JAMA Clinical Reviews

Latest Episodes:

Beyond the Rhetoric: Gun Control That Works, Part 3 Apr 09, 2019

Show notes

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

Show notes

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

Show notes

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 communities is reviewed in this podcast with JAMA author April M. Zeoli, PhD, MPH, from the School of Criminal Justice at Michigan State University, Lansing. Part 2 of 3.

Update on Atrial Fibrillation: Review of the New AHA/ACC/HRS Treatment Guidelines Mar 15, 2019

Show notes

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 Fibrillation Guideline

8:04 Cost and efficacy of NOACs used to treat atrial fibrillation

11:42 Preference for specific NOACs

14:00 Rate vs rhythm control

20:00 How catheter ablation is performed

26:20 Anticoagulation requirements following ablation

31:23 How to achieve rate control

32:25 Left atrial appendage occlusion devices

36:29 New lifestyle recommendation

37:44 More about rate vs rhythm control

Beyond the Rhetoric: Gun Control That Works, Part 1 Mar 12, 2019

Show notes

Is It Safe? What Happens When Your Surgeon Is Not Actually Doing Some of Your Operation? Feb 26, 2019

Show notes

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 Research and Policy, Stanford University School of Medicine, California.

COPD: All You Need to Know in 20 Minutes Feb 26, 2019

Show notes

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

Show notes

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 infectious pathogens is being implemented in clinical practice and in public health surveillance for infectious disease.

Can I Believe the Results From Observational Studies? Using E-Values That Anyone Can Calculate for Evaluating the Risk of Confounding Feb 12, 2019

Show notes

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 in Observational Studies

E-Value Calculator

Finding a Serious Arrhythmia Using a Watch Jan 29, 2019

Show notes

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 Rhythm Diagnosis and Management

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