The Patient Driven Payment Model was associated with increased coding intensity and Medicare expenditures in skilled nursing facilities, especially for medically complex patients, without affecting rehospitalization or mortality rates. ja.ma/42O774P

This Guide to Statistics and Methods explains how covariate-constrained randomization (CCR) enhances rigor in cluster randomized clinical trials. ja.ma/3ICwGz1

In adults with acute mild to moderate #COVID19, metformin did not shorten recovery time compared to placebo, with similar median times to symptom resolution in both groups. ja.ma/3UWpQHi

In the latest episode of JAMA Internal Medicine Author Interviews, author Sammy Saab, MD, MPH, and guest expert Guadalupe Garcia-Tsao, MD, discuss metabolic-associated steatotic liver disease with Eve Rittenberg, MD. Listen now: ja.ma/4pxWbSy

This Review explores the factors that predispose Hispanic/Latino patients to metabolic dysfunction–associated steatotic liver disease and metabolic dysfunction–associated steatohepatitis. ja.ma/4nlpAhp

Cognitive behavioral therapy for #insomnia was associated with improvements in insomnia severity, sleep efficiency, and sleep onset latency, with high treatment acceptability. ja.ma/3Ium59e

Viewpoint: While the Inflation Reduction Act may initially lower anticancer drug costs, long-term spending could increase due to improved affordability and mandatory coverage. ja.ma/46SMkhZ

Integrating lifestyle factors like diet and physical activity with #GLP1 receptor agonists is essential for managing symptoms, maintaining nutrition, preserving lean mass, and promoting regular physical activity. ja.ma/4nEsmhB

A nurse-led, interprofessional family support intervention in ICUs showed improvements in family satisfaction, communication quality, and cognitive and emotional support for families of critically ill patients. ja.ma/47NoC8V

First-year over-the-counter naloxone sales showed limited uptake and did not effectively bridge gaps from pharmacy or distribution programs, likely due to high prices. ja.ma/46lB1yw

#HormoneTherapy reduces vasomotor symptoms w/o increasing #cardiovascular risk in postmenopausal women aged 50 to 59, but raises cardiovascular risk in those over 70, finds this secondary analysis of 2 RCTs. ja.ma/41TpDIG

From @jama.com: Centralizing data from diverse reporting systems enables timely, actionable measles surveillance, helping guide public health interventions, improve vaccination efforts, and model outbreak risk more precisely within communities. ja.ma/46nWgQ7

From @jama.com: Superficial vein thrombosis (SuVT) is characterized by thrombus in the superficial veins, typically in the lower or upper extremities. This Review summarizes the diagnosis and treatment of SuVT. ja.ma/465GQRD

The Mighty-Heart trial found mobile integrated health offered no overall benefit over care coordination alone for #HeartFailure patients' health status or 30-day readmissions, but younger patients showed potential health improvements. ja.ma/3JUvGGS

Viewpoint: The Women's Preventive Services Initiative recommends expanded coverage and patient navigation for breast cancer screening to improve effectiveness and accessibility. ja.ma/47D1XMn

Germicidal UV appliances in common areas of long-term care facilities did not significantly reduce the incidence rate of acute respiratory infections per zone per cycle. ja.ma/3VLiu9F

An electronic health record–integrated clinical decision support system increased prescriptions for naloxone and opioid use disorder treatment with no change in treatment coverage duration or overdose and death rates. ja.ma/4634LBa

"Home self-collection has the potential to meaningfully reduce cervical cancer burden." This Editorial discusses the potential of home-based HPV self-collection kits to address barriers to cervical cancer screening. ja.ma/3Ihk7ZD

Mailed self-collection was effective for increasing #CervicalCancer screening participation among never- and under-screened women in a safety net health setting. ja.ma/4gkOP0P

Editorial: The study by Florian et al highlights that while cannabidiol (CBD) can raise liver enzymes even at doses typical of over-the-counter products, the long-term hepatotoxicity risks remain unclear. ja.ma/4nrFAy1

RCT: Among participants using CBD at a dosage representative of consumer products, 5.6% experienced liver enzyme elevations. ja.ma/4gdqMAy

Viewpoint: The #Medicare hospice benefit's limited custodial care burden on families highlights the need for reform to meet the growing caregiving demands of end-of-life care. ja.ma/3JMIK0Z

RCT: In postmenopausal women, elinzanetant reduced vasomotor symptoms compared to placebo at 12 weeks, with continued benefits in frequency, sleep, and quality of life over 52 weeks, while maintaining safety. ja.ma/4n5IIzG

From 2017 to 2023, #Medicare Advantage beneficiaries saw disproportionately greater increases in hospital length of stay compared to traditional Medicare, particularly for discharges to skilled nursing facilities. ja.ma/4ge74Vr

🆕analysis from CP3's Dr. Ravy Vajravelu, @timandersonmd.bsky.social, Bridget Mayrer, & team examined the implications of recdent iron deficiency guidelines for the prevalence & management of iron deficiency anemia. Read more @jamainternalmed.com: jamanetwork.com/journals/jam...

New paper w/ Brian McGarry, Ashvin Gandhi, and Drew Wilcock in @jamainternalmed.com! Hospitals are complaining across the US that patients are "stuck" waiting for rehab beds at nursing homes when they are medically stable and ready for discharge. What is going on?? jamanetwork.com/journals/jam...

RCT: Among 450 participants, Azelastine nasal spray was associated with a reduced incidence of lab-confirmed SARS-CoV-2 respiratory infections (2.2% compared to 6.7% with placebo). ja.ma/4lUgWos

Viewpoint: The rapid spread of BTMPS, a non-psychoactive adulterant in the US drug supply, poses health challenges due to its unknown effects. ja.ma/42boIDs

This JAMA patient page covers #GLP1 weight-loss medications, focusing on food craving reduction, blood glucose control, dietary strategies, exercise for muscle retention, and lifestyle changes to prevent weight regain. ja.ma/3JNr6Ks

📌 Most viewed this week from JAMA Internal Medicine: Among 450 participants, Azelastine nasal spray was associated with a reduced incidence of lab-confirmed SARS-CoV-2 respiratory infections (2.2% compared to 6.7% with placebo). ja.ma/4pff24U

A woman in her 50s with #obesity, #diabetes, and #hypertension was treated for mild autonomous cortisol secretion caused by an adrenal nodule and improved following an adrenalectomy. Learn more in this Teachable Moment: ja.ma/426GCaq

RCT: In #dementia care, caregivers reported higher satisfaction with health system and community-based interventions compared to usual care, despite no significant differences in patient cognition, functional status, or overall caregiver burden. ja.ma/3I2iFKx

In this podcast episode, listen to authors Robert Bals, MD, PhD, and Dan Barouch, MD, PhD, discuss the use of azelastine nasal spray to prevent #COVID transmission with Eve Rittenberg, MD. Listen now:

Viewpoint: An external medical review board for compassionate release could reduce the incarceration of terminally ill patients by focusing on medical criteria, addressing ethical concerns, and promoting dignified end-of-life care. ja.ma/45UD6T7

RCT: Among 450 participants, Azelastine nasal spray was associated with a reduced incidence of lab-confirmed SARS-CoV-2 respiratory infections (2.2% compared to 6.7% with placebo). ja.ma/4lUgWos

Case report shows that continuous glucose monitors (CGMs) can yield false hypoglycemia alerts in non-diabetic patients, emphasizing the need for clinical correlation and careful use to avoid unnecessary stress and hospitalizations. ja.ma/4mC9Whd

Viewpoint: The definition of disease is vital for clinical and public health, but broad criteria risk overdiagnosis and overtreatment. ja.ma/420e6Hs

Indian Health Service hospitals are smaller and more isolated, highlighting the potential benefits of introducing GME accreditation programs to alleviate physician shortages. ja.ma/462nBas

Most CFTR heterozygotes in this genetic association study showed no increased risk of cystic fibrosis-related diseases compared to noncarriers. ja.ma/41ZLLRA

The proportion of older adults experiencing prolonged emergency department stays and admission delays has increased, particularly in academic hospitals. ja.ma/3JCrHhY

Switching from a budesonide-formoterol metered-dose inhaler to a fluticasone-salmeterol dry-powder inhaler in the Veterans Health Administration was linked to increased health care utilization and adverse outcomes. ja.ma/4fXYqdq

The FDA's Breakthrough Devices Program has expedited the authorization of novel therapeutic devices, yet concerns remain due to the lack of comprehensive evidence on the benefits and risks. ja.ma/3Jd5ZAI

Patients with metabolic dysfunction and alcohol-associated liver disease and alcohol-associated liver disease have modestly higher risks of major adverse liver outcomes and all-cause mortality compared to those with MASLD. ja.ma/4occIeh

Patient navigation services were found to increase screening and follow-up rates for breast and cervical cancer compared to usual care. ja.ma/45xP9p7

The American Gastroenterological Association's 2020 guidelines increased the diagnostic serum ferritin threshold from 15 ng/mL to 45 ng/mL, raising the estimated prevalence of iron deficiency #anemia among US adults by 3.3 million. ja.ma/45L8xOb

This case report describes a man in his 60s with South African flag sign on electrocardiography. ja.ma/47aMEdv

A centralized, remote bone health service screening model was associated with improving rates of #osteoporosis screening, treatment, and adherence with high diagnostic yield. ja.ma/47J8XHr

Most viewed this week from JAMA Internal Medicine: A patient in their 70s experienced muscle weakness and elevated CK due to statins, diagnosed with necrotizing autoimmune myopathy, and treated by stopping atorvastatin plus prednisone, tacrolimus, and IVIg. ja.ma/45vgTut

Viewpoint: Following the Dobbs decision, states like Texas are challenging protective shield laws for out-of-state abortion providers, raising legal questions about access in states with abortion bans. ja.ma/4oQvbgW

People experiencing homelessness had higher rates of emergency department visits for heat-related illness compared to nonhomeless individuals. ja.ma/41kYbTR