National Academy of Medicine Vital Directions
Vital Directions for Health and Health Care
National Academy of Medicine’s Vital Directions initiative
Since 1883, physicians and health care professionals around the world have turned to JAMA for groundbreaking research and insightful commentary from leaders across the broad spectrum of health care. Subscribe/Learn More
Original Investigation | September 27, 2016
Endovascular Thrombectomy and Outcomes in Ischemic Stroke
This meta-analysis of trials comparing treatment of acute ischemic stroke with vs without endovascular thrombectomy characterizes the threshold time after which treatment is no longer beneficial.
Original Investigation | September 27, 2016 CME
Association Between Lowering LDL-C and CV Risk Reduction
This meta-analysis compares the association between lowering low-density lipoprotein cholesterol (LDL-C) and cardiovascular (CV) risk reduction for statin vs nonstatin therapies that lower LDL-C.
Original Investigation | September 19, 2016 FREE ONLINE FIRST
Medicare Bundled Payments and Joint Replacement
This study evaluates whether the Bundled Payments for Care Improvement initiative of the CMS was associated with a greater reduction in Medicare payments without loss of quality of care for patients with lower extremity joint replacement.
Editorial | Viewpoint
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Clinical Review & Education
The Rational Clinical Examination | September 27, 2016 CME
Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?
This Rational Clinical Examination systematic review summarizes studies that evaluated the diagnostic accuracy of tests for predicting fluid responsiveness in hemodynamically unstable adult patients to better identify patients who would benefit from further fluid administration.
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Viewpoint | September 28, 2016 FREE ONLINE FIRST
Lowering the Bar on the Low-Fat Diet
This Viewpoint by David Ludwig assesses the lessons learned from US nutrition recommendations to limit fat intake and the continuing increase in obesity and diabetes and discusses the challenges inherent in scientific evidence regarding nutrition.
Viewpoint | September 22, 2016 FREE ONLINE FIRST
Black Gains in Life Expectancy
This Viewpoint discusses the narrowing life-expectancy gap between the US black and white populations and points out categories of disease and death that could further narrow the gap.
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Medical News & Perspectives
Medical News & Perspectives | September 21, 2016 FREE ONLINE FIRST
Pharmacogenomics Into the Clinic
This Medical News article discusses barriers to widespread implementation of genotype-guided prescribing.
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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?”
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USPSTF Recommendation Statement: Screening for Colorectal Cancer
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Ultrasound Examination of the Inferior Vena Cava
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JAMA Editor's Audio Summary
September 27, 2016
Reading by Graham McMahon, author of Advancing Continuing Medical Education
Health Care Reform
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| Complete the CME Activity
Painless Vesicular Eruption on the Dorsal Surfaces of the Hands
A 67-year-old man with a history of heavy smoking and alcohol consumption presented with painless vesicles and milia on the dorsal surfaces of the hands. Results of a basic laboratory tests were normal; liver function tests revealed elevated levels of bilirubin, AST, and ALT.
What would you do next?
A Public Health Perspective on Mental and Medical Comorbidity
For your patients: Diagnosis and Treatment of Pancreatic Cystic Neoplasms.
Past JAMA Patient Pages are available in English and Spanish.
It’s Time to Change the Rules
JAMA offers a 4-week elective in medical editing to third- and fourth-year US medical students. The elective is full-time and must be taken for academic credit. For information and an application, please email email@example.com.
Zika: Worse Than Thalidomide?
HIV Awareness and Testing, 2013 AND 2014
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