JAMA Clinical Reviews

Author interviews that explore the latest clinical reviews.


  • The Effect of Hearing Loss on Cognitive Decline

    May 19 2020

    Even limited hearing loss might be associated with cognitive decline. If true, early intervention with hearing aids might help people have better cognitive performance. Michael Johns III, MD, online editor for JAMA Otolaryngology, speaks with Justin Golub, MD, assistant professor of otolaryngology at Columbia University, whose research has shown that very mild hearing loss can be associated with cognitive disability. Related Article 

  • My Father Was Murdered by Terrorists: Recollections of a Trauma Surgeon

    May 05 2020

    When she was a teenager Melissa Red Hoffman's father was killed by terrorists. Dr Hoffman recalls her father's death and how that has influenced her career and how she can identify with patients and their families at the most difficult moments. Read the story: The Sound of Silence—When There Are No Words

  • Coronavirus (COVID-19) Update: Ventilatory Management for COVID-Related Respiratory Failure

    Apr 24 2020

    Management of COVID-19-related respiratory failure differs from what is necessary for ARDS. Rather than having alveolar edema, COVID-19 patients have pulmonary vascular dysregulation. Gas exchange is severely compromised with little reduction in lung compliance. Ventilatory support for COVID-19 patients requires higher than normal tidal volumes with minimal PEEP and allowance for higher than usual serum CO2 levels. How the unique pathophysiology of respiratory failure should be treated is discus...more

  • Parkinson Disease Information for Patients

    Apr 14 2020

    More than 6 million people worldwide have Parkinson disease. Even though it is classically associated with tremors, the disease has many manifestations and is very treatable for most patients. Michael S. Okun, MD, from the Department of Neurology at the University of Florida, Gainesville, discusses the pathophysiology, clinical presentation, diagnosis, and treatment of Parkinson disease. Related: Choosing a Parkinson Disease Treatment

  • Coronavirus (COVID-19) Update: Reusing Face Masks and N95 Respirators

    Apr 08 2020

    Shortages of face masks and N95 respirators have forced clinicians and hospitals to reuse these normally disposable items. Ron Shaffer, PhD, former CDC PPE Research Branch Chief, discusses effective sterilization techniques and how to test that the equipment stays protective after sterilization.

  • Treating Pediatric Eczema

    Apr 07 2020

    Eczema is extremely common in children. Most the time it is easily treated with topical steroids but on occasion it requires systemic therapies. JAMA Pediatrics Editor Dimitri Christakis, MD, MPH, and JAMA Network Open Editor Frederick Rivara, MD, MPH, discuss the results of a clinical trial of a new monoclonal antibody intended to improve eczema in children that was published in the January 2020 issue of JAMA Pediatrics. Related: Are Bacteria Transplants the Future of Eczema Therapy? Effect o...more

  • Coronavirus (COVID-19) Update: Safe Shopping at Stores and Pharmacies

    Apr 03 2020

    Food and medicine shopping is essential during the COVID-19 pandemic, but requires getting out and standing close to strangers at a time when social distancing and sheltering-in-place are recommended to slow spread of disease. David Aronoff, MD, director of the Division of Infectious Diseases at Vanderbilt University in Nashville, explains how to minimize COVID-19 risk while shopping.

  • Coronavirus Disease 2019 (COVID-19) Update: PCR Testing and Shortages

    Mar 27 2020

    The lack of availability of COVID-19 testing has interfered with the ability to contain the spread of disease. Omai Garner, PhD, laboratory director for Clinical Microbiology in the UCLA health system, explains how PCR testing for COVID-19 works and why testing is in short supply.

  • Coronavirus Disease 2019 (COVID-19) Update: How the VA Is Preparing

    Mar 25 2020

    As COVID-19 spreads, clinicians and health systems are struggling to prepare for a surge of patients. Richard Stone, MD, the US Veterans Health Administration's Executive in Charge, spoke with JAMA about how the VA health system is preparing for this public health emergency.

  • Coronavirus (COVID-19) Update: Lessons Learned From The 2003 SARS Outbreak

    Mar 25 2020

    In 2003, Toronto was the North American center for Severe Acute Respiratory Syndrome (SARS). The disease spread through the city’s hospitals before anyone knew what was happening. Dr Allison McGeer was a clinician caring for SARS patients and ultimately was infected herself. She describes her experience as a patient and provider and reviews lessons learned that might help others manage their regional COVID-19 outbreaks. Related: Supporting the Health Care Workforce During the COVID-19 Global Ep...more

  • Coronavirus (COVID-19) Update: Chloroquine/Hydroxychloroquine and Azithromycin

    Mar 24 2020

    Chloroquine was shown in 2004 to be active in vitro against SARS coronavirus but is of unproven efficacy and safety in patients infected with SARS-CoV-2. The drug's potential benefits and risks for COVID-19 patients, without and with azithromycin, is discussed by Dr. David Juurlink, head of the Division of Clinical Pharmacology and Toxicology at Sunnybrook Health Sciences Centre in Toronto.

  • The Diagnosis and Management of Primary Hyperparathyroidism

    Mar 24 2020

    Hyperparathyroidism is a fairly common disease that causes elevated calcium levels and bone depletion, resulting in fractures and kidney problems. There are medications that can effectively manage hyperparathyroidism, and in some cases surgery is indicated. Michael Yeh, MD, professor and chief of endocrine surgery at UCLA, discusses the management of hyperparathyroidism.

  • Nonalcoholic Steatohepatitis: The Primary Care Perspective

    Mar 24 2020

    Nonalcoholic steatohepatitis (NASH) is becoming more frequent as the population becomes more obese. This is not a benign problem, and NASH can ultimately lead to cirrhosis and liver failure. It is thought that NASH will ultimately become the most common cause for liver transplant. NASH is usually diagnosed as an incidental finding, but once found requires careful monitoring and patient counseling. Lisa N. Kransdorf, MD, MPH, from UCLA Health in California, discusses the diagnosis and management ...more

  • Coronavirus (COVID-19) Update: Early Safety Signals Around Ibuprofen and Renin-Angiotensin Inhibitors

    Mar 20 2020

    Emerging information about how SARS-CoV-2 virus infects cells has led to speculation that NSAIDs and ACE inhibitors/angiotensin receptor blockers (ARBs) may worsen clinical disease. Infectious disease physician Carlos del Rio, MD, of Emory University explains the concerns and their clinical implications.

  • Who Was Nathan Pritikin and Why Is There a Diet Named After Him?

    Mar 17 2020

    This podcast explains the Pritikin diet to patients. Nathan Pritikin was a college dropout who became an entrepreneur. While doing research for the government during World War II, he observed that populations that had extremely limited food availability because of the war had substantially reduced mortality from cardiovascular disease—something unexpected at a time when cardiovascular disease was thought to be due to stress. After the war when food became more available CVD death rates went back...more

  • Nathan Pritikin and His Diet

    Mar 17 2020

    Nathan Pritikin was a college dropout who became an entrepreneur. While doing research for the government during World War II, he observed that populations that had extremely limited food availability because of the war had substantially reduced mortality from cardiovascular disease—something unexpected at a time when cardiovascular disease was thought to be due to stress. After the war when food became more available CVD death rates went back up, resulting in Pritikin concluding that CVD was re...more

  • COVID-19 in Seattle: Clinical Features and Managing the Outbreak

    Mar 15 2020

    Seattle was one of the first US cities to have a COVID-19 outbreak, with a cluster of nursing home-related deaths. However, many people who tested positive for the novel coronavirus never became ill, and in some the clinical illness was indistinguishable from influenza. John Lynch, MD, MPH, an infectious disease physician and medical director for infection prevention and control at the Harborview Medical Center, summarizes his hospital’s experience managing the patients and outbreak.

  • The Effect of the COVID-19 Pandemic on Clinic Operations

    Mar 13 2020

    Seattle has been a focal point for the US in the coronavirus pandemic. Doug Paauw, MD, professor of medicine at the University of Washington, in Seattle, describes the UW primary care clinic experience as this pandemic evolved. Major lessons learned included accommodating for significant numbers of staff not available to work in the clinic because of school closures, change in workflow because of shortages of personal protective equipment, physicians having to accommodate very large numbers of p...more

  • Update on Coronavirus: March 6, 2020, by NIAID’s Anthony Fauci, MD

    Mar 09 2020

    Coronovirus (the virus SARS-CoV-2) continues to spread throughout the world. In recent weeks, there has been an increasing number of cases and deaths in the US. As concern about the virus increases, there is an increasing need for accurate information about the disease and how much concern we should have. Anthony Fauci, MD, is the director of the National Institute for Allergy and Infectious Diseases (NIAID) and has been the main spokesperson for the US government about coronavirus. Dr Fauci spo...more

  • Unprofessional Behavior Leads to Complications

    Feb 25 2020

    Physicians who act out cause all sorts of problems. Fortunately, only a few clinicians have behavior problems and in the modern era, bad behaviors are not tolerated. Bad behaviors get reported these days and actions are taken against these sorts of clinicians. Clinicians who act out frequently say they are doing so to protect their patients. But are they? William Cooper, MD, MPH, and Gerald B. Hickson, MD, from Vanderbilt University Medical Center in Nashville, Tennessee, discuss a study they pu...more

  • The 2020 Influenza Epidemic—More Serious Than Coronavirus in the US

    Feb 18 2020

    Although coronavirus disease 2019 (COVID-19) dominates the news in early 2020, it affects few people in the US. In contrast, at the same time the US is experiencing a severe influenza epidemic, which has caused an estimated 250 000 hospitalizations and 14 000 deaths. Timothy Uyeki, MD, lead for the CDC’s 2019 novel coronavirus response team and Chief Medical Officer of CDC’s influenza division, discusses influenza in the US, how it compares to coronavirus, and what both patients and clinicians s...more

  • AIDS-Related Chronic Inflammation Leading to Chronic Disease

    Feb 18 2020

    Great strides have been made in treating HIV, as Anthony Fauci, MD, discusses in this podcast episode. But even substantial viral suppression leaves some virus behind, causing chronic inflammation. Many chronic diseases, including atherosclerotic coronary vascular disease, are worsened by this chronic inflammatory state. Because HIV patients are now living very long lives, they are also developing chronic diseases at a more rapid rate than their non-HIV-infected peers because of this chronic inf...more

  • Testing for Breast Cancer Susceptibility Genes

    Feb 11 2020

    Breast cancer is a leading cause of death in women. Some women have a cancer susceptibility gene known as BRCA, and women should be tested for BRCA under some circumstances. Carol Mangione, MD, division chief of General Internal Medicine and Health Services Research at UCLA, discusses when testing is appropriate, and Ranjit Manchanda, MD, PhD, from Barts Cancer Institute in London, UK, discusses the cost-effectiveness of BRCA screening for women who have had breast cancer.

  • Parkinson Disease

    Feb 11 2020

    More than 6 million people worldwide have Parkinson disease. Even though it is classically associated with tremors, the disease has many manifestations and is very treatable for most patients. Michael S. Okun, MD, from the Department of Neurology at the University of Florida, Gainesville, discusses the pathophysiology, clinical presentation, diagnosis, and treatment of Parkinson disease. Related article: Parkinson Disease AMA Manual of Style

  • Treating Conjunctivitis and Dry Eye Disease

    Feb 04 2020

    Conjunctivitis and dry eye disease are some of the most common conditions patients present with. They are usually benign entities that respond well to conservative measures and usually don’t require medications. However, if medications are necessary, clinicians can find a comprehensive assessment of these drugs recently published in the December 2, 2019, issue of The Medical Letter. An excerpt from this article summarizing information about conjunctivitis and dry eye disease was published in the...more

  • Management of Chronic Stable Angina in 2020

    Feb 04 2020

    Controversy exists regarding how to best manage chronic stable angina. Intuitively, it seems that because it is usually caused by coronary artery lesions, addressing those lesions either via percutaneous coronary angiography or coronary artery bypass operations would be the best way to manage this problem. Several studies have suggested that this is not the case and that results of these interventions are no better than optimal medical management. Recently, a very large trial examining this clin...more

  • 2019 Novel Coronavirus: An Update From NIAID Director Anthony Fauci, MD

    Jan 30 2020

    A new virus known as the 2019 novel coronavirus (2019-nCoV) is rapidly spreading through China. The rapid spread and severity of this illness are worrisome and the possibility that it develops into a pandemic is very real. Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, provides an update on this new disease.

  • Football Players and Erectile Dysfunction Associated With Repetitive Head Injury

    Jan 29 2020

    American football is a dangerous sport and is characterized by violent contact between people that often leads to repetitive head injury. A multitude of health effects may result from this sort of head injury, but a new finding reported in the December issue of JAMA Neurology maintains that football players are at risk for developing low testosterone levels and erectile dysfunction. Rachel Grashow, PhD, from Harvard T.H. Chan School of Public Health and the Football Players Health Study at Harva...more

  • The Keto Diet: Advice for Patients

    Jan 28 2020

    The keto diet is very popular and involves eating very few carbohydrates, a fair amount of fat, and normal amounts of protein. It is one of many ways to lose weight. David Heber, MD, formerly the chair of Clinical Nutrition at UCLA, explains the keto diet. Related article: Ketogenic Diets  

  • The Keto, Atkins, and Pritikin Diets

    Jan 28 2020

    There are many named diets that receive a great deal of attention. But what are they and do they work? David Heber, MD, PhD, from the UCLA Center for Human Nutrition explains these diets. Related articles: Ketogenic Diets (Patient Page) Interest in the Ketogenic Diet Grows for Weight Loss and Type 2 Diabetes Comparison of Weight Loss Among Named Diet Programs in Overweight and Obese Adults: A Meta-analysis

  • The American Heart Association Takes a Stance Against e-Cigarettes

    Jan 21 2020

    e-Cigarettes are dangerous, but the public has been falsely led to believe that they are safe. Because of this misconception and the inherent dangers, the American Heart Association (AHA) has taken an aggressive stance to educate the public about e-cigarettes, especially their use by kids. Rose Marie Robertson, MD,deputy chief science and medical officer for the AHA, spoke to JAMA about e-cigarettes and the frightening increase in their use among kids. Read the article: The American Heart Assoc...more

  • An Inconvenient Tooth

    Jan 14 2020

    Animal bites can be a cause of significant injury and on occasion, fatalities. In this episode, JAMA Fishbein Fellow Angel Desai, MD, MPH discusses the prevention, treatment, and epidemiological oddities of animal bites with Dr Sandra Nelson, Assistant Professor of Medicine at Massachusetts General, Dr Justin Hensley from Children’s Hospital of San Antonio, and others. Desai also talks prevention and risk of rabies acquisition with Dr Catherine Brown, state epidemiologist and public health veter...more

  • NICE Guidelines for Heavy Menstrual Bleeding: What to Make of Them

    Dec 19 2019

    The UK’s National Institute for Health and Care Excellence (NICE) recently issued guidelines for how to manage heavy menstrual bleeding. Guidelines only provide guidance and they must be interpreted for an individual patient's clinical context. Andrew Kauntiz, MD, professor and associate chair in the department of obstetrics and gynecology, University of Florida College of Medicine in Jacksonville, an expert in this topic, discusses these new NICE guidelines and how clinicians should use them. R...more

  • The Medical and Political Response to the 2019 Christchurch Mosque Mass Shooting

    Dec 10 2019

    On March 15, 2019, a lone gunman walked into 2 mosques within minutes of each other in Christchurch, New Zealand, and opened fire with semiautomatic weapons, killing 51 and wounding many more. We spoke to Greg Robertson, MB ChB, the surgeon who coordinated the medical response to this mass casualty event. Robertson talks about what his hospital had to do to manage all these casualties and also how New Zealand quickly changed its laws to restrict the availability of weapons used for these sorts o...more

  • What Do I Need to Know About e-Cigarettes and If They Help People Stop Smoking?

    Nov 25 2019

    Electronic cigarette (e-cigarette) use, otherwise known as “vaping,” has been increasing since 2010. This podcast reviews research on the epidemiology and possible adverse health effects of e-cigarette and nicotine use, and the pitfalls associated with using e-cigarettes as a method to stop smoking. These issues are discussed by Suchitra Krishnan-Sarin, PhD, a professor with the Department of Psychiatry at Yale University School of Medicine, and JAMA Associate Editor George O’Connor, a professor...more

  • The Underappreciated Problem of Cardiac Disease in Women

    Nov 18 2019

    Barbra Streisand and Noel Bairey Merz, MD, director of the Streisand Women’s Heart Center at Cedars-Sinai in Los Angeles, California, discuss the problem of cardiovascular disease in women and especially coronary microvascular disease, which causes an unusual presentation of cardiac ischemic disease in women.

  • Review of Atrial Fibrillation Treatment

    Nov 12 2019

    Atrial fibrillation is a very common problem that is treated with a variety of medications and interventions. Sandip Mukherjee, MD, a contributing editor to The Medical Letter, is the Medical Director of Physician Liaison Services with the Office of the Chief Medical Officer at Yale New Haven Hospital, and an associate professor of medicine at Yale. He summarizes the latest information published in The Medical Letter on treatments for atrial fibrillation.

  • Influenza Vaccination in 2019-2020

    Nov 06 2019

    Winter is coming…and with it, the onset of flu season. In this episode, Jean-Marie Pflomm, PharmD, Editor in Chief of The Medical Letter, decodes flu vaccines: trivalent vs quadrivalent, live attenuated vs inactivated, and much more.

  • How Adolescent Boys’ Need for Friendship Affects Their Mental Health

    Nov 05 2019

    Adolescent boys are notoriously difficult to deal with. However, some of their behaviors mask a need they have for developing intimate friendships. Being adolescent boys living in a macho culture, many deny that they need these relationships. Niobe Way, EdD, professor of Developmental Psychology at New York University, has spent her professional career studying adolescent boys’ relationships with each other and how they affect their behaviors. She explains how to intervene to help them better un...more

  • Emerging Applications for Ketamine

    Oct 22 2019

    Even though it gained notoriety for recreational uses, Ketamine is experiencing a resurgence in clinical settings given its versatility and potential applications, including for pain treatment and depression. David Juurlink, MD, from Sunnybrook Health Sciences Center and John Krystal, MD from Yale University discuss current and emerging applications of this drug.

  • Understanding Lipids and Cardiovascular Risk Through Mendelian Randomization

    Oct 08 2019

    Mendelian randomization is a powerful technique that enables investigators to mimic randomized clinical trials by characterizing genetic differences between groups of people and studying their clinical outcomes. Brian A. Ference, MD, MPhil, from the University of Cambridge in England, is a leading expert on this topic and spoke with us about how mendelian randomization has facilitated a better understanding of lipid biology and how it relates to cardiovascular risk.

  • Pancreatic Cancer

    Oct 08 2019

    Pancreatic cancer is the third most common cause of cancer death in the United States. Timothy Donohue, MD, chief of surgical oncology at the University of California, Los Angeles, provides an overview of the disease. Read the articles: Screening for Pancreatic Cancer Pancreatic Cancer  

  • Personal Protective Equipment for Health Care Infection Control

    Oct 07 2019

    Personal protective equipment comprises gloves, gowns, masks, regular respirators, and powered air purifying respirators (PAPRs). In this Clinical Review podcast Trish Perl, MD, of UT Southwestern Medical Center reviews the indications for each and the results of the RESPECT trial, which reported no difference in incidence of laboratory-confirmed influenza among health care personnel randomized to wear N95 respiratory or medical masks. She’s interviewed by JAMA Fishbein fellow Angel Desai, MD.

  • Improving Uptake of Preexposure Prophylaxis (PrEP) for HIV in Primary Care

    Oct 06 2019

    JAMA Fishbein Fellow Angel Desai, MD interviews Douglas S. Krakower, MD at the IDWeek 2019 conference in Washington, D.C. Related article: Rising PrEP Awareness

  • Update in Clinical Infectious Diseases 2019-2020

    Oct 06 2019

    This Clinical Review podcast reviews some of the most important advances in clinical infectious diseases presented at IDWeek 2019 including data on rapid testing, new antimicrobial agents, and new strategies for using existing antibiotics to manage antimicrobial resistance. JAMA Fishbein Fellow Angel Desai, MD interviews Helen Boucher, MD of Tufts University.

  • A New Path for Gun Research Funding

    Sep 10 2019

    Since the passage of the Dickey Amendment in 1996, federal funding for gun violence research has been withheld from the CDC and other federal agencies that should be tasked with figuring out the origins and solutions to this problem. But while the US government has been locked in a political stalemate, other entities are stepping up in a new model for getting the job done.

  • Bariatric Surgery and Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity

    Sep 03 2019

    JAMA Deputy Editor Ed Livingston, MD, interviews Steven Nissen, MD, at the European Society of Cardiology's 2019 conference in Paris, France.

  • Management of Heart Failure in 2019-2020, Part 2

    Sep 02 2019

    JAMA Deputy Editor Ed Livingston, MD, interviews James Januzzi, MD, at the European Society of Cardiology's 2019 conference in Paris, France.

  • Management of Heart Failure in 2019-2020, Part 1

    Sep 02 2019

    JAMA Deputy Editor Ed Livingston, MD, interviews Akshay Desai, MD, at the European Society of Cardiology's 2019 conference in Paris, France.

  • The Influence of Obesity on Cancer

    Aug 20 2019

    Jennifer A. Ligibel, MD, from the Dana-Farber Cancer Institute and Harvard Medical School, Boston, explains how obesity influences the risk of developing cancer and how it influences the prognosis of existing cancer.

  • Responsible Use of Opioids to Treat Cancer Pain

    Aug 06 2019

    Dr. Eduardo Bruera, Chair of the Department of Palliative Care at MD Anderson, discusses how to responsibly manage cancer pain using opioids.

  • Diagnosing Menopause

    Jul 22 2019

    Menopause is inevitable for women. It symptoms are uncomfortable and distressing. For women to best cope with menopause, it is useful to firmly establish the onset so that appropriate counseling can follow. In this podcast, an expert in this field, Nanette Santoro, MD, from the University of Colorado, explains how to diagnose menopause. Read the article: Diagnosing the Onset of Menopause

  • Guns and Suicide

    Jul 16 2019

    Using firearms to commit suicide is one of the most common causes of firearm related deaths. This can happen even in families where it seems highly unlikely to occur. In this podcast, we tell the story of a policeman’s daughter who got a hold of his gun and tried to kill herself.

  • Subclinical Hypothyroidism

    Jul 09 2019

    Subclinical hypothyroidism is common, but it is not clear how best to treat it. Anne R. Cappola, MD, ScM, professor of medicine at the University of Pennsylvania, explains how to manage this important clinical condition. Read the article: Subclinical Hypothyroidism: A Review  

  • The Clinical Ramifications of Dense Breasts

    Jul 02 2019

    There are now 36 states and recent federal legislation that require that clinicians inform women about breast density results from mammography. Consequently, clinicians must be aware of the clinical ramifications of dense breasts and what to do about them when found. Karla Kerlikowske, MD, from UCSF explains the risks associated with dense breasts and how to manage patients who have them. CME will be available on July 2 when the print/online issue of JAMA is published.

  • California’s Attempt to Improve Measles Vaccination Rates

    Jul 02 2019

    California enacted 3 aggressive laws between 2014 and 2016 in an effort to improve measles vaccination rates. To a large extent these laws were effective in increasing vaccination rates, but some of the improvements were offset by clinicians granting inappropriate medical exemptions for vaccinations. S. Cassandra Pingali, MPH, MS, and Saad B. Omer, MBBS, MPH, PhD, from the Department of Epidemiology at Emory University, Atlanta, Georgia, discuss measles and what happened in California when legis...more

  • Reducing the Intensity of Antiplatelet Therapy Following Coronary Stent Procedures

    Jun 25 2019

    A conversation with Greg Curfman, MD, JAMA Deputy Editor and a cardiologist, who reviews 2 new studies showing that a short duration of dual antiplatelet therapy may not result in more myocardial ischemic events. Read the article: Effect of 1-Month Dual Antiplatelet Therapy Followed by Clopidogrel vs 12-Month Dual Antiplatelet Therapy on Cardiovascular and Bleeding Events in Patients Receiving PCI: The STOPDAPT-2 Randomized Clinical Trial  

  • The Gabby Giffords Shooting

    Jun 11 2019

    Over the span of less than a minute, a gunman with a history of mental health issues turned a Safeway parking lot into the scene of a mass shooting, killing 6 and wounding 13 in 20 seconds. In this inaugural episode of the In Our Lane podcast series, we hear the stories of the survivors who wrestled the gunman to the ground and treated the injured during the wait for first responders.

  • Abnormal Uterine Bleeding

    Jun 04 2019

    Andrew M. Kaunitz, MD, from the Department of Obstetrics and Gynecology at the University of Florida, Jacksonville, explains how to diagnose and treat various patterns of abnormal uterine bleeding. Read the article: Abnormal Uterine Bleeding in Reproductive-Age Women  

  • Menopausal Hormone Therapy

    May 30 2019

    Jan L. Shifren, MD, from the department of obstetrics and gynecology, Massachusetts General Hospital, and Harvard Medical School discusses menopausal symptoms such as hot flashes and how they can be effectively treated by the administration of hormones when given appropriately. Read the article: Menopausal Hormone Therapy CME will be available on June 25 when this article appears in the print edition of JAMA.

  • Cervical Cancer Screening

    May 28 2019

    George F. Sawaya, MD, professor of obstetrics and gynecology at the University of California, San Francisco, discusses cervical cancer screening in the modern era. Read the article: Cervical Cancer Screening: More Choices in 2019 Read the transcript  

  • Treating Nonmetastatic Breast Cancer in 2019

    May 07 2019

    Breast cancer outcomes continue to improve. Treatments for the disease are very effective and continually evolving. We spoke with Patricia A. Ganz, MD, from UCLA about what is new in breast cancer treatment. Read the article here.

  • JAMA Women's Health Series Introduction by Dr Carolyn Crandall

    May 07 2019

    Dr Carolyn Crandall, professor of medicine at the David Geffen School of Medicine at UCLA and JAMA Associate Editor, introduces JAMA's new series of articles on women's health.

  • Beyond the Rhetoric: Gun Control That Works, Part 3

    Apr 09 2019

    Congressman Mike Thompson chairs the US House Gun Violence Prevention Taskforce. He spoke with us about what the House has done to address gun violence and what you can do to help them see necessary legislation make it into law. We also talk with Joshua Sharfstein, MD, about strategies that can be undertaken by the physician community to reduce gun violence.

  • How to Reduce Maternal Mortality Rates in the United States

    Apr 02 2019

    Maternal mortality rates in most of the United States are high. These rates were successfully lowered in the United Kingdom and also in California. Many of these deaths are preventable. In this podcast we interview Elizabeth A. Howell, MD, MPP, from the Icahn School of Medicine at Mt Sinai in New York, who explains the relatively simple ways to address this problem. See related article.

  • Beyond the Rhetoric: Gun Control That Works, Part 2

    Mar 26 2019

    Almost nothing is more controversial than gun control in the United States. Yet while passions flare and legislators posture but do little, deaths from gun violence are all too common. Almost every proposal put forward to address gun violence eventually fails. Seemingly, the Second Amendment stops any attempt to control guns. Despite this, there have been commonsense approaches to reducing gun violence that have been very effective in some communities. How gun violence has been managed in these ...more

  • Update on Atrial Fibrillation: Review of the New AHA/ACC/HRS Treatment Guidelines

    Mar 15 2019

    Cardiologist and JAMA Deputy Editor Greg Curfman, MD, discusses the many changes in the new AHA/ACC/HRS atrial fibrillation guidelines with University of Chicago cardiologists Gaurav Upadhyay, MD, and Francis Alenghat, MD, PhD. Major changes include recommendations for the use of various agents for anticoagulation, catheter ablation, and left atrial appendage occlusion. Read the article: Management of Patients With Atrial Fibrillation Index of content: 2:19 Summary of the new ACC/AHA Atrial Fib...more

  • Beyond the Rhetoric: Gun Control That Works, Part 1

    Mar 12 2019

    Almost nothing is more controversial than gun control in the United States. Yet while passions flare and legislators posture but do little, deaths from gun violence are all too common. Almost every proposal put forward to address gun violence eventually fails. Seemingly, the Second Amendment stops any attempt to control guns. Despite this, there have been commonsense approaches to reducing gun violence that have been very effective in some communities. How gun violence has been managed in these ...more

  • Is It Safe? What Happens When Your Surgeon Is Not Actually Doing Some of Your Operation?

    Feb 26 2019

    Great controversy exists regarding the safety of surgery when the attending surgeon allows someone else to perform parts of the operation. These practices are necessary components of surgical training, but how safe this is for patients remains unknown. In this podcast we discuss the risks and benefits associated with overlapping and concurrent surgery with a recognized expert in this topic, Michelle M. Mello, JD, PhD, a professor of law at Stanford University and the Department of Health Researc...more

  • COPD: All You Need to Know in 20 Minutes

    Feb 26 2019

    COPD is common enough that it is responsible for 3% of all clinic visits in the United States. Clinicians will undoubtedly deal with this disease in their practice. How to diagnose and manage it is reviewed by Frank C. Sciurba, MD, a professor of medicine from the University of Pittsburgh, Pennsylvania.

  • Next Generation Sequencing of Infectious Pathogens in Public Health and Clinical Practice

    Feb 14 2019

    Next-generation sequencing is a catchall term for new, high-throughput technologies that allow rapid sequencing of a full genome. It can be used to sequence a patient’s DNA in diagnosing a genetic disorder or characterizing a cancer, but can also be used to sequence the genome of a pathogenic bacteria, virus, fungi, or parasites. In this JAMA clinical review podcast, we talk with authors Marta Gwinn, MD, MPH, and Gregory L. Armstrong, MD, from the CDC, about how next-generation sequencing of inf...more

  • Can I Believe the Results From Observational Studies? Using E-Values That Anyone Can Calculate for Evaluating the Risk of Confounding

    Feb 12 2019

    E-values are a new tool that enables investigators to estimate the likelihood that some unmeasured confounder might overcome seemingly positive results. They are very easy to calculate and any reader of the medical literature can do this calculation to get a sense for how likely it is that there is some unmeasured factor in an observational study that might negate otherwise seemingly positive findings. Read the article: Using the E-Value to Assess the Potential Effect of Unmeasured Confounding ...more

  • Finding a Serious Arrhythmia Using a Watch

    Jan 29 2019

    Saved by a Fitbit. Technology is developing at a pace far exceeding its application in medical care. An exception is in consumer devices, which as long as they do not hold themselves out as diagnostic tools, can apply as many technologies to wearable devices as companies want to put into them. In this episode we discuss how a clinician used a wearable device to diagnose his father's rapid heart rates consistent with dangerous cardiac arrhythmias. Read the article: Wearable Devices for Cardiac R...more

  • Screening for Breast Cancer: Is It Worth It?

    Jan 22 2019

    Breast cancer screening is debated passionately among those who advocate for very aggressive screening and other experts who believe that screening can be harmful. The arguments for all sides of the debate are best understood by knowing the numbers of women who will benefit or be harmed by breast cancer screening. Both sides of the debate are explained in this podcast by Nancy Keating, MD, and Lydia Pace, MD, both from the Brigham and Women's Hospital and Harvard Medical School in Boston.

  • Major Societies Agree – A New Approach to Penicillin Allergy Is Needed

    Jan 15 2019

    Very few people who think they are allergic to penicillin actually are. Yet, even if someone reports a remote and vague history of penicillin allergy, these very useful medications will not be given. This forces many patients to use antibiotics that may be too broad spectrum, not very effective, or expensive. Three major societies have come together to agree on an approach for assessing if penicillin allergy is really present when a patient reports an allergy to these medications. Erica S. Sheno...more

  • Medical Emergencies While Flying

    Dec 21 2018

    When flying and they call "Is there a licensed medical professional on board," should physicians respond? If so, what should they do? Are they liable if things go wrong? We interview Christian Martin-Gill, MD, MPH, Department of Emergency Medicine, University of Pittsburgh, who is an expert on in-flight emergencies and authored a JAMA review on the topic.

  • Bayes for Clinicians Who Need to Know but Don’t Like Math

    Dec 11 2018

    The statistical concept of Bayes comes up in clinical medicine all the time. It simply means that what you know about something factors into how you analyze it. This contrasts with the commonly used statistical approach called frequentist analysis of hypothesis testing, in which it is assumed that every situation is unique and not influenced by the past. Bayesian analysis accounts for how prior information gets factored into decision making and is important to understand when applying clinical r...more

  • Battle of the Heart Societies, Part 2: Who Is Right – the US or Europe Regarding How to Manage Hypertension? Their Differences

    Nov 20 2018

    Within the last 2 years, major guidelines have been issued from US-based and European organizations that differ in their recommendations for the diagnosis and treatment of hypertension. Experts from both sides of the Atlantic--Paul Whelton, MD, from the United States and Bryan Williams, MD, from Europe--discuss the similarities and differences in these guidelines and the basis for the differences. They were interviewed by JAMA editors Greg Curfman, MD, and Ed Livingston, MD. Part 1 [LINK] of thi...more

  • A Family’s Struggle With Alcoholism

    Nov 13 2018

    What is it like to go through alcohol withdrawal at home? What is it like for a mother to sit by her son's side while he goes through withdrawal and supporting him? Why does someone who doesn't have any particular reason to drink misuse alcohol? The answers to these questions can be found by listening to a narrative from one patient and his mother about his descent into alcohol misuse, his experiences with withdrawal, and his eventual overcoming of a dreadful alcohol addiction. Read the article:...more

  • Battle of the Heart Societies: Who Is Right – the US or Europe Regarding How to Manage Hypertension?

    Nov 06 2018

    Within the last 2 years, major guidelines have been issued from US-based and European organizations that differ in their recommendations for the diagnosis and treatment of hypertension. Experts from both sides of the Atlantic—Paul Whelton, MD, from the United States (Tulane University, New Orleans, Louisiana) and Bryan Williams, MD, from Europe (University College London in England)—discuss the similarities and differences in these guidelines and the basis for the differences. They were intervie...more

  • Observations From ICU Patients We Thought Were Asleep, but Were Not

    Oct 23 2018

    What if the patient you are managing in the ICU is not asleep when you thought they were? Patients relate their very disturbing stories about what they experienced while in an ICU and their treating clinicians thought they were asleep.

  • An Update on the Diagnosis and Treatment of Venous Thromboembolic Disease

    Oct 16 2018

    Venous thromboembolic disease is common. There are many steps necessary to establish a diagnosis or treat this disease. These are summarized in this JAMA Clinical Reviews podcast and interview with Philip S. Wells, MD, from the Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada, and author of a recent JAMA review on the topic.

  • Alcohol Withdrawal Syndrome

    Oct 02 2018

    Alcohol withdrawal is a serious problem that can lead to mortality. How to predict if it will occur when a patient who is misusing alcohol is admitted to the hospital is challenging. This Rational Clinical Examination article reports results of a systematic review of the literature to determine the best way to predict the occurrence of alcohol withdrawal. Read the article: Will This Hospitalized Patient Develop Severe Alcohol Withdrawal Syndrome?: The Rational Clinical Examination Systematic Re...more

  • Treating Appendicitis Without Surgery – 5-Year Follow-up From a Randomized Clinical Trial of Antibiotic Treatment

    Sep 25 2018

    In 2015, JAMA published results of a randomized clinical trial showing that antibiotic treatment for acute appendicitis was feasible. Doubters of the efficacy of antibiotics for treating appendicitis were concerned about what the long-term recurrence rate would be for those patients treated without surgery. The 5-year results of the study are now presented, showing that only about 40% of patients treated with antibiotics ultimately go on to have an appendectomy. Read the article: Five-Year Foll...more

  • Treating Lyme Disease in 2018, Part 2

    Sep 18 2018

    There are new findings about another form of Borrelia: Borrelia miyamotoi. This form of Borrelia causes a relapsing fever but is spread in the same way that Lyme disease is. To help understand these new findings we spoke with Eugene Shapiro, MD, from the Department of Pediatrics and Department of Epidemiology of Microbial Diseases at Yale.

  • Treating Lyme Disease in 2018, Part 1

    Sep 11 2018

    In this JAMA Clinical Reviews podcast, we talk to Eugene D. Shapiro, MD, from Yale University School of Medicine for an update on Lyme disease, including new ideas about its diagnosis and treatment.

  • What you need to know about syphilis in 2018

    Sep 04 2018

    Syphilis is on the rise despite prior successful efforts to control it. Why is it coming back and what needs to be done about it? Dr Charles Hicks from UC San Diego explains. This podcast coincides with updated syphilis screening recommendations from the USPSTF that were published in the September 4, 2018 issue of JAMA.

  • Treating Alcohol Use Disorder

    Aug 28 2018

    Up to 7% of the entire US population has alcohol use disorder. It’s important for every clinician to understand how to approach patients to question them about their use of alcohol and to establish a diagnosis when alcohol use disorder is present. Dr Henry Kranzler, from the University of Pennsylvania, is an authority on managing alcohol use disorder and discusses its diagnosis and treatment in this JAMA clinical reviews podcast. Read the article: Diagnosis and Pharmacotherapy of Alcohol Use Di...more

  • Saving Lives by Stopping Bleeding

    Aug 14 2018

    Bleeding is one of the most common preventable causes of death. It is common, yet most people don't know what to do about it when they see it. The Stop the Bleed campaign is an effort to educate the public should they encounter people who are bleeding. Simple maneuvers can have a great beneficial effect. In this JAMA Clinical Reviews podcast, we hear from people with substantial experience in managing bleeding in the field and what they recommend for managing this otherwise deadly problem. Read ...more

  • Working on the Precipice: On the Frontlines of the AIDS Epidemic at the CDC, Part II

    Aug 01 2018

    As the AIDS crisis unfolded, each discovery seemed to lead to a new mystery. Who was at risk? Why was this disease of immune activation so hard for the body to fight? Most important, what could be done to stop it? In the conclusion of this JAMA Clinical Reviews series, we'll continue the story of the small team of CDC clinicians on the frontlines of the AIDS epidemic as they worked to stem the flow of this devastating disease.

  • Working on the Precipice: On the Frontlines of the AIDS Epidemic at the CDC, Part I

    Jul 24 2018

    When AIDS first appeared in the gay community in 1981, it was terrifying for patients and clinicians alike. Nobody knew exactly what was going on. But using basic epidemiologic methods, a small team of public servants at the CDC raced against the clock to unravel the mystery, doing their best to minimize the damage of this rapidly spreading disease.

  • Return of the IUD: Long-acting Reversible Contraception Is Safe and Effective

    Jul 06 2018

    Misplaced fears about IUDs have caused them to be avoided by many women, despite the fact that they are very safe and among the most effective means for contraception. In this JAMA Clinical Reviews podcast, we review long-acting reversible contraception (LARC) and how contraceptive practices were affected by the Dalkon Shield tragedy.

  • Health Care Spending Gone Wild: Using Expensive Insulin Analogs With Few Clinical Advantages

    Jun 23 2018

    Health care spending in the United States is out of control. The most significant aspect of medical care driving this spending is pharmaceuticals; within pharmaceuticals the greatest increases have been in spending for diabetes medications. The cost of insulin analogs has increased 5- to 6-fold in the last 10 years for no particular reason. More than 90% of US patients who use insulin use these analogs, despite the fact that they have few if any clinical benefits relative to regular or NPH insul...more

  • A Goal Too Far: Rethinking HbA1c Targets for Diabetes Treatment

    Jun 19 2018

    The American College of Physicians just changed its guidance for how aggressively to treat type 2 diabetes, relaxing the HbA1c goal to something below 8 rather than 6.5 or 7 as other organizations recommend. This has stirred up substantial controversy. The rationale behind this decision is presented in this podcast. Related article

  • When Will It Stop? Clinicians Are Still Ordering Routine ECGs Despite Recommendations to the Contrary

    Jun 12 2018

    For many years guidelines have recommended against obtaining ECGs for low-risk patients undergoing routine health examinations. Yet about a fifth of all patients having these exams get an ECG. Why? Are clinicians just stubborn or uninformed or are the guidelines missing something clinicians are concerned about? Read the article: The Screening ECG and Cardiac Risks  

  • Replacing the Trachea: An Exciting New Procedure; But How Do We Know It Really Works?

    May 20 2018

    Many attempts to replace the trachea have failed in the past. The most spectacular failure was fraudulent research done in Europe by a high-profile surgeon who was eventually charged with scientific misconduct. JAMA now reports a clinical series of successful tracheal transplants done in France. How do we know the procedures described in JAMA really worked? The answer is provided in this podcast.

  • Update: New Recommendations for Prostate Cancer Screening

    May 08 2018

    The controversy continues about the efficacy of PSA screening for prostate cancer. New recommendations were just issued from the USPSTF about who should be screened for prostate cancer and when. But not everyone agrees with these recommendations. Ballentine Carter, MD, from the Department of Urology at the Johns Hopkins School of Medicine, discusses the new recommendations and provides an expert urologist's perspective on PSA screening for prostate cancer. Related article

  • Peanut Allergy: The Recommendations Have Changed

    Mar 06 2018

    Peanut allergy is common. But it is more common in countries that delay the introduction of peanuts into the diets of infants. Guidelines in the United States previously recommended delayed introduction of peanuts for infants, which resulted in an increased prevalence of peanut allergy. New recommendations now recommend early introduction of peanuts into infants’ diets to minimize the risk of developing peanut allergy. Read the article: Peanut Allergy Prevention

  • What Is New in Acute Respiratory Disease Syndrome?

    Feb 20 2018

    Acute respiratory disease syndrome is characterized by respiratory failure that occurs after someone is acutely ill, usually from a disease that does not primarily involve the lungs. Its cause, diagnosis, and treatment are reviewed in this JAMA Clinical Reviews Podcast for the February 20, 2018 issue

  • Medical Findings In U.S. Government Personnel Reporting Symptoms After Exposure To Sensory Phenomena in Havana, Cuba

    Feb 14 2018

    Douglas H. Smith, MD, of the University of Pennsylvania's Department of Neurosurgery and Center for Brain Injury and Repair, and Randel Swanson II, DO, PhD, of the University of Pennsylvania's Physical Medicine and Rehabilitation department, summarize findings from a clinical evaluation of US government personnel reporting neurologic symptoms after exposure to directional auditory and sensory phenomena during their official postings in Havana, Cuba.