This essay describes the negative impact of secure messaging on attention, learning opportunities, and autonomy for medical trainees. from JAMA Internal Medicine Online First https://ift.tt/nxIorZv

This cross-sectional study assesses the prevalence of incomplete team staffing in the post–COVID-19 pandemic health care landscape and its association with burnout and work intentions among US physicians. from JAMA Internal Medicine Online First https://ift.tt/aCF95Yp

This cohort study assessed the association of criteria-based testing and the number of publicly funded vitamin D tests performed in Ontario, Canada. from JAMA Internal Medicine Online First https://ift.tt/MOf0eKN

This Viewpoint examines front-of-package food labeling and how clear nutrition labels can help consumers make more informed decisions in unhealthy food environments. from JAMA Internal Medicine Online First https://ift.tt/lcLEdDU

In Reply We appreciate the Letter from Osinski et al regarding our investigation of the overtreatment of prostate cancer among men with limited longevity. We recognize the uncertainties in risk stratification that limit the application of population-based estimates of life expectancy to an individual patient. Given these concerns, it is important to note that in population-based analyses, there will be a minority of patients that drastically outlive their estimated life expectancy and may derive meaningful benefit from treatment. Similarly, there will be men with longer life expectancy that do not live long enough to benefit from treatment. Yet, treatment decisions should be driven by evidence-based factors predicting when the vast majority of patients will or will not benefit from treatment. from JAMA Internal Medicine Online First https://ift.tt/0UulW1T

This cluster randomized trial examines whether a more intensive implementation strategy resulted in greater use of a mobile app targeting multilevel barriers to colorectal cancer screening. from JAMA Internal Medicine Online First https://ift.tt/JeMv7rF

This cross-sectional study examines the quality and safety of discharge summary narratives for inpatient hospital medicine encounters generated by a language learning model. from JAMA Internal Medicine Online First https://ift.tt/gZHNdrE

This Viewpoint examines the urinary nitrite test and questions its effectiveness and relevance in distinguishing between urinary tract infection and asymptomatic bacteriuria. from JAMA Internal Medicine Online First https://ift.tt/HCyYunS

To the Editor We read with great interest the Viewpoint by Peoples and Ubel. With our collective and ongoing 3 decades of experience with student-run clinics (SRCs), we concur with many points, but dissent with their argument that national guidelines are the best way to ensure high-quality care in SRCs. from JAMA Internal Medicine Online First https://ift.tt/9oDlmnj

In Reply In a recent Viewpoint, we called for a national discussion on student-run clinics (SRCs). We appreciate the response of Lee et al, and applaud their efforts with SRCs. Encouragingly, there is much common ground. Their Letter recapitulates our own arguments in several places, and in this response, we provide additional clarity on some areas of difference. from JAMA Internal Medicine Online First https://ift.tt/LKEsnB0

This randomized clinical trial assesses the efficacy of a pharmacist-led transition of care program in reducing emergency department visits related to the same medication-related event at 6 months compared with usual care. from JAMA Internal Medicine Online First https://ift.tt/MhG5FaE

This cohort study evaluates the association between sodium-glucose cotransporter 2 inhibitors and hyperkalemia in individuals with diabetes, heart failure, or chronic kidney disease receiving renin-angiotensin-aldosterone system inhibitors. from JAMA Internal Medicine Online First https://ift.tt/RfObPxu

This randomized clinical trial compares the effectiveness of initiating oral naltrexone vs extended-release injectable naltrexone on reduction in alcohol use and health care utilization among medical inpatients with alcohol use disorder. from JAMA Internal Medicine Online First https://ift.tt/AlU7HEr

This phase 3 replication randomized clinical trial reassesses the efficacy and tolerability of cytisinicline for smoking cessation and reducing nicotine craving. from JAMA Internal Medicine Online First https://ift.tt/9ZQ6nlJ

This Viewpoint discusses positive labels vs warning labels to help solve the problem of underperforming pulse oximeters in individuals with darker skin. from JAMA Internal Medicine Online First https://ift.tt/Y36c19Q

This risk model projects how many future cancers in the United States could result from annual computed tomography examinations. from JAMA Internal Medicine Online First https://ift.tt/OCmc7N2

This Viewpoint discusses clinicians as legal petitioners of extreme risk protection orders to promote the safety and well-being of patients and communities. from JAMA Internal Medicine Online First https://ift.tt/jvi8qPf

This cluster randomized clinical trial evaluates whether computerized provider order entry prompts presenting patient-specific and pathogen-specific multidrug-resistant organism infection risk estimates could reduce empiric extended-spectrum antibiotics for noncritically ill patients admitted with skin and soft tissue infection. from JAMA Internal Medicine Online First https://ift.tt/3WTzSxM

In Reply We thank Mermel for his thoughtful and careful review of our Teachable Moment article, “The Harm of Inappropriate Central Line Blood Cultures in Clinical Practice.” We agree that whether a positive central line culture reflects a bloodstream infection, colonization, or a false-positive result requires accounting for the outcome of each blood culture obtained. In our case, we reported that the initial central line blood culture grew coagulase-negative Staphylococcus, yet the initial and repeated peripheral cultures had negative results. As only 1 of the 2 initial blood cultures revealed infection, the positive result was limited to the central line culture, and subsequent cultures revealed negative results. This suggests colonization of the catheter hub or lumen or a false-positive result due to a skin contaminant. Coupled with an alternative explanation for the patient’s fever (ie, community-acquired pneumonia), the infectious diseases consultant did not disregard the possibil...

This randomized clinical trial compares usual care to an addiction-focused consultation service in hospitalized patients with opioid use disorder. from JAMA Internal Medicine Online First https://ift.tt/pUbs4gq