JAMA Network Open最新文献

{"title":"Errors in Results and Table 1.","authors":"","doi":"10.1001/jamanetworkopen.2025.39809","DOIUrl":"10.1001/jamanetworkopen.2025.39809","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2539809"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199513","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":"Traumatic Brain Injury and Risk of Amyotrophic Lateral Sclerosis.","authors":"Xingxing Zhu, Emma R Russell, Donald M Lyall, Frederick Ho, Daniel F Mackay, Jill P Pell, William Stewart","doi":"10.1001/jamanetworkopen.2025.35119","DOIUrl":"10.1001/jamanetworkopen.2025.35119","url":null,"abstract":"<p><strong>Importance: </strong>History of traumatic brain injury (TBI) or repetitive head impacts is associated with an increased risk of neurodegenerative disease. This association has attracted attention in recent years through the relationship between contact sports participation and the increased risk of a number of neurodegenerative diseases, including motor neuron disease or amyotrophic lateral sclerosis (ALS). However, to date, the association between TBI in the community and ALS risk remains uncertain.</p><p><strong>Objective: </strong>To leverage population-level health records to explore the association between a history of TBI and subsequent ALS risk.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study accessed UK-wide electronic health record (EHR) data from individuals 18 years or older with TBI history and age-, sex-, and area deprivation-matched general population comparators. EHR data were available from January 1, 2005, to December 31, 2020, with database interrogation performed on February 11, 2021, and data analysis conducted between June 1, 2023, and October 3, 2024.</p><p><strong>Exposure: </strong>Documented history of TBI.</p><p><strong>Main outcomes and measures: </strong>Outcomes were obtained by individual-level linkage to EHR data available via Clinical Practice Research Datalink. Risk of ALS was evaluated using Cox proportional hazards regression models to investigate its association with TBI.</p><p><strong>Results: </strong>Overall, 85 690 adults with a history of TBI and 257 070 matched adults with no history of TBI were included, for a total of 342 760 participants (50.1% male; mean [SD] age, 50.7 [17.6] years). During a median 5.72 (IQR, 3.07-8.82) years of follow-up, providing 2.13 million person-years of follow-up, 150 incident ALS cases were recorded, resulting in 7.05 cases per 100 000 person-years. Risk of ALS was higher among individuals with a history of TBI compared with individuals without a TBI history (hazard ratio [HR], 2.61; 95% CI, 1.88-3.63). However, this association was time dependent, with risk confined to the 2 years following TBI (HR, 6.18; 95% CI, 3.47-11.00), but not thereafter.</p><p><strong>Conclusions and relevance: </strong>In this retrospective cohort study of 342 760 adults, an association between TBI and subsequent risk of ALS was identified. However, this association was confined to the 2 years immediately following injury. As such, the association between TBI and higher ALS risk may indicate reverse causality, with TBI in some individuals perhaps reflecting a consequence of early, subclinical ALS.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2535119"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206481","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":"Open-Label Placebos as Adjunct for the Preventive Treatment of Migraine: A Randomized Clinical Trial.","authors":"Julian Kleine-Borgmann, Katharina Schmidt, Linda Ludwig, Moritz Schulz, Dagny Holle-Lee, Charly Gaul, Ulrike Bingel","doi":"10.1001/jamanetworkopen.2025.35739","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.35739","url":null,"abstract":"<p><strong>Importance: </strong>Placebo effects contribute substantially to the therapeutic success of many treatments, particularly in pain-related conditions. Open-label placebos (OLPs) offer an ethically acceptable approach to harness this potential without deception.</p><p><strong>Objective: </strong>To evaluate the efficacy of a 3-month OLP regimen in reducing headache and migraine days and improving migraine-related outcomes, including medication use, disability, and quality of life, in patients with migraine.</p><p><strong>Design, setting, and patients: </strong>This controlled, bicenter, parallel-group randomized clinical trial, with a 3-month treatment phase, enrolled adults with episodic or chronic migraine between November 9, 2020, and November 1, 2022. The trial was conducted at 2 tertiary headache centers in Germany (University Medicine Essen and Headache Center Frankfurt).</p><p><strong>Interventions: </strong>Participants received OLPs plus treatment as usual (TAU) or TAU alone. OLPs were administered twice daily for 3 months.</p><p><strong>Main outcomes and measures: </strong>The preregistered primary outcome was the change in monthly headache days from a baseline to a test period after 3 months. Secondary outcomes included patient-reported quality of life assessed using the 12-Item Short-Form Health Survey physical component summary, pain-related disability assessed using the Pain Disability Index and Headache Impact Test, and global improvement.</p><p><strong>Results: </strong>Of the 120 patients (median age, 34.2 years; 95% CI, 29.8-39.3 years; 103 [86%] female), 102 (85%) had episodic migraine, and 18 (15%) had chronic migraine. All participants completed the study. Headache days did not significantly decrease in the OLP group compared with TAU. Similarly, there was no difference in the number of migraine days, pain intensity, days of rescue medication, and the 50% responder rate. However, OLP-treated patients reported improved quality of life (β = 4.25; 95% CI, 1.33-7.17; d = 0.47; P = .01), reduced pain-related disability (Pain Disability Index: β = -5.96; 95% CI, -9.01 to -2.92; d = 0.53; P < .001; Headache Impact Test 6: β = -1.88; 95% CI, -3.28 to -0.48; d = 0.35; P = .02), and higher global improvement (χ2 = 14.16; P = .01) compared with TAU patients.</p><p><strong>Conclusions and relevance: </strong>In this randomized clinical trial, OLP treatment did not reduce headache frequency but was associated with improvements in quality of life and pain-related disability. Future research should clarify the mechanisms underlying these effects and determine their potential supportive role in migraine care for selected patients.</p><p><strong>Trial registration: </strong>drks.de identifier: DRKS00021259.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2535739"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250998","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":"IL-1 Receptor Antagonist Antibodies in Idiopathic Recurrent Pericarditis.","authors":"Maddalena Alessandra Wu, Christoph Kessel, Natalie Fadle, Evi Regitz, Sabrina Fuehner, Enrica Negro, Silvia Berra, Jochen Pfeifer, Elisa Ceriani, Bernhard Thurner, Karin Klingel, Alida Caforio, Massimo Imazio, Antonio Brucato, Lorenz Thurner","doi":"10.1001/jamanetworkopen.2025.36691","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.36691","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2536691"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251085","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":"Global Crises and Worsening Health Outcomes-Unmasking the Pandemic Ghost.","authors":"Jonah Musa, Robert L Murphy","doi":"10.1001/jamanetworkopen.2025.29743","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.29743","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2529743"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251091","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-Centered Priorities for Older Adults in Ambulatory Care.","authors":"Nicholas K Schiltz, Bootan Ahmed, Heba M Aldossary, Grace Q Armstrong, Sherry A Greenberg, Anna E Bender, Anne Pohnert, Mary A Dolansky","doi":"10.1001/jamanetworkopen.2025.35769","DOIUrl":"10.1001/jamanetworkopen.2025.35769","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2535769"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232692","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":"Barriers and Facilitators of Treatment Intensification in Metastatic Castration-Sensitive Prostate Cancer.","authors":"Stacy Loeb, Neeraj Agarwal, Nader El-Chaar, Laura de Ruiter, Janet Kim, Jesse Mack, Betty Thompson, Sarah Rich-Zendel, Jay Sheldon, Jin Su Joo, Judith Dyson","doi":"10.1001/jamanetworkopen.2025.35728","DOIUrl":"10.1001/jamanetworkopen.2025.35728","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Despite evidence of clinical benefits and guidelines recommending first-line treatment intensification (TI) for metastatic castration-sensitive prostate cancer (mCSPC), the majority of patients do not receive it.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify barriers to and facilitators of first-line TI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;The IMPLEMENT study (December 2022 to August 2024) comprised 3 phases and used a mixed-methods, qualitative and quantitative approach. US-based urologists and oncologists who were primary treaters for 1 or more patients with mCSPC in the past 6 months, had been practicing for 2 to 35 years, spent 50% or more of their time in direct patient care, and were able to provide informed consent were included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Phase 1 consisted of semistructured interviews based on the Theoretical Domains Framework. Phase 2 consisted of a discrete choice experiment to identify priority barriers and helpful resources. Phase 3 consisted of cocreation sessions to ideate potential solutions to underutilization based on the findings of the previous phases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome in phase 1 was barriers to and facilitators of first-line TI, as identified through thematic analysis. The primary outcome of phase 2 was perceived helpfulness of potential resources for first-line TI decisions, measured with a coefficient of helpfulness [CoH] for each resource. The primary outcome of phase 3 was potential solutions to increase TI uptake, as cocreated and ranked by urologists and oncologists.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 352 participants were included in IMPLEMENT, with 36 in phase 1 (33 men [92%]; mean [range] years in practice, 19 [5-34]), 302 in phase 2 (253 men [84%]; mean [range] years in practice, 18 [4-35]), and 14 in phase 3 (12 men [86%]; mean [range], years in practice, 20 [8-35]). In each phase, one-half of participants were oncologists and one-half were urologists (18 urologists and 18 oncologists in phase 1, 151 urologists and 151 oncologists in phase 2, and 7 urologists and 7 oncologists in phase 3). In phase 1, 5 domains had the greatest perceived influence on intensification: memory, attention, and decision processes; environmental context and resources; knowledge; beliefs about consequences; and social or professional role. Urologists more commonly reported barriers to intensification, while oncologists more commonly reported facilitators. In phase 2, urologists found decision-support tools most helpful (CoH, 3.27; 95% CI, 2.90-3.65), while oncologists preferred databases of posttreatment options (CoH, 2.58; 95% CI, 2.29-2.89) and clinical trial summaries (CoH, 2.41; 95% CI, 2.14-2.69). In phase 3, cross-specialty tumor boards were ranked by both specialties as the best solution to address TI underutilization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;This study using a mixed-meth","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2535728"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251037","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":"Errors in Figure 1 and Figure 4B.","authors":"","doi":"10.1001/jamanetworkopen.2025.35685","DOIUrl":"10.1001/jamanetworkopen.2025.35685","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2535685"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954717","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":"Modeled Cost-Effectiveness of a Rideshare Program to Facilitate Colonoscopy Completion.","authors":"Rachel B Issaka, Laura Matrajt, Pedro Nascimento de Lima, Carolyn M Rutter","doi":"10.1001/jamanetworkopen.2025.30515","DOIUrl":"10.1001/jamanetworkopen.2025.30515","url":null,"abstract":"<p><strong>Importance: </strong>In colorectal cancer (CRC) screening, too many patients fail to receive follow-up colonoscopy after an abnormal fecal immunochemical test (FIT), and transportation is a frequently reported barrier.</p><p><strong>Objective: </strong>To determine the outcomes and cost-effectiveness of providing a rideshare intervention to patients with abnormal FIT results.</p><p><strong>Design, setting, and participants: </strong>The CRC-Simulated Population Model for Incidence and Natural History microsimulation model was used to simulate the outcomes and cost-effectiveness of a rideshare intervention to improve colonoscopy completion in a population-based CRC screening program. Cohorts were adherent to annual FIT-based screening; baseline analyses assumed that 35% would complete a follow-up colonoscopy. Data were analyzed from November 14, 2023, to July 8, 2025.</p><p><strong>Intervention: </strong>A $40 or $100 rideshare to increase completion of follow-up colonoscopy.</p><p><strong>Main outcomes and measures: </strong>Lifetime outcomes included the number of CRC cases, deaths, and life-years gained (LYG) per 1000 people screened and costs associated with improved completion of a colonoscopy after an abnormal FIT result.</p><p><strong>Results: </strong>Four single-age cohorts (ages 45, 55, 65, and 70 years on January 1, 2024) of 10 million people each were simulated. In cohorts with similar sex distribution as the US population (aged 45 years, 50.0% male; aged 55 years, 49.4% male); aged 65 years, 48.0% male; and aged 70 years, 46.9% male), compared with no intervention, using a rideshare intervention starting at age 45 years that costs $100 per ride to increase colonoscopy completion from 35% to 70% was associated with a reduction in CRC cases per 1000 by 26.3% (30.7 vs 41.6 cases per 1000), CRC deaths per 1000 by 32.5% (9.8 vs 14.6 cases per 1000), 24.9 LYG per 1000, and at $100 per ride cost $43 308 per 1000 people screened and saved $330 587 per 1000 people screened.</p><p><strong>Conclusions and relevance: </strong>In a microsimulation model, increasing colonoscopy completion in a population with abnormal FIT results via a rideshare intervention was cost saving up to $100 per ride due to the combined outcome of cancer prevention and early detection.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2530515"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992508","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":"Stability After Legal Gender Change Among Adults With Gender Dysphoria.","authors":"Kristen D Clark, Richard A White, Georgios Karamanis, Malin Indremo, Fatih Özel, Alkistis Skalkidou, Thomas Frisell, Fotios C Papadopoulos","doi":"10.1001/jamanetworkopen.2025.27780","DOIUrl":"10.1001/jamanetworkopen.2025.27780","url":null,"abstract":"<p><strong>Importance: </strong>The number of people seeking treatment for gender dysphoria (GD) has risen in recent decades, yet data remain limited for understanding cases of detransition (ie, the reversal of social, medical, or legal transition). Legal gender change in national registers poses an opportunity to examine legal gender reversals, which may reflect an aspect of the detransition process, while also informing an understanding of the stability after a legal gender change.</p><p><strong>Objective: </strong>To determine the probability of obtaining a legal gender change and its stability over time among people diagnosed with GD in Sweden during a 10-year study period.</p><p><strong>Design, setting, and participants: </strong>In this population cohort study using data from Swedish national registers from January 1, 2013, to December 31, 2023, individuals who received their first International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), diagnosis code for GD during the study period were included. While participants may have received a GD ICD-10 code as youths, legal gender changes only occurred for adults (aged ≥18 years) based on legal requirements during the time of data collection.</p><p><strong>Exposure: </strong>Gender dysphoria.</p><p><strong>Main outcomes and measures: </strong>Legal gender change and its stability, that is, absence of legal gender reversal, as reported in the registry. Kaplan-Meier survival analysis was used to determine the probability of legal gender change and its stability during a 10-year study period.</p><p><strong>Results: </strong>A total of 7293 people with a GD diagnosis were included (36 025 person-years). Approximately one-third of the sample (n = 2467) obtained a legal gender change during the study period. The probability of legal gender change at 10 years following diagnosis was 58.3% (95% CI, 56.2%-60.4%). Twenty-one cases of legal gender reversal were identified. The probability of legal gender stability at 10 years following the initial change was 97.7% (95% CI, 96.3%-99.2%), with no differences by sex assigned at birth for either outcome.</p><p><strong>Conclusions and relevance: </strong>In this cohort study using national population registry data, a significant proportion of participants with GD in Sweden obtained legal gender change within 10 years of follow-up. Despite significant growth of the population with GD, the probability of legal gender stability during the 10-year study period was high, at almost 98%. These results highlight that legal gender reversal was an infrequent occurrence in a national sample.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2527780"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992529","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}