Interview with Irfan A. Dhalla, MD, MSc, author of Effect of a Postdischarge Virtual Ward on Readmission or Death for High-Risk Patients

Interview with Ziad Obermeyer, MD, MPhil, author of Association Between the Medicare Hospice Benefit and Health Care Utilization and Costs for Patients With Poor-Prognosis Cancer

Interview with Stefanie Schulz-Schüpke, MD, author of Comparison of Vascular Closure Devices vs Manual Compression After Femoral Artery Puncture: The ISAR-CLOSURE Randomized Clinical Trial

Interview with Mitesh S. Patel, MD, MBA, MS, author of Association of the 2011 ACGME Resident Duty Hour Reforms With Mortality and Readmissions Among Hospitalized Medicare Patients

Interview with Bradley M. Gray, PhD, author of Association Between Imposition of a Maintenance of Certification Requirement and Ambulatory Care-Sensitive Hospitalizations and Health Care Costs

Interview with Frank M. Sacks, MD, author of Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity

Interview with Steven A. Narod, MD, FRCPC, author of Differences in Breast Cancer Stage at Diagnosis and Cancer-Specific Survival by Race and Ethnicity in the United States

Interview with Richard K. Burt, MD, author of Association of Nonmyeloablative Hematopoietic Stem Cell Transplantation With Neurological Disability in Patients With Relapsing-Remitting Multiple Sclerosis

Interview with Peter A. Pinto, MD, author of Comparison of MR/Ultrasound Fusion-Guided Biopsy With Ultrasound-Guided Biopsy for the Diagnosis of Prostate Cancer

Interview with Karl Y. Bilimoria, MD, MS, author of Underlying Reasons Associated With Hospital Readmission Following Surgery in the United States

Interview with Vicky Stergiopoulos, MD, author of Effect of Scattered-Site Housing Using Rent Supplements and Intensive Case Management on Housing Stability Among Homeless Adults With Mental Illness

Interview with Xiaobin Wang, MD, ScD, author of Efficacy of Folic Acid Therapy in Primary Prevention of Stroke Among Adults With Hypertension in China: The CSPPT Randomized Clinical Trial

Interview with Joann G. Elmore, MD, MPH, author of Diagnostic Concordance Among Pathologists Interpreting Breast Biopsy Specimens

Interview with Andrew J. Muir, MD, author of Daclatasvir in Combination With Asunaprevir and Beclabuvir for Hepatitis C Virus Genotype 1 Infection With Compensated Cirrhosis

Interview with Diana W. Bianchi, MD, author of Noninvasive Prenatal Testing and Incidental Detection of Occult Maternal Malignancies

Interview with Shalender Bhasin, MBBS, author of Effects of Testosterone Administration for 3 Years on Subclinical Atherosclerosis Progression in Older Men With Low or Low-Normal Testosterone Levels: A Randomized Clinical Trial

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 Luke Rudmik, MD, MSc, author of Medical Therapies for Adult Chronic Sinusitis: A Systematic Review. This systematic review summarizes the evidence-based medical treatment of adult chronic sinusitis and proposes a treatment algorithm.

Interview with Timothy Fendler, MD, MS, author of Alignment of Do-Not-Resuscitate Status With Patients’ Likelihood of Favorable Neurological Survival After In-Hospital Cardiac Arrest

Interview with David Simel, MD, author of Does This Patient With Chest Pain Have Acute Coronary Syndrome? The Rational Clinical Examination Systematic Review

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

Constipation is one of the most frequent problems clinicians are asked to deal with. Despite how common it is, constipation is frequently not treated adequately. In this podcast, Arnold Wald, MD, explains a stepwise approach to the management of constipation ranging from very simple measures to the most novel and complicated new medical therapies.

Interview with Michael P. Pignone, MD, MPH, author of Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement

Interview with Clifford Deutschman, MD, MS, Mervyn Singer, MD and Derek Angus, MD, MPH, authors of The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

Interview with Lynn Babcock, MD, MS, author of Identifying Children and Adolescents at Risk for Persistent Postconcussion Symptoms

Polypharmacy is a rapidly worsening problem that hits elderly patients particularly hard.  As patients grow older, they need more medications but at the same time become less capable of managing the complexity of drug treatments.  In order to simplify treatment regimens for older patients, it is necessary to consider the evidence supporting treatment of various conditions and when the evidence is not particularly strong, reduce or eliminate medications accordingly.  Diabetes management in the elderly is highlighted in this podcast with specific attention given to deintensifying diabetes treatment in the elderly.

Articles discussed in this episode:

• Polypharmacy in the Aging Patient: Glycemic Control in Older Adults With Type 2 Diabetes: A Review (Kasia J. Lipska, MD, MHS)
• Evaluation and Treatment of Older Patients With Hypercholesterolemia: A Clinical Review (Timo E. Strandberg, MD, PhD)
• Trends in Prescription Drug Use Among Adults in the United States From 1999-2012 (Elizabeth D. Kantor, PhD, MPH)

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

Interview with Wendy C. King, PhD, author of Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity

Mononucleosis is a common disease of young adults manifested by lethargy, fever, pharyngitis, lymphadenopathy and splenomegaly. In this podcast, we review the clinical features of the disease and how good each of them is at establishing a diagnosis of mononucleosis. We also review how Epstein Barr virus was discovered as the cause of mononucleosis and talk to Mark H. Ebell, MD, MS, author of Does This Patient Have Infectious Mononucleosis? The Rational Clinical Examination Systematic Review.

Articles discussed in this episode:

• Does This Patient Have Infectious Mononucleosis? The Rational Clinical Examination Systematic Review (2016)
• Acute Lymphatic Leukemia and Infectious Mononucleosis (1931)
• Infectious Mononucleosis: Part I. Clinical Aspects (1935) 
• Infectious Mononucleosis: Clinical Manifestations in Relation to EB Virus Antibodies (1968)

Interview with Douglas B. White, MD, MAS, author of Prevalence of and Factors Related to Discordance About Prognosis Between Physicians and Surrogate Decision Makers of Critically Ill Patients

Interview with Cynthia L. Ogden, PhD, author of Trends in Obesity Among Adults in the United States, 2005 to 2014

Interview with Jeff D. Williamson, MD, MHS, author of Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years: A Randomized Clinical Trial

Persistent diarrhea is a poorly recognized syndrome in all populations that requires proper assessment and diagnosis to ensure that affected individuals receive the treatment needed to experience improvement of clinical symptoms. Listen to Drs Herbert DuPont and Annie Feagins discuss how to diagnose and treat diarrhea. Related article: Persistent Diarrhea

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 Barbara E. Murray, MD, author of Infectious Disease Expert Sees Threat From Colistin-Resistant Superbug

Interview with Axel Linke, MD, author of Effect of a Cerebral Protection Device on Brain Lesions Following Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis: The CLEAN-TAVI Randomized Clinical Trial

Introducing a new series of JAMA articles on professionalism, discussed from the perspective of how clinicians should address challenging clinical situations and adverse events in their medical practice. In the first episode of the accompanying podcast, JAMA Professionalism: Best Practice, we interview Wendy Levinson, MD, and Jensen Yeung, MD, authors of Disclosure of Medical Error, which appeared in the August 16, 2016 issue of JAMA, as well as Thomas H. Gallagher, MD.

Interview with Francisco A.R. García, MD, MPH, author of Screening for Latent Tuberculosis Infection in Adults: US Preventive Services Task Force Recommendation Statement

Nearly all women experience some element of nausea and vomiting during their pregnancies. In this podcast we review the entire spectrum of disease all the way up to hyperemesis gravidarum and how to provide care for women experiencing these problems.

Article discussed in this episode:

Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy

In this episode of JAMA Professionalism: Best Practice, Edward H. Livingston, MD looks at the case of a physician requesting prescription medication from a colleague to examine professional boundaries between physicians and options for managing those boundaries. Shiphra Ginsburg, MD and Wendy Levinson, MD, authors of the related article, join Dr Livingston to discuss the best options for handling this challenging situation. Arthur S. Hengerer, MD, chair of the Federation of State Medical Boards discusses the legal and licensure ramifications of physicians prescribing for other clinicians and Kate E. Engelhardt, MD, and D. Brock Hewitt, MD, MPH, practicing physicians, relate their experience with other clinicians asking them to prescribe medications.

Medicare recently developed a star rating system to help consumers determine the quality of care delivered at various hospitals. This rating system was considered controversial by many. In this podcast we discuss the rating system with one of its critics, Karl Y. Bilimoria, MD, MS, and with Kate Goodrich, MD, the Director of the Center for Clinical Standards and Quality at Medicare.

Article discussed in this episode:

The New CMS Hospital Quality Star Ratings: The Stars Are Not Aligned

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 Roger L. Zemek, MD, author of Association Between Early Participation in Physical Activity Following Acute Concussion and Persistent Postconcussive Symptoms in Children and Adolescents

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 Maureen G. Phipps, MD, MPH, Task Force member and co-author of Screening for Preeclampsia: US Preventive Services Task Force Recommendation Statement

Whole-genome sequencing is now easily done for very little cost. It is not known how to interpret the results of this testing. Healthy individuals should not have this performed. If someone has a reason to suspect a particular disease with a known genetic association, then whole-genome or targeted sequencing is reasonable to pursue.

Interview with David C. Grossman, MD, MPH, author of Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

Interview with Alex R Kemper, MD, MPH, MS, Task Force member and co-author of Vision Screening in Children Aged 6 Months to 5 Years: US Preventive Services Task Force Recommendation Statement