Prediction Utility of Urinary Albumin-Creatinine vs Protein-Creatinine Ratios in Chronic Kidney Disease
https://jamanetwork.com/journals/jama/fullarticle/2854453
This study compares the clinical utility of the urinary albumin-creatinine ratio (UACR) vs the the urinary protein-creatinine ratio (UPCR) for prediction of kidney failure, chronic kidney disease (CKD) progression, and cardiovascular outcomes in an established CKD cohort.
https://jamanetwork.com/journals/jama/fullarticle/2854453
This study compares the clinical utility of the urinary albumin-creatinine ratio (UACR) vs the the urinary protein-creatinine ratio (UPCR) for prediction of kidney failure, chronic kidney disease (CKD) progression, and cardiovascular outcomes in an established CKD cohort.
Lifestyle Modification and Incretin Therapy for Individuals With Obesity
https://jamanetwork.com/journals/jama/fullarticle/2854452
To the Editor A recent JAMA Insights article proposed that lifestyle modification be reconceived as an adjunct to incretin-based therapy rather than its foundation, noting that even low-intensity counseling preserves most of the weight loss achieved with semaglutide and tirzepatide. Although this reframing is reasonable for weight reduction, it risks understating when nutritional guidance should be delivered. Pharmacologic suppression of appetite, satiation, and food cravings begins within days of initiation of incretin-based therapy, before many patients have acquired the skills to eat well on substantially diminished oral intake. Counseling that occurs after energy intake reduction is reactive at best; the expertise should be proactive and initiated before therapy is prescribed.
https://jamanetwork.com/journals/jama/fullarticle/2854452
To the Editor A recent JAMA Insights article proposed that lifestyle modification be reconceived as an adjunct to incretin-based therapy rather than its foundation, noting that even low-intensity counseling preserves most of the weight loss achieved with semaglutide and tirzepatide. Although this reframing is reasonable for weight reduction, it risks understating when nutritional guidance should be delivered. Pharmacologic suppression of appetite, satiation, and food cravings begins within days of initiation of incretin-based therapy, before many patients have acquired the skills to eat well on substantially diminished oral intake. Counseling that occurs after energy intake reduction is reactive at best; the expertise should be proactive and initiated before therapy is prescribed.
Lifestyle Modification and Incretin Therapy for Individuals With Obesity—Reply
https://jamanetwork.com/journals/jama/fullarticle/2854451
In Reply The emphasis of the letter by Dr Glatter and Ms Luciani about our recent JAMA Insights article on lifestyle modification and incretin therapy for obesity is that nutritional education and counseling should be a prerequisite to initiating incretin-based therapy. Consistent with recent obesity pharmacologic standards of care and guidelines, we strongly support combining diet and physical activity (ie, lifestyle) modification with obesity medication to achieve critical improvements in adiposity and health. As we have argued, lifestyle counseling is important for attenuating drug-related gastrointestinal adverse effects; preventing nutritional deficiencies; optimizing body composition and physical and psychological function; treating obesity-related complications; and promoting weight loss maintenance. That is why we assert that lifestyle modification is a critical adjunct to pharmacotherapy.
https://jamanetwork.com/journals/jama/fullarticle/2854451
In Reply The emphasis of the letter by Dr Glatter and Ms Luciani about our recent JAMA Insights article on lifestyle modification and incretin therapy for obesity is that nutritional education and counseling should be a prerequisite to initiating incretin-based therapy. Consistent with recent obesity pharmacologic standards of care and guidelines, we strongly support combining diet and physical activity (ie, lifestyle) modification with obesity medication to achieve critical improvements in adiposity and health. As we have argued, lifestyle counseling is important for attenuating drug-related gastrointestinal adverse effects; preventing nutritional deficiencies; optimizing body composition and physical and psychological function; treating obesity-related complications; and promoting weight loss maintenance. That is why we assert that lifestyle modification is a critical adjunct to pharmacotherapy.
Long COVID: The Problem Society Wants to Forget
https://jamanetwork.com/journals/jama/fullarticle/2854450
Long COVID, including the difficulty in defining it and caring for patients experiencing it, is discussed by JAMA Senior Editor Derek C. Angus, MD, MPH, and E. Wesley Ely, MD, MPH, professor of medicine at Vanderbilt University, for this episode of the Healthy Dialogue podcast.
https://jamanetwork.com/journals/jama/fullarticle/2854450
Long COVID, including the difficulty in defining it and caring for patients experiencing it, is discussed by JAMA Senior Editor Derek C. Angus, MD, MPH, and E. Wesley Ely, MD, MPH, professor of medicine at Vanderbilt University, for this episode of the Healthy Dialogue podcast.
Undiagnosed CKD, Outcomes, and Finerenone in Heart Failure
https://jamanetwork.com/journals/jamacardiology/fullarticle/2854529
This secondary analysis of the FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure) randomized clinical trial investigates the prevalence of undiagnosed chronic kidney disease in high-risk individuals with heart failure and its association with cardiovascular outcomes.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2854529
This secondary analysis of the FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure) randomized clinical trial investigates the prevalence of undiagnosed chronic kidney disease in high-risk individuals with heart failure and its association with cardiovascular outcomes.
On Becoming a Gold Standard Scientist
https://jamanetwork.com/journals/jama/fullarticle/2854581
This Viewpoint discusses the recent National Institutes of Health announcement that its Career Development (K) awards cannot be used to conduct clinical trials, feasibility studies, or ancillary studies, which may negatively affect awardees’ ability to lead pilot clinical trials.
https://jamanetwork.com/journals/jama/fullarticle/2854581
This Viewpoint discusses the recent National Institutes of Health announcement that its Career Development (K) awards cannot be used to conduct clinical trials, feasibility studies, or ancillary studies, which may negatively affect awardees’ ability to lead pilot clinical trials.
Research Letters at JAMA
https://jamanetwork.com/journals/jama/fullarticle/2854582
Important research findings do not always require a lengthy manuscript. Research Letters in JAMA offer authors an effective way to communicate focused, timely, and impactful studies in a high-profile journal (2025 Journal Impact Factor = 65.4).
https://jamanetwork.com/journals/jama/fullarticle/2854582
Important research findings do not always require a lengthy manuscript. Research Letters in JAMA offer authors an effective way to communicate focused, timely, and impactful studies in a high-profile journal (2025 Journal Impact Factor = 65.4).
Months, Not Years
https://jamanetwork.com/journals/jama/fullarticle/2854473
In this narrative medicine essay, a newly graduated medical student about to start his orthopedic residency halted his training upon learning his cancer had returned and was inoperable.
https://jamanetwork.com/journals/jama/fullarticle/2854473
In this narrative medicine essay, a newly graduated medical student about to start his orthopedic residency halted his training upon learning his cancer had returned and was inoperable.
Patient Information: Hodgkin Lymphoma
https://jamanetwork.com/journals/jama/fullarticle/2854474
This JAMA Patient Page describes the risk factors, symptoms, and diagnosis of Hodgkin lymphoma along with treatment details and prognosis.
https://jamanetwork.com/journals/jama/fullarticle/2854474
This JAMA Patient Page describes the risk factors, symptoms, and diagnosis of Hodgkin lymphoma along with treatment details and prognosis.
Errors in Results, Figure 3, and Supplement 1
https://jamanetwork.com/journals/jama/fullarticle/2854480
In the Original Investigation titled “Vibration-Controlled Transient Elastography Scores to Predict Liver-Related Events in Steatotic Liver Disease,” published in the March 21, 2024, issue of JAMA, there were errors in the Results, Figure 3, and Supplement 1. In Results, the percentage given as 92.1% should have been 92.6%. In Supplement 1,the number 20.1 in eTable 10 should have been 20.6, the number 1.9 in eTable 17 should have been 11.9, the numbers 31.6 and 23.7 in eTable 18 should have been 3.6 and 237.7, respectively, and the headings “≥30% increase” and “<30% increase” in eTable 21 should have been reversed. In main article Figure 3, the listing “7, 0.01%” should have been “7, 0.1%.” This article was corrected online.
https://jamanetwork.com/journals/jama/fullarticle/2854480
In the Original Investigation titled “Vibration-Controlled Transient Elastography Scores to Predict Liver-Related Events in Steatotic Liver Disease,” published in the March 21, 2024, issue of JAMA, there were errors in the Results, Figure 3, and Supplement 1. In Results, the percentage given as 92.1% should have been 92.6%. In Supplement 1,the number 20.1 in eTable 10 should have been 20.6, the number 1.9 in eTable 17 should have been 11.9, the numbers 31.6 and 23.7 in eTable 18 should have been 3.6 and 237.7, respectively, and the headings “≥30% increase” and “<30% increase” in eTable 21 should have been reversed. In main article Figure 3, the listing “7, 0.01%” should have been “7, 0.1%.” This article was corrected online.
Lipoprotein(a)-Lowering Medication Agent to Reduce Cardiovascular Events
https://jamanetwork.com/journals/jama/fullarticle/2854684
The experimental drug pelacarsen did not reduce the risk of adverse cardiovascular events in a phase 3 study, despite lowering lipoprotein(a) (Lp[a]) levels, the manufacturer announced.
https://jamanetwork.com/journals/jama/fullarticle/2854684
The experimental drug pelacarsen did not reduce the risk of adverse cardiovascular events in a phase 3 study, despite lowering lipoprotein(a) (Lp[a]) levels, the manufacturer announced.
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JAMA Editors' Summary Podcast September 25, 2026
https://jamanetwork.com/journals/jama/fullarticle/2854701
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/2854701
Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.
ACOG Strengthens Recommendation for Fallopian Tube Removal to Prevent Ovarian Cancer
https://jamanetwork.com/journals/jama/fullarticle/2854677
This Medical News article discusses the American College of Obstetricians and Gynecologists’ clinical practice update on opportunistic salpingectomy procedures to prevent ovarian cancer in patients with average risk.
https://jamanetwork.com/journals/jama/fullarticle/2854677
This Medical News article discusses the American College of Obstetricians and Gynecologists’ clinical practice update on opportunistic salpingectomy procedures to prevent ovarian cancer in patients with average risk.
Which Profession Has the Highest Risk of Radiation-Related Cancer Mortality?
https://jamanetwork.com/journals/jama/fullarticle/2854678
This Medical News article discusses findings that pilots and flight attendants have a higher risk of death from radiation-related cancers than other professions and examines what the results may mean for occupational protections for aircrew.
https://jamanetwork.com/journals/jama/fullarticle/2854678
This Medical News article discusses findings that pilots and flight attendants have a higher risk of death from radiation-related cancers than other professions and examines what the results may mean for occupational protections for aircrew.
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Anxiety and Chest Pain
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854608
Each day, in thousands of emergency departments (EDs) across the US, patients seeking unscheduled care for low-risk chest pain hear the refrain: “It’s not your heart.” In most cases, their final diagnosis is the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code R07.9, which is chest pain. This paradigm is frustrating for patients, who want to know: “then what is it?” It is equally unsatisfying for clinicians, who are left to document a diagnosis that is verbatim the same as the chief concern. Many clinicians, and sometimes patients, recognize a metaphorical elephant in the room called anxiety. This rogue elephant unleashes fear and disabling panic attacks. As an emergency physician, I have repeatedly heard patients with panic disorder say that they would rather die than experience another panic attack.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854608
Each day, in thousands of emergency departments (EDs) across the US, patients seeking unscheduled care for low-risk chest pain hear the refrain: “It’s not your heart.” In most cases, their final diagnosis is the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code R07.9, which is chest pain. This paradigm is frustrating for patients, who want to know: “then what is it?” It is equally unsatisfying for clinicians, who are left to document a diagnosis that is verbatim the same as the chief concern. Many clinicians, and sometimes patients, recognize a metaphorical elephant in the room called anxiety. This rogue elephant unleashes fear and disabling panic attacks. As an emergency physician, I have repeatedly heard patients with panic disorder say that they would rather die than experience another panic attack.
Time to Stop Fasting Before Blood Sampling
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854607
Patients are frequently asked to fast before obtaining blood tests. The rationale for fasting is to standardize preanalytical variation of results. However, most people spend the majority of the day in a nonfasting state, making nonfasting tests more representative of the habitual physiological condition. And, despite burdening patients and complicating clinical care, fasting has been shown to be clinically relevant for only a few tests.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854607
Patients are frequently asked to fast before obtaining blood tests. The rationale for fasting is to standardize preanalytical variation of results. However, most people spend the majority of the day in a nonfasting state, making nonfasting tests more representative of the habitual physiological condition. And, despite burdening patients and complicating clinical care, fasting has been shown to be clinically relevant for only a few tests.
Dexmedetomidine Use and ICU Admissions for Patients With Medetomidine Withdrawal
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854606
This cohort study examines trends in dexmedetomidine administration and intensive care unit (ICU) admissions between 2020 and 2025 among hospitalized patients with opioid use disorder in Philadelphia, Pennsylvania.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854606
This cohort study examines trends in dexmedetomidine administration and intensive care unit (ICU) admissions between 2020 and 2025 among hospitalized patients with opioid use disorder in Philadelphia, Pennsylvania.
Concern Regarding Reported Testosterone Measurements
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854605
To the Editor Bhasin et al recently reported the results of the SPIRIT trial, a randomized, placebo-controlled study that evaluated testosterone replacement therapy in prostate cancer survivors with hypogonadism. We would like to seek clarification regarding the baseline testosterone values reported in Table 1. The table header states that total testosterone levels are expressed in nmol/L, with mean (SD) values of 397.7 (152.2) and 395.2 (118.3) in the testosterone and placebo groups, respectively. However, applying the conversion factor provided in the same table footnote (ng/dL × 0.0347 = nmol/L), values of approximately 397 nmol/L would correspond to roughly 11 440 ng/dL, a level far beyond any physiologically plausible range in humans.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854605
To the Editor Bhasin et al recently reported the results of the SPIRIT trial, a randomized, placebo-controlled study that evaluated testosterone replacement therapy in prostate cancer survivors with hypogonadism. We would like to seek clarification regarding the baseline testosterone values reported in Table 1. The table header states that total testosterone levels are expressed in nmol/L, with mean (SD) values of 397.7 (152.2) and 395.2 (118.3) in the testosterone and placebo groups, respectively. However, applying the conversion factor provided in the same table footnote (ng/dL × 0.0347 = nmol/L), values of approximately 397 nmol/L would correspond to roughly 11 440 ng/dL, a level far beyond any physiologically plausible range in humans.
Concern Regarding Reported Testosterone Measurements—Reply
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854604
In Reply We thank the authors for picking up this error in the units for total and free testosterone levels in Table 1 in our article. The units for total testosterone levels should be ng/dL, and the units for free testosterone level should be pg/mL. As stated in the Methods section of the article, the participants were required to have an average of 2 fasting, morning testosterone level of less than 275 ng/dL, and/or a free testosterone level of 70 pg/mL or less, plus 1 or more symptoms of hypogonadism. Some participants with total testosterone levels greater than 275 ng/dL were included based on a free testosterone level of 70 pg/mL or less. As shown in Table 1, although the mean total testosterone level was 396.5 ng/dL, the mean free testosterone level was 50.6 pg/mL. Also, the baseline testosterone levels in randomized trials in men with hypogonadism are typically higher than the screening value because of the regression to the mean phenomenon. The correction to Table 1 has been published.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854604
In Reply We thank the authors for picking up this error in the units for total and free testosterone levels in Table 1 in our article. The units for total testosterone levels should be ng/dL, and the units for free testosterone level should be pg/mL. As stated in the Methods section of the article, the participants were required to have an average of 2 fasting, morning testosterone level of less than 275 ng/dL, and/or a free testosterone level of 70 pg/mL or less, plus 1 or more symptoms of hypogonadism. Some participants with total testosterone levels greater than 275 ng/dL were included based on a free testosterone level of 70 pg/mL or less. As shown in Table 1, although the mean total testosterone level was 396.5 ng/dL, the mean free testosterone level was 50.6 pg/mL. Also, the baseline testosterone levels in randomized trials in men with hypogonadism are typically higher than the screening value because of the regression to the mean phenomenon. The correction to Table 1 has been published.