JAMA Clinical Reviews

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Understanding Stepped-Wedge Clinical Trials Sep 03, 2020

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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.

The Stepped-Wedge Clinical Trial

What Is It Like to Have COVID-19? Sep 01, 2020

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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.

Potential Implications of COVID-19 for the 2020-2021 Residency Application Cycle

Update on Bariatric Surgery—2020 Sep 01, 2020

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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

Update on Ulcerative Colitis—2020 Aug 27, 2020

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The new American College of Gastroenterology guideline on ulcerative colitis is discussed by one of its authors, David T. Rubin, MD, from the Inflammatory Bowel Disease Center at the University of Chicago, and Maylyn Martinez, MD, also from the University of Chicago.

Related Article(s):

Ulcerative Colitis in Adults

Managing Acute Pancreatitis Aug 25, 2020

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Acute pancreatitis can be a devastating disease. Complications of pancreatitis can be minimized by appropriate early, initial management. Joe Hines, MD, and Raman Muthusamy, MD, from UCLA discuss the recent American Gastroenterological Association guideline on managing acute pancreatitis.

Related Article(s):

Initial Management of Acute Pancreatitis

A Physician Gets Cancer Aug 18, 2020

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Patients with serious disease fear the unknown. A physician with a serious disease knows the potential outcomes, making it far more difficult to cope. How does a physician react to developing cancer? Adam Stern, MD, an assistant professor of Psychiatry at Harvard Medical School, developed metastatic renal cell carcinoma when he was just 33 years old. He wrote about his experiences as a cancer patient in a Piece of My Mind article in the March 3, 2020, issue of JAMA and spoke about this to JAMA Clinical Reviews.

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The Secret About Achieving Your Dreams

The Consequences of Not Vaccinating for Measles Aug 14, 2020

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Before COVID-19, even though most children got vaccinated for measles, too many did not, resulting in worsening outbreaks of measles. People forgot how bad a disease measles is and became lax about getting their children vaccinated. Now in the COVID-19 era everyone is aware of what an out-of-control infectious disease can do and we are all anxiously awaiting a COVID-19 vaccine. Will this experience help encourage parents to get their children vaccinated? We discussed the problems of an adequate measles vaccination with Dr. Saad Omer, PhD, from the Yale Institute for Global Health at Yale University in New Haven, Connecticut.

Related Article(s):

Vaccine Refusal and Measles Outbreaks in the US

The Intersection Between Flu and COVID-19 Aug 14, 2020

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As the COVID-19 pandemic continues to spread throughout the world, flu season is almost upon us. This is concerning because there will be an overlap between flu and COVID-19 and patients could get both diseases. Daniel Solomon, MD, from the Division of Infectious Diseases at the Brigham and Women's Hospital of the Harvard Medical School in Boston, discusses COVID-19 and how the flu might pan out this year.

Influenza in the COVID-19 Era

How to Reopen Schools in the COVID-19 Era Aug 13, 2020

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One of the most contentious issues relating to COVID-19 is when to reopen schools. This is a complicated matter because placing people in close quarters risks spread of the disease. Yet children being at home makes it difficult for their working parents to manage their affairs and can potentially affect the learning experience. JAMA Associate Editor Preeti Malani, MD, chief health officer for the University of Michigan, discusses school reopening and how the University of Michigan is addressing this problem.

Association Between Statewide School Closure and COVID-19 Incidence and Mortality in the US

Why Are We Still Talking About Hydroxychloroquine as a Treatment for COVID-19? Aug 13, 2020

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The use of hydroxychloroquine as a treatment for COVID-19 serves as an example of what is wrong with medical information being widely disseminated before it is thoroughly vetted by peer review. Preliminary studies of this treatment modality were spread widely, creating false hope that a treatment for COVID-19 existed. Several randomized trials have shown that hydroxychloroquine is not an effective therapy for COVID-19.

David Juurlink, MD, PhD, from the University of Toronto summarizes the evidence base regarding hydroxychloroquine and COVID-19.

Related Article(s):

Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19)