Accelerating Workforce Well-Being
https://jamanetwork.com/journals/jama/fullarticle/2852848
To the Editor A recent JAMA Perspective framed clinician burnout as a systems-level issue, describing lessons from parallels to the patient safety and quality movement.
https://jamanetwork.com/journals/jama/fullarticle/2852848
To the Editor A recent JAMA Perspective framed clinician burnout as a systems-level issue, describing lessons from parallels to the patient safety and quality movement.
What to Know About the New mRNA Flu Vaccine
https://jamanetwork.com/journals/jama/fullarticle/2853094
This Medical News article discusses the role of the first messenger RNA influenza vaccine to receive US Food and Drug Administration approval.
https://jamanetwork.com/journals/jama/fullarticle/2853094
This Medical News article discusses the role of the first messenger RNA influenza vaccine to receive US Food and Drug Administration approval.
Audio Highlights August 14, 2026
https://jamanetwork.com/journals/jama/fullarticle/2853147
Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.
https://jamanetwork.com/journals/jama/fullarticle/2853147
Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.
Blood Tests in the New Colorectal Cancer Screening Guideline
https://jamanetwork.com/journals/jama/fullarticle/2853040
This Medical News article discusses the American Cancer Society’s latest colorectal cancer screening guideline, which now includes a blood test as an option.
https://jamanetwork.com/journals/jama/fullarticle/2853040
This Medical News article discusses the American Cancer Society’s latest colorectal cancer screening guideline, which now includes a blood test as an option.
Drinking Water Contaminants Associated With Uterine Cancer Risk
https://jamanetwork.com/journals/jama/fullarticle/2853041
Common public drinking water contaminants may be linked to an increased risk of uterine cancer, a study published in JAMA Network Open found.
https://jamanetwork.com/journals/jama/fullarticle/2853041
Common public drinking water contaminants may be linked to an increased risk of uterine cancer, a study published in JAMA Network Open found.
Reframing the Approach to High-Risk Electrocardiography Patterns
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2852507
This case report describes the electrocardiogram findings of a patient in their 40s with dizziness and presyncope after hematemesis and multiple black stools.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2852507
This case report describes the electrocardiogram findings of a patient in their 40s with dizziness and presyncope after hematemesis and multiple black stools.
Vaccine Policy in the Face of Low Hepatitis B Immunity
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2852506
Despite the availability of hepatitis A and B vaccinations, a rise in hepatitis A outbreaks and minimal progress in hepatitis B prevention efforts necessitated a collaborative, strategic approach to eliminating hepatitis infection in the US. The Viral Hepatitis—National Strategic Plan: A Roadmap to Elimination for the United States (2021-2025), spearheaded by the US Department of Health and Human Services, was published in 2020 as a framework to achieve this goal, defined by the World Health Organization as a 90% reduction in new chronic infections and a 65% reduction in mortality.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2852506
Despite the availability of hepatitis A and B vaccinations, a rise in hepatitis A outbreaks and minimal progress in hepatitis B prevention efforts necessitated a collaborative, strategic approach to eliminating hepatitis infection in the US. The Viral Hepatitis—National Strategic Plan: A Roadmap to Elimination for the United States (2021-2025), spearheaded by the US Department of Health and Human Services, was published in 2020 as a framework to achieve this goal, defined by the World Health Organization as a 90% reduction in new chronic infections and a 65% reduction in mortality.
A World With Platelets Stored Cold for 21 Days
https://jamanetwork.com/journals/jama/fullarticle/2852958
A platelet transfusion is a small miracle. To get the platelets, a supplier must find donors who will volunteer to spend 2 hours undergoing apheresis. Every platelet unit donated needs complex bacterial testing or expensive pathogen reduction followed by continuous agitation in a thermally controlled shaker at room temperature. After all this, the platelets have a shelf life of only 5 to 7 days, and because the testing takes up most of the first 2 days, the usable window is only 3 to 5 days long. Platelets are fragile, expensive, and perpetually in short supply.
https://jamanetwork.com/journals/jama/fullarticle/2852958
A platelet transfusion is a small miracle. To get the platelets, a supplier must find donors who will volunteer to spend 2 hours undergoing apheresis. Every platelet unit donated needs complex bacterial testing or expensive pathogen reduction followed by continuous agitation in a thermally controlled shaker at room temperature. After all this, the platelets have a shelf life of only 5 to 7 days, and because the testing takes up most of the first 2 days, the usable window is only 3 to 5 days long. Platelets are fragile, expensive, and perpetually in short supply.
Suicide Mortality After Launch of a Suicide and Crisis Lifeline
https://jamanetwork.com/journals/jama/fullarticle/2852956
To the Editor Dr Patel and colleagues report that the national launch of the 988 Suicide and Crisis Lifeline was associated with an 11% reduction in adolescent and young adult suicide deaths (4372 fewer than expected). These findings suggest that a phone-based open-access crisis service achieved what the traditional health care system seldom does—population-level reductions in mortality. Missing from the authors’ discussion is the close connection between suicide and substance use disorders, particularly opioid use disorder (OUD). Suicidal ideation is highly prevalent (25%-40%) in OUD, and the distinction between opioid-related risk taking and suicidality is often clinically ambiguous. In the year after an emergency department visit for nonfatal opioid overdose, survivors experienced 282 excess suicide deaths per 100 000 persons vs a demographically matched general population—an 18-fold increase in risk. National Center for Health Statistics data show that unintentional drug overdose deaths outnumber suicide deaths in the age cohort studied by Patel and colleagues. The authors’ outcome definition excludes unintentional and undetermined-intent drug poisonings (International Classification of Diseases and Related Health Problems, Tenth Revision codes X40-X44 and Y10-Y14), which likely include many unrecognized suicide deaths (more than 20% in one study).
https://jamanetwork.com/journals/jama/fullarticle/2852956
To the Editor Dr Patel and colleagues report that the national launch of the 988 Suicide and Crisis Lifeline was associated with an 11% reduction in adolescent and young adult suicide deaths (4372 fewer than expected). These findings suggest that a phone-based open-access crisis service achieved what the traditional health care system seldom does—population-level reductions in mortality. Missing from the authors’ discussion is the close connection between suicide and substance use disorders, particularly opioid use disorder (OUD). Suicidal ideation is highly prevalent (25%-40%) in OUD, and the distinction between opioid-related risk taking and suicidality is often clinically ambiguous. In the year after an emergency department visit for nonfatal opioid overdose, survivors experienced 282 excess suicide deaths per 100 000 persons vs a demographically matched general population—an 18-fold increase in risk. National Center for Health Statistics data show that unintentional drug overdose deaths outnumber suicide deaths in the age cohort studied by Patel and colleagues. The authors’ outcome definition excludes unintentional and undetermined-intent drug poisonings (International Classification of Diseases and Related Health Problems, Tenth Revision codes X40-X44 and Y10-Y14), which likely include many unrecognized suicide deaths (more than 20% in one study).
Suicide Mortality After Launch of a Suicide and Crisis Lifeline
https://jamanetwork.com/journals/jama/fullarticle/2852955
To the Editor Dr Patel and colleagues’ recent article provides promising evidence that the 988 Suicide and Crisis Lifeline has been successful at preventing suicide death. Indeed, their results comparing “high-uptake” and “low-uptake” states are consistent with a time series analysis of pre–988 Lifeline data that found that daily increases in call volume were associated with daily decreases in suicide deaths. However, the precision of Patel and colleagues’ estimates could be enhanced by accounting for between-state heterogeneity in 988 Lifeline implementation and relevant state-level contextual factors.
https://jamanetwork.com/journals/jama/fullarticle/2852955
To the Editor Dr Patel and colleagues’ recent article provides promising evidence that the 988 Suicide and Crisis Lifeline has been successful at preventing suicide death. Indeed, their results comparing “high-uptake” and “low-uptake” states are consistent with a time series analysis of pre–988 Lifeline data that found that daily increases in call volume were associated with daily decreases in suicide deaths. However, the precision of Patel and colleagues’ estimates could be enhanced by accounting for between-state heterogeneity in 988 Lifeline implementation and relevant state-level contextual factors.
Safety of Antiseizure Medication During DOAC Therapy in Epilepsy
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853050
This cohort study investigates the associations between concomitant antiseizure medication selection and risks of thromboembolic events, major bleeding, and all-cause mortality among adults with epilepsy receiving direct oral anticoagulants (DOACs).
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853050
This cohort study investigates the associations between concomitant antiseizure medication selection and risks of thromboembolic events, major bleeding, and all-cause mortality among adults with epilepsy receiving direct oral anticoagulants (DOACs).
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A Call for Benzodiazepines in Airline Emergency Medical Kits
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853048
This Viewpoint discusses the importance of and considerations for including benzodiazepines in airline emergency medical kits for treating patients who experience seizure during a flight.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853048
This Viewpoint discusses the importance of and considerations for including benzodiazepines in airline emergency medical kits for treating patients who experience seizure during a flight.
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Anti-CD320 Autoantibodies and CNS Vitamin B 12 Deficiency in Idiopathic Myelopathy
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853049
This case-control study reports on a novel antibody associated with idiopathic myelopathy.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2853049
This case-control study reports on a novel antibody associated with idiopathic myelopathy.
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Arginine Treatment and Sickle Cell Disease Pain—A Great STArT, but a Hard End Point
https://jamanetwork.com/journals/jama/fullarticle/2853070
Acute pain episodes, also called pain crises, are a hallmark of sickle cell disease and the leading driver of health care utilization across the lifespan. In the pediatric population, acute pain crises account for more than 70 000 emergency department (ED) visits annually, with many encounters requiring hospitalization. The burden of pain does not end at discharge—nearly 30% of patients discharged from the ED return within days, and similar proportions are readmitted within 30 days of hospitalization. Despite the significant burden of disease, the standard treatment for an acute pain crisis has not significantly changed over decades: intravenous opioids, nonsteroidal anti-inflammatory drugs, and intravenous fluids remain the cornerstone of treatment, carrying well-known risks of opioid dependence, respiratory depression, and edema without addressing the underlying vascular pathophysiology. An urgent need exists for a targeted treatment to address the biology of vaso-occlusion itself, rather than relying on symptom management alone.
https://jamanetwork.com/journals/jama/fullarticle/2853070
Acute pain episodes, also called pain crises, are a hallmark of sickle cell disease and the leading driver of health care utilization across the lifespan. In the pediatric population, acute pain crises account for more than 70 000 emergency department (ED) visits annually, with many encounters requiring hospitalization. The burden of pain does not end at discharge—nearly 30% of patients discharged from the ED return within days, and similar proportions are readmitted within 30 days of hospitalization. Despite the significant burden of disease, the standard treatment for an acute pain crisis has not significantly changed over decades: intravenous opioids, nonsteroidal anti-inflammatory drugs, and intravenous fluids remain the cornerstone of treatment, carrying well-known risks of opioid dependence, respiratory depression, and edema without addressing the underlying vascular pathophysiology. An urgent need exists for a targeted treatment to address the biology of vaso-occlusion itself, rather than relying on symptom management alone.
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Exclusion of HIV-Positive Patients From Sickle Cell Gene Therapy
https://jamanetwork.com/journals/jama/fullarticle/2853060
This Perspective discusses the ethical, scientific, clinical, and manufacturing implications of excluding patients living with HIV from gene therapies for sickle cell disease.
https://jamanetwork.com/journals/jama/fullarticle/2853060
This Perspective discusses the ethical, scientific, clinical, and manufacturing implications of excluding patients living with HIV from gene therapies for sickle cell disease.
Daily Zinc Supplementation for Infection Prevention in Children With Sickle Cell Anemia Research Summary
https://jamanetwork.com/journals/jama/fullarticle/2853058
This trial assessed whether daily zinc supplementation can safely prevent all-cause infection in children younger than 5 years with sickle cell anemia in Uganda.
https://jamanetwork.com/journals/jama/fullarticle/2853058
This trial assessed whether daily zinc supplementation can safely prevent all-cause infection in children younger than 5 years with sickle cell anemia in Uganda.
Review of Prepregnancy Care and Counseling
https://jamanetwork.com/journals/jama/fullarticle/2853068
To the Editor I appreciate the expanded women’s health learning opportunities provided by the JAMA Network journals under the editorial leadership of Linda Brubaker, MD, MS. The comprehensive Review of prepregnancy care and counseling by Dr Cooper and colleagues will be a valuable resource for clinicians caring for women of reproductive age. I am curious whether the authors recommend preconception screening for hepatitis C virus (HCV) infection. The US Preventive Services Task Force, Centers for Disease Control and Prevention, and American College of Obstetricians and Gynecologists recommend screening for HCV infection. Curative antiviral treatment for HCV infection is available.
https://jamanetwork.com/journals/jama/fullarticle/2853068
To the Editor I appreciate the expanded women’s health learning opportunities provided by the JAMA Network journals under the editorial leadership of Linda Brubaker, MD, MS. The comprehensive Review of prepregnancy care and counseling by Dr Cooper and colleagues will be a valuable resource for clinicians caring for women of reproductive age. I am curious whether the authors recommend preconception screening for hepatitis C virus (HCV) infection. The US Preventive Services Task Force, Centers for Disease Control and Prevention, and American College of Obstetricians and Gynecologists recommend screening for HCV infection. Curative antiviral treatment for HCV infection is available.
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Review of Prepregnancy Care and Counseling
https://jamanetwork.com/journals/jama/fullarticle/2853067
To the Editor In reading the otherwise comprehensive article by Dr Cooper and colleagues on prepregnancy care and counseling, we were surprised by the lack of discussion about testing for iron deficiency. Iron deficiency, the world’s most common micronutrient deficiency, is epidemic in young women. Studies of healthy reproductive-aged female patients report that iron deficiency is present in approximately 38% using a ferritin cutoff of 30 μg/L. Questioning for the most frequent etiology, heavy menstrual bleeding, is often absent, and symptoms are frequently normalized and marginalized. In a high-resource population of primigravid patients without symptoms or anemia, iron deficiency was reported in 21%, 47%, and 84%, respectively, at 15 weeks’, 20 weeks’, and 33 weeks’ gestation, with the strongest predictor of severe iron deficiency (ferritin <15 μg/L) in the third trimester being a ferritin level of less than 60 μg/L at 15 weeks’ gestation. Also, McCarthy et al used the Bayley Scales of Infant and Toddler Development to determine that a maternal ferritin level of less than 30 μg/L at 15 weeks’ gestation was associated with statistically and clinically significant decrements in language and motor skills in offspring measured at 2 years. Iron deficiency with and without anemia is associated with disorders that negatively affect patients, such as fatigue, restless legs syndrome, pica, and brain fog. Modeling studies have shown that screening for iron deficiency and treating when identified are cost-effective in reproductive-aged female patients. Screening for iron deficiency prior to pregnancy is now recommended by several societies, including the International Federation of Gynecology and Obstetrics, the European Hematology Association, the American Society of Hematology, and the Haematology in Obstetrics & Women’s Health Collaborative (Australia). Counseling young women considering pregnancy options is an ideal time to screen for iron deficiency given its high incidence and morbidity for both mothers and any future children. Therefore, we agree with the increasing number of society recommendations to screen for iron deficiency in all reproductive-aged female patients and all pregnant patients at presentation, irrespective of the presence or absence of anemia.
https://jamanetwork.com/journals/jama/fullarticle/2853067
To the Editor In reading the otherwise comprehensive article by Dr Cooper and colleagues on prepregnancy care and counseling, we were surprised by the lack of discussion about testing for iron deficiency. Iron deficiency, the world’s most common micronutrient deficiency, is epidemic in young women. Studies of healthy reproductive-aged female patients report that iron deficiency is present in approximately 38% using a ferritin cutoff of 30 μg/L. Questioning for the most frequent etiology, heavy menstrual bleeding, is often absent, and symptoms are frequently normalized and marginalized. In a high-resource population of primigravid patients without symptoms or anemia, iron deficiency was reported in 21%, 47%, and 84%, respectively, at 15 weeks’, 20 weeks’, and 33 weeks’ gestation, with the strongest predictor of severe iron deficiency (ferritin <15 μg/L) in the third trimester being a ferritin level of less than 60 μg/L at 15 weeks’ gestation. Also, McCarthy et al used the Bayley Scales of Infant and Toddler Development to determine that a maternal ferritin level of less than 30 μg/L at 15 weeks’ gestation was associated with statistically and clinically significant decrements in language and motor skills in offspring measured at 2 years. Iron deficiency with and without anemia is associated with disorders that negatively affect patients, such as fatigue, restless legs syndrome, pica, and brain fog. Modeling studies have shown that screening for iron deficiency and treating when identified are cost-effective in reproductive-aged female patients. Screening for iron deficiency prior to pregnancy is now recommended by several societies, including the International Federation of Gynecology and Obstetrics, the European Hematology Association, the American Society of Hematology, and the Haematology in Obstetrics & Women’s Health Collaborative (Australia). Counseling young women considering pregnancy options is an ideal time to screen for iron deficiency given its high incidence and morbidity for both mothers and any future children. Therefore, we agree with the increasing number of society recommendations to screen for iron deficiency in all reproductive-aged female patients and all pregnant patients at presentation, irrespective of the presence or absence of anemia.
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Review of Prepregnancy Care and Counseling—Reply
https://jamanetwork.com/journals/jama/fullarticle/2853066
In Reply We thank Dr Barbieri and Drs Auerbach and DeLoughery for their comments. With regard to Barbieri’s Letter on HCV screening, the US Preventive Services Task Force recommendation is for adults aged 18 to 79 years. We agree with screening reproductive-aged female patients for HCV, as identification of infection and treatment with direct-acting antiviral medications prior to pregnancy can lead to improved maternal health outcomes and reduced perinatal transmission. Auerbach and DeLoughery describe the case for iron deficiency screening in reproductive-aged female patients well. Screening recommendations for iron deficiency vary between professional organizations, as outlined in their recent narrative review. We were unable to find specific recommendations or robust data in prepregnancy counseling studies to support screening for iron deficiency in individuals seeking pregnancy.
https://jamanetwork.com/journals/jama/fullarticle/2853066
In Reply We thank Dr Barbieri and Drs Auerbach and DeLoughery for their comments. With regard to Barbieri’s Letter on HCV screening, the US Preventive Services Task Force recommendation is for adults aged 18 to 79 years. We agree with screening reproductive-aged female patients for HCV, as identification of infection and treatment with direct-acting antiviral medications prior to pregnancy can lead to improved maternal health outcomes and reduced perinatal transmission. Auerbach and DeLoughery describe the case for iron deficiency screening in reproductive-aged female patients well. Screening recommendations for iron deficiency vary between professional organizations, as outlined in their recent narrative review. We were unable to find specific recommendations or robust data in prepregnancy counseling studies to support screening for iron deficiency in individuals seeking pregnancy.
Daily Zinc Supplementation for Infection Prevention in Children With Sickle Cell Anemia
https://jamanetwork.com/journals/jama/fullarticle/2853064
This randomized clinical trial examines the safety and effectiveness of daily zinc supplementation to prevent all-cause infection in children with sickle cell anemia in Uganda.
https://jamanetwork.com/journals/jama/fullarticle/2853064
This randomized clinical trial examines the safety and effectiveness of daily zinc supplementation to prevent all-cause infection in children with sickle cell anemia in Uganda.