JAMA最新文献

{"title":"Injuries From Electric Bicycles and Scooters Managed in Pediatric Health Systems","authors":"Alan R. Schroeder, Eric S. Hall, Sahal Master, Frederick P. Rivara, Melissa Bronson, Suchitra Rao, Marc Rosenman, Bethanie S. Van Horne, Stephanie D. Chao, Christopher B. Forrest","doi":"10.1001/jama.2026.20796","DOIUrl":"https://doi.org/10.1001/jama.2026.20796","url":null,"abstract":"This study used a pediatric database to compare recent trends, rates, and severity of injuries from electric micromobility devices vs injuries from nonmotorized devices.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149304453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regression Discontinuity Approaches to Evaluate Threshold-Guided Interventions in Observational Studies","authors":"Matias D. Cattaneo, Rocío Titiunik","doi":"10.1001/jama.2026.22316","DOIUrl":"https://doi.org/10.1001/jama.2026.22316","url":null,"abstract":"This Guide to Statistics and Methods provides an overview of the regression discontinuity approach, including its use in observational studies, particularly with threshold-guided interventions, and its limitations.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149304455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Payment Reform Transform Heart Failure Care?","authors":"Sarah Chuzi, Karen Joynt Maddox, Tara Lagu","doi":"10.1001/jama.2026.19267","DOIUrl":"https://doi.org/10.1001/jama.2026.19267","url":null,"abstract":"This Viewpoint discusses how the Ambulatory Specialty Model (ASM) recently announced by the Center for Medicare & Medicaid Innovation might address gaps in implementation of heart failure care, describes 4 categories of performance assessment under the ASM, and suggests several ASM features that could limit its ability to address implementation gaps.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149304437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antithrombotic Therapy After Left Atrial Appendage Occlusion","authors":"Vivek Y. Reddy, Walid I. Saliba, Thomas Waggoner, Devi G. Nair, Stanislav Weiner, Rudolph Evonich, Michael Hoskins, Andrew Dublin, Michael Rinaldi, Gaurang Gandhi, Jonathan W. Dukes, Madhu Reddy, David DeLurgio, Venkat R. Iyer, Ganesh Venkataraman, Ashish Sadhu, Vamsee Yaganti, Kevin Trulock, Douglas N. Gibson, Mohamad Alkhouli, Manish Shah, Shephal K. Doshi, Andrea Natale, Megan Coylewright, C. Michael Gibson, Ahmed A. Kolkailah, Wael A. Jaber, Krystal Leger, Elizabeth Matznick, Thomas Christen, Brad S. Sutton, Kenneth M. Stein, Saibal Kar","doi":"10.1001/jama.2026.21361","DOIUrl":"https://doi.org/10.1001/jama.2026.21361","url":null,"abstract":"Importance Following a left atrial appendage closure (LAAC) procedure, antithrombotic therapy is administered to safely allow time for device endothelialization. However, the optimal postimplant antithrombotic regimen is unknown. Objective To determine if either reduced-dose non–vitamin K oral anticoagulants (NOACs) or aspirin alone are noninferior to dual antiplatelet therapy (DAPT) for the composite clinical end point of death, stroke, systemic embolism, or major bleeding through 6 months post LAAC. Design, Setting, and Participants This open-label, 3-group, multicenter clinical trial randomized 1857 patients between October 2024 and December 2025 at 87 US investigational sites, with the final 6-month follow-up in July 2026. Enrolled patients had nonvalvular atrial fibrillation, underwent successful LAAC, and were eligible for all 3 regimens. Interventions Patients were randomly allocated 1:1:1 to DAPT for 6 months followed by aspirin (n = 624), a reduced-dose NOAC for 3 months followed by aspirin (n = 620), or aspirin alone for 12 months (n = 613). Main Outcomes and Measures The primary outcome was the 6-month composite of all-cause death, stroke, systemic embolism, or major bleeding. Noninferiority was tested in the primary analysis population with a 1-sided Farrington-Manning test (α = .025). Bleeding and 45-day device-related thrombus rates were exploratory without multiplicity adjustment. Results The cohort had a mean age of 76 (SD, 8) years, 42.9% were female, the mean CHA <jats:sub>2</jats:sub> DS <jats:sub>2</jats:sub> -VASc score was 4.2 (SD, 1.3), and 68.0% had paroxysmal atrial fibrillation. The primary outcome occurred in 41 patients (6.9%) with DAPT vs 31 (5.1%) with a reduced-dose NOAC (risk ratio, 0.75 [95% CI, 0.48-1.18]; risk difference, −1.7 percentage points; 97.5% upper bound, 1.2) and 20 (3.3%) with aspirin alone (risk ratio, 0.49 [95% CI, 0.29-0.82]; risk difference, −3.5 percentage points; 97.5% upper bound, −0.8). Both monotherapy strategies met noninferiority criteria ( <jats:italic>P</jats:italic> &amp;amp;lt; .001 for noninferiority for both). Major bleeding was 4.5% with DAPT, 2.7% with reduced-dose NOACs, and 1.7% with aspirin alone; clinically relevant nonmajor bleeding was 8.7%, 4.8%, and 3.8%, respectively. Device-related thrombus was observed in 3.4%, 0.9%, and 2.7%, respectively. Conclusions and Relevance Both reduced-dose NOACs and aspirin alone were noninferior to DAPT for 6-month outcomes after uncomplicated LAAC. Trial Registration ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://www.clinicaltrials.gov/study/NCT06521463\">NCT06521463</jats:ext-link>","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149304436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis Asks: Are GLP-1 Drugs Safe in People With Frailty?","authors":"Anna Bock","doi":"10.1001/jama.2026.22482","DOIUrl":"https://doi.org/10.1001/jama.2026.22482","url":null,"abstract":"This Medical News article discusses an analysis of cardiovascular benefits and safety of semaglutide use in trial participants with frailty, defined by accumulated age-related health deficits.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"342 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149293044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massachusetts Marketplace Disenrollment Following Enhanced Subsidy Expiration","authors":"Adrianna McIntyre, Briana Stone, Kai Shen Lim, Mark Shepard, Benjamin D. Sommers","doi":"10.1001/jama.2026.19941","DOIUrl":"https://doi.org/10.1001/jama.2026.19941","url":null,"abstract":"This study uses administrative enrollment data from the Massachusetts Health Marketplace to analyze patterns of Marketplace disenrollment when enhanced subsidies expired vs end-of-year disenrollment in prior years.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149293048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Horses With Stripes","authors":"Clara Baselga-Garriga","doi":"10.1001/jama.2026.21582","DOIUrl":"https://doi.org/10.1001/jama.2026.21582","url":null,"abstract":"In this narrative medicine essay, a medical student discusses the difference in encountering a rare disease as a medical student and resident compared with a personal experience with one.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149293045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wagering on Unfinished Experiments—Prediction Markets and Clinical Trial Integrity","authors":"Jay B. Lusk, Robert M. Califf, Ann Marie Navar, Emily C. O’Brien","doi":"10.1001/jama.2026.19361","DOIUrl":"https://doi.org/10.1001/jama.2026.19361","url":null,"abstract":"This Viewpoint discusses the potential impact on recruitment, retention, measurement, or evidence generation after a prediction market platform announced it would host betting on the outcomes of clinical trials and US Food and Drug Administration regulatory reviews, noting that policy action is needed to ensure that prediction markets do not undermine the public interest.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149293047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why Epidemic Responses Need Operational Field Ethics","authors":"Serge Tonen-Wolyec, Félicien Munday Mulopo, Salomon Batina-Agasa, Laurent Bélec","doi":"10.1001/jama.2026.19114","DOIUrl":"https://doi.org/10.1001/jama.2026.19114","url":null,"abstract":"This Viewpoint defines operational field ethics and explains its value in epidemic preparedness; highlights areas in which field ethics can be helpful in addressing community resistance to public health protocols; and suggests ways in which field ethicists might be integrated into public health infrastructure to improve epidemic responses.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149274959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Management of Acute Rhinosinusitis in Adults","authors":"James Fan, Jason T. Alexander","doi":"10.1001/jama.2026.16552","DOIUrl":"https://doi.org/10.1001/jama.2026.16552","url":null,"abstract":"This JAMA Clinical Guidelines Synopsis summarizes the 2025 update of the American Academy of Otolaryngology–Head and Neck Surgery Foundation guideline on diagnosis and management of acute rhinosinusitis in adults.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149274781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}