JAMA Internal Medicine最新文献

{"title":"Randomized Clinical Trial of the Year.","authors":"Tracy Y Wang","doi":"10.1001/jamainternmed.2026.5268","DOIUrl":"https://doi.org/10.1001/jamainternmed.2026.5268","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":26.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224094","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":"Time to Measure the Outcomes of What Nurses Really Do.","authors":"Lori S Kennedy, Laura Beth Kalvas, Martha A Q Curley","doi":"10.1001/jamainternmed.2026.5066","DOIUrl":"https://doi.org/10.1001/jamainternmed.2026.5066","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":26.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224109","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":"Noncompete Agreements for US Physicians.","authors":"Yashaswini Singh, Isabelle Boun, Hasan Quadri, Daniel Arnold, Erin Fuse Brown","doi":"10.1001/jamainternmed.2026.4593","DOIUrl":"https://doi.org/10.1001/jamainternmed.2026.4593","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":26.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224121","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":"Cost-Effectiveness of HCV Screening in Emergency Departments Using DETECT Hep C Trial Results.","authors":"Larsan M W Czoty, Sarah Munroe, Emily Stewart, Jason Haukoos, Sarah E Rowan, Emily Hopkins, Richard E Rothman, James W Galbraith, Yu-Hsiang Hsieh, Carolynn Lyle, Stephanie Gravitz, Kevin F Kamis, Douglas A E White, Michael S Lyons, Edward M Gardner, Alia A Al-Tayyib, Allison L Sabel, David L Wyles, Dimitri Baptiste, Benjamin P Linas, Jake R Morgan","doi":"10.1001/jamainternmed.2026.5163","DOIUrl":"https://doi.org/10.1001/jamainternmed.2026.5163","url":null,"abstract":"<p><strong>Importance: </strong>Nontargeted hepatitis C virus (HCV) screening in emergency departments (EDs) has been demonstrated to identify more patients with HCV than targeted screening. Cost-effectiveness is key to strategy selection; however, the cost-effectiveness of these strategies in EDs remains unknown.</p><p><strong>Objective: </strong>To compare clinical outcomes and cost-effectiveness of 2 novel ED-based HCV screening strategies with no ED HCV screening.</p><p><strong>Design, setting, and participants: </strong>In this economic evaluation study, a cohort of individuals presenting to the ED in the US was simulated with data from the Determining Effective Testing in Emergency Departments and Care Coordination on Treatment Outcomes for Hepatitis C Screening (DETECT Hep C) trial using the Hepatitis C Cost-Effectiveness (HEP-CE) model from a health sector perspective. Using data from EDs at Denver Health Medical Center, Johns Hopkins Hospital, and the University of Mississippi Medical Center, 3 strategies were simulated over a lifetime horizon, including (1) no ED HCV screening, (2) targeted HCV screening, and (3) nontargeted HCV screening. Data were collected from November 2019 to August 2022 and analyzed from December 2021 to July 2026.</p><p><strong>Exposure: </strong>HCV screening in the ED.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were remaining life expectancy, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and costs (2024 US dollars). An annual discount rate of 3% was applied to future costs and benefits when calculating ICERs. An ICER of less than $100 000 per QALY gained was considered cost-effective.</p><p><strong>Results: </strong>A simulated cohort with a total of 500 million individuals (mean [SD] age, 46.3 [17.2] years; 264.4 million male [52.88%]) were included in this analysis. Nontargeted HCV screening yielded the best clinical and cost-effectiveness outcomes in the base case cohort, with 65.89% of infections being cured, a discounted cost of $214 465, discounted quality-adjusted life expectancy of 15.8723 QALYs, and an ICER of $12 820 per QALY gained. Compared with nontargeted HCV screening, no ED HCV screening and targeted HCV screening, respectively, had fewer infections cured (65.60% and 65.88%), lower QALYs (15.8717 QALYs and 15.8721 QALYs), and similar discounted costs ($214 467 and $214 462). Absolute benefits appeared narrow because over 90% of those screened did not have HCV; however, benefits were clear among those living with HCV infection.</p><p><strong>Conclusions and relevance: </strong>Results of this economic evaluation study suggest that nontargeted HCV screening was cost-effective when compared with no HCV screening or targeted HCV screening in the ED. Implementing routine nontargeted HCV screening in emergency departments provides good economic value and could be an important pillar of HCV elimination.</p>","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":26.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224078","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":"The Case for Multidimensional Optimization in Food Is Medicine Interventions-Finding the Right Recipe-Reply.","authors":"Connor Drake, Susan E Spratt, Michael Pignone","doi":"10.1001/jamainternmed.2026.5035","DOIUrl":"https://doi.org/10.1001/jamainternmed.2026.5035","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":26.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224060","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":"Error in Text.","authors":"","doi":"10.1001/jamainternmed.2026.5668","DOIUrl":"https://doi.org/10.1001/jamainternmed.2026.5668","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":26.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224072","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":"Rethinking the Risk Evaluation and Mitigation Strategies (REMS) Program: Moving Toward Rigorous Evaluation of the FDA's Drug Safety Programs.","authors":"Eric P Sun, Reshma Ramachandran","doi":"10.1001/jamainternmed.2026.5209","DOIUrl":"https://doi.org/10.1001/jamainternmed.2026.5209","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":26.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224119","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":"Palpitations and Muscle Cramps in an Older Man.","authors":"Mohan Prasad Akkineni, Krishna Prasad Akkineni, Sudipta Mondal","doi":"10.1001/jamainternmed.2026.5156","DOIUrl":"https://doi.org/10.1001/jamainternmed.2026.5156","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":26.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224131","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":"Mifepristone Patient Agreement Form and Medication Abortion Knowledge: A Randomized Clinical Trial.","authors":"M Antonia Biggs, Katherine Ehrenreich, Shelly Kaller, Lauren Ralph, Daniel Grossman","doi":"10.1001/jamainternmed.2026.5197","DOIUrl":"https://doi.org/10.1001/jamainternmed.2026.5197","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;While the US Food and Drug Administration requires medication abortion patients to review and sign a patient agreement form (PAF) under its Risk Evaluation and Mitigation Strategy program, there is limited research examining whether the PAF improves patient knowledge.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To determine whether patients are more knowledgeable about medication abortion after reviewing and signing the PAF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;People receiving mifepristone and misoprostol medications (15 years or older and proficient in English or Spanish) were recruited from 5 facilities in California, Colorado, Illinois, Kansas, and Minnesota (January to October 2025). After receiving standard clinic counseling and the mifepristone medication guide, patients were randomized into 2 study groups and then completed a survey either before (n = 301 control) or after (n = 292 exposed) receiving and signing the PAF. Data were analyzed December 2025 to August 2026.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;The control group completed the survey before receiving the PAF and any PAF-related counseling. The exposed group received and signed the PAF and any PAF-related counseling and then completed a knowledge survey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Overall medication abortion knowledge (correct response to 12 items regarding when to seek medical care, effectiveness, administration, potential serious risks, and side effects) and responses to each individual knowledge item.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 593 participants (mean [SD] age, 26.9 [5.8] years; 44 Asian/Pacific Islander [7%], 132 Black [22%], 181 Hispanic [31%], and 159 White [27%] individuals) completed knowledge items (301 control [51%]; 292 exposed [49%]). Across participant characteristics, study groups only differed significantly in reported abortion history. In adjusted analyses, participants answered a mean (95% CI) of 10.37 (10.26-10.48) of 12 knowledge items consistently with the PAF with no study group differences (control: difference, 10.26; exposed: difference, 10.44; adjusted difference, 0.18; 95% CI, -0.04 to 0.39). Nearly everyone knew to contact a \"provider\" if they \"were to have an infection (590 [99%]) or heavy bleeding that soaked through 2 full-size sanitary pads per hour for 2 hours (566 [96%]).\" The items with answers that were least often concordant with the PAF included how often the treatment does not work (320 [54%]) and taking misoprostol 24 to 48 hours after mifepristone (458 [77%]).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;The randomized clinical trial found that patient knowledge about medication abortion following standard counseling was high. Exposure to the required PAF did not result in a clinically meaningful increase in medication abortion knowledge. The findings raise questions about the PAF requirement from the US Food and Drug Administration, as it does not appear ","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":26.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224133","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":"The Case for Multidimensional Optimization in Food Is Medicine Interventions-Finding the Right Recipe.","authors":"Jing Li, Camille R Schneider-Worthington, Tapan Mehta","doi":"10.1001/jamainternmed.2026.5032","DOIUrl":"https://doi.org/10.1001/jamainternmed.2026.5032","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":26.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224052","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}