JAMA Internal Medicine最新文献

{"title":"Inclusion of Retracted Studies in Systematic Reviews and Meta-Analyses of Interventions: A Systematic Review and Meta-Analysis.","authors":"Carolina Graña Possamai, Guillaume Cabanac, Elodie Perrodeau, Lina Ghosn, Philippe Ravaud, Isabelle Boutron","doi":"10.1001/jamainternmed.2025.0256","DOIUrl":"10.1001/jamainternmed.2025.0256","url":null,"abstract":"<p><strong>Importance: </strong>Retractions are rising in the scientific literature, increasing the risk of reusing unreliable results.</p><p><strong>Objectives: </strong>To identify reports of systematic reviews that included retracted studies in their meta-analyses, and to assess the impact of these retracted studies on the results.</p><p><strong>Design, setting, and participants: </strong>In this systematic review and meta-analysis the Feet of Clay Detector tool was searched to identify all systematic reviews that reported at least 1 meta-analysis including at least 1 retracted study and were published in the 25 highest impact factor journals in medicine, general and internal, from January 2013 to April 2024. All effect estimates where the retracted study contributed to the analysis were identified. For each meta-analysis, the summary effect, including all studies and excluding retracted studies was calculated. The search was conducted on April 8, 2024.</p><p><strong>Results: </strong>Overall, 61 systematic reviews were identified that included retracted studies in their meta-analyses. Of these, 11 (18%) have been republished, retracted, or withdrawn. Data were extracted from 50 systematic reviews that included a total of 62 retracted studies. Retraction occurred after the publication in 37 systematic reviews (74%). Overall, 173 meta-analyses including the retracted study were identified; 70 of them (40%) were primary outcomes. One-hundred sixty-six meta-analyses were recalculated. Overall, 160 (96%) of the 166 recalculated effect estimates were within the CIs of the original effect. After exclusion of the retracted study, the statistical significance of the results changed in 18 meta-analyses (11%). The rate of evolution between effect estimates with and without retracted studies for 163 meta-analyses overall were calculated, including 64 addressing the primary outcomes of the systematic reviews. For primary outcomes (n = 64), the recalculated effect estimates changed by at least 10% in 27 meta-analyses (42%), 30% in 16 (25%), and 50% in 12 (19%). Overall (n = 163), effect estimates changed by at least 10% in 57 meta-analyses (35%), 30% in 31 (19%), and 50% in 23 (14%).</p><p><strong>Conclusions and relevance: </strong>This study found that retracted studies have been included in systematic reviews and meta-analyses, with retractions occurring mainly after the publication of the systematic review. The inclusion of retracted studies can impact the results and interpretation of reviews. Quality control measures should be implemented to prevent the dissemination of unreliable data in scientific literature.</p>","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752777","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":"Tolerance of Guideline-Directed Medical Therapy.","authors":"Oscar M P Jolobe","doi":"10.1001/jamainternmed.2025.0027","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.0027","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752784","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":"Mitigating the Impact of Retracted Studies in the Medical Literature.","authors":"Cary P Gross, Annette Flanagin, Eli N Perencevich, Sharon K Inouye","doi":"10.1001/jamainternmed.2025.0251","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.0251","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752779","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":"Tolerance of Guideline-Directed Medical Therapy-Reply.","authors":"Adeoluwa Ayoola, Alison Ohringer, Oanh Kieu Nguyen","doi":"10.1001/jamainternmed.2025.0024","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.0024","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752786","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":"Risk of Major Congenital Malformations Following Prenatal Exposure to Smoking Cessation Medicines.","authors":"Duong T Tran, Jacqueline M Cohen, Sarah Donald, Carolyn E Cesta, Kari Furu, Lianne Parkin, Sallie-Anne Pearson, Johan Reutfors, Annelies L Robijn, Helga Zoega, Nicholas Zwar, Alys Havard","doi":"10.1001/jamainternmed.2025.0290","DOIUrl":"10.1001/jamainternmed.2025.0290","url":null,"abstract":"<p><strong>Importance: </strong>Nicotine replacement therapy (NRT), varenicline, and bupropion are effective smoking cessation pharmacotherapies, but evidence on fetal safety is limited.</p><p><strong>Objective: </strong>To assess whether prenatal use of smoking cessation pharmacotherapies was associated with increased risks of major congenital malformations (MCMs).</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study was conducted across 4 countries, and results were pooled via meta-analyses. Records of all births (2001-2020) in New South Wales (NSW; Australia), New Zealand (NZ), Norway, and Sweden were linked to prescribed medicine dispensings, hospital admission, outpatient, and death data. Follow-up ended December 31, 2021, and the data were analyzed between August and October 2023. The base cohort comprised 391 474 infants among 267 522 women who smoked during the first trimester or were dispensed a smoking cessation pharmacotherapy 90 days before conception or during the first trimester.</p><p><strong>Exposures: </strong>Supply of NRT, varenicline, and bupropion overlapping the first trimester. Unexposed infants were born to women who smoked but were not dispensed a pharmacotherapy 90 days preconception and the first trimester. Propensity score matching (1:10) was used.</p><p><strong>Main outcomes and measures: </strong>MCM overall and subgroups.</p><p><strong>Results: </strong>The mean (SD) maternal age at childbirth was 27.2 (6.0) years. Analyses included 9325 infants exposed to NRT (NSW, NZ), 3031 to varenicline (NSW, NZ, Norway, and Sweden), and 1042 to bupropion (NSW, NZ). Compared with unexposed infants, there were no differences in prevalence of MCMs overall following NRT exposure (37.6 vs 34.4 per 1000 live births; adjusted relative risk [aRR], 1.10; 95% CI, 0.98-1.22), varenicline (32.7 vs 36.6; aRR, 0.90; 95% CI, 0.73-1.10), or bupropion (35.5 vs 38.8; aRR, 0.93; 95% CI, 0.67-1.29). NRT analyses showed no difference in the risk of MCMs of the heart, limbs, genital organs, kidney/urinary tract, respiratory system, and orofacial clefts but a higher risk of digestive organ MCMs (3.8 vs 2.5 per 1000 live births; aRR, 1.53; 95% CI, 1.05-2.23; P = .41 after multiple comparison adjustment). Varenicline analyses revealed no difference in the risk of heart, limb, and genital MCMs but a higher risk of kidney/urinary tract MCMs (11.5 vs 4.2 per 1000 live births; aRR, 2.75; 95% CI, 1.42-5.34; P = .09 after multiple comparison adjustment), with findings for other MCMs being too imprecise. For bupropion, data were too sparse to estimate the risk of MCM subgroups.</p><p><strong>Conclusions and relevance: </strong>The results of this cohort study suggest that there is no clear increased risk of MCMs associated with prenatal use of NRT and varenicline compared with smoking during the first trimester.</p>","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752782","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":"Using Pharmacologic Smoking Cessation Treatments in Pregnancy.","authors":"Tim Coleman, Sophie Orton","doi":"10.1001/jamainternmed.2025.0278","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.0278","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752808","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":"Veterans Affairs Research Under Threat.","authors":"Stephan D Fihn, David Atkins, Timothy O'Leary, Kenneth W Kizer","doi":"10.1001/jamainternmed.2025.1270","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.1270","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729994","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":"Medicare Competitive Bidding Program and the SOAR Act.","authors":"Christopher M Worsham","doi":"10.1001/jamainternmed.2024.8441","DOIUrl":"https://doi.org/10.1001/jamainternmed.2024.8441","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692018","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":"Continued Use of Cholinesterase Inhibitors and Memantine in Hospice.","authors":"Lauren J Hunt, Siqi Gan, W John Boscardin, Krista L Harrison, Matthew E Growdon, Ulrike U Muench, Lauren B Gerlach, Alexander K Smith, Michael A Steinman","doi":"10.1001/jamainternmed.2024.8579","DOIUrl":"10.1001/jamainternmed.2024.8579","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691883","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":"Avoidable Mortality Across US States and High-Income Countries.","authors":"Irene Papanicolas, Maecey Niksch, Jose F Figueroa","doi":"10.1001/jamainternmed.2025.0155","DOIUrl":"10.1001/jamainternmed.2025.0155","url":null,"abstract":"<p><strong>Importance: </strong>Although there are increasing differences in health policy and population health across US states over the past decade, little is known about how US states compare with other countries on avoidable mortality.</p><p><strong>Objective: </strong>To compare trends in avoidable mortality across US states and countries in the European Union (EU) and the Organisation for Economic Co-operation and Development (OECD).</p><p><strong>Design, setting, and participants: </strong>Retrospective, population-based, repeated cross-sectional study comparing changes in avoidable mortality among decedents aged 0 to 74 years in 50 US states (and Washington, DC) and 40 high-income countries between 2009 and 2021. Data analysis was conducted from May to July 2024.</p><p><strong>Main outcomes and measures: </strong>Avoidable mortality comprising both preventable deaths related to prevention and public health and treatable deaths related to timely and effective health care treatment.</p><p><strong>Results: </strong>Between 2009 and 2019, total avoidable mortality increased in all US states (median [IQR], 29.0 [20.1 to 44.2] deaths per 100 000 people), while it decreased in most comparator countries (-14.4 [-28.4 to -8.0]). During this period, variation in avoidable mortality widened across US states (2009: median [IQR], 251.1 [228.4 to 280.4]; 2019: 282.8 [249.1 to 329.5]), but narrowed in comparator countries (2009: 201.5 [166.2 to 320.8]; 2019: 187.1 [152.0 to 298.2]). During the COVID-19 pandemic (2019-2021), avoidable mortality increased for all US states (median [IQR], 101.5 [64.7 to 143.1]) and comparator countries (25.8 [9.1 to 117.7]). The states and countries that experienced the greatest increase in avoidable deaths during the COVID-19 period were those with the highest baseline avoidable mortality (Pearson ρ = 0.86; P < .001). Health spending and avoidable mortality have a consistent, negative, and significant association among comparator countries (2019: Pearson ρ = -0.7; P < .001) but no statistically significant association within US states (2019: Pearson ρ = -0.12; P = .41).</p><p><strong>Conclusions and relevance: </strong>This cross-sectional study found that the stark contrast in avoidable mortality trends between all US states compared with EU and OECD countries suggests that broad, systemic factors play a role in worsening US population health. While other countries appear to make gains in health with increases in health care spending, such an association does not exist across US states, raising questions regarding US health spending efficiency.</p>","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691876","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}