JAMA Clinical Reviews
370 episodes - English - Latest episode: 4 days ago - ★★★★★ - 413 ratingsAuthor interviews that explore the latest clinical reviews.
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Episodes
Management of Heart Failure in 2019-2020, Part 2
September 02, 2019 06:35 - 11 minutes - 10.4 MBJAMA 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
September 02, 2019 06:30 - 16 minutes - 15.4 MBJAMA 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
August 20, 2019 15:00 - 20 minutes - 19.3 MBJennifer 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
August 06, 2019 15:00 - 29 minutes - 26.7 MBDr. Eduardo Bruera, Chair of the Department of Palliative Care at MD Anderson, discusses how to responsibly manage cancer pain using opioids.
Diagnosing Menopause
July 22, 2019 15:00 - 15 minutes - 14.5 MBMenopause 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
July 16, 2019 15:00 - 27 minutes - 25 MBUsing 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
July 09, 2019 15:00 - 16 minutes - 15.4 MBSubclinical 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
July 02, 2019 17:00 - 23 minutes - 21.7 MBThere 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
July 02, 2019 15:00 - 19 minutes - 18.4 MBCalifornia 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 l...
Reducing the Intensity of Antiplatelet Therapy Following Coronary Stent Procedures
June 25, 2019 15:00 - 11 minutes - 10.9 MBA 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
June 11, 2019 21:00 - 32 minutes - 74.1 MBOver 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
June 04, 2019 15:00 - 34 minutes - 32.2 MBAndrew 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 15:00 - 29 minutes - 27.3 MBJan 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 15:00 - 9 minutes - 8.78 MBGeorge 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 15:00 - 29 minutes - 26.9 MBBreast 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 14:55 - 2 minutes - 2.76 MBDr 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
April 09, 2019 15:00 - 25 minutes - 23.3 MBCongressman 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
April 02, 2019 15:00 - 27 minutes - 25.6 MBMaternal 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
March 26, 2019 15:00 - 26 minutes - 24 MBAlmost 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 th...
Update on Atrial Fibrillation: Review of the New AHA/ACC/HRS Treatment Guidelines
March 15, 2019 15:00 - 42 minutes - 38.8 MBCardiologist 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 ...
Beyond the Rhetoric: Gun Control That Works, Part 1
March 12, 2019 15:00 - 27 minutes - 25.6 MBAlmost 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 th...
COPD: All You Need to Know in 20 Minutes
February 26, 2019 16:00 - 21 minutes - 20.3 MBCOPD 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.
Is It Safe? What Happens When Your Surgeon Is Not Actually Doing Some of Your Operation?
February 26, 2019 16:00 - 24 minutes - 22.7 MBGreat 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 Res...
Next Generation Sequencing of Infectious Pathogens in Public Health and Clinical Practice
February 14, 2019 16:00 - 25 minutes - 23.2 MBNext-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...
Can I Believe the Results From Observational Studies? Using E-Values That Anyone Can Calculate for Evaluating the Risk of Confounding
February 12, 2019 16:00 - 28 minutes - 26 MBE-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 Confou...
Your Watch Can Tell You the Time and If You Are About to Die From a Cardiac Arrhythmia
January 29, 2019 16:00 - 14 minutes - 13.8 MBSaved 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 Car...
Finding a Serious Arrhythmia Using a Watch
January 29, 2019 16:00 - 14 minutes - 13.8 MBSaved 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 Car...
Screening for Breast Cancer: Is It Worth It?
January 22, 2019 16:00 - 17 minutes - 16.7 MBBreast 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
January 15, 2019 16:00 - 35 minutes - 32.8 MBVery 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. S...
Medical Emergencies While Flying
December 21, 2018 16:00 - 29 minutes - 27.2 MBWhen 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
December 11, 2018 17:00 - 28 minutes - 26.2 MBThe 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 clinic...
Battle of the Heart Societies, Part 2: Who Is Right – the US or Europe Regarding How to Manage Hypertension? Their Differences
November 20, 2018 16:00 - 38 minutes - 35.3 MBWithin 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...
A Family’s Struggle With Alcoholism
November 13, 2018 16:00 - 31 minutes - 28.9 MBWhat 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 ar...
Battle of the Heart Societies: Who Is Right – the US or Europe Regarding How to Manage Hypertension?
November 06, 2018 16:00 - 32 minutes - 29.8 MBWithin 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 inte...
Observations From ICU Patients We Thought Were Asleep, but Were Not
October 23, 2018 15:00 - 25 minutes - 23.8 MBWhat 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
October 16, 2018 15:00 - 17 minutes - 16 MBVenous 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
October 02, 2018 15:00 - 20 minutes - 19 MBAlcohol 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 Systema...
Treating Appendicitis Without Surgery – 5-Year Follow-up From a Randomized Clinical Trial of Antibiotic Treatment
September 25, 2018 15:00 - 29 minutes - 27.5 MBIn 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-Yea...
Treating Lyme Disease in 2018, Part 2
September 18, 2018 15:00 - 29 minutes - 27.5 MBThere 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
September 11, 2018 15:00 - 24 minutes - 22.6 MBIn 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
September 04, 2018 15:00 - 30 minutes - 27.8 MBSyphilis 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
August 28, 2018 15:00 - 23 minutes - 22.1 MBUp 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 ...
Saving Lives by Stopping Bleeding
August 14, 2018 15:00 - 21 minutes - 19.7 MBBleeding 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. ...
Working on the Precipice: On the Frontlines of the AIDS Epidemic at the CDC, Part II
August 01, 2018 15:00 - 26 minutes - 24.1 MBAs 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
July 24, 2018 15:00 - 24 minutes - 22.6 MBWhen 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
July 06, 2018 15:00 - 26 minutes - 24.3 MBMisplaced 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
June 23, 2018 14:00 - 27 minutes - 25.2 MBHealth 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 i...
A Goal Too Far: Rethinking HbA1c Targets for Diabetes Treatment
June 19, 2018 15:00 - 29 minutes - 27.3 MBThe 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
June 12, 2018 15:00 - 22 minutes - 25.7 MBFor 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 15:00 - 21 minutes - 20.3 MBMany 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.