, Benjo A. Delarmente, Cheryl L. Damberg, Catherine A. Sarkisian, John N. Mafi
Journal: JAMA Internal Medicine (2024)

This cross-sectional study examines the wastage observed with the use of weight-based dosing of lecanemab in treatment of Alzheimer disease and proposes alternative vial sizes to reduce wastage.
Moving the Needle on Acupuncture Trials
Authors: Jerard Z. Kneifati-Hayek, Mitchell H. Katz
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
State Social Expenditures and Preterm Birth and Low Birth Weight in the US
Authors: Lawrence Chang, Henry T. Puls, Michael C. Monuteaux, Jeffrey D. Colvin, Paul J. Chung, Lois K. Lee
Journal: JAMA Pediatrics (2024)

Importance Adverse birth outcomes in the US, including preterm birth and low birth weight, are strongly tied to socioeconomic disadvantage and disproportionately impact infants of Black mothers. Increasing investments in social programs represents a potential policy approach to addressing disparities in birth outcomes. Objective To examine state-level associations of government expenditures on social programs with rates of preterm birth and low birth weight both overall and by race. Design, Setting, and Participants This cross-sectional, ecological study was conducted among liveborn infants in the 50 US states between January 1, 2011, and December 31, 2019. Data analysis was performed from May 2022 to May 2024. Exposures Yearly state and local government expenditures per low-income person on social programs in the following categories: state refundable Earned Income Tax Credit; cash assistance; childcare assistance; housing and community development; and public health. Main Outcomes and Measures Yearly state-level rates of preterm birth (gestational age &amp;amp;lt;37 weeks) and low birth weight (&amp;amp;lt;2500 g). Results From January 1, 2011, to December 31, 2019, there were 35.1 million live births in the US, of which 3.4 million (9.8%) were preterm and 2.8 million (8.1%) were low birth weight. Median (IQR) state social expenditures per low-income person were $1546 ($1074-$2323). Greater total state social expenditures were associated with lower overall rates of preterm birth (adjusted prevalence ratio [aPR] for every increase of $1000 per low-income person, 0.99; 95% CI, 0.97-0.999) but not with overall rates of low birth weight. In secondary analyses, greater state social expenditures were associated with lower preterm birth rates for infants of Black mothers (aPR, 0.96; 95% CI, 0.92-0.999). Greater state expenditures specifically on cash assistance (aPR, 0.64; 95% CI, 0.43-0.94) and housing and community development (aPR, 0.91; 95% CI, 0.84-0.98) were associated with lower preterm birth rates for infants of Black mothers. Conclusions and Relevance In this cross-sectional, ecological study, greater state-level expenditures on social programs were associated with reduced rates of preterm birth, particularly for infants of Black mothers. State and local governments may consider bolstering investments in cash assistance and housing and community development to address maternal and infant health disparities.
Performance of Machine Learning Suicide Risk Models in an American Indian Population
Authors: Emily E. Haroz, Paul Rebman, Novalene Goklish, Mitchell Garcia, Rose Suttle, Dominick Maggio, Eben Clattenburg, Joe Mega, Roy Adams
Journal: JAMA Network Open (2024)

Few suicide risk identification tools have been developed specifically for American Indian and Alaska Native populations, even though these populations face the starkest suicide-related inequities.
Physicians, the Homelessness Crisis, and Public Health—All Hands on Deck
Authors: Cary P. Gross, Abbe R. Gluck, Giselle Corbie
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Approach to Hospital Preparedness for Acute Surge Events Due to Emerging Infectious Diseases—Reply
Authors: Rahi Abouk, David Powell
Journal: JAMA (2024)

In Reply We appreciate Dr Anesi's interest in our Research Letter,1 which reported that ransomware attacks disrupting care delivery in targeted hospitals in California from 2014 to 2020 led to an increase in emergency department (ED) visits at nearby facilities.
Recovery From COVID-19–Related Disruptions in Cancer Detection
Authors: Uriel Kim, Johnie Rose, Bryan T. Carroll, Richard S. Hoehn, Eric Chen, Jeremy S. Bordeaux, Siran M. Koroukian
Journal: JAMA Network Open (2024)

The COVID-19 pandemic impacted the timely diagnosis of cancer, which persisted as the second leading cause of death in the US throughout the pandemic.
SARS-CoV-2 Infection and New-Onset Type 2 Diabetes Among Pediatric Patients, 2020 to 2022
Authors: Margaret G. Miller, Pauline Terebuh, David C. Kaelber, Rong Xu, Pamela B. Davis
Journal: JAMA Network Open (2024)

Importance In adults, diagnoses of new-onset type 2 diabetes (T2D) have increased following diagnosis with COVID-19, but whether this occurs in children is unclear. Objective To determine whether risk of incident T2D diagnosis is increased during the 6 months after SARS-CoV-2 infection among children. Design, Setting, and Participants This retrospective cohort study used electronic health records from the TriNetX analytics platforms between January 1, 2020, and December 31, 2022. Pediatric patients aged 10 to 19 years without preexisting diabetes were eligible for inclusion. Data were analyzed from August 15 to September 15, 2023, with supplemental analyses January 20 and August 8 to 13, 2024. Exposures Diagnosis of COVID-19 or a non–COVID-19 respiratory infection. Main Outcomes and Measures New diagnosis of T2D compared by risk ratios (RRs) and 95% CIs at 1, 3, and 6 months after index infection. Results The main study population included 613 602 patients, consisting of 306 801 with COVID-19 (mean [SD] age at index, 14.9 [2.9] years; 52.8% female) and 306 801 with other respiratory infections (ORIs) but no documented COVID-19 (mean [SD] age at index, 14.9 [2.9] years; 52.6% female) after propensity score matching. Risk of a new diagnosis of T2D was significantly increased from day of infection to 1, 3, and 6 months after COVID-19 diagnosis compared with the matched cohort with ORIs (RR at 1 month, 1.55 [95% CI, 1.28-1.89]; RR at 3 months: 1.48 [95% CI, 1.24-1.76]; RR at 6 months: 1.58 [95% CI, 1.35-1.85]). Similar results were found in the subpopulation classified as having overweight or obesity (RR at 1 month: 2.07 [95% CI, 1.12-3.83]; RR at 3 months: 2.00 [95% CI, 1.15-3.47]; RR at 6 months: 2.27 [95% CI, 1.38-3.75]) and the hospitalized subpopulation (RR at 1 month: 3.10 [95% CI, 2.04-4.71]; RR at 3 months: 2.74 [95% CI, 1.90-3.96]; RR at 6 months: 2.62 [95% CI, 1.87-3.66]). Similar elevation in risk was found at 3 and 6 months when excluding patients diagnosed during the interval from the index date to 1 month after infection. Conclusions and Relevance In this retrospective cohort study of children and adolescents aged 10 to 19 years, the risk of an incident diagnosis of T2D was greater following a COVID-19 diagnosis than in children diagnosed with ORIs. Further study is required to determine whether diabetes persists or reverses later in life.
Naloxone Access Laws and Opioid-Related Overdose Deaths in Youths
Authors: Michael S. Toce, Kenneth A. Michelson, Scott E. Hadland, Michael C. Monuteaux, Florence T. Bourgeois
Journal: JAMA Pediatrics (2024)

This cross-sectional study assesses fatal drug overdoses in youths associated with implementation of state-level naloxone access expansions.
Risk of Suicidal Ideation or Attempts in Adolescents With Obesity Treated With GLP1 Receptor Agonists
Authors: Liya Kerem, Joshua Stokar
Journal: JAMA Pediatrics (2024)

Importance Glucagon-like peptide 1 receptor agonists (GLP1R) are increasingly being used for the treatment of obesity in adolescents. It is currently unknown whether GLP1R treatment is associated with suicidal ideation or attempts in this population. Objective To investigate the association between GLP1R initiation and suicidal ideation or attempts in adolescents with obesity. Design, Setting, and Participants Retrospective propensity score–matched cohort study using electronic health records from the TriNetX global federated network between December 2019 and June 2024. The analysis included data from 120 health care organizations, mainly from the USA. Participants were adolescents aged 12 to 18 years with a diagnosis of obesity and evidence of an antiobesity GLP1R prescription or lifestyle intervention without GLP1R within the following year. Cohorts were balanced for baseline demographic characteristics, psychiatric medications and comorbidities, and diagnoses associated with socioeconomic status and health care access using propensity score matching. Exposure Initial prescription of GLP1R (study cohort) or lifestyle intervention without GLP1R (control cohort). Main Outcomes and Measures Incidence of suicidal ideation or attempts based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes recorded in patient electronic health records during 12 months of follow-up. Diagnoses of upper respiratory tract infections (URTI) were used as negative control outcomes, and gastrointestinal symptoms (GI) were used as positive control outcomes. Results A total of 4052 adolescents with obesity and a concomitant antiobesity intervention were identified for the GLP1R cohort and 50 112 were identified for the control cohort. Propensity score matching resulted in 3456 participants in each balanced cohort. Prescription of GLP1R was associated with a 33% reduced risk for suicidal ideation or attempts over 12 months of follow-up (1.45% vs 2.26%; hazard ratio [HR], 0.67; 95% CI, 0.47-0.95; P = .02) and a higher rate of GI symptoms (6.9% vs 5.4%; HR, 1.41; 95% CI, 1.12-1.78; P = .003) but no difference in rates of URTI diagnoses. Conclusions and Relevance In this study, adolescents with obesity prescribed a GLP1R had a lower incidence of suicidal ideation or attempts compared with matched patients not prescribed GLP1R who were treated with lifestyle intervention. These results suggest a favorable psychiatric safety profile of GLP1R in adolescents. The detected reduction in HRs for suicidal ideation among adolescents with obesity prescribed GLP1R suggests potential avenues for future research.
Are Artificial Intelligence–Generated Replies the Answer to the Electronic Health Record Inbox Problem?
Authors: Lisa S. Rotenstein, Robert M. Wachter
Journal: JAMA Network Open (2024)

The use of patient portals has increased markedly in recent years. According to the Office of the National Coordinator for Health Information Technology, in 2022, about 60% of individuals accessed their online medical records or patient portals, up from 25% in 2014.1
Patterns of Migration Following Dementia Diagnosis
Authors: Momotazur Rahman, Bishnu Bahadur Thapa, Christopher Santostefano, Pedro Gozalo, Ulrike Muench, Cyrus M. Kosar, Hyesung Oh, Elizabeth White, Vincent Mor
Journal: JAMA Network Open (2024)

Importance Diseases have historically prompted individual relocations to mitigate the risk of disease acquisition or improve access to care. As dementia prevalence increases, comprehending the migration patterns of affected individuals is vital for public policy. Objective To quantify the association of dementia diagnosis with migration patterns by examining the proportion of individuals with dementia who relocate, the timing of their moves relative to diagnosis, and the nature of their new living arrangements, whether in institutional settings or different households. Design, Setting, and Participants This cohort study leveraged a comprehensive dataset of national Medicare claims and assessments spanning from 2012 to 2020, including Medicare Beneficiary Summary File and nursing home administrative datasets. The study focused on beneficiaries who received diagnoses in 2016 of dementia, myocardial infarction, chronic obstructive pulmonary disease, or colon cancer. Analyses were performed from March 2023 to August 2024. Main Outcomes and Measures The primary outcome was migration, defined as change in county or state. The analysis distinguished between migrations with and without a nursing home stay. By tracking patients’ residential county for 4 years before and after diagnosis, a difference-in-differences approach was used to contrast migration tendencies associated with dementia against the other 3 conditions. Results The sample included 1 626 127 Medicare beneficiaries (mean [SD] age, 80.1 [8.0] years; 922 194 women [56.7%]) who received diagnoses of the 4 conditions in 2016. In total, 818 862 had a new dementia diagnosis (age, 82.0 [7.8] years; 492 146 women [60.1%]). Comparing between the prediagnosis and postdiagnosis months, the proportion migrating to a different county increased by 8.5 percentage points (95% CI, 7.6-9.4 percentage points) for individuals with dementia and between 4.2 to 5.8 percentage points among those with myocardial infarction, chronic obstructive pulmonary disease, or colon cancer. The difference-in-difference estimates indicated a 3.9 percentage point (95% CI, 3.7-4.0 percentage points) increase in intercounty migration and a 1.9 percentage point (95% CI, 1.8-2.0 percentage points) increase in interstate migration for patients with dementia, effectively doubling the likelihood of migration compared with the other conditions. Of the excess migrations resulting from dementia diagnosis, 55% occurred in community settings, and 45% occurred in institutional settings. Conclusions and Relevance In this retrospective cohort study of Medicare fee-for-service beneficiaries, dementia was associated with a marked increase in migration rates over other major illnesses. This finding underscores the need to understand the factors associated with these distinct migration behaviors.
The Credibility Deficit Experienced by Black Patients
Authors: Mary Catherine Beach, Somnath Saha
Journal: JAMA Network Open (2024)

Courtney R. Lee, MD, MPH, MSHP; Jaya Aysola, MD, DTMH, MPH; Xinwei Chen, MS; Eden Addisu; Ari Klein, PhD; Davy Weissenbacher, PhD; Graciela Gonzalez-Hernandez, PhD; Gary E. Weissman, MD, MSHP
Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk
Authors: Jian-Feng Tu, Guang-Xia Shi, Shi-Yan Yan, Guang-Xia Ni, Fang-Ting Yu, Guo-Wei Cai, Zhi-Shun Liu, Chao-Yang Ma, Li-Qiong Wang, Jing-Wen Yang, Xiao-Qing Zhou, Xiu-Li Meng, Hai-Yang Fu, Jing Li, Wen-Jun Wan, Tian-Heng Sun, Xue-Zhou Wang, Cun-Zhi Liu
Journal: JAMA Internal Medicine (2024)

Importance Sciatica is commonly caused by herniated lumbar disc and contributes to severe pain and prolonged disability. Although acupuncture is widely used by patients with chronic sciatica, the evidence of its efficacy is scarce. Objective To investigate the efficacy and safety of acupuncture compared with sham acupuncture in patients with chronic sciatica from herniated disk. Design, Settings, and Participants This was a multicenter 2-arm randomized clinical trial conducted in 6 tertiary-level hospitals in China of patients with chronic sciatica from herniated disk. Participants were recruited from March 25, 2021, to September 23, 2021, with a final follow-up through September 22, 2022. Data analyses were performed from December 2022 to March 2023. Interventions Participants were randomly assigned to receive 10 sessions of acupuncture (n = 110) or sham acupuncture (n = 110) over 4 weeks. Participants, outcome assessors, and statisticians were blinded. Main Outcomes and Measures The 2 coprimary outcomes were changes in visual analog scale (VAS) for leg pain and Oswestry Disability Index (ODI) from baseline to week 4. Secondary outcomes were adverse events. Results A total of 216 patients (mean [SD] age, 51.3 [15.2] years; 147 females [68.1%] and 69 males [31.9%]) were included in the analyses. The VAS for leg pain decreased 30.8 mm in the acupuncture group and 14.9 mm in the sham acupuncture group at week 4 (mean difference, −16.0; 95% CI, −21.3 to −10.6; P &amp;amp;lt; .001). The ODI decreased 13.0 points in the acupuncture group and 4.9 points in the sham acupuncture group at week 4 (mean difference, −8.1; 95% CI, −11.1 to −5.1; P &amp;amp;lt; .001). For both VAS and ODI, the between-group difference became apparent starting in week 2 (mean difference, −7.8; 95% CI, −13.0 to −2.5; P = .004 and −5.3; 95% CI, −8.4 to −2.3; P = .001, respectively) and persisted through week 52 (mean difference, −10.8; [95% CI, −16.3 to −5.2; P &amp;amp;lt; .001; and −4.8; 95% CI, −7.8 to −1.7; P = .003, respectively). No serious adverse events occurred. Conclusions and Relevance This randomized clinical trial found that in patients with chronic sciatica from herniated disk, acupuncture resulted in less pain and better function compared with sham acupuncture at week 4, and these benefits persisted through week 52. Acupuncture should be considered as a potential treatment option for patients with chronic sciatica from a herniated disk. Trial Registration Chictr.org Identifier: ChiCTR2100044585
GLP-1 Receptor Agonists and the Path to Sustainable Obesity Care
Authors: Jennifer Manne-Goehler, Felix Teufel, Willem D. F. Venter
Journal: JAMA Internal Medicine (2024)

This Viewpoint discusses the optimal treatment duration of glucagon-like peptide-1 receptor agonists in people with obesity and the benefits of off-ramping, the tapering of these antiobesity medications following an initial treatment period.
Layperson-Administered Naloxone Trends Reported in Emergency Medical Service Activations, 2020-2022
Authors: Christopher B. Gage, Jonathan R. Powell, Alexander Ulintz, Rebecca E. Cash, Michael S. Lyons, Henry Wang, Ashish R. Panchal
Journal: JAMA Network Open (2024)

Importance Layperson-administered naloxone (LAN) is a powerful but incompletely characterized intervention to prevent opioid-related overdose mortality. LAN trends are relevant to policy and strategic planning in naloxone distribution initiatives. Objective To assess the 2-year LAN trend for persons in the United States receiving naloxone during emergency medical services (EMS) activations. Design, Setting, and Participants This retrospective cross-sectional study was conducted in the United States from June 2020 to June 2022 among 65 621 195 EMS activations from 911 responses, EMS standbys, or when EMS crews functioned in an ambulance intercept role or during mutual aid to another ambulance response. Activations within health care settings and interfacility or medical transports were excluded. Data are from the National Emergency Medical Services Information System (NEMSIS), the national EMS patient care record database. From June 2020 to June 2022, NEMSIS included more than 96 million EMS activations from nearly 14 000 agencies across 54 states and territories. Exposures EMS clinician–reported LAN. Main Outcome and Measures The primary outcome was the trend of receiving LAN, measured by EMS clinician documentation. Results From June 2020 to June 2022, EMS reported 744 078 patients receiving naloxone, with 24 990 (3.4%) involving LAN. Patients were predominantly male (17 331 [69.4%]) and had a median (IQR) age of 42 (31-56) years, with the majority treated in urban homes or residences (21 692 [86.8%] urban; 13 223 [52.9%] in-home or residence). Of the total naloxone recipients, 243 985 patients (32.8%) had suspected drug overdose documentation as either the primary or secondary impression. Overall, the percentage change in naloxone administration rates decreased 6.1% over the study period (from 1140.1 [95% CI, 1135.1-1145.1] per 100 000 EMS activations to 1070.1 [95% CI, 1064.9-1075.3] per 100 000 EMS activations), while the percentage change of persons receiving LAN increased 43.5% (from 30.0 [95% CI, 29.2-30.8] per 100 000 EMS activations to 43.1 [95% CI, 42.0-44.1] per 100 000 EMS activations). Conclusions and Relevance In this cross-sectional study, the LAN rate increased from June 2020 to June 2022 as reported in the national EMS database. These findings help inform policies and practices aimed at mitigating the devastating impacts of the opioid epidemic and saving lives. Novel public health strategies are needed to measure the effects of this intervention nationally, evaluate approaches to expand naloxone distribution, and address naloxone usage barriers.
Postpartum Mental Health Care Use Among Parents During Simultaneous Parental Leave
Authors: Helena Honkaniemi, Sol P. Juárez
Journal: JAMA Network Open (2024)

Flexible parental leave schemes can help families balance work, childcare, and postpartum treatment, including treatment for mental health. In Sweden, both parents are eligible to use parental leave simultaneously in the first year after birth; however, the consequences for postpartum mental health care uptake remain underinvestigated.