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JAMA | The Latest Medical Research, Reviews, and Guidelines

jamanetwork.com/journals/jama is the official online presence of the Journal of the American Medical Association (JAMA). It is a peer-reviewed medical journal that publishes original research, reviews, and other articles on a wide range of medical topics. The website provides access to the journal's current and past issues, as well as other resources such as podcasts, videos, and blogs. Users can browse articles by topic, author, or date, and can also search for specific articles using a keyword search function. Some of the key features of the website include: - A large collection of articles and research papers on various medical topics - A search function that allows users to find specific articles or topics - A section for podcasts and videos that provide additional information and insights on medical topics - A blog section that features articles and commentary from medical experts - A section for news and updates on medical research and policy - A section for authors and researchers to submit their work for publication Overall, the website is a valuable resource for medical professionals, researchers, and students who are looking for reliable and up-to-date information on medical topics.
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JAMA Current Issue jamanetwork.com
RSS Hunter RSS Hunter • Aug 19, 2024

Thread Of Notes

Stereotactic Radiation vs Hippocampal-Avoidance Whole Brain Radiation

To the Editor The recent trial comparing stereotactic radiation with hippocampal-avoidance whole brain radiation in patients with 5 to 20 brain metastases fills a critical evidence gap. While the primary outcome demonstrated symptom benefit favoring stereotactic radiation, the interpretation of secondary end points warrants further discussion to guide clinicians toward a more comprehensive framework for evaluating clinical outcomes.
https://jamanetwork.com/journals/jama/fullarticle/2850220 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

The Future of Survivorship in Critical Illness

In this issue of JAMA, O’Neill and colleagues report the results of a pragmatic, multicenter, randomized clinical trial evaluating a remotely delivered, 6-week, multicomponent, rehabilitation intervention for critical illness survivors. Across 52 National Health Service hospitals in the UK, 429 adults who received at least 48 hours of invasive mechanical ventilation, could speak English or had a translator, and were directly discharged home from the hospital were randomized to a rehabilitation intervention (n = 231) or standard care (n = 198). Specially trained interventionists led weekly 1-on-1 remote appointments encompassing exercise, symptom management, and psychological well-being support. The interventionists had regular meetings (1-2 per month) with a multiprofessional team to address participants’ queries and identify further management strategies. Additional program offerings included weekly group-based remote exercise sessions and an online peer support group.
https://jamanetwork.com/journals/jama/fullarticle/2849322 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

Correction to Primary Composite Outcome in a Trial of Transfusion Strategy

The Original Investigation titled “Effect of a Restrictive vs Liberal Blood Transfusion Strategy on Major Cardiovascular Events Among Patients With Acute Myocardial Infarction and Anemia: The REALITY Randomized Clinical Trial” published February 9, 2021, was corrected to fix the number of events for the primary outcome. Calculation of the primary composite outcome had mistakenly included heart failure events as a component, and the date of consent withdrawal was recorded incorrectly for 4 patients (before 30 days rather than after 30 days). Thus, as specified in the protocol and statistical analysis plan, they should have been considered missing, but had been coded as “no event.” After correction, the number of events for the primary outcome is slightly lower than in the original analysis (29 vs 36 for the restrictive transfusion group and 36 vs 45 for the liberal group). This change does not impact the main conclusion: the restrictive strategy resulted in a noninferior rate of major adverse cardiovascular events after 30 days compared with the liberal strategy. This article has been corrected online; a letter of explanation appears in this issue.
https://jamanetwork.com/journals/jama/fullarticle/2850727 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

Primary Composite Outcome Corrected in a Trial of Transfusion Strategy

To the Editor We wish to report corrections to our study of a restrictive vs liberal blood transfusion strategy on major cardiovascular events among patients with acute myocardial infarction and anemia. During secondary analyses of the trial results related to heart failure, it became apparent that the original analysis of the primary composite outcome had mistakenly included heart failure events as a component of the primary outcome (although heart failure events were adjudicated, they were not part of the prespecified primary composite outcome, which included all-cause death, stroke, recurrent myocardial infarction, or emergency revascularization prompted by ischemia at 30 days). In addition, the date of consent withdrawal was recorded incorrectly for 4 patients (before 30 days rather than after 30 days). Thus, as specified in the protocol and statistical analysis plan, they should have been considered missing, but had been coded as “no event.”
https://jamanetwork.com/journals/jama/fullarticle/2850724 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

Author AI Disclosure in JAMA Network Journal Submissions—Reply

In Reply We appreciate Mr Mahajan’s observation that appropriate AI use is increasingly difficult to define. We observed that author disclosure rates of AI use in submissions to JAMA Network journals were increasing over time (up to 6%), while another study of 49 BMJ Group journals found a similar rate in 2024 (5.7%). In light of these relatively low rates of reported use, we believe authors may have differing views of what constitutes appropriate AI use that should be disclosed. In a similar vein, we found that disclosures of AI use by peer reviewers during the same time frame were even lower. Beyond disclosure, our policy for reviewers is more conservative and advises that they not enter confidential manuscripts or their peer reviews into AI models. We will continue to monitor disclosures of use and will continue to update guidance for authors and reviewers, as we have done in the past.
https://jamanetwork.com/journals/jama/fullarticle/2850539 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

Weight Loss for Atrial Fibrillation Prevention

Atrial fibrillation, the most common sustained arrhythmia encountered in clinical practice, is now considered a preventable disorder. Professional societies and the National Institutes of Health have highlighted the importance of addressing lifestyle factors as a pillar in the management of atrial fibrillation. Central among these is weight loss in individuals with overweight (body mass index [BMI, calculated as weight in kilograms divided by height in meters squared] between ≥27 and <30) and obesity (BMI ≥30), which now garners a class 1 recommendation in both US and European guidelines to reduce the risk of atrial fibrillation. The evidence supporting those recommendations is extensive.
https://jamanetwork.com/journals/jama/fullarticle/2849341 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

Author AI Disclosure in JAMA Network Journal Submissions

To the Editor A recent Research Letter analyzed trends in self-reported artificial intelligence (AI) use across JAMA Network journals, offering an important foundation for policy discussions. However, the article’s conclusion that journals may need greater effort to confirm appropriate use, accountability, and accuracy raises a prior question: has the scientific community established what meaningful and appropriate use of AI in research entails? Without such consensus, the scientific community may be unable to meaningfully evaluate whether and how AI affects the validity and reproducibility of published research—the very concern motivating disclosure requirements.
https://jamanetwork.com/journals/jama/fullarticle/2850541 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

National Trends in Patient Messaging

Over the past decade, the electronic inbox has become a defining feature of modern clinical practice. Patient portal messaging—direct communication between patients and clinicians via a portal in the electronic health record—has evolved from a supplementary communication tool to a central modality of care delivery. Prior studies have linked growing message volume to increased after-hours use of the electronic health record and clinician burnout, raising concerns that asynchronous communication, while convenient for patients, may contribute to unsustainable workloads. The COVID-19 pandemic accelerated these changes through both telehealth visits and patient portal messaging. Yet despite widespread recognition of this shift, national trends in patient portal messaging have not been described, nor how messaging relates to more traditional care modalities, such as telephone encounters and office visits.
https://jamanetwork.com/journals/jama/fullarticle/2850608 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

Trends in Newborn Hepatitis B Virus Vaccination

To the Editor Dr Rothman and colleagues reported trends in newborn hepatitis B virus (HBV) vaccination in Epic Cosmos, a large-scale electronic health record database. They found that vaccinations rose from 67.5% in January 2017, peaked at 83.5% in February 2023, and then declined to 73.2% in August 2025. As pediatricians and neonatologists who observe HBV vaccine declination, we applaud the authors for quantifying this public health issue.
https://jamanetwork.com/journals/jama/fullarticle/2850606 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

Stereotactic Radiation vs Hippocampal-Avoidance Whole Brain Radiation—Reply

In Reply We appreciate the thoughtful Letters to the Editor about our randomized clinical trial comparing stereotactic radiation with hippocampal-avoidance whole brain radiation in patients with 5 to 20 brain metastases, which demonstrated lower symptom burden with stereotactic approaches. The comments from each Letter inform the real-world application of our study findings.
https://jamanetwork.com/journals/jama/fullarticle/2850219 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

Mom, Doc, Patient, Home: Poetry and the Merging of Identities

Poetry is a valuable medium that has survived for millennia, encouraging emotional seeking and contemplative depth in an ever-changing world. It provides a sense of steadiness and peace, which is scarce for clinicians who often have to juggle multiple responsibilities. The poem "Pager" uses poetry's intentionality to facilitate reflection on the busy life of a physician, highlighting the challenges of balancing patient care, administrative tasks, and home life. The poem's protagonist is constantly on the go, with the pager serving as both a disruptor and an anchoring object that transports her between roles. The use of poetic enjambment brings unexpected transitions, mirroring the jarring nature of the physician's life. The poem captures the feeling of constancy in interruption, which is familiar to clinicians who often have to erase boundaries between work and personal life. Despite efforts to protect caregiver well-being, the poem highlights the dedication required of physicians, who must be responsive to both their patients and loved ones. The speaker of the poem is torn between their professional and personal life, longing for respite and relief from the demands of their job. Poetry provides a unique perspective on this duality, encompassing the complexities of being a physician and a human being. Ultimately, the poem shows that the speaker's dedication to their work does not make them any less human, but rather highlights their admirable commitment to caring for others while also seeking care for themselves.
https://jamanetwork.com/journals/jama/fullarticle/2850534 jamanetwork.com
RSS Hunter RSS Hunter • Jul 21

When Medicine, and Poetry, Stop Time

Every clinician has experienced moments during patient care when time seems to stand still, often at critical junctures in a patient's life. These moments are an integral part of medicine and can be just as impactful as they are unforgettable. Poetry has a unique ability to suspend time, making it a suitable medium for capturing and reflecting on significant life events. The poem "Post Code" is a prime example of poetry's time-stopping powers, particularly in its medical context. As a lyric poem, "Post Code" is written in a kind of eternal present tense, which contributes to its ability to freeze time. This technique is reminiscent of John Keats' poem, where he addresses figures on a Grecian urn as if they are permanently alive, suspending them in a timeless moment. In "Post Code," the reader is similarly frozen in time, transfixed by the vivid descriptions of the code room and the patient's daughter's grip on the bed rail. The poem's use of line breaks, punctuation, and other literary devices also slows down the reader's pace, forcing them to linger over certain lines and phrases. Poetry's capacity for expressing epiphanies, or timeless and exalted realizations, is another key aspect of its time-stopping powers, as seen in the final line of "Post Code." Ultimately, the poem suggests that the clinician's healing work continues transcendentally, even as time keeps moving forward, and this realization is a testament to the enduring power of poetry to capture and convey the human experience.
https://jamanetwork.com/journals/jama/fullarticle/2850181 jamanetwork.com
RSS Hunter RSS Hunter • Jul 14

Spillover Effects in Clinical Trials

The conduct of randomized clinical trials (RCTs) is often a large-scale endeavor, with the potential to impact patients, clinicians, health care systems, and even the communities in which they are carried out. The effects of trials on participants may flow through the randomized study treatments or through other pathways, for example, by inducing changes to aspects of care separate from the randomized treatments. These effects may be beneficial (eg, participants may receive more careful evaluation, additional diagnostic studies, closer follow-up, or earlier detection of complications) or they may be harmful (eg, inconvenience or financial costs).
https://jamanetwork.com/journals/jama/fullarticle/2849768 jamanetwork.com
RSS Hunter RSS Hunter • Jul 14