JAMA Network Open最新文献

{"title":"Nicotine Exposure From Smoking Tobacco and Vaping Among Adolescents.","authors":"David Hammond, Jessica L Reid, Maciej L Goniewicz, Ann McNeill, Richard J O'Connor, Danielle Corsetti, Ashleigh C Block, Leonie S Brose, Deborah Robson","doi":"10.1001/jamanetworkopen.2024.62544","DOIUrl":"10.1001/jamanetworkopen.2024.62544","url":null,"abstract":"<p><strong>Importance: </strong>It remains unknown whether nicotine intake among youths who vape is lower, comparable, or higher than among youths who smoke.</p><p><strong>Objective: </strong>To examine potential differences in biomarkers of exposure to nicotine (1) between adolescents who smoke tobacco, vape, both vape and smoke (dual use), or do not use; (2) between adolescents in 3 countries; and (3) by nicotine content and form in the vaping product last used among adolescents who exclusively vaped.</p><p><strong>Design, setting, and participants: </strong>This population-based, observational cross-sectional study invited adolescents aged 16 to 19 years in Canada, England, and the US who had previously completed national surveys to participate in a biomarker study based on their vaping and smoking status. Participants completed questionnaires and self-collected urine samples between September 2019 and January 2022. Analyses were conducted in February 2023 and between January and June 2024.</p><p><strong>Exposures: </strong>Vaping, tobacco smoking, dual use, or no use in the past 7 days.</p><p><strong>Main outcomes and measures: </strong>Urine concentration of cotinine, trans-3'-hydroxycotinine (3OH-cotinine), and total nicotine equivalents (TNE-2; molar sum of cotinine and 3OH-cotinine), normalized for creatinine concentration.</p><p><strong>Results: </strong>Among the 364 participants (mean [SD] age, 17.6 [1.1] years; 203 females [55.8%]) who provided usable urine samples and completed questionnaires, no differences in TNE-2 concentration were observed between adolescents who exclusively vaped (n = 73; geometric mean [SD], 3.10 [16.69] nmol/mg creatinine), exclusively smoked (n = 68; geometric mean [SD], 3.78 [18.00] nmol/mg creatinine), or both vaped and smoked (n = 77; geometric mean [SD], 6.07 [19.08] nmol/mg creatinine) in the past week, adjusting for creatinine concentration, age, sex, country, and cannabis use. All vaping and/or smoking groups had higher concentrations of TNE-2 than no use (n = 146; geometric mean [SD], 0.19 [1.14] nmol/mg creatinine; P < .001 for all contrasts). Among adolescents who exclusively vaped (n = 73), TNE-2 concentrations were not significantly different between those who reported using products containing more than 20 mg/mL nicotine (n = 33; geometric mean [SD], 4.35 [18.25] nmol/mg creatinine) and containing 20 mg/mL nicotine or less (n = 28; geometric mean [SD], 5.13 [15.64] nmol/mg creatinine). Reported use of vaping products containing nicotine salts (n = 23) was associated with higher concentration of TNE-2 (geometric mean [SD], 10.78 [18.03] nmol/mg creatinine) than reported use of products without nicotine salts (n = 29; geometric mean [SD], 2.72 [15.42] nmol/ng creatinine; P = .03) or reporting \"don't know\" (n = 14; geometric mean [SD], 1.55 [15.01] nmol/ng creatinine; P = .009). Similar patterns of exposure were observed for cotinine and 3OH-cotinine.</p><p><strong>Conclusions and relevance: </stro","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 3","pages":"e2462544"},"PeriodicalIF":10.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated Cancer Risk in Females Who Meet the Criteria to Exit Cervical Cancer Screening.","authors":"Shalini L Kulasingam, Inge M C M de Kok, Abhinav Mehta, Erik E L Jansen, Mary Caroline Regan, James W Killen, Stephen Sy, Ran Zhao, Karen Canfell, Jane J Kim, Megan A Smith, Nicole G Campos","doi":"10.1001/jamanetworkopen.2025.0479","DOIUrl":"10.1001/jamanetworkopen.2025.0479","url":null,"abstract":"<p><strong>Importance: </strong>Cervical screening guidelines in the US recommend that most females can exit routine screening at age 65 years following 2 recent consecutive negative cotest results (concurrent human papillomavirus and cytology tests). However, empirical data on the subsequent risks of cancer and cancer death in this subgroup of females are limited.</p><p><strong>Objective: </strong>To estimate the risks of cervical cancer and cervical cancer death among females who meet the cotesting criteria to exit screening.</p><p><strong>Design, setting, and participants: </strong>In this decision analytical comparative modeling study, 4 decision analytical models from the Cancer Intervention and Surveillance Modeling Network-Cervical modeling consortium that fit common US epidemiological data targets were validated against published estimates of 3- and 5-year risks of cervical intraepithelial neoplasia grade 3 (CIN3) among females meeting exit criteria at Kaiser Permanente Northern California (KPNC).</p><p><strong>Main outcomes and measures: </strong>Age-conditional and cumulative risks of cervical cancer and cervical cancer death at ages 65, 70, 75, 80, and 85 years were estimated by performing a comparative modeling analysis of the 4 models to estimate the risks of cervical cancer and cervical cancer death after exiting screening.</p><p><strong>Results: </strong>All models estimated a 5-year risk of CIN3 that was within the range of empirical data from KPNC. Projections of the cumulative and age-conditional risks of cervical cancer and cervical cancer death increased with time since exiting screening. The cumulative risks of cervical cancer and cervical cancer death by age 70 years were estimated to range from 0.001% to 0.003% and from 0% to 0.001%, respectively. The cumulative risks of cervical cancer and cervical cancer death by age 85 years ranged from 0.026% to 0.081% and from 0.005% to 0.038%, respectively, across models. Results were sensitive to assumptions about screening test sensitivity and incidence of high-risk human papillomavirus.</p><p><strong>Conclusions and relevance: </strong>In this decision analytical comparative modeling study, a low risk of cervical cancer and cervical cancer death was estimated among females who fulfilled the US criteria to exit screening with cotesting; however, the risks increased with age and/or time since screening exit. The findings suggest that future guidelines should consider acceptable risk levels when defining screening modality and exit age requirements.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 3","pages":"e250479"},"PeriodicalIF":10.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Genomic Characterization of Secondary Rectal Cancer After Radiotherapy for Prostate Cancer.","authors":"Dana M Omer, Farheen Shah, Anisha Luthra, Chin-Tung Chen, Christina I Lee, Hannah Williams, Henry Walch, Floris S Verheij, Roni Rosen, Janet Alvarez, Canan Firat, Georgios Karagkounis, Martin R Weiser, Maria Widmar, Iris H Wei, Emmanouil P Pappou, Garrett M Nash, J Joshua Smith, Walid K Chatila, Paul B Romesser, Jinru Shia, Philip B Paty, Julio Garcia-Aguilar, Francisco Sanchez-Vega","doi":"10.1001/jamanetworkopen.2025.1039","DOIUrl":"10.1001/jamanetworkopen.2025.1039","url":null,"abstract":"<p><strong>Importance: </strong>Patients treated with radiotherapy (RT) for prostate cancer (PC) have increased risk of secondary rectal cancer (SRC) and more limited treatment options.</p><p><strong>Objective: </strong>To assess the tumor molecular profile, clinical characteristics, and oncologic outcomes of SRC after PC and compare them with those of primary rectal cancer (PRC).</p><p><strong>Design, setting, and participants: </strong>This case-control study included patients with SRC diagnosed 5 or more years after RT for PC and patients with PRC who were treated at Memorial Sloan Kettering Cancer Center in New York between February 1, 1994, and September 31, 2022.</p><p><strong>Main outcomes and measures: </strong>Clinical information and DNA sequencing data were analyzed. Oncologic outcomes were compared between patients with SRC and clinically matched patients with PRC using log-rank tests and Cox proportional hazards regression models. Numerical and categorical variables were compared using the Wilcoxon rank sum test and Fisher exact test, respectively.</p><p><strong>Results: </strong>The analysis included 604 male patients with PRC (71.6%; median age, 55 [IQR, 46-66] years) and 64 male patients with SRC (median age, 78 [IQR, 72-82] years). Patients with SRC had more distal rectum (37 of 63 [58.7%] vs 131 of 581 [22.5%]; P < .001) and anterior rectal wall (20 of 57 [35.1%] vs 67 of 496 [13.5%]; P < .001) tumors, were less likely to receive neoadjuvant treatment (33 of 64 [51.6%] vs 570 of 604 [94.4%]), and had shorter 5-year overall survival (45.7% vs 64.9%; P = .01) and disease-free survival (40.3% vs 71.2%; P = .006) compared with clinically matched patients with PRC. Targeted DNA sequencing data from 31 SRC tumors identified lower mutational burden (median, 4.4 [IQR, 3.2-6.7] per megabase [Mb] vs 5.8 [IQR, 4.4-7.0] per Mb; P = .047), lower frequency of APC alterations (15 [48.4%] vs 432 [79.9%]; P < .001), and higher rates of SMAD4 inactivation (8 [25.8%] vs 54 [10.0%]; P = .01) compared with 541 PRC tumors. Whole-exome sequencing data from 17 SRC tumors identified a higher rate of frameshift deletions compared with 28 PRC tumors (median, 5.0 [IQR, 4.0-9.0] vs 2.5 [IQR, 1.0-4.2] variants; P < .001).</p><p><strong>Conclusions and relevance: </strong>In this case-control study, patients with SRC after RT for PC had worse survival and different molecular profiles than patients with PRC. These findings may help improve the clinical management of SRC.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 3","pages":"e251039"},"PeriodicalIF":10.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generalizability of Treatment Outcome Prediction Across Antidepressant Treatment Trials in Depression.","authors":"Peter Zhukovsky, Madhukar H Trivedi, Myrna Weissman, Ramin Parsey, Sidney Kennedy, Diego A Pizzagalli","doi":"10.1001/jamanetworkopen.2025.1310","DOIUrl":"10.1001/jamanetworkopen.2025.1310","url":null,"abstract":"<p><strong>Importance: </strong>Although several predictive models for response to antidepressant treatment have emerged on the basis of individual clinical trials, it is unclear whether such models generalize to different clinical and geographical contexts.</p><p><strong>Objective: </strong>To assess whether neuroimaging and clinical features predict response to sertraline and escitalopram in patients with major depressive disorder (MDD) across 2 multisite studies using machine learning and to predict change in depression severity in 2 independent studies.</p><p><strong>Design, setting, and participants: </strong>This prognostic study included structural and functional resting-state magnetic resonance imaging and clinical and demographic data from the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) randomized clinical trial (RCT), which administered sertraline (in stage 1 and stage 2) and placebo, and the Canadian Biomarker Integration Network in Depression (CANBIND-1) RCT, which administered escitalopram. EMBARC recruited participants with MDD (aged 18-65 years) at 4 academic sites across the US between August 2011 and December 2015. CANBIND-1 recruited participants with MDD from 6 outpatient centers across Canada between August 2013 and December 2016. Data were analyzed from October 2023 to May 2024.</p><p><strong>Main outcomes and measures: </strong>Prediction performance for treatment response was assessed using balanced classification accuracy and area under the curve (AUC). In secondary analyses, prediction performance was assessed using observed vs predicted correlations between change in depression severity.</p><p><strong>Results: </strong>In 363 adult patients (225 from EMBARC and 138 from CANBIND-1; mean [SD] age, 36.6 [13.1] years; 235 women [64.7%]), the best-performing models using pretreatment clinical features and functional connectivity of the dorsal anterior cingulate had moderate cross-trial generalizability for antidepressant treatment (trained on CANBIND-1 and tested on EMBARC, AUC = 0.62 for stage 1 and AUC = 0.67 for stage 2; trained on EMBARC stage 1 and tested on CANBIND-1, AUC = 0.66). The addition of neuroimaging features improved the prediction performance of antidepressant response compared with clinical features only. The use of early-treatment (week 2) instead of pretreatment depression severity scores resulted in the best generalization performance, comparable to within-trial performance. Multivariate regressions showed substantial cross-trial generalizability in change in depression severity (predicted vs observed r ranging from 0.31 to 0.39).</p><p><strong>Conclusions and relevance: </strong>In this prognostic study of depression outcomes, models predicting response to antidepressants show substantial generalizability across different RCTs of adult MDD.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 3","pages":"e251310"},"PeriodicalIF":10.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presymptomatic Awareness of BRCA1/BRCA2 Status and Outcomes in Women With Ovarian Cancer.","authors":"Shunit Armon, Adi Hollander, Yakir Segev, Ora Rosengarten, Ariela Tomer, Ephrat Levy-Lahad, Rachel Michaelson-Cohen","doi":"10.1001/jamanetworkopen.2025.1435","DOIUrl":"10.1001/jamanetworkopen.2025.1435","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 3","pages":"e251435"},"PeriodicalIF":10.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech Recognition Technology and Documentation Efficiency.","authors":"Abdul R Shour, Ronald Anguzu, Adedayo A Onitilo","doi":"10.1001/jamanetworkopen.2025.1526","DOIUrl":"10.1001/jamanetworkopen.2025.1526","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 3","pages":"e251526"},"PeriodicalIF":10.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Access to Research Opportunities Among Those Who Speak Languages Other Than English.","authors":"Elizabeth A Jacobs, Monica Vela","doi":"10.1001/jamanetworkopen.2025.2387","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.2387","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 3","pages":"e252387"},"PeriodicalIF":10.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Notice of Retraction. Xu LL, et al. Efficacy and Safety of Esketamine for Supplemental Analgesia During Elective Cesarean Delivery: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(4):e239321.","authors":"Xin-Zhong Chen, Dong-Xin Wang","doi":"10.1001/jamanetworkopen.2025.6386","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.6386","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 3","pages":"e256386"},"PeriodicalIF":10.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Complexity and Bile Duct Injury After Robotic-Assisted vs Laparoscopic Cholecystectomy.","authors":"Cody Lendon Mullens, Sarah Sheskey, Jyothi R Thumma, Justin B Dimick, Edward C Norton, Kyle H Sheetz","doi":"10.1001/jamanetworkopen.2025.1705","DOIUrl":"10.1001/jamanetworkopen.2025.1705","url":null,"abstract":"<p><strong>Importance: </strong>Recent evidence suggests higher bile duct injury rates for patients undergoing robotic-assisted cholecystectomy compared with laparoscopic cholecystectomy. Proponents of the robotic-assisted approach contend that this may be due to selection of higher-risk and more complex patients being offered robotic-assisted cholecystectomy.</p><p><strong>Objective: </strong>To evaluate the comparative safety of robotic-assisted cholecystectomy and laparoscopic cholecystectomy among patients with varying levels of risk for adverse postoperative outcomes.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study assessed fee-for-service Medicare beneficiaries aged 66 to 99 years who underwent cholecystectomy between January 1, 2010, and December 31, 2021. Data analysis was performed between June and August 2024. Medicare beneficiaries were separated into model training and experimental cohorts (60% and 40%, respectively). Random forest modeling and least absolute shrinkage and selection operator techniques were then used in a risk model training cohort to stratify beneficiaries based on their risk of a composite outcome of postoperative adverse events consisting of 90-day postoperative complications, serious complications, reoperations, and rehospitalization in an independent experimental cohort.</p><p><strong>Exposures: </strong>Robotic-assisted vs laparoscopic cholecystectomy.</p><p><strong>Main outcomes and measures: </strong>The primary outcome of interest was bile duct injury requiring operative intervention after cholecystectomy. Secondary outcomes were composite outcomes from cholecystectomy composed of any complications, serious complications, reoperations, and readmissions.</p><p><strong>Results: </strong>A total of 737 908 individuals (mean [SD] age, 74.7 [9.9] years; 387 563 [52.5%] female) were included, with 295 807 in an experimental cohort and 442 101 in a training cohort. Bile duct injury was higher among patients undergoing robotic-assisted compared with laparoscopic cholecystectomy in each subgroup (low-risk group: relative risk [RR], 3.14; 95% CI, 2.35-3.94; medium-risk group: RR, 3.13; 95% CI, 2.35-3.92; and high-risk group: RR, 3.11; 95% CI, 2.34-3.88). Overall, composite outcomes between the 2 groups were similar for robotic-assisted cholecystectomy compared with laparoscopic cholecystectomy (RR, 1.09; 95% CI, 1.07-1.12), aside from reoperation, which was overall higher in the robotic-assisted group compared with the laparoscopic group (RR, 1.47; 95% CI, 1.35-1.59).</p><p><strong>Conclusions and relevance: </strong>In this cohort study of Medicare beneficiaries, bile duct injury rates were higher among low-, medium-, and high-risk surgical candidates after robotic-assisted cholecystectomy. These findings suggest that patient selection may not be the cause of differences in bile duct injury rates among patients undergoing robotic-assisted vs laparoscopic cholecystectomy.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 3","pages":"e251705"},"PeriodicalIF":10.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older Adults' Views on Insurance Coverage for Weight Management Medications.","authors":"Lauren Oshman, Matthias Kirch, Erica Solway, Dianne C Singer, Preeti N Malani, J Scott Roberts, Jeffrey T Kullgren, Dina Hafez Griauzde","doi":"10.1001/jamanetworkopen.2025.2008","DOIUrl":"10.1001/jamanetworkopen.2025.2008","url":null,"abstract":"<p><strong>Importance: </strong>Medicare and many commercial insurers do not cover US Food and Drug Administration-approved weight management medications, such as incretin mimetics (semaglutide, tirzepatide, and liraglutide), bupropion-naltrexone, and phentermine-topiramate).</p><p><strong>Objectives: </strong>To assess older adults' interest in weight management medications and associated characteristics and to understand their perceptions about insurance coverage of weight management medications.</p><p><strong>Design, setting, and participants: </strong>This survey study used cross-sectional data from a nationally representative sample of US adults ages 50 to 80 years from the July 2023 National Poll on Healthy Aging. Data were analyzed from August to November 2023.</p><p><strong>Main outcomes and measures: </strong>Outcomes of interest were estimates of interest in taking weight management medication and perceptions about coverage for US Food and Drug Administration-approved weight management medications by insurers, including Medicare.</p><p><strong>Results: </strong>Among 2657 respondents, 60.3% (95% CI, 56.7%-63.8%) were ages 50 to 64 years, 52.2% (95% CI, 49.8%-54.5%) were female, and 10.6% (95% CI, 9.3%-12.0%) were non-Hispanic Black, 11.4% (95% CI, 10.4%-12.6%) were Hispanic, and 70.3% (95% CI, 68.2%-72.4%) were non-Hispanic White. Overall, 35.1% (95% CI, 31.9%-38.4%) of participants were interested in using weight management medications, including 59.1% (95% CI, 53.4%-64.5%) of individuals with body mass index (BMI) of 30 or greater. Interest was most robustly associated with having used these medications in the past (adjusted odds ratio, 7.57 [95% CI, 4.41-13.02]) and BMI of 30 or greater (adjusted odds ratio, 5.04 [95% CI, 3.48-7.30]). Most participants (of any BMI) agreed that health insurance should cover weight management medications (2176 of 2625 respondents [83.2%]). When asked whether Medicare should cover such medications, most still favored coverage (2097 of 2616 respondents [75.7%]), but fewer approved of paying more for a Medicare premium to ensure coverage (829 of 2604 respondents [30.2%]).</p><p><strong>Conclusions and relevance: </strong>In this survey study of older US adults, most participants agreed that Medicare should cover weight management medications and more than half of those with BMI of 30 or greater were interested in using them. These results should inform decisions to include weight management medications in the Medicare and commercial insurance programs, as well as utilization policies to control health care costs.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 3","pages":"e252008"},"PeriodicalIF":10.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}