JAMA

This Viewpoint discusses recent problems with undisclosed conflicts of interest and proposes broadening disclosure requirements beyond individuals to include the institutions funding the research. [...]

This Viewpoint proposes that failure of authors to completely disclose conflicts of interest (COIs) should be considered a form of research misconduct subject to institutional review and sanctions if appropriate to establish a basic standard of consistent COI reporting. [...]

In this Viewpoint, Eric Topol and Lionel Tarrasenko, a biomedical engineer known for developing early-warning systems in critical care settings, contrast the precision monitoring of jet engines with existing monitoring systems in patients, and discuss how sensors, artificial intelligence, and other contemporary digital technologies used to monitor the maintenance needs of engines can be used to personalize treatment and improve outcomes for patients without generating false alarms. [...]

In this Viewpoint, the authors review Medicare & Medicaid Services 340B Payment program and recent rules to curtail expansion of drug discounts beyond serving poor patients. [...]

In this narrative medicine essay, a pediatrician and PhD-trained epidemiologist considers the personal significance of the statistically rare event that has happened to her and the implications for how she cares for patients and communicates risks to families confronting medical decisions. [...]

Conflict of interest affects virtually every aspect of medicine, including research, teaching, and clinical care. In May 2017, JAMA published a theme issue that included 23 articles on conflicts of interest (COIs) that represented “the multifaceted aspects and complexity of COI from numerous perspectives,” such as academia, medical education, medical practice, and research; industry payments to physicians and industry funding of and collaboration with researchers, guideline panels, professional [...]

Cardiovascular disease (CVD) is the leading cause of death among patients with end-stage kidney disease (ESKD) who are undergoing hemodialysis, yet many standard cardioprotective therapies have not been effective in reducing CVD in this patient population. This reality has motivated the quest to identify dialysis-related and kidney disease–specific factors that promote CVD. [...]

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic conditions contributing to morbidity and mortality. In 2016, it was the third leading cause of years of life lost and diasbility-adjusted life-years in the United States, with an estimated 164 000 deaths. Even with aggressive inpatient management, patients who are hospitalized for COPD often experience a recurrent cycle of rehospitalizations, resulting in reductions in overall health and quality of life (QOL). To help [...]

This randomized, open-label, blinded end point randomized clinical trial examined the effect of oral alfacalcidol, a vitamin D receptor activator, on cardiovascular events in patients with cardiovascular kidney disease receiving hemodialysis. [...]

This randomized clinical trial compares the effects of a program combining transition and long-term self-management support vs transition support alone on 6-month hospitalizations and emergency department visits among patients with chronic obstructive pulmonary disease (COPD). [...]

This study uses a series of aggregated N-of-1 trials to investigate the effectiveness of mexiletine for treatment of muscle stiffness in adult patients with nondystrophic myotonia and compares results from this series with those from a previously conducted randomized clinical trial. [...]

This nested case-control study of patients with early-onset atrial fibrillation (AF) used large-scale, deep-coverage whole-genome sequencing to identify a loss-of-function variant in TTN, the gene encoding the rare nerve protein titin, as a genetic risk factor for early AF. [...]

This JAMA Guide to Statistics and Methods discusses the use, limitations, and interpretation of Bayesian hierarchical modeling, a statistical procedure that integrates information across multiple levels and uses prior information about likely treatment effects and their variability to estimate true vs random treatment effects. [...]

This Clinical Evidence Synopsis summarizes a Cochrane review of randomized trials comparing the effects of treatment of lower extremity superficial thrombophlebitis on venous thromboembolism and major bleeding. [...]