JAMA, in continuous publication since 1883, is an international peer-reviewed general medical journal published 48 times per year. The Editor in Chief of JAMA is Howard Bauchner, MD. JAMA has complete editorial independence of its owner and publisher, the American Medical Association. See JAMA’s Key and Critical Objectives. JAMA is the most widely
circulated general medical journal in the world. The online version is made freely available to institutions in developing countries.
Manuscripts should be submitted online via the JAMA online manuscript submission and review system at http://manuscripts.jama.com. For more information, see Manuscript Submission.
JAMA, 330 N Wabash Ave, Chicago, IL 60611-5885, USA; telephone: (312) 464-4444 or (312) 464-2402; fax: (312) 464-5824; email: email@example.com.
Editorial Policies for Authors
Most of JAMA’s editorial policies for authors are summarized in these instructions. Citations and links to the AMA Manual of Style1 and other publications with additional information
are also provided.
Authorship Criteria and Contributions and Authorship Form
Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. One or more
authors should take responsibility for the integrity of the work as a whole, from inception to published article. According to the guidelines of the
International Committee of Medical Journal Editors (ICMJE) as revised in 2013,2 authorship credit should be based on the following 4 criteria: (1) substantial contributions to conception or design of the work, or the acquisition, analysis, or interpretation of data for the work; and (2) drafting of the work or revising it critically for important intellectual content; and (3) final approval of the version to be published; and (4) agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Each author should be accountable for the parts of the work he or she has done. In addition, each author should be able to identify which coauthors are responsible for specific other parts of the work and should have confidence in the integrity of the contributions of any coauthors.
All those designated as authors should meet all 4 criteria for authorship, and all who meet the 4 criteria should be identified as authors. Those who do not meet all 4 criteria should be acknowledged (see Acknowledgment Section).
All authors (ie, the corresponding author and each coauthor) must read, complete, and submit an electronic Authorship Form with signed statements on Authorship
Responsibility, Criteria, and Contributions; Confirmation of Reporting Conflicts of Interest and Funding; and Publishing
Agreement.1(pp128-133) In addition, authors are required to identify their contributions to the work described in the manuscript.
An email with links to the Authorship Form will be sent to authors for completion after manuscripts have been submitted (see sample Authorship Form).
For reports of original data and systematic reviews, authors’ specific contributions will be published in the Acknowledgment section (see
Manuscript Preparation and Submission Requirements, Acknowledgment Section).1 All other persons who have made substantial contributions to the work
reported in this manuscript (eg, data collection, analysis, or writing or editing assistance) but who do not fulfill the authorship criteria should be
named with their specific contributions and affiliations in an Acknowledgment in the manuscript. Written permission to include the names of individuals in the
Acknowledgment section must be obtained (see Manuscript Preparation and Submission Requirements, Acknowledgment Section).
The authors also must certify that the manuscript represents valid work and that neither this manuscript nor one with substantially similar content
under their authorship has been published or is being considered for publication elsewhere (see also Duplicate/Previous Publication or Submission).1
Authors of manuscripts reporting original data or systematic reviews must provide an access to data statement from at least 1 named author, often the
corresponding author (see also Data Access and Responsibility). If requested, authors should be prepared to provide the data and must cooperate fully
in obtaining and providing the data on which the manuscript is based for examination by the editors or their assignees.
Role of the Corresponding Author
The corresponding author (or coauthor designee) will serve on behalf of all coauthors as the primary correspondent with the editorial office during the
submission and review process. If the manuscript is accepted, the corresponding author will review an edited manuscript and proof, make decisions
regarding release of information in the manuscript to the news media, federal agencies, or both, and will be identified as the corresponding author in
the published article. The corresponding author is responsible for ensuring that the Acknowledgment section of the manuscript is complete (see Acknowledgment Section) and is responsible for ensuring that the conflict of interest disclosures reported
in the Acknowledgment section of the manuscript are accurate, up-to-date, and consistent with the information provided in each author’s ICMJE Form for Disclosure of Potential Conflicts of Interest (see Conflicts of
Interest and Financial Disclosures).3
The corresponding author also must complete the
Acknowledgment statement part of the Authorship Form confirming that all persons who have contributed substantially but who are not authors are
identified in the Acknowledgment section and that written permission from each person acknowledged has been obtained (see sample Authorship Form and Acknowledgment Section).
Changes in Authorship
Authors should determine the order of authorship among themselves and should settle any disagreements before submitting their manuscript. Changes in authorship (ie, order, addition, and deletion of authors) should be discussed and approved by all authors. Any requests for such changes in authorship after initial manuscript submission and before publication should be explained in writing to the editor in a letter or email from all authors.1(pp128-133)
If authorship is attributed to a group (either solely or in addition to 1 or more individual authors), all members of the group must meet the full
criteria and requirements for authorship as described above, and all group member authors must complete Authorship Forms (see sample Authorship Form and ICMJE Form for Disclosure of Potential Conflicts of Interest).4 If all members of a group do not meet all authorship criteria, a group must designate 1 or more individuals as authors or
members of a writing group who meet full authorship criteria and requirements. Other group members who are not authors may be listed as collaborators in an
Acknowledgment.1(pp128-133) Both authors and collaborators will be noted in published articles and in PubMed records.
Conflicts of Interest and Financial Disclosures
A conflict of interest may exist when an author (or the author’s institution or employer) has financial or personal relationships or affiliations
that could influence (or bias) the author’s decisions, work, or manuscript. All authors are required to complete and submit the ICMJE Form for Disclosure of Potential Conflicts of Interest. Note: This form will be requested after a manuscript has been submitted, but authors should also include conflict of interest disclosures in the Acknowledgment section of the submitted manuscript. Authors are expected to provide detailed information about all relevant financial interests, activities, relationships, and affiliations (other than those affiliations listed in the title page of the manuscript) including, but not limited to, employment, affiliation, funding and grants received or pending, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Following the guidelines of the ICMJE,2 the definitions and terms of such disclosures include
Any potential conflicts of interest “involving the work under consideration for publication” (during the time involving the work, from
initial conception and planning to present),
Any “relevant financial activities outside the submitted work” (over the 3 years prior to submission), and
Any “other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially
influencing” what is written in the submitted work (based on all relationships that were present during the 3 years prior to submission).3
Authors without conflicts of interest, including relevant financial interests, activities, relationships, and affiliations, should indicate such
in the ICMJE form and include a statement of no such interests in the Acknowledgment section of the manuscript. Failure to include this information in
the manuscript may delay evaluation and review of the manuscript. Authors should err on the side of full disclosure and should contact the editorial
office if they have questions or concerns.3
Although many universities and other institutions have established policies and thresholds for reporting financial interests and other conflicts of
interest, JAMA requires complete disclosure of all relevant financial relationships and potential financial conflicts of interest,
regardless of amount or value. For example, authors of a manuscript about hypertension should report all financial relationships they have with
all manufacturers and owners of products, devices, tests, and services used in the management of hypertension, not only those relationships with entities whose specific products, devices, tests, and services are mentioned
in the manuscript. If authors are uncertain about what constitutes a relevant financial interest or relationship, they should contact the editorial office.
For all accepted manuscripts, the corresponding author will have been asked to confirm that each coauthor’s disclosures of conflicts of interest
and relevant financial interests, activities, relationships, and affiliations and declarations of no such interests are accurate, up-to-date, and
consistent with the disclosures reported in the Acknowledgment section of the manuscript because this information will be published in the
Acknowledgment section of the article. Decisions about whether such information provided by authors should be published, and thereby disclosed to
readers, are usually straightforward. Although editors are willing to discuss disclosure of specific conflicts of interest with authors, JAMA
’s policy is one of complete disclosure of all potential conflicts of interest, including relevant financial interests, activities,
relationships, and affiliations (other than those affiliations listed in the title page of the manuscript). The policy requiring disclosure of
conflicts of interest applies for all manuscript submissions, including letters to the editor. If an author’s disclosure of
potential conflicts of interest is determined to be inaccurate or incomplete after publication, a correction will be published to rectify the original
published disclosure statement, and additional action may be taken as necessary.
Authors also are required to report detailed information regarding all financial and material support for the research and work, including but not
limited to grant support, funding sources, and provision of equipment and supplies, in the Acknowledgment section of the manuscript.
All authors must also complete and sign a summary statement confirming the reporting of conflicts of interest and funding that is part of the JAMA Authorship Form.3,5 Space is provided for authors to confirm that they have completed the ICMJE Form for Disclosure of Potential Conflicts of Interest and will submit it to JAMA and provide a copy to the corresponding author (see sample Authorship Form).
All financial and material support for the research and the work should be clearly and completely identified in an Acknowledgment section of the
manuscript. At the time of submission, information on the funding source must also be completed via the JAMA online manuscript submission and review system. The specific role of the funding organization or sponsor in each of the following should be specified: “design and conduct of the
study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.”3,5
Data Access, Responsibility, and Analysis
For all reports (regardless of funding source) containing original data, at least 1 named author (eg, the principal investigator), and no more than 2
authors, must indicate that she or he “had full access to all the data in the study and
takes responsibility for the integrity of the data and the accuracy of the data analysis.”5 This exact statement should be included in the
Acknowledgment section at the end of the manuscript. Modified statements or generic statements indicating that all authors had such access are not
In addition, for all reports containing original data, the names and affiliations of all authors (or other individuals) who conducted and are responsible for the data analysis must be indicated in the Acknowledgment section of the manuscript. If the individual who conducted the analysis is not named as an author, a detailed explanation of his/her contributions and reasons for his/her involvement with the data analysis should be included.
The “Acknowledgment section” is the general term for the list of contributions, disclosures, credits, and other information included at the
end of the text of a manuscript but before the references. The Acknowledgment section includes authors’ contributions (see sample Authorship Form); information on author
access to data; disclosure of potential conflicts of interest, including financial interests, activities, relationships, and affiliations; sources of
funding and support; an explanation of the role of sponsor(s); names, degrees, and
affiliations of participants in a large study or other group (ie, "collaborators"); any important disclaimers; information on previous presentation of the information
reported in the manuscript; and the contributions, names, degrees, affiliations, and indication if compensation has
been received for all persons who have made substantial contributions to the work but who are not authors.1
All other persons who have made substantial contributions to the work reported in the manuscript (eg, data collection, analysis, and writing or editing assistance) but who do not fulfill the authorship criteria should be named with their specific contributions in an Acknowledgment in the manuscript.
Authors must obtain written permission to include the names of all individuals included in the Acknowledgment section, and the corresponding author must confirm that such permission has been obtained in the Authorship Form (see sample Authorship Form).
Duplicate/Previous Publication or Submission
Manuscripts are considered with the understanding that they have not been published previously in print or electronic format and are not under
consideration by another publication or electronic medium. Copies of related or possibly duplicative materials (ie, those containing substantially
similar content or using the same or similar data) that have been previously published or are under consideration elsewhere must be provided at the
time of manuscript submission (see Previous or Planned Meeting Presentation or Release of Information).1(pp151-152)
Timeliness of Data
Research reports submitted to JAMA should be timely and current and should be based on data collected as recently as possible. Manuscripts based
on data from randomized controlled trials should be reported as soon as possible after the trial has ended, ideally within 1 year after follow-up has
been completed. For cohort studies, the date of final follow-up should be no more than 5 years before manuscript submission. Likewise, data used in
case-control or cross-sectional studies should have been collected as recently as possible, but no more than 5 years before manuscript submission.
Because manuscripts in which the most recent data have been collected more than 5 years ago (ie, prior to 2010) ordinarily will receive lower priority
for publication, authors of such manuscripts should provide a detailed explanation of the relevance of the information in light of current knowledge
and medical practice.
The ICMJE defines a clinical trial as any research project that prospectively assigns human participants to intervention or comparison groups to study
the cause-and-effect relationship between an intervention and a health outcome. Interventions include but are not limited to drugs, surgical
procedures, devices, behavioral treatments, process-of-care changes, and the like. All manuscripts reporting clinical trials, including those limited to secondary exploratory or post hoc analysis of trial outcomes, must include a copy of the
trial protocol including the complete statistical analysis plan (see Protocols), a flow diagram (CONSORT flow diagram), and a completed trial checklist (see Checklist). All clinical trials must be registered at an appropriate online public registry (see Trial Registration requirements). These
and other requirements for manuscript preparation are detailed in Categories of Articles, Clinical Trial. For additional guidance on reporting cluster
trials, noninferiority and equivalence trials, pragmatic trials, and trials with patient-reported outcomes, see Extensions of the CONSORT Statement.
As a member of ICMJE, JAMA requires, as a condition of consideration for publication, registration of all trials in a public trials registry
that is acceptable to the ICMJE (ie, the registry must be owned by a not-for-profit entity, be publicly accessible, and require the minimum
registration data set as described by ICMJE).2,6,7
Acceptable trial registries include the following and
others listed at http://www.icmje.org:
For this purpose, a clinical trial is any study that prospectively assigns human participants to intervention or comparison groups to evaluate the
cause-and-effect relationship between an intervention and a health outcome. All clinical trials, regardless of when they were completed, and secondary
analyses of original clinical trials must be registered before submission of a manuscript based on the trial. Please note: for clinical trials starting
patient enrollment after July 2005, trials must have been registered before onset of patient enrollment. For trials that began before July 2005 but
that were not registered before September 13, 2005, trials must have been registered before journal submission. Studies designed for other purposes,
such as to study pharmacokinetics or major toxicity (eg, phase 1 trials), are exempt. Trial registry name, registration identification number, and the
URL for the registry should be included at the end of the abstract and also in the space provided on the online manuscript submission form.
Authors of manuscripts reporting clinical trials must submit trial protocols (including the complete statistical analysis plan) along with their
manuscripts. If the manuscript is accepted, the protocol will be published as an online supplement.
CONSORT Flow Diagram and Checklist:
Manuscripts reporting the results of randomized trials must include the CONSORT flow diagram showing the progress of patients throughout the trial (see
Figure). The CONSORT checklist also should be completed and submitted with the manuscript.8
Figure. Profile of a Randomized Clinical Trial
Manuscripts reporting survey data, such as studies involving patients, clinicians, the public, or others, should report data collected as recently as
possible, ideally within the past 2 years. Survey studies should have sufficient response rates (generally at least 60%) and appropriate
characterization of nonresponders to ensure that nonresponse bias does not threaten the validity of the findings. For most surveys, such as those
conducted by telephone, personal interviews (eg, drawn from a sample of households), mail, email, or via the web, authors are encouraged to report the
survey outcome rates using standard definitions and metrics, such as those proposed by the American Association for Public Opinion Research.9 In addition, authors should submit the survey instrument if possible
for publication as an online-only supplement (see Online-Only Supplements and Multimedia).
Reports of Diagnostic Tests
These manuscripts may be classified as Original Investigations, Brief Reports, or Research Letters. Authors of reports of diagnostic tests are
encouraged to submit the STARD flow diagram and checklist.
Reports of Cost-effectiveness Analyses and Decision Analyses
These manuscripts may be classified as Original Contributions, Brief Reports, or Research Letters. Authors of reports of cost-effectiveness analyses
and decision analyses must submit a copy of the decision tree comprising their model. This is for editorial evaluation and review, not necessarily for
publication, unless it is included in the body of the manuscript.
If race and/or ethnicity is reported, indicate in the Methods section who classified individuals as to race/ethnicity, the classifications, and whether
the options were defined by the investigator or the participant. Explain why race and/or ethnicity was assessed in the study.10
Report the sex distribution of study participants or samples in the Methods section, including studies of humans, tissues, cells, or animals. If only one sex is reported, or included in the study, explain why the other sex is not reported or included, except for studies of diseases/disorders that only affect males (eg, prostate disease) or females (eg, ovarian disease).
Ethical Approval of Studies and Informed Consent
For all manuscripts reporting data from studies involving human participants or animals, formal review and approval, or formal review and waiver, by an
appropriate institutional review board or ethics committee is required and should be described in the Methods section.1(p226) For those investigators
who do not have formal ethics review committees, the principles outlined in the Declaration of Helsinki should be followed.11 For investigations of
humans, state in the Methods section the manner in which informed consent was obtained from the study participants (ie, oral or written) and whether participants received a stipend. Editors may
request that authors provide documentation of the formal review and recommendation from the institutional review board or ethics committee responsible
for oversight of the study.
Identification of Patients in Descriptions, Photographs, Video, and Pedigrees
A signed statement of informed consent to publish (in print and online) patient descriptions, photographs, video, and pedigrees should be obtained from
all persons (parents or legal guardians for minors) who can be identified (including by the patients themselves) in such written descriptions,
photographs, or pedigrees and should be submitted with the manuscript and indicated in the Acknowledgment section of the manuscript. Such persons
should be shown the manuscript before its submission.1(pp229-232) Omitting data or making data less specific to deidentify patients is acceptable, but
changing any such data is not acceptable.
Only those details essential for understanding and interpreting a specific case report or case series should be provided. Although the degree of specificity needed will depend on the context of what is being reported, specific ages, race/ethnicity, and other sociodemographic details should be presented only if clinically or scientifically relevant and important.1 Cropping of photographs to remove identifiable personal features that are not essential to the clinical message may be permitted as long as the photographs are not otherwise altered. Please do not submit masked photographs of patients. Patients’ initials or other personal identifiers may not appear in an image.
Patient Permission Form:
The Patient Consent form for publication of identifying material is available here.
Personal Communications and Unpublished Data
A signed statement of permission should be included from each individual identified as a source of information in a personal communication or as a
source for unpublished data, and the date of communication and whether the communication was written or oral should be specified.1(p199) Personal communications should not be included in the list of references but added to the text parenthetically.
Manuscripts That Pose Security Risks
Authors and reviewers are expected to notify editors if a manuscript could be considered to report dual use research of concern (ie, research that
could be misused by others to pose a threat to public health and safety, agriculture, plants, animals, the environment, or material).12 The editor in
chief will evaluate manuscripts that report potential dual use research of concern and, if necessary, consult additional reviewers.
Previous or Planned Meeting Presentation or Release of Information
A complete manuscript following presentation at a meeting or publication of preliminary findings elsewhere (eg, an abstract) is eligible for
consideration for publication. Authors considering presenting or planning to present the work at an upcoming scientific meeting should indicate the
name and date of the meeting on the manuscript submission form. For accepted papers, the editors may be able to coordinate publication with the meeting
presentation. Authors who present information contained in a manuscript that is under consideration by JAMA during scientific or clinical
meetings should not distribute complete reports (ie, copies of manuscripts) or full data presented as tables and figures to conference attendees or
journalists. Publication of abstracts in print and online conference proceedings, as well as posting of slides or videos from the scientific
presentation on the meeting website, is acceptable. However, for manuscripts under consideration by JAMA, publication of full reports in
proceedings or online, issuing detailed news releases reporting the results of the study, or participation in formal news conferences will jeopardize
chances for publication of the submitted manuscript in JAMA.12 Media coverage of presentations at scientific meetings will not jeopardize
consideration, but direct release of information through press releases or news media briefings may preclude consideration by JAMA.12 Rare
instances of papers reporting public health emergencies should be discussed with the editor. Authors submitting manuscripts or letters to the editor
regarding adverse drug or medical device reactions, reportable diseases, etc, should also report this information to the relevant government agency.
All information regarding the content and publication date of accepted manuscripts is strictly confidential. Unauthorized prepublication release of
accepted manuscripts may result in rescinding the acceptance and rejecting the paper. This policy applies to all categories of articles, including
Original Investigations, Reviews, Editorials, Viewpoints, Letters, etc. Information contained in or about accepted articles cannot appear in print,
audio, video, or digital form or be released by the news media until the
specified embargo release date.13
All authors are required to complete and submit a Publishing Agreement that is part of the JAMA electronic Authorship Form. In this agreement, authors will transfer copyright; or indicate that they are employed by a federal government; or indicate that they are an employee of an institution that considers the work in the manuscript a work for hire, in which case an authorized representative of that institution will assign copyright on the author’s behalf.
All research articles are made free access online 6 months after publication on the journal website. All articles are made free access on The JAMA Network Reader on the day of publication.
Depositing Research Manuscripts With an Approved Public Repository
All JAMA articles reporting original research are made freely available 6 months after publication, subject to certain
conditions. JAMA’s editors and publishers believe that the public is best served by accessing the freely available research articles on
the journal site to ensure access to the final published version, any corrections, and related web features. However, some funding organizations
require that authors of manuscripts reporting research deposit those manuscripts with an approved public repository, such as PubMed Central or Europe PubMed Central. Authors
have JAMA’s permission to deposit manuscripts with an approved repository on the following conditions:
Permission is granted only for manuscripts reporting research funded by not-for-profit organizations to be deposited in not-for-profit, publicly
Permission is granted to post either the accepted version of the submitted manuscript or a copy of the published article.
Authors must ensure that the posted content links back to the published article on the JAMA website to provide readers with access to the
final version plus any corrections and letters, as well as the article-related features only available on JAMA’s
Authors who submit their manuscripts to an approved public repository, such as PubMed Central or Europe PubMed Central, must indicate that the content may not be made
available to the public sooner than 6 months after publication in JAMA.
If authors adhere to these requirements, they may submit the final accepted version of the manuscript or a published copy of the article to the repository, if and only if the repository
ensures that the deposited manuscript will not be made available to the public during the 6-month embargo following publication in JAMA.
The published article is protected by copyright at the time of publication and thereafter (see http://jamanetwork.com/public/ConditionsOfUse.aspx). This research access policy does not include
permission to use the JAMA logo and trademarks. The JAMA article of record is the final published version; JAMA assumes no
responsibility for earlier versions because substantive changes and corrections may occur during the postacceptance editing process. Authors may
contact JAMA with any questions at firstname.lastname@example.org.
Published manuscripts become the permanent property of the American Medical Association (AMA) and may not be published elsewhere without written
permission. Unauthorized use of the JAMA name, logo, or any content for commercial purposes or to promote commercial goods and services (in any
format, including print, video, audio, and digital) is not permitted by JAMA or the AMA.
Editorial Review and Publication
Authors will be sent notifications of the receipt of manuscripts and editorial decisions by e-mail. During the review process, authors can check the
status of their submitted manuscript via the online manuscript submission and review system.
JAMA-EXPRESS provides rapid peer review and publication of major clinical trials and other original research studies that have immediate or
public health importance.14 Authors who wish to have manuscripts considered for JAMA-EXPRESS should send the manuscript file and a request
letter to email@example.com or call (312) 464-2402. Authors will be notified promptly
whether the manuscript is approved for rapid peer review. Authors of those manuscripts determined not to qualify for rapid review may be invited to
submit the manuscript for further consideration under the standard review process.
Editorial and Peer Review
All submitted manuscripts are reviewed initially by a JAMA editor. Manuscripts are evaluated according to the following criteria: material is
original and timely, writing is clear, study methods are appropriate, data are valid, conclusions are reasonable and supported by the data, information
is important, and topic has general medical interest. From these basic criteria, the editors assess a paper’s eligibility for publication.
Manuscripts with insufficient priority for publication are rejected promptly. Other manuscripts are sent to expert consultants for peer review. Peer
reviewer identities are kept confidential, but author identities are made known to reviewers. The existence of a manuscript under review is not
revealed to anyone other than peer reviewers and editorial staff. Peer reviewers are required to maintain confidentiality about the manuscripts they
review and must not divulge any information about a specific manuscript or its content to any third party without prior permission from the journal
editors. Information from submitted manuscripts may be systematically collected and analyzed as part of research to improve the quality of the
editorial or peer review process. Identifying information remains confidential. Final decisions regarding manuscript publication are made by an editor who does not have any relevant conflicts of interest.
Accepted manuscripts are edited in accordance with the AMA Manual of Style, 10th edition,1 and returned to the corresponding author (or his/her
designee) for approval. Authors are responsible for all statements made in their work, including changes made during editing and production that are
authorized by the corresponding author.
Requests to publish corrections should be sent to the editorial office. Corrections are reviewed by editors and authors, published promptly, and linked
online to the original article.
Reprints and e-prints may be ordered online at www.ama-authorreprints.com when the edited manuscript is sent for
approval to the corresponding author.
Categories of Articles
publishes Original Investigations, Reviews, Brief Reports, Special Communications, Viewpoints, and other categories of articles. Topics of interest
include all subjects that relate to the practice of medicine and the betterment of public health worldwide. The most frequently published types of
articles are described herein.
These reports typically include randomized trials (see Clinical Trial), intervention studies, cohort studies, case-control studies, epidemiologic
assessments, other observational studies, surveys with high response rates (see Survey Research), cost-effectiveness analyses and decision analyses (see Reports of Cost-effectiveness Analyses and Decision Analyses), and
studies of screening and diagnostic tests (see also Reports of Diagnostic Tests). Each manuscript should clearly state an objective or hypothesis; the
design and methods (including the study setting and dates, patients or participants with inclusion and exclusion criteria and/or participation or
response rates, or data sources, and how these were selected for the study); the essential features of any interventions; the main outcome measures;
the main results of the study; a comment section placing the results in context with the published literature and addressing study limitations; and the
conclusions. Data included in research reports must be original and should be as timely and current as possible (see Timeliness of Data). A structured
abstract is required; for more information, see instructions for preparing structured Abstracts. Maximum length: 3000 words of text (not including
abstract, tables, figures, references, and online-only material) with no more than a total of 5 tables and/or figures.
The ICMJE defines a clinical trial as any research project that prospectively assigns human participants to intervention or comparison groups to study
the cause-and-effect relationship between an intervention and a health outcome. Interventions include but are not limited to drugs, surgical
procedures, devices, behavioral treatments, process-of-care changes, and the like. All manuscripts reporting clinical trials, including those limited to secondary exploratory or post hoc analysis of trial outcomes, must include a copy of the
trial protocol including the complete statistical analysis plan (see Protocols), a flow diagram (Figure), and a completed trial checklist (see CONSORT
Flow Diagram and Checklist). All clinical trials must be registered at an appropriate online public registry (see Trial Registration requirements).
For additional guidance on preparing manuscripts reporting cluster trials, noninferiority and equivalence trials, and pragmatic trials, see Extensions of the CONSORT Statement. Each manuscript should clearly state an objective or
hypothesis; the design and methods (including the study setting and dates, patients or participants with inclusion and exclusion criteria, or data
sources, and how these were selected for the study); the essential features of any interventions; the main outcome measures; the main results of the
study; a discussion section placing the results in context with the published literature and addressing study limitations; and the conclusions. A
structured abstract is required, and trial registration information (name, number, and URL) must be listed at the end of the abstract; for more
information, see instructions for preparing structured Abstracts. Maximum length: 3000 words of text (not including abstract, tables, figures,
references, and online-only material) with no more than a total of 5 tables and/or figures.
The subtitle should include the phrase “A Randomized Clinical Trial” as relevant.
These manuscripts are systematic, critical assessments of literature and data sources pertaining to clinical topics, emphasizing factors such as cause,
diagnosis, prognosis, therapy, or prevention. All articles or data sources should be searched for and selected systematically for inclusion and
critically evaluated, and the search and selection process should be described in the manuscript. The specific type of study or analysis, population,
intervention, exposure, and tests or outcomes should be described for each article or data source. The data sources should be as current as possible,
ideally with the search having been conducted within several months of manuscript submission. Authors of reports of
meta-analyses of clinical trials should submit the PRISMA flow diagram and checklist. Authors of meta-analyses of observational
studies should submit the MOOSE checklist. A structured abstract is required; for more information, see instructions for preparing structured Abstracts. Maximum length: 3500 words of text (not
including abstract, tables, figures, references, and online-only material), with no more than a total of 4 tables and/or figures and no more than 50-75
The subtitle should include the phrase “A Meta-analysis.”
Caring for the Critically Ill Patient
These manuscripts are original research reports, preferably clinical trials, or systematic reviews (see above classifications for manuscript submission
requirements by category of article) that address virtually any aspect of critical illness, from prevention and triage, through resuscitation and acute
treatment, to rehabilitation and palliative care. Manuscripts that provide new insights into the diagnosis, prognosis, and treatment of critically ill
patients, as well as those that explore pathophysiological, technological, ethical, or other related aspects of critical care medicine, are welcome.
For reports of original data and systematic reviews, a structured abstract is required; see instructions for preparing structured Abstracts. Maximum
length: 3000 words of text (not including abstract, tables, figures, references, and online-only material) with no more than a total of 5 tables and/or
These manuscripts are short reports of original studies or evaluations or unique, first-time reports of clinical case series. Note: It is very rare for JAMA to publish case reports. A structured abstract is required; for more information, see instructions for preparing structured Abstracts.
Recommended length: 1000-1500 words (not including abstract, tables, figures, references, and online-only material) with no more than a total of 3
tables and/or figures.
JAMA Clinical Challenge
A JAMA Clinical Challenge presents an actual patient scenario about a specific disease or condition with an accompanying clinical image. Authors should
provide 4 single-sentence plausible treatment options describing possible courses of action with one of these being preferred for the question
“What would you do next?” Manuscripts should include a brief discussion of the relevant clinical issues and provide well-supported
explanations discussing the 4 potential courses of action. A key clinical feature should be definable, which drives the next course of action. All diagnostic and treatment recommendations should be supported by referencing authoritative texts or journal publications. Preferably, these recommendations should be supported by governmental or multisociety guidelines, meta-analyses, or systematic reviews. The text should have a maximum length of 850 words, consisting of no more than 250 words for
the case presentation, question, and 4 one-sentence answers, followed by no more than 600 words that include the diagnosis and a brief discussion.
There should be no more than 3 authors and no more than 10 references. In addition, the JAMA Patient Permission form must be completed by the patient and included at the time of
manuscript submission. The image and case presentation should be from the same patient and must not
have been published previously. In some cases, additional figures may be included to accompany the answer explanations. All images submitted should be high-quality .jpg or .tif files. Submit the original version of all image files at the highest
resolution possible without labels. In general, the original image file should have a minimum resolution of 300 dpi at a width of about 5 inches. Do
not increase the original resolution, resize, or crop the image; where applicable, we will crop to maintain patient confidentiality. If any labels,
arrowheads, or A/B panel indicators are desired, provide a separate labeled version of the figure(s) for reference. All labels will be reformatted in JAMA style.
For a recently published example, see JAMA. 2014;312(20):2158-2159. For more
information on how to submit figures, see Guidelines for Figures in Accepted Manuscripts. Manuscripts not meeting these
guidelines will not be considered.
These papers may address virtually any important topic in medicine, public health, research, ethics, health policy, or health law and generally are not
linked to a specific article. Viewpoints should be well focused, scholarly, and clearly presented and must have no more than 3 authors. The text should include the
name, academic degrees, and no more than 2 institutional affiliations for each
author. Maximum length:
up to 1200 words of text—or 1000 words of text with 1 small table or figure—and no more than 7 references. Viewpoints not meeting these
guidelines will not be considered.
A Piece of My Mind
Most essays published in A Piece of My Mind are personal vignettes (eg, exploring the dynamics of the patient-physician relationship) taken from
wide-ranging experiences in medicine; occasional pieces express views and opinions on the myriad issues that affect the profession. If the patient(s)
described in these manuscripts is identifiable, a Patient Permission form must be completed and signed by the patient(s) and submitted with the manuscript. Omitting data or making data less specific
to deidentify patients is acceptable, but changing any such data is not acceptable. Manuscripts are not published anonymously or pseudonymously. All manuscripts must be submitted formally at JAMA’s website; we do not review drafts or unfinished manuscripts prior to submission. Length
limit: 1800 words.
Letter to the Editor
Letters discussing a recent JAMA article should be submitted within 4 weeks of the article’s publication in print.15 Letters received
after 4 weeks will rarely be considered. Letters should not exceed 400 words of text and 5 references, 1 of which should be to the recent JAMA
article. They should be double-spaced and a word count should be provided. Letters may have no more than 3 authors. The text should include the full
name, academic degrees, and a single institutional affiliation for each author and the e-mail address for the corresponding author. Letters must not
duplicate other material published or submitted for publication and should not include unpublished data. Letters not meeting these specifications are
generally not considered. Letters being considered for publication ordinarily will be sent to the authors of the JAMA article, who will be given the opportunity to reply. Letters will be published at the discretion of the editors and are subject to abridgement and editing for style and content.
Letter in Reply
Replies by authors should not exceed 500 words of text and 6 references. They should have no more than 3 authors.
Research Letters reporting original research should not exceed 600 words of text and 6 references and may include up to 2 tables or figures. Online
supplementary material is not allowed. Research letters may have no more than 7 authors. The text should include the full name, academic degrees, and a
single institutional affiliation for each author and the e-mail address for the corresponding author. Other persons who have contributed to the study
may be indicated in an Acknowledgment, with their permission, including their academic degrees, affiliation, contribution to the study, and an
indication if compensation was received for their role. Letters must not duplicate other material published or submitted for publication. In general,
Research Letters should be divided into the following sections: Introduction, Methods, Results, and Discussion.
Research Letters should be double-spaced and a word count should be provided with each letter. They should not include an abstract, but otherwise
should follow all of the guidelines in Manuscript Preparation and Submission Requirements. Letters not meeting these specifications are generally not
considered. Research Letters considered for publication undergo external peer review.
Poetry and Medicine
Poems related to the medical experience, whether from the point of view of a health care worker or patient, or simply an observer, will be considered.
Poems should be original, not previously published or under consideration elsewhere, and no longer than 50 lines. Authors may submit multiple poems to JAMA simultaneously. Questions about submitting poems may be sent to firstname.lastname@example.org.
Articles Requiring a Presubmission Inquiry
The following categories of articles require a presubmission inquiry and discussion with an editor:
Note: JAMA publishes very few of these types of articles:
ordinarily, fewer than 6 per year. These manuscripts describe an
important issue in clinical medicine, public health, health policy, or
medical research in a scholarly, thorough, well-referenced, systematic,
and evidence-based manner. Depending on the content, either a structured abstract or unstructured abstract is required. Maximum length: 3000 words of text (not
including tables, figures, or references) with no more than a total of 4
tables and/or figures and no more than 50 references. For a recently published example, see JAMA. 2014;312(20):2146-2155.
Clinical Crossroads is a patient-focused, evidence-based review and discussion of a diagnostic or treatment decision faced by an actual patient and
physician. The discussant should summarize the relevant evidence along with a description of how the evidence was identified, assessed for quality, and selected for inclusion. The best-quality evidence (eg, practice guidelines, meta-analyses, systematic reviews, well-conducted clinical trials, and high-quality prospective cohort studies) should receive the greatest emphasis. The clinical question to be resolved should be discussed in the context of the evidence along with a discussion of controversial aspects and unresolved issues. Clinical Crossroads can address any medical condition but the topic should be relevant for primary care physicians. Case reports are not
considered for Clinical Crossroads. A structured abstract is required; for more information, see instructions for preparing structured Abstracts for Reviews. Maximum length: 4000 words of text (not including abstract, tables, figures, references, and online-only material) with no more than a total
of 5 tables and/or figures and no more than 50-75 references. If the patient(s) described in these manuscripts is identifiable, a Patient Permission form must be completed and signed by the
patient(s) and submitted with the manuscript (see also Identification of Patients in Descriptions, Photographs, Video, and Pedigrees). All illustrations in JAMA articles are created by JAMA medical illustrators. For each proposed illustration, the authors should provide a list of the elements to be included in the illustration; 3-4 relevant recent references; example illustrations, if available; a working figure title and legend; and an explanation of how this new illustration would add to the published literature. Potential
authors should contact the editorial office to determine whether the topic is appropriate for Clinical Crossroads by sending an e-mail to email@example.com.
Systematic reviews without meta-analysis address a specific question or issue that is relevant for clinical practice and provide an evidence-based, balanced,
patient-oriented review on a focused topic. Reviews should include the clinical question or issue and its importance for general medical
practice, specialty practice, or public health; description of how the relevant evidence was identified, assessed for quality, and selected for
inclusion; synthesis of the available evidence such that the best-quality evidence (eg, randomized clinical trials, meta-analyses, systematic reviews, and high-quality prospective
cohort studies) should receive the greatest emphasis; and discussion of controversial aspects and unresolved issues. Authors will be asked to describe characteristics of the literature search performed for their review. A structured abstract is required;
for more information, see instructions for preparing structured Abstracts. Maximum length: 3500 words of text (not including abstract, tables, figures,
references, and online-only material), with no more than a total of 4 tables and/or figures and no more than 50-75 references. All illustrations in JAMA articles are created by JAMA medical illustrators. For each proposed illustration, the authors should provide a list of the elements to be included in the illustration; 3-4 relevant recent references; example illustrations, if available; a working figure title and legend; and an explanation of how this new illustration would add to the published literature. Authors interested in
submitting a Review manuscript should contact the editorial office prior to manuscript preparation and submission by sending an e-mail to Mary
McDermott at firstname.lastname@example.org.
Review: Diagnostic and Therapeutic Advances
Reviews featuring Diagnostic and Therapeutic Advances will provide clinicians with the latest information about disease management from the perspective of internationally recognized experts in these disciplines. Systematic review of the literature is not be required. If the author’s recommendations differ from those issued by major societies or guidelines, the rationale for the differences should be justified.
The introduction should be no more than 250 words. Any relevant epidemiological data regarding the importance of the problem should be reviewed. The Methods section should include the search terms used and emphasize recently published meta-analyses, RCTs, and guidelines. The Results section should detail the results of the literature review. Subsections in Results should include “Major Diagnostic Advances” and “Major Therapeutic Advances.” The Discussion should summarize the author’s perspectives on these advances. A final section called “Clinical Bottom Line” should contain 4-5 bullet points with the major take-home message for the reader.
The recommended structure for data display is the following:
Table 1: major epidemiologic and burden of disease facts
Table 2: major diagnostic advances
Table 3: major therapeutic advances
Table 4: diagnostic and therapeutic uncertainty; controversies; etc.
All illustrations in JAMA articles are created by JAMA medical illustrators. For each proposed illustration, the authors should provide a list of the elements to be included in the illustration; 3-4 relevant recent references; example illustrations, if available; a working figure title and legend; and an explanation of how this new illustration would add to the published literature.
A structured abstract is required; for more information, see instructions for preparing structured Abstracts. Maximum length: 3500 words of text (not including abstract, tables, figures, references, and online-only material), with no more than a total of 5 tables and/or figures and no more than 50-75 references. Authors interested in submitting a Review manuscript should contact the editorial office prior to manuscript preparation and submission by sending an email to Edward Livingston at email@example.com.
These papers present a case-based discussion of a clinically relevant topic. They should be based on an actual Grand
Rounds presentation that was made by the author. We recommend that the presentation be transcribed or taped to assist the author in maintaining the
realism of the presentation. Grand Rounds papers begin with a case presentation or, preferably, an interview with the actual patient who has the
disease or condition under discussion. Following the case summary, the topic is presented in the same way as it was at the actual “live”
Grand Rounds. Discussions should be evidence-based and the manuscript should include a summary of the relevant evidence along with a description of how the evidence was identified, assessed for quality, and selected for inclusion. Authors will be asked to describe characteristics of the literature search performed for their review. The best-quality evidence (eg, randomized clinical trials, meta-analyses, high-quality systematic reviews, and high-quality prospective cohort studies) should receive the greatest emphasis. Controversial aspects of the evidence and unresolved issues should be addressed. Maximum length: 3000 words of text (not including abstract, tables, figures,
references, and online-only material), with no more than 50 references and no more than a total of 4 tables and/or figures. For an example, see JAMA. 2014;311(21):2216-2224. If the patient(s) described in these manuscripts is
identifiable, a Patient Permission form must be completed and
signed by the patient(s) and submitted with the manuscript (see also Identification of Patients in Descriptions, Photographs, Video, and Pedigrees).
All illustrations in JAMA articles are created by JAMA medical illustrators. For each proposed illustration, the authors should provide a list of the elements to be included in the illustration; 3-4 relevant recent references; example illustrations, if available; a working figure title and legend; and an explanation of how this new illustration would add to the published literature. Authors interested in submitting a Grand Rounds presentation should contact the editorial office prior to manuscript preparation and submission by
sending an email to firstname.lastname@example.org.
JAMA Clinical Evidence Synopsis
JAMA Clinical Evidence Synopsis is intended to help clinicians apply evidence to practice by summarizing new evidence from recently published data-driven reviews and reports, such as the Cochrane Database of Systematic Reviews or the US Preventive Services Task Force Reports. Manuscripts submitted for the JAMA Clinical Evidence Synopsis section should begin with a 1-sentence Clinical Question (such as, “Clinical Question: What hemoglobin threshold for prescribing red blood cell transfusions is best for minimizing both red blood cell use and adverse clinical outcomes in anemic patients?”) and a 1-sentence Clinical Application statement (such as, “Clinical Application: Compared with higher hemoglobin thresholds, a hemoglobin threshold of 7 g/dL or 8 g/dL reduces the number of red blood cell units transfused without adverse associations with mortality, cardiac morbidity, functional recovery, or length of hospital stay.”). The manuscript should include the following main headings and subsections:
Introduction: 1 brief paragraph of background and context for the clinical question
Evidence Profile: In a Box or list include the following bulleted sections:
• No. of studies overall
• No. of randomized controlled trials
• Study years (eg, 1956 to 2012) (not years of publication)
• No. of patients
• Men XX% Women XX%
• Age (mean XX and range xx-xxx)
• Comparison (eg, higher vs lower hemoglobin threshold for transfusion of patients with anemia)
• Primary outcomes
• Secondary outcomes
If the manuscript summarizes a Cochrane Collaboration review, please indicate at the bottom of the Evidence Profile whether the full review represents an original review or an update. The original publication (eg, Cochrane review or US Preventive Services Task Force) should be referenced.
Summary of Findings: a brief summary of the results of the review or report with no more than 1 simple table or figure. Results must include absolute rates or absolute differences and number needed to treat.
Discussion: a brief summary of the key results placed in
context for the clinician. This section should include 3 subheadings:
Limitations; Comparison of Findings With Current Practice Guidelines (if
applicable); and Areas in Need of Future Study.
The text length (complete manuscript and Evidence Profile excluding the title, references, and acknowledgment section) should have a maximum length of 800 words with 1 table or figure and no more than 7 references. Manuscripts submitted for the JAMA Clinical Evidence Synopsis section should have no more than 3 authors. For an example, see JAMA. 2013;309(1):83-84. Please submit the original full review at the time the JAMA Clinical Evidence Synopsis is submitted. Authors interested in submitting a manuscript for JAMA Clinical Evidence Synopsis should contact the editorial office prior to manuscript preparation and submission by sending an email to Mary McDermott at email@example.com.
JAMA Diagnostic Test Interpretation
JAMA Diagnostic Test Interpretation presents the results of a diagnostic test from a single patient and explores the clinical application of the test result. The JAMA Diagnostic Test Interpretation is intended to help clinicians understand the underlying rationale in ordering tests, interpreting test results, and acting on the diagnostic test findings.
The diagnostic test result must be obtained from the care of an actual patient, with that patient’s written permission. The JAMA Patient Permission form should be read and completed by the patient and included at the time of manuscript submission. The results of laboratory, pathologic, or radiographic tests are appropriate but clinical images are not. Authors of manuscripts based on clinical images should consult the instructions for JAMA Clinical Challenge.
Manuscripts for JAMA Diagnostic Test Interpretation should have the following sections:
Case presentation. The case presentation should be brief and focus on the diagnostic test in question. At the end of the case presentation the pertinent diagnostic test results and normal ranges should be provided. (200 words)
How do you interpret these test results? Four plausible interpretations should be provided. These should be presented in the format of a multiple choice question with a single correct (or best) answer. The answers may be brief phrases or short sentences, should be similar in length, and should be arranged alphabetically by first word in the answer. (50 words)
Test characteristics. A brief review of the diagnostic test should be provided. For biomarkers, this should include a brief description of the related physiology. Test accuracy should be reported using sensitivity and specificity or likelihood ratios, and predictive values should be provided for common clinical scenarios. Please use likelihood ratios whenever possible, since they do not depend on disease prevalence. The prevalence of the disease should be stated so that the pretest probability may be estimated. For example, “For patients with a typical disease prevalence of 10%, the predictive values of positive and negative test results are approximately 50% and 1%, respectively.” Discussion of the application and utility of the diagnostic test should be based on a high-quality systematic review or authoritative practice guideline. If a more recent, original study supersedes or adds meaningfully to the prior synthesis of research, that article also should be cited. The approximate cost of the test should be provided. Some costs can be obtained from Medicare fee schedules at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/index.html. (200 words)
Application of test result to this patient. A brief discussion of how the diagnostic test result will facilitate the next steps in a patient’s management should be presented. Please also address the correct answer to the question about test interpretation in this section. (200 words)
What Are Alternative Diagnostic Testing Approaches? If there are different testing strategies that can be used to evaluate patients to establish a diagnosis, please discuss them. (100 words)
Patient Outcome. Long-term follow-up on the patient’s condition and outcome of treatment is necessary. (100 words)
Clinical Bottom Line.
Please provide a bulleted list of 3-5 items that reflect the most important message readers should obtain from this article.
The overall text of the manuscript should have a maximum of 850 words, no more than 10 references, and no more than 3 authors. The case presentation must not have been previously published. For an example of this article type, see JAMA. 2014;311(19):2017-2018.
If there are questions about patient identifiability, please contact the editorial office. Authors interested in submitting a manuscript for JAMA Diagnostic Test Interpretation should contact the editorial office prior to manuscript preparation and submission by sending an email to Mary McDermott at firstname.lastname@example.org.
The Rational Clinical Examination
These systematic review articles rigorously assess the evidence produced during the clinical encounter between patient and physician. The article
should evaluate, in a qualitative manner, and if the evidence justifies doing so, in a quantitative manner, reports of tests of the usefulness of
individual items in the patient’s history and physical examination. In addition, the article may evaluate how these items are modified in the
presence of simple laboratory or radiological tests. An extension of this series is the Rational Clinical Procedures series, in which clinical
procedures frequently performed by the clinician are evaluated for their diagnostic usefulness and also may be demonstrated with illustrations,
animations, or video. Maximum length: 4000 words of text (not including abstract, tables, figures, references, and online-only material) with no more
than a total of 5 tables and/or figures. Potential authors should contact the editorial office in advance to determine whether the topic is appropriate
for the Rational Clinical Examination series by sending an email to email@example.com.
Questions about any other categories of articles should be directed to the editorial office (see Editorial Office Contact Information).
Manuscript Preparation and Submission Requirements
All manuscripts must be submitted online via the JAMA online manuscript submission and review system. At the time of submission, complete contact
information (affiliation, postal/mail address, email address, telephone and fax numbers) for the corresponding author is required. First and last
names, email addresses, and institutional affiliations of all coauthors are also required. After the manuscript is submitted, the corresponding author will receive an acknowledgment confirming receipt and
a manuscript number. Authors will be able to track the status of their manuscripts via the online system. After manuscript submission, all authors of
papers under consideration for publication will be sent a link to the Authorship Form to complete and submit (see sample Authorship Form). See Manuscript Checklist, Manuscript Preparation and Submission
Requirements,1,2 and other details in these instructions for additional requirements.
Include a cover letter and complete contact information for the corresponding author (affiliation, postal/mail address, email address, and telephone number) and whether the authors have published or submitted any related papers from the same study (see Duplicate/Previous Publication or
Manuscripts should be prepared in accordance with the AMA Manual of Style, 10th edition,1 and/or
the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals.2
Include a title page, abstract, text, references, and as appropriate, figure legends, tables, and figures. Start each of these sections on a new page,
numbered consecutively, beginning with the title page.
Recommended File Sizes
We recommend individual file sizes of no more than 500 kB and not exceeding 1 MB, with the total size for all files not exceeding 5 MB (not including
any video files).
Manuscript File Formats
For submission and review, acceptable manuscript file formats include Word and WordPerfect. Do not submit your manuscript in PDF format.
Use 10-, 11-, or 12-point font size, double-space text, and leave right margins unjustified (ragged).
The title page should include a word count for text only (eg, not including abstract, acknowledgment, or references) and the full names, highest
academic degrees, and affiliations of all authors. If an author’s affiliation has changed since the work was done, the new affiliation also
should be listed.
Titles should be concise, specific, and informative and should contain the key points of the work.1(p8) Please limit the length of titles to 150 characters for reports of research and other major articles and 100 characters for Editorials, Viewpoints, Commentaries, and Letters. For scientific manuscripts, overly general titles are not desirable and questions and declarative sentences should be avoided. For reports of clinical trials, meta-analyses, and systematic reviews, include the type of study as a subtitle (eg, A Randomized Clinical Trial, A Meta-analysis, A Systematic Review). For reports of other types of research, do not include study type or design in the title or subtitle.
Include a structured abstract of no more than 350 words for reports of original data, reviews, and meta-analyses. Abstracts should be prepared in JAMA style—see instructions for preparing abstracts below. For other major manuscripts, include an unstructured abstract of no more
than 200 words that summarizes the objective, main points, and conclusions of the article. Abstracts are not required for Editorials, Viewpoints, and
some special features.
All reports of original data, systematic reviews, and meta-analyses should be submitted with structured abstracts as described
below. No information should be reported in the abstract that does not appear in the text of the manuscript.
Abstracts for Reports of Original Data:
Reports of original data should include an abstract of no more than 350 words using the headings listed below. For brevity, parts of the abstract may be written as phrases rather than complete sentences. Each section should include the following content:
Importance: The abstract should begin with a sentence or 2 explaining the clinical (or other) importance of the study question.
Objective: State the precise objective or study question addressed in the report (eg, “To determine whether…”). If more than 1 objective is addressed, the main objective should be indicated and only key secondary objectives stated. If an a priori hypothesis was tested, it should be stated.
Design: Describe the basic design of the study. State the years of the study and the duration of follow-up. If applicable, include the name of the study (eg, the Framingham Heart Study). As relevant, indicate whether observers were blinded to patient groupings, particularly for subjective measurements.
Setting: Describe the study setting to assist readers to determine the applicability of the report to other circumstances, for example, general community, a primary care or referral center, private or institutional practice, or ambulatory or hospitalized care.
Participants: State the clinical disorders, important eligibility criteria, and key sociodemographic features of patients. The numbers of participants and how they were selected should be provided (see below), including the number of otherwise eligible individuals who were approached but refused. If matching is used for comparison groups, characteristics that are matched should be specified. In follow-up studies, the proportion of participants who completed the study must be indicated. In intervention studies, the number of patients withdrawn because of adverse effects should be given. For selection procedures, these terms should be used, if appropriate: random sample (where random refers to a formal, randomized selection in which all eligible individuals have a fixed and usually equal chance of selection); population-based sample; referred sample; consecutive sample; volunteer sample; convenience sample.
Note: the preceding 3 sections are usually combined for accepted
papers during the editing process as “Design, Setting, and
Participants,” but for manuscript submission these sections should be
Intervention(s) for clinical trials or Exposure(s) for observational studies: The essential features of any interventions, or exposures, should be described, including their method and duration. The intervention, or exposure, should be named by its most common clinical name, and nonproprietary drug names should be used.
Main Outcome(s) and Measure(s): Indicate the primary study outcome measurement(s) as planned before data collection began. If the manuscript does not report the main planned outcomes of a study, this fact should be stated and the reason indicated. State clearly if the hypothesis being tested was formulated during or after data collection. Explain outcomes or measurements unfamiliar to a general medical readership.
Results: The main outcomes of the study should be reported and quantified, including baseline characteristics and final included/analyzed sample. Include absolute numbers and measures of absolute risks (such as increase/decrease or absolute differences between groups), along with confidence intervals (for example, 95%) or P values. Approaches such as number needed to treat to achieve a unit of benefit may be included when appropriate. Measures of relative risk also may be reported (eg, relative risk, hazard ratios) and should include confidence intervals. Studies of screening and diagnostic tests should report sensitivity, specificity, and likelihood ratio. If predictive value or accuracy is reported, prevalence or pretest likelihood should be given as well. All randomized controlled trials should include the results of intention-to-treat analysis, and all surveys should include response rates.
Conclusions and Relevance: Provide only conclusions of the study that are directly supported by the results. Give equal emphasis to positive and negative findings of equal scientific merit. Also, provide a statement of relevance indicating implications for clinical practice or health policy, avoiding speculation and overgeneralization. The relevance statement may also indicate whether additional study is required before the information should be used in clinical settings.
For clinical trials, the name of the trial registry, registration number, and URL of the registry must be included.
Manuscripts reporting the results of meta-analyses should include an abstract of no more than 350 words using the headings listed below. The text of the manuscript should also include a section
describing the methods used for data sources, study selection, data extraction, and data synthesis. Each heading should be followed by a brief
Importance: A sentence or 2 explaining the importance of the review question.
Objective: State the precise primary objective of the review. Indicate whether the review emphasizes factors such as cause, diagnosis, prognosis, therapy, or prevention and include information about the specific population, intervention, exposure, and tests or outcomes that are being reviewed.
Data Sources: Succinctly summarize data sources, including years searched. The search should include the most current information possible, ideally with the search being conducted within several months before the date of manuscript submission. Potential sources include computerized databases and published indexes, registries, abstract booklets, conference proceedings, references identified from bibliographies of pertinent articles and books, experts or research institutions active in the field, and companies or manufacturers of tests or agents being reviewed. If a bibliographic database is used, state the exact indexing terms used for article retrieval, including any constraints (for example, English language or human study participants). If abstract space does not permit this level of detail, summarize sources in the abstract including databases and years searched, and place the remainder of the information in the Methods section.
Study Selection: Describe inclusion and exclusion criteria used to select studies for detailed review from among studies identified as relevant to the topic. Details of selection should include particular populations, interventions, outcomes, or methodological designs. The method used to apply these criteria should be specified (for example, blinded review, consensus, multiple reviewers). State the proportion of initially identified studies that met selection criteria.
Data Extraction and Synthesis: Describe guidelines used for abstracting data and assessing data quality and validity (such as criteria for causal inference). The method by which the guidelines were applied should be stated (for example, independent extraction by multiple observers).
Main Outcome(s) and Measure(s): Indicate the primary study outcome(s) and measurement(s) as planned before data collection began. If the manuscript does not report the main planned outcomes of a study, this fact should be stated and the reason indicated. State clearly if the hypothesis being tested was formulated during or after data collection. Explain outcomes or measurement unfamiliar to a general medical readership.
Results: State the main quantitative results of the review, including baseline characteristics and final included/analyzed studies and/or sample(s). Include absolute risks whenever possible (such as increase/decrease or absolute differences between groups), along with confidence intervals (for example, 95%) or P values. Meta-analyses should state the major outcomes that were pooled and include odds ratios or effect sizes and, if possible, sensitivity analyses. Numerical results should be accompanied by confidence intervals, if applicable, and exact levels of statistical significance. Evaluations of screening and diagnostic tests should include sensitivity, specificity, likelihood ratios, receiver operating characteristic curves, and predictive values. Assessments of prognosis should summarize survival characteristics and related variables. Major identified sources of variation between studies should be stated, including differences in treatment protocols, co-interventions, confounders, outcome measures, length of follow-up, and dropout rates.
Conclusions and Relevance: The conclusions and their applications (clinical or otherwise) should be clearly stated, limiting interpretation to the domain of the review.
Abstracts for Reviews:
Review articles should include an abstract of no more than 350 words using the headings listed below.
Importance: Include 1 or 2 sentences describing the clinical question or issue and its importance in clinical practice or public health.
Objective: State the precise primary objective of the review. Indicate whether the review emphasizes factors such as cause, diagnosis, prognosis, therapy, or prevention and include information about the specific population, intervention, exposure, and tests or outcomes that are being reviewed.
Evidence Review: Describe the information sources used, including the search strategies, years searched, and other sources of material, such as subsequent reference searches of retrieved articles. Methods used for quality assessment and inclusion of identified articles should be explained.
Findings: The major findings of the review of the clinical issue or topic should be addressed in an evidence-based, objective, and balanced fashion, with the highest quality evidence available receiving the greatest emphasis.
Conclusions and Relevance: The conclusions should clearly answer the questions posed if applicable, be based on available evidence, and emphasize how clinicians should apply current knowledge.
Do not use abbreviations in the title or abstract and limit their use in the text. Expand all abbreviations at first mention in the text.
Methods and Statistics
Describe statistical methods with enough detail to enable a knowledgeable reader with access to the original data to reproduce the reported results. When possible, quantify findings and present them with appropriate indicators of measurement error or uncertainty (such as confidence intervals). Avoid relying solely on statistical hypothesis testing, such as the use of P values, which fails to convey important quantitative information. Give details about randomization. Describe the methods for and success of any blinding of observations. Report complications of treatment. Give numbers of observations. Report losses to observation (such as dropouts from a clinical trial). For multivariate models, report all variables included in models, and report model diagnostics and proportion of variance explained by both individual variables and the complete model.
Put a general description of methods in the “Methods” section. Restrict tables and figures to those needed to explain the argument of the article and to assess its support. Use graphs as an alternative to tables with many entries; do not duplicate data in graphs and tables. Avoid nontechnical uses of technical terms in statistics, such as random (which implies a randomizing device), normal, significant, correlations, and sample. Define statistical terms, abbreviations, and most symbols. Provide a brief description of statistical tests used and levels of significance to the Statistical Analysis paragraph in the Methods section.
Units of Measure
Laboratory values are expressed using conventional units of measure, with relevant Système International (SI) conversion factors expressed
secondarily (in parentheses) only at first mention. Articles that contain numerous conversion factors may list them together in a paragraph at the end
of the Methods section. In tables and figures, a conversion factor to SI should be presented in the footnote or legend. The metric system is preferred
for the expression of length, area, mass, and volume. For more details, see the Units of Measure conversion table on the website for the AMA Manual of Style.1
Names of Drugs, Devices, and Other Products
Use nonproprietary names of drugs, devices, and other products, unless the specific trade name of a drug is essential to the discussion.1(pp567-569)
Gene Names, Symbols, and Accession Numbers
Authors describing genes or related structures in a manuscript should include the names and official symbols provided by the US National Center for Biotechnology Information (NCBI) or the HUGO Gene Nomenclature Committee. Before submission of a research manuscript reporting on large genomic data
sets (eg, protein or DNA sequences), the data sets should be deposited in a publicly available database, such as NCBI’s GenBank, and a complete accession number (and version number if appropriate) must be
provided in the Methods section or Acknowledgment of the manuscript.
does not republish text, tables, figures, or other material from other publishers, except under rare circumstances. Please delete any such material and
replace with originals.
Authors are responsible for the accuracy and completeness of their references and for correct text citation. Number references in the order they appear
in the text; do not alphabetize. In text, tables, and legends, identify references with superscript Arabic numerals. When listing references, follow
AMA style and abbreviate names of journals according to the journals list in PubMed. List all authors and/or editors up to 6; if more than 6, list the first
3 followed by “et al.” Note: Journal references should include the issue number in parentheses after the volume number.
Examples of reference style:
- Youngster I, Russell GH, Pindar C, Ziv-Baran T, Sauk J, Hohmann EL. Oral, capsulized, frozen fecal microbiota transplantation for relapsing Clostridium difficile infection. JAMA. 2014;312(17):1772-1778.
- Murray CJL. Maximizing antiretroviral therapy in developing countries: the dual challenge of efficiency and quality [published online December 1, 2014]. JAMA. doi:10.1001/jama.2014.16376.
- Centers for Medicare & Medicaid Services. CMS proposals to implement certain disclosure provisions of the Affordable Care Act. http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4221. Accessed January 30, 2012.
McPhee SJ, Winker MA, Rabow MW, Pantilat SZ, Markowitz AJ, eds. Care at the Close of Life: Evidence and Experience. New York, NY: McGraw Hill
Number all tables in the order of their citation in the text. Include a title for each table (a brief phrase, preferably no longer than 10 to 15
words). Include all tables at the end of the manuscript file. Refer to Categories of Articles because there may be a limit on the number of tables for
the type of manuscript. If a table must be continued, repeat the title on the second page, followed by “(continued).”
Instructions for Table Creation
These instructions are available here.
Number all figures (graphs, charts, photographs, and illustrations) in the order of their citation in the text. Include a title for each figure (a
brief phrase, preferably no longer than 10 to 15 words). For initial manuscript submissions, figures must be of sufficient quality for editorial
assessment and peer review. If the manuscript is accepted, authors will be asked to provide figures that meet the Guidelines for Figures in Accepted Manuscripts. Graphs, charts, titles, and
legends in accepted manuscripts will be re-created or edited according to JAMA style and standards prior to publication. All illustrations of
accepted manuscripts will be redrawn by JAMA medical illustrators. Online-only figures will not be edited or re-created (see Online-Only
Preparation of scientific images (clinical images, radiographic images, micrographs, gels, etc) for publication must preserve the integrity of the
image data. Digital adjustments of brightness, contrast, or color applied uniformly to an entire image are permissible as long as these adjustments do
not selectively highlight, misrepresent, obscure, or eliminate specific elements in the original figure, including the background. Selective
adjustments applied to individual elements in an image are not permissible. Individual elements may not be moved within an image field, deleted, or
inserted from another image. Cropping may be used for efficient image display but must not misrepresent or alter interpretation of the image by
selectively eliminating relevant visual information. Juxtaposition of elements from different parts of a single image or from different images, as in a
composite, must be clearly indicated by the addition of dividing lines, borders, and/or panel labels.
When inappropriate image adjustments are detected by the JAMA staff, authors will be asked for an explanation and will be requested to submit
the image as originally captured prior to any adjustment, cropping, or labeling. Authors may be asked to resubmit the image prepared in accordance with
the above standards.
Guidelines for Figures in Accepted Manuscripts:
These guidelines are available here.
Acceptable Figure File Size
To reduce the time that it takes to upload files to the JAMA submission site and for reviewers to download files from the site, we recommend
that the file size of figures be compressed before uploading them. This can be done by using compression software or by decreasing the resolution of
Acceptable Figure File Formats
At submission, the following file formats are acceptable: AI, BMP, DOC, EMF, EPS, JPG, PDF, PPT, PSD, TIF, WMF, or XLS. Figures may be embedded at the
end of the manuscript text file or loaded as separate files for submission purposes.
Figure Titles and Legends (Captions)
At the end of the manuscript, include a title for each figure. The figure title should be a brief descriptive phrase, preferably no longer than 10 to 15 words. A figure legend can be used for a brief explanation of the figure or markers if needed (preferred maximum length, 40 words) and expansion of abbreviations. For photomicrographs, include the type of specimen, original magnification or a scale bar, and stain in the legend. For gross pathology specimens, label any rulers with unit of measure. Digitally enhanced images must be clearly identified in the figure legends as enhanced or manipulated, eg, computed tomographic scans, magnetic resonance images, photographs, photomicrographs, x-ray films.
Figures With Labels, Arrows, or Other Markers
Photographs, clinical images, photomicrographs, gel electrophoresis, and the like that include labels, arrows, or other markers must be submitted in 2 versions: one version with the markers and one without. Provide an explanation for all labels, arrows, or other markers in the figure legend. The Figure field in the File Description tab of the manuscript submission form allows for uploading of 2 versions of the same figure.
Number of Figures
Refer to Categories of Articles as there may be a limit on the number of figures for the type of manuscript.
Authors may submit supporting material to accompany their article for online-only publication when there is insufficient space to include the material
in the print article. This material should be important to the understanding and interpretation of the report and should not repeat material in the
print article. The amount of online-only material should be limited and justified. Online-only material should be original and not previously
Online-only material will undergo editorial and peer review with the main manuscript. If the manuscript is accepted for publication and if the
online-only material is deemed appropriate for publication by the editors, it will be posted online at the time of publication of the article as
additional material provided by the authors. This material will not be edited or formatted; thus, authors are responsible for the accuracy and
presentation of all such material.
Online-only material should be submitted in a single Word document with pages numbered consecutively. Each element included in the online-only material
should be cited in the text of the main manuscript (eg, eTable in the Supplement) and numbered in order of citation in the text (eg, eTable 1, eTable 2, eFigure 1,
eFigure 2, eMethods). The first page of the online-only document should list the number and title of each element included in the document.
Online-only text should be set in Times New Roman font, 10 point in size, and single-spaced. The main heading of the online-only text should be in 12
point and boldface; subheadings should be in 10 point and boldface.
All references cited within the online-only document must be included in a separate reference section, including those that also were cited in the main
manuscript. They should be formatted just as in the main manuscript and numbered and cited consecutively in the online-only material.
Online-only tables should be inserted in the document and numbered consecutively according to the order of citation as eTable 1, eTable 2, etc. The
text and data in online tables should be Arial font, 10 point in size, and single-spaced. The table title should be set in Arial font, 12 point, and
bold. Headings within tables should be set in 10 point and bold. Table footnotes should be set in 8 point and single-spaced. See also instructions for
Tables above. If a table runs on to subsequent pages, repeat the column headers at the top of each page. Wide tables may be presented using a landscape
Online-only figures should be inserted in the document and numbered consecutively according to the order of citation as eFigure 1, eFigure 2, etc.
Figure titles should be set in Arial font, 12 point, bold, and single-spaced. Text within figures should be set as Arial font, 10 point. Figure legends
should be set in 8 point and single-spaced. Graphs and diagrams should be exported directly out of the software application used to create them in a
vector file format, such as .wmf, and then inserted into the Word document. Image file formats such as .jpg, .tif, and .gif are generally not suitable
for graphs. Photographs, including all radiological images, should be prepared as .jpg (highest option) or .tif (uncompressed) files at a resolution of
300 dpi and width of 3-5 inches, but the resolution of photographic files with an original resolution <300 dpi should not be increased digitally to
achieve a 300-dpi resolution. Photographs should be inserted in the document with the “Link to File” button turned off. Wide figures may be
presented using a landscape orientation.
For editorial and peer review of an initial submission, submit videos according to the following specifications:
Acceptable file formats: .mov, .wmv, .mpg, .mpeg, .mp4, or .avi
Maximum file size: 10 MB
Minimum dimensions: 320 pixels wide by 240 pixels deep
Maximum length: 5 minutes
Verify that the videos are viewable in QuickTime or Windows Media Player.
For each video, provide a citation in the appropriate place in the manuscript text and include a title (a brief phrase, preferably no longer than 10 to
15 words) and a caption at the end of the manuscript. In the video caption, specify the video file format and briefly describe the content of the
video. The same title and caption must be entered in the designated fields on the web-based manuscript submission system when uploading each video. If
multiple video files are submitted, number them in the order in which they should be viewed.
If patient(s) are identifiable in the video, authors must submit with the manuscript the Patient Permission form completed and signed by the patient.
See also Identification of Patients in Descriptions, Photographs, Video, and Pedigrees.
If the author does not hold copyright to the video, the author must obtain permission for the video to be published in JAMA. This permission
must be for unrestricted use in all print, online, and licensed versions of JAMA.
Note: If the manuscript and accompanying video(s) are accepted for publication, all video files will be placed into a journal video frame and may be
edited by the journal staff according to journal style. The journal staff may contact you to request the original full-size video without text or
labels to be sent by email, FTP, or CD/DVD.
For more information, read our additional guidelines for videography.
For editorial and peer review of an intial submission, submit audio files acccording to the following minimum requirements:
Acceptable file formats: .mp3, .wav, or .aiff
Maximum file size: 10 MB
To achieve the best quality, when saving audio files as an mp3, use a setting of 256 kbps or higher for stereo or 128 kbps or higher for mono.
Sampling rate should be either 44.1 kHz or 48 kHz.
Bit rate should be either 16 or 24 bit.
To avoid audible clipping noise, please make sure that audio levels do not exceed 0 dBFS.
For each audio file, provide a citation in the appropriate place in the manuscript text and include a title (a brief phrase, preferably no longer than 10-15 words) and a caption at the end of the manuscript.
Postacceptance requirements: if the manuscript and accompanying audio(s) are accepted for publication, journal staff will contact you to request the original uncompressed audio file. Note: there is no minimum file size requirement once it has been accepted.
Review manuscript submission requirements in these instructions and in our online manuscript submission and review system.
Include a cover letter as an attachment.
Designate a corresponding author and provide a complete affiliation, postal/mail address, telephone and fax numbers, and e-mail address.
Provide first (given) and last (family) names, e-mail addresses, and institutional affiliations for any coauthors.
On the title page, include a word count for text only, exclusive of title, abstract, references, tables, and figure legends.
Provide an abstract that conforms to the required abstract format (see specific Categories of Articles).
Double-space manuscript and leave right margins unjustified (ragged).
Check all references for accuracy and completeness. Put references in proper format in numerical order, making sure each is cited in sequence in the
Include a title for each table and figure and online-only material (a brief, succinct phrase, preferably no longer than 10 to 15 words) and explanatory
legend as needed.
For reports of original data, include statement from at least 1 named author, but no more than 2 named authors, that she or he “had full access
to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis” in the
Acknowledgment section at the end of the manuscript.
- For all reports containing original data, the names and affiliations of all authors (or other individuals) who conducted and are responsible for the data analysis must be indicated in the Acknowledgment section of the manuscript. If the individual who conducted the analysis is not named as an author, a detailed explanation of his/her contributions and reasons for his/her involvement with the data analysis should be included.
Inform all coauthors that the JAMA editorial office will send an email to each author with a link to the electronic Authorship Form to be completed after the manuscript is submitted.
Inform all coauthors that each will need to complete the ICMJE Form for Disclosure of Potential Conflicts of Interest. JAMA will
request this disclosure form after the manuscript is submitted.
Include all authors’ potential conflicts of interest, including relevant financial interests, activities, relationships, and affiliations in the
Acknowledgment section of the manuscript. The corresponding author is responsible for ensuring that the disclosure information in the Acknowledgment
section of the manuscript is consistent with that reported in each author’s ICMJE Form for Disclosure of Potential Conflicts of Interest.
Include all sources of financial and material support and assistance along with detailed information on the roles of each sponsor/funder in each of
the following: “design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or
approval of the manuscript” in the Acknowledgment section of the manuscript.
In the Acknowledgment section of the manuscript, include the names, academic degrees, affiliations, and specific contributions of all persons who have
contributed to the work reported in the manuscript (eg, data collection, analysis, writing or editing assistance, review of manuscript) but who do not
fulfill authorship criteria, and also indicate whether any compensation was received for such contributions. Written permission must be obtained from
all persons named in the Acknowledgment section and the corresponding author must confirm that such written permission has been obtained (see also the
Acknowledgment statement in the Authorship Form that must be completed by the corresponding author).
Include a copy of written permission from each individual identified as a source for personal communication or unpublished data.
If appropriate, include information on institutional review board/ethics committee approval or waiver and informed consent.
The reproduction of material (including tables and figures) that was previously published is discouraged. Original material should be provided, except
under extraordinary circumstances.
Include Patient Permission forms for identifiable patient
descriptions, photographs, video, and pedigrees.
Review more detailed instructions for specific Categories of Articles.
1. Iverson C, Christiansen S, Flanagin A, et al. AMA Manual of Style: A Guide for Authors and Editors. 10th ed. New York, NY: Oxford
University Press; 2007. http://www.amamanualofstyle.com.
2. International Committee of Medical Journal Editors. Recommendations for the conduct, reporting, editing and publication of scholarly work in medical journals.
http://www.icmje.org. Updated 2014. Accessed December 8, 2014.
3. Fontanarosa PB, Flanagin A, DeAngelis CD. Implementation of the ICMJE form for reporting potential conflicts of interest. JAMA.
2010;304(13):1496. FULL TEXT.
4. Flanagin A, Fontanarosa PB, DeAngelis CD. Authorship for research groups. JAMA. 2002;288(24):3166-3168.
5. Fontanarosa PB, Flanagin A, DeAngelis CD. Reporting conflicts of interest, financial aspects of research, and role of sponsors in funded
studies. JAMA. 2005;294(1):110-111.FULL TEXT.
6. DeAngelis CD, Drazen JM, Frizelle FA, et al; International Committee of
Medical Journal Editors. Clinical trial registration: a
statement from the International Committee of Medical Journal Editors. JAMA. 2004;292(11):1363-1364.
7. DeAngelis CD, Drazen JM, Frizelle FA, et al; International Committee of Medical Journal Editors. Is this clinical trial fully
registered? a statement from the International Committee of Medical Journal Editors. JAMA. 2005;293(23):2927-2929.
8. The CONSORT statement.
http://www.consort-statement.org/consort-statement/overview0. Updated 2014. Accessed December 8, 2014.
9. Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. 7th ed. Lenexa, KS: American Association
for Public Opinion Research; 2011. http://www.aapor.org.
Accessed December 9, 2014.
10. Winker MA. Measuring race and ethnicity: why and how? JAMA. 2004;292(13):1612-1614.
11. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194. http://jama.jamanetwork.com/article.aspx?articleid=1760318. Accessed January 2, 2014.
12. Journal Editors and Authors Group. Statement on scientific publication and security. Science. 2003;299(5610):1149.
Accessed February 28, 2012.
13. Fontanarosa PB, Flanagin A, DeAngelis CD. Update on JAMA’s policy on release of information to the public.
JAMA. 2008;300(13):1585-1587.FULL TEXT.
14. Fontanarosa PB, DeAngelis CD. Update on JAMA-EXPRESS: rapid review and publication. JAMA. 2008;300(24):2920-2921.
15. Golub RM. Correspondence course: tips for getting a letter published in JAMA. JAMA. 2008;300(1):98-99.
Last updated February 9, 2015.