Jama Clinical Reviews: Interviews About Ideas & Innovations In Medicine, Science & Clinical Practice. Listen & Earn Cme Credi

Roger J. Lewis, MD, PhD, discusses Randomization in Clinical Trials from the JAMA Guide to Statistics and Methods Related Article(s): Randomization in Clinical Trials

Judith Lieu, MD, from the Department of Otolaryngology–Head & Neck Surgery at Washington University in St Louis, discusses the need for screening young children for hearing loss and the importance of treating hearing loss as early in life as is possible. Related Article: Hearing Loss in Children

Certificates of Need are regulations required by some states before any construction or expansion of services at medical facilities are undertaken. Originally developed to prevent excessive construction of expensive health care facilities, these rules have distorted health care markets and probably should be repealed. Karl Bilimoria, MD, from Northwestern University, Tarik K Yuce, MD, and JAMA Associate Editor Karen Joynt Maddox, MD, from Washington University, discuss the current status of these regulations and their effect on health care markets. Related Article(s): Association of State Certificate of Need Regulation With Procedural Volume, Market Share, and Outcomes Among Medicare Beneficiaries

Mark Litwin, MD, chair of Urology at the UCLA School of Medicine, discusses the evaluation of hematuria and also the presentation, diagnosis, and treatment of bladder cancer. Related Article(s): Bladder Cancer

Are e-cigarettes helpful or harmful as a tool to help people stop smoking? Mark J. Eisenberg, MD, MPH, from the Jewish General Hospital and McGill University in Montreal, Canada, discuss a recent clinical trial he reported in the November 10, 2020, issue of JAMA examining the efficacy of e-cigarettes as a smoking cessation aid. Related Article: Effect of e-Cigarettes Plus Counseling vs Counseling Alone on Smoking Cessation

There are hundreds of thousands of liver transplant patients, all of whom will be seen in general clinical practices. It is common for them to develop elevated liver enzymes--a potentially serious problem that may be a sign that the transplanted liver is failing. Traditionally, patients with these findings are sent to a liver transplant center for an inpatient workup. A new protocol facilitating management of most of these patients in routine outpatient clinics has been developed, greatly improving the efficiency of managing patients with this clinical problem. Fady Kaldas, MD, director of the Dumont-UCLA transplant center, discusses how to manage elevated liver function results in liver transplant patients on an outpatient basis. Related Article(s): Outpatient Management of Liver Function Test Abnormalities in Patients With a Liver Transplant

A new multisociety guideline was recently released suggesting that for many patients, the interval between colonoscopies following polyp resection is less than previously recommended. Cecelia Zhang, MD, Duke University, and Maylyn Martinez, MD, University of Chicago, discuss the new guideline. Related Article: Recommendations for Follow-up Colonoscopy After Polypectomy

Tim Uyeki, MD, chief medical officer for the Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), discusses how the COVID-19 pandemic may affect the 2020-2021 influenza season. Related Article(s): Preparing for the 2020-2021 Influenza Season

The Platelet Inhibition and Patient Outcomes (PLATO) trial showed that ticagrelor had better outcomes than clopidogrel for avoiding thrombotic complications following acute coronary syndrome. Subsequent trials suggested that the outcomes for the drugs were about the same. The effects of ticagrelor and clopidogrel were examined in a very large observational study performed by Harlan Krumholz, MD, and colleagues, published in the October 27, 2020, issue of JAMA. Dr Krumholz explains how his study was performed and what it showed. Related Article: Association of Ticagrelor vs Clopidogrel With Net Adverse Clinical Events in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention ohdsi.org

Many people are hoping that enough people develop resistance to COVID-19, either from being exposed to the disease or from vaccination, to develop herd immunity that will enable society to return to normal. But will that happen? Saad Omer, MD, from the Yale Institute for Global Health, discusses his JAMA article on herd immunity and how much we can count on having it to return society to normal from this COVID-19 pandemic. Related Article(s): Herd Immunity and Implications for SARS-CoV-2 Control

David Juurlink, MD, PhD, a clinical pharmacologist and professor of internal medicine at Sunnybrook Health Sciences Centre and professor of medicine at the University of Toronto, discusses 10 things new doctors should know about drugs and thir complications as they start practicing medications in the the fourth and final episode of this series.

One of the most important things clinicians can do is help patients and their families deal with impending death. Despite its importance, this part of medical care is hardly covered in medical training. Clinicians have to learn this on their own. One of the most powerful ways to find out what it’s like is to go through it yourself. Martin F. Shapiro, MD, professor of medicine at the Weill Cornell School of Medicine, describes along with his sister, Lori Shapiro, what they went through in dealing with their mother’s death. Dr Shapiro relates what he learned to more effectively manage his patients and their families in coping with the end of life. Related Article(s): The Last Breath—Enriching End-of-Life Moments

Sweden’s response to the COVID-19 pandemic differed from its neighbors in Europe. Lockdowns were minimized with the belief that they would be more damaging than the virus itself. Much criticism was levied at the country regarding these policies. Anders Tegnell, MD, is the head of the Department of Public Health Analysis and Data Management, Deputy Director General at the Public Health Agency of Sweden, and had been Sweden's state epidemiologist since 2013. He discusses what Sweden did in response to COVID-19 and what their outcomes were. Related Article: COVID-19 and Health Equity—A New Kind of “Herd Immunity”

In the 13 years since the American Thoracic Society and Infectious Diseases Society of America have issued guidelines for the treatment of community-acquired pneumonia much has changed, resulting in a new guideline with 16 major recommendations. These are reviewed by Maylyn Martinez, MD, from the Department of Medicine at the University of Chicago and JAMA Network Open Associate Editor Angel Desai, MD, from the Department of Medicine at the University of California at Davis. Related Article: Diagnosis and Treatment of Adults With Community-Acquired Pneumonia

Intimate partner violence--also known as domestic abuse--may affect as many as 1 in 3 women. It’s often underreported but that shouldn’t be the case. Harriet L. MacMillan, MD, from the Departments of Psychiatry & Behavioral Neurosciences and Pediatrics at McMaster University, discusses how to identify and intervene in intimate partner violence. Related Article(s): Intimate Partner Violence

When trying to administer its qualifying examination during the COVID-19 shutdowns, the American Board of Surgery failed. Jo Buyske, MD, president and chief executive officer of the American Board of Surgery, discusses what went wrong and what they are doing to fix it. Related Article: Association Between Resident Physician Training Experience and Program-Level Performance on Board Examinations

A new clinical trial suggests that obstructive sleep apnea (in patients unable to tolerate treatment with CPAP or other devices) can be treated with airway surgery. The author of the study published in JAMA, Stuart MacKay, MBBS, from the University of Wollongong, Australia, discusses the study and treatments for obstructive sleep apnea. Related Article: Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive Sleep Apnea

Cluster randomized trials are performed when an intervention must be delivered to a group of patients like when testing new nursing protocols on award or different means for cleaning beds on a ward. One type of cluster trials is called a stepped-wedge where every cluster in the study ultimately undergoes the intervention. How this works it is explained by Susan Ellenberg, PhD, from the Department of Biostatistics, Epidemiology, and Informatics at the University of Pennsylvania School of Medicine. Related Article: The Stepped-Wedge Clinical Trial

Bariatric surgery is unequivocally the most effective means for inducing weight loss and managing diabetes for obese patients. There are numerous other benefits for these operations including improved long-term cardiovascular outcomes. David Arterburn, MD, MPH, a senior investigator from the Kaiser Permanente Washington Health Research Institute, discusses bariatric surgery outcomes. Related Article(s): Benefits and Risks of Bariatric Surgery in Adults

COVID-19 continues to rapidly spread throughout the world. In the past few months, the population affected by the disease has shifted from older to younger patients. Public health officials are concerned that younger people seem not to be very compliant with recommendations regarding masking and social distancing. It is believed that younger people think that the adverse consequences of the disease occur in the elderly and not in them. Garrett Salzman, MD, is a resident physician at UCLA and contracted the disease. He is young and healthy, but he has had substantial disability from COVID-19. He tells a cautionary tale of his experience with COVID-19 that this is not a benign disease in young people, that they need to be careful. Related Article: Potential Implications of COVID-19 for the 2020-2021 Residency Application Cycle