JAMA

Causal Inference About the Effects of Interventions From Observational Studies in Medical Journals

Importance  Many medical journals, including JAMA, restrict the use of causal language to the reporting of randomized clinical trials. Although well-conducted randomized clinical trials remain the preferred approach for answering causal questions, methods for observational studies have advanced such that causal interpretations of…

Prognostic Value of Cardiovascular Biomarkers in the Population

Importance  Identification of individuals at high risk for atherosclerotic cardiovascular disease within the population is important to inform primary prevention strategies. Objective  To evaluate the prognostic value of routinely available cardiovascular biomarkers when added to established risk factors. Design, Setting, and Participants  Individual-level…

Smoking Cessation After Initial Treatment Failure With Varenicline or Nicotine Replacement – A Randomized Clinical Trial

Importance  Most people who smoke do not quit on their initial attempt. Objective  To determine the best subsequent strategy for nonabstinence following initial treatment with varenicline or combined nicotine replacement therapy (CNRT). Design, Setting, and Participants  Using a double-blind, placebo-controlled, sequential multiple assignment…

The Women’s Health Initiative Randomized Trials and Clinical Practice – A Review

Importance  Approximately 55 million people in the US and approximately 1.1 billion people worldwide are postmenopausal women. To inform clinical practice about the health effects of menopausal hormone therapy, calcium plus vitamin D supplementation, and a low-fat dietary pattern, the Women’s…

Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity – The SURMOUNT-4 Randomized Clinical Trial

Importance  The effect of continued treatment with tirzepatide on maintaining initial weight reduction is unknown. Objective  To assess the effect of tirzepatide, with diet and physical activity, on the maintenance of weight reduction. Design, Setting, and Participants  This phase 3, randomized withdrawal clinical…

Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults – A Review

Importance  Falls are reported by more than 14 million US adults aged 65 years or older annually and can result in substantial morbidity, mortality, and health care expenditures. Observations  Falls result from age-related physiologic changes compounded by multiple intrinsic and extrinsic risk…

Common Oral Conditions – A Review

Importance  Dry mouth, oral candidiasis, and recurrent aphthous ulcers are 3 of the most common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity. Observations  In a meta-analysis of 26 population-based cohort and cross-sectional studies, the…

Clinical, Biomarker, and Research Tests Among US Government Personnel and Their Family Members Involved in Anomalous Health Incidents

Importance  Since 2015, US government and related personnel have reported dizziness, pain, visual problems, and cognitive dysfunction after experiencing intrusive sounds and head pressure. The US government has labeled these anomalous health incidents (AHIs). Objective  To assess whether participants with AHIs differ significantly from…

Skin Biopsy Detection of Phosphorylated a-Synuclein in Patients With Synucleinopathies

Importance  Finding a reliable diagnostic biomarker for the disorders collectively known as synucleinopathies (Parkinson disease [PD], dementia with Lewy bodies [DLB], multiple system atrophy [MSA], and pure autonomic failure [PAF]) is an urgent unmet need. Immunohistochemical detection of cutaneous phosphorylated α-synuclein…

A Patient With Type 1 Diabetes and Acute Rhinosinusitis

A 41-year-old with type 1 diabetes had generalized weakness, muffled voice, and slurred speech. Neck computed tomography showed soft-tissue gas in the nasopharynx and prevertebral fascia; examination of sinus mucosal samples identified numerous broad, nonseptate right-angled hyphae and fruiting bodies….