JAMA Clinical Reviews

Cost-effectiveness analysis defines trade-offs between costs, harms, and benefits of alternative treatments and combines them into a single metric, the incremental cost-effectiveness ratio (ICER), that can inform decisions about which interventions to recommend when limited resources are available. Gillian Sanders-Schmidler, PhD, professor of population health sciences and medicine at Duke University, explains the method in terms clinicians can understand. Related Articles: Overview of Cost-effectiveness Analysis Choosing a Time Horizon in Cost and Cost-effectiveness Analyses

Rules for the regulation of medical devices, such as hip prostheses and implantable defibrillators, are complex and differ from those for drugs. Aaron Kesselheim, MD, JD, MPH, and Jonathan Darrow, SJD, LLM, JD, MBA, both faculty members in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham & Women's Hospital, review device classes and approval pathways used by the US Food and Drug Administration (FDA), and prospects for improvements and reform in the agency's processes. Related Content: FDA Regulation and Approval of Medical Devices

Anabolic drugs activate osteoblasts and are an alternative to bisphosphonates for treating osteoporosis. Kristine Ensrud, MD, MPH, professor of medicine and epidemiology at the University of Minnesota and Minneapolis VA Healthcare System, joins JAMA Associate Editor Carolyn Crandall, MD, MS, to discuss the role of teriparatide, abaloparatide, and romosozumab in the management of osteoporosis. Related Content: Anabolic Therapy for Osteoporosis

Several new therapeutic drug classes are now available to manage lipid levels. John Wilkins, MD, MS, and Donald Lloyd-Jones, MD, ScM, of the Department of Preventive Medicine and Division of Cardiology at Northwestern University Feinberg School of Medicine, discuss the use of ezetimibe, PCSK-9 inhibitors, bempedoic acid, and icosapent ethyl to manage lipid levels in patients taking statins who require additional LDL lowering. Related Content: Novel Lipid-Lowering Therapies to Reduce Cardiovascular Risk Lipids and Lipoproteins in 2020

Alcoholic liver disease is increasing in incidence, especially in younger age groups. Ashwani Singal, MD, MS, professor of medicine at University of South Dakota, reviews the diagnosis, clinical presentation, and management of alcoholic liver disease, from acute alcoholic hepatitis to cirrhosis. Related Content: Diagnosis and Treatment of Alcohol-Associated Liver Disease

Approximately 1 in 8 women of reproductive age seek treatment for infertility. JAMA Associate Editor Linda Brubaker, MD, joins Sandra Ann Carson, MD, of Yale School of Medicine, to discuss causes and clinical correlates of infertility as well as evaluation options and treatment approaches. Related Content: Diagnosis and Management of Infertility

Transcatheter valve repair has emerged as an important therapeutic option for patients with aortic and mitral valve disease. JAMA Deputy Editor Gregory Curfman, MD, interviews Charles Davidson, MD, clinical chief of Cardiology at Northwestern University, to review the range of indications and procedures now available, including transcatheter aortic valve implantation (TAVI), valve-in-valve procedures after bioprosthetic valve failure, and mitral valve transcatheter edge-to-edge repair. Related Article: Transcatheter Treatment of Valvular Heart Disease

Chronic pelvic pain is a challenging condition that affects an estimated 26% of the world's female population. JAMA Associate Editor Linda Brubaker, MD, and Georgine Lamvu, MD, of the University of Central Florida, discuss recommendations from consensus guidelines intended to improve the care of women with chronic pelvic pain and to facilitate positive clinical experiences for them. Related Articles: Chronic Pelvic Pain in Women I Have Chronic Pelvic Pain: What Should I Know?

Routine wellness or "checkup" visits are popular with patients and physicians but questions persist about their value, goals, and effective components. JAMA Associate Editor Anne Cappola, MD, ScM, discusses the evidence for and against the practice with Jeffrey Linder, MD, MPH, of the Northwestern University Feinberg School of Medicine, and Allan S. Brett, MD, of the University of Colorado School of Medicine. Related Content: General Health Checks in Adult Primary Care

Lower extremity peripheral artery disease (PAD) affects approximately 8.5 million people in the US and about 230 million worldwide. JAMA Deputy Editor Greg Curfman, MD, interviews Mary M. McDermott, MD, of Northwestern University Feinberg School of Medicine, to discuss current evidence regarding diagnosis and optimal medical treatment of people with PAD to prevent cardiovascular events, improve walking impairment, and prevent lower extremity ischemic events such as amputation or limb ischemia. Related Article(s): Lower Extremity Peripheral Artery Disease Without Chronic Limb-Threatening Ischemia