Interview with Anne R. Cappola, MD, ScM, author of Subclinical Thyroid Dysfunction and Fracture Risk: A Meta-analysis

Interview with Krista F. Huybrechts, MS, PhD, author of Antidepressant Use Late in Pregnancy and Risk of Persistent Pulmonary Hypertension of the Newborn

Interview with Eve Hill, JD, author of The ADA, Disability, and Identity

Interview with Deborah A. Levine, MD, MPH, author of Trajectory of Cognitive Decline After Incident Stroke

Interview with Drew Altman, PhD and William Frist, MD, authors of Medicare and Medicaid at 50 Years: Perspectives of Beneficiaries, Health Care Professionals and Institutions, and Policy Makers

Interview with Rachel E. Patzer, PhD, MPH, author of Variation in Dialysis Facility Referral for Kidney Transplantation Among Patients With End-Stage Renal Disease in Georgia. This population epidemiology study uses United States Renal Data System data to characterize dialysis facility–level referral for kidney transplant evaluation in Georgia, the US state with the lowest transplantation rates, and patient and facility factors associated with referral and waitlisting.

Interview with Jeffrey L. Cummings, MD, ScD, author of Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia: A Randomized Clinical Trial

Interview with Elizabeth T. H. Fontham, MPH, DrPH, author of Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society, Nancy L. Keating, MD, MPH, author of New Guidelines for Breast Cancer Screening in US Women, and Evan R. Myers, MD, MPH, author of Benefits and Harms of Breast Cancer Screening: A Systematic Review

Interview with David A. Asch, MD and Kevin G. Volpp, MD, PhD, authors of Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels: A Randomized Clinical Trial

Edward H. Livingston, MD, Deputy Editor of Clinical Reviews and Education discusses prostate cancer screening with Otis Brawley, MD, author of Prostate Cancer Incidence and PSA Testing Patterns in Relation to USPSTF Screening Recommendations and David F. Penson, MD, MPH, author of a related editorial entitled The Pendulum of Prostate Cancer Screening.

Interview with Thomas L. Schwenk, MD, author of Resident Depression: The Tip of a Graduate Medical Education Iceberg

The 2015-2020 US Dietary Guidelines for Americans were recently released. They are intended to provide guidance for health policy officials and clinicians regarding healthy diets and establishing goals for improving nutrition. These are important since bad eating habits are the underlying cause for a great deal of disease in the US and that these guidelines influence the operations of programs such as school lunch assistance, meals on wheels etc. Because these guidelines influence policy, they have been criticized by various investigators and special interest groups. Karen DeSalvo, MD, Acting Assistant Secretary for Health at HHS and author of Dietary Guidelines for Americans responds to some of these criticisms and explains how the guideline was created and what it is intended to do. Implementation of the guidelines dietary advice may be challenging and Deborah Clegg, RD, PhD, Professor of Internal Medicine at UCLA discusses how the various recommendations can be followed.

An opioid abuse epidemic now plagues US healthcare. It was caused, in part, by overzealous advocacy for controlling chronic pain resulting in overuse of narcotics. There are now 2 million Americans addicted to opioids. The approach for treating chronic pain must change. In this podcast, we summarize recent CDC guidelines for the proper use of opioids for treating chronic pain.

Articles discussed in this episode:

• CDC Guideline for Prescribing Opioids for Chronic Pain— United States, 2016,
• The CDC Guideline on Opioid Prescribing: Rising to the Challenge (Yngvild Olsen, MD, MPH),
• The DSM-V definition for opioid use disorder and 11 point checklist

Christine Curry, MD, PhD, assistant professor of obstetrics and gynecology at the University of Miami, discusses the challenges of keeping pregnant patients and her colleagues well-informed of the facts as Zika virus fears circulate.

Interview with Ezekiel J. Emanuel, MD, PhD, author of Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada, and Europe

Richard N. Rosenthal, MD discusses a randomized clinical trial demonstrating the efficacy of an implantable buprenorphine-releasing device for treating opioid use disorder.

Interview with David Grossman, MD, author of Screening for Lipid Disorders in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

Edward H. Livingston, MD, discusses the British Columbia Ministry of Health’s 2015 guidelines on clinical management of opioid use disorder in adults with Keith Ahamad, MD,  Evan Wood, MD, PhD, ABIM, FRCPC, Tony L. Yaksh, PhD, and Humayun J. Chaudhry, DO, MS, MACP, FACOI.

Articles and resources discussed in this episode: 

• Opioid Use and Addiction Microsite,
• Clinical Management of Opioid Use Disorder (JAMA Clinical Guidelines Synopsis),
• The Vancouver Opioid Use Disorder Guideline,
• Model Policy on DATA 2000 And Treatment of Opioid Addiction in the Medical Office

When managing septic shock, passive leg raising is the best test to determine if a patient is likely to respond to a fluid bolus, better than CVP lines or even bedside ultrasound. Dr Najib Ayas, Associate professor of Critical Care Medicine at the University of British Columbia, discusses shock management from the context of his Rational Clinical examination article in the September 27, 2016 issue of JAMA, entitled “Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?”

Approximately one-third of all medical school graduates report having been abused as students. Medical student and resident abuse has long been considered unacceptable behavior but still persists in the teaching environment. In this podcast we discuss how students and residents might respond to these events. We interview Geoffrey Young, MD, from the Association of American Medical Colleges and Thomas J. Nasca, MD, from the Accreditation Council for Graduate Medical Education, who discuss how they expect medical schools to respond to abusive behaviors and what resources are available to students and residents who have been abused to report those experiences without fearing retribution.

Article discussed in this episode:

Medical Student Mistreatment

Interview with Alex R. Kemper, MD, MPH, MS, Task Force member and co-author of Folic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement

In 2017 the Society for Critical Care Medicine updated its guidelines for sepsis management. These new guidelines differ significantly from ones in the past in that they no longer recommend protocolized resuscitation and emphasize early and aggressive fluid resuscitation when patients present with septic shock. This is the first podcast in the Surviving Sepsis guideline series. The next episode discusses why the new sepsis guideline changed.

Article discussed in this episode: Management of Sepsis and Septic Shock

Speakers:

Laura Evans, MD, MSc, of Bellevue Hospital and NYU Medical Center

Andrew Rhodes, MBBS, MD, of St George’s University Hospitals NHS Trust and co-chair of the Surviving Sepsis guideline panel

Mitchell M. Levy, MD, of the Alpert Medical School of Brown University and Rhode Island Hospital

Recent guidelines for how to best manage septic shock have changed. Gone are recommendations for central venous oxygen saturation monitoring and goal-directed therapy. In is the concept that septic shock be treated as an emergency with rapid administration of antibiotics and large amounts of fluids. Our discussants Derek C. Angus, MD, MPH, and Michael D. Howell, MD, MPH, discuss why these recommendations have changed. This is the second podcast in the Surviving Sepsis guideline series. The first podcast reviewed what recommendations are in the guideline itself.

Article discussed in this episode: Management of Sepsis and Septic Shock

Speakers: JAMA Associate Editor Derek C. Angus, MD, MPH, University of Pittsburgh, and Michael D. Howell, MD, MPH, University of Chicago.

Interview with Charles Landefeld, MD, author of Screening for Thyroid Cancer: US Preventive Services Task Force Recommendation Statement

Interview with Stuart M. Butler, PhD, MA, BSc, author of State Flexibility for Medicaid: How Much?

Interview with Alex R Kemper, MD, MPH, MS, Task Force member and co-author of Screening for Adolescent Idiopathic Scoliosis: US Preventive Services Task Force Recommendation Statement

Interview with Alan Leshner, PhD, author of Medication-Based Treatment to Address Opioid Use Disorder

Interview with Paul A. Volberding, MD, and Hyman Scott, MD MPH, authors of HIV Screening and Preexposure Prophylaxis Guidelines: Following the Evidence

Interview with Yngvild Olsen, M.D., M.P.H., author of Lessons Learned From the Opioid Epidemic

Interview with Anna D. Sinaiko, Ph. D., author of What Is the Value of Market-Wide Health Care Price Transparency?

Interview with Benjamin Daniel Sommers, MD, PhD, author of Medicaid Expansion and Health: Assessing the Evidence After Five Years

Interview with Francisco G. Cigarroa, MD, author of The Advancing American Kidney Health Executive Order: An Opportunity to Enhance Organ Donation

Interview with Deborah Dowell, M.D., M.P.H., author of Patient-Centered Reduction or Discontinuation of Long-term Opioid Analgesics: The HHS Guide for Clinicians

Interview with Pascale Carayon, PhD, author of Improving the System to Support Clinician Well-being and Provide Better Patient Care

Interview with Anthony S. Fauci, MD, author of Comorbidities in Persons With HIV: The Lingering Challenge

Interview with Maya M. Hammoud, MD, MBA, author of Improving the Residency Application and Selection Process: An Optional Early Result Acceptance Program

In February 2020 the nature of the 2019-nCoV outbreak is still slowly coming into focus but it appears to be acting more like bad pandemic influenza (efficient spread, overall lower mortality) than like SARS (less efficient spread, overall higher mortality). Anthony Fauci, MD, of the US National Institute of Allergy and Infectious Diseases (NIAID) discusses the latest developments with JAMA Editor in Chief Howard Bauchner.

Coronavirus Resource Center

By mid-February 2020 there were 60,000 confirmed cases of COVID-19, the vast majority diagnosed in Hubei Province (including Wuhan city) in mainland China. China CDC Chief Epidemiologist Zunyou Wu, MD, PhD discusses the latest COVID-19 developments in the country with JAMA Editor in Chief Howard Bauchner, MD.

Coronavirus testing, mortality, vaccine development, containment vs mitigation, and more. JAMA Editor Howard Bauchner, MD, interviews US NIAID Director Anthony Fauci, MD, about the latest developments in SARS-CoV-2 science and global spread of infection.

JAMA Coronavirus Resource Page

Interview with Victor M. Montori, MD, MSC, author of When Guidelines Recommend Shared Decision-making

Diagnostic testing, NSAIDs, ACE Inhibitors, antivirals, and more. Anthony Fauci, MD from NIAID discusses latest developments in the spread and clinical management of COVID-19 and the SARS-CoV-2 virus with JAMA Editor Howard Bauchner, MD.

JAMA Coronavirus Resource Center

The strategy for managing the COVID-19 pandemic has shifted from containment to mitigation. What does that mean for US hospitals and health systems? Kaiser Permanente Executive Vice President Stephen M. Parodi, MD, discusses telemedicine, protecting health care workers, equipment allocation planning, and more.

As COVID-19 spreads globally, populations who survive their illness will become immune. Mayo Vaccine Research Group Director Gregory Poland, MD, discusses antibody responses, duration of immunity, vaccine safety, and the prospects for using convalescent serum to passively immunize people unexposed to SARS-CoV-2.

Hospitals need ways to make rational, fair decisions about who gets ICU beds and ventilators if COVID-19 patients overwhelm capacity. Douglas B. White, MD, MAS, Director of the Program on Ethics and Decision Making in Critical Illness at the University of Pittsburgh, discusses a framework for those decisions and a guideline he helped develop for allocation of scarce resources in public health emergencies.

How does the current pandemic compare to historical infectious outbreaks and what can we expect in summer and fall of 2020? Nicholas Christakis, MD, PhD, MPH, director of the Human Nature Lab, Co-director of the Institute of Network Science, and Sterling Professor of Social and Natural Science at Yale University, discusses the epidemiology of COVID-19.

Noninvasive ventilation (NIV), working with dying patients’ families, use of experimental therapies, and more. JAMA Associate Editor Derek Angus, MD, MPH, Distinguished Professor and Chair of Critical Care Medicine at the University of Pittsburgh, provides a COVID-19 ICU management update.

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Infectious epidemics have always driven change and triggered discrimination in human societies. Frank Snowden, DPhil, Professor Emeritus of History and History of Medicine at Yale University and author of Epidemics and Society: From the Black Death to the Present (Yale University Press, 2019), puts the COVID-19 pandemic in historical context.

Questions about testing, chloroquine toxicity, duration of immunity and reinfection, and what to expect next are gripping the US as the novel coronavirus spreads. JAMA Associate Editor Preeti Malani, MD, professor of medicine and Chief Health Officer at the University of Michigan, discusses recent developments in a live conversation with JAMA Editor in Chief Howard Bauchner. Recorded on April 6, 2020.

New York City coronavirus update from Mitchell Katz, MD, President and CEO of NYC Health + Hospitals, the largest municipal public health system in the United States. Recorded April 13, 2020.

Interview with Jeffrey A. Linder, MD, author of Delayed Antibiotic Prescriptions in Ambulatory Care: Reconsidering a Problematic Practice