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JAMA Clinical Reviews

Interviews about ideas & innovations in medicine, science & clinical practice. Listen & earn CME credit
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Now displaying: Page 1

In-depth interviews about current ideas and innovation in medicine, science, and clinical practice.

Jul 2, 2020

One of the most common causes for problems we see in manuscripts at JAMA is an inappropriately calculated study sample size. This seemingly mysterious process is explained by Lynne Stokes, PhD, professor of Statistical Science at Southern Methodist University in Dallas, Texas.

Jun 25, 2020

Generalizability of randomized trials is always limited because of the super-selectivity of the patients enrolled in these trials and the very controlled conditions in which clinical care is delivered. Pragmatic trials are performed in order to provide guidance for how to best deliver clinical care in situations that more closely resemble actual clinical scenarios. Hal Sox, MD, director of peer review for the Patient-Centered Outcomes Research Institute (PCORI), explains how these trials work and what clinical questions they answer.

Related:

Pragmatic Trials: Practical Answers to “Real-world” Questions

Jun 2, 2020

Nearly 10% of all patients seen in primary care have depression. Although usually mild, when depression is severe the consequences can be serious. Tom Garrick, MD, professor of Psychiatry at the University of Southern California, discusses the diagnosis and treatment of depression.

Related:

Drugs for Depression

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 

May 5, 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

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 discussed by John J. Marini, MD, professor of medicine at the University of Minnesota.

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

Apr 8, 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.

Apr 7, 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 of an Intervention to Promote Breastfeeding on Asthma, Lung Function, and Atopic Eczema at Age 16 Years: Follow-up of the PROBIT Randomized Trial

Persistence of Childhood Eczema Into Adulthood

Association Between Eczema and Stature in 9 US Population-Based Studies

Healthcare Utilization, Patient Costs, and Access to Care in US Adults With Eczema: A Population-Based Study

Management of Atopic Dermatitis

Anti-IgE Medication Lessens Pediatric Atopic Dermatitis Severity

Atopic Eczema

Apr 3, 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.

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.

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 Epidemic

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.

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.

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 of NASH from a primary care clinician's perspective.

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.

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.

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 related to diet. Pritikin devised his own very low-fat diet that bears his name and the diet is still in use 65 years later.

Related:

The Pritikin Diet

The Lost Lectures from Nathan Pritikin (drmcdougall.com)

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 up, resulting in Pritikin concluding that CVD was related to diet. Pritikin devised his own very low-fat diet that bears his name and the diet is still in use 65 years later.

Related:

The Pritikin Diet

The Lost Lectures from Nathan Pritikin (drmcdougall.com)

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.

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 patient queries via telephone, email, or electronic health record, and the importance of the rapid development of local ability to test for SARS-CoV-2 independent of public health agencies.

Mar 9, 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 spoke with JAMA Editor in Chief Howard Bauchner, MD, about where we are as of today with the SARS-CoV-2 epidemic.

JAMA Coronavirus Resource Center

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 published in relating bad behaviors to having more complications of surgical care.

Related article:

Association of Coworker Reports About Unprofessional Behavior by Surgeons With Surgical Complications in Their Patients

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 should know about this year’s flu season.

CDC's Influenza site

CDC's Weekly U.S. Influenza Surveillance Report

HealthMap Vaccine Finder

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 inflammation.

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