Effectiveness of Ambient AI Scribes
https://jamanetwork.com/journals/jama/fullarticle/2847322
Ambient artificial intelligence (AI) scribes—technology tools that streamline documentation by listening in the background and drafting notes during clinical encounters—have rapidly moved from novelty into clinical infrastructure, motivated by a pressing goal: reducing the clerical burden that threatens workforce sustainability. While these tools have the potential to meaningfully advance parts of the quintuple aim—improving population outcomes, reducing costs, enhancing patient experience, addressing clinician burnout, and advancing health equity—the evidence supporting their ability to do so remains uneven across domains.
https://jamanetwork.com/journals/jama/fullarticle/2847322
Ambient artificial intelligence (AI) scribes—technology tools that streamline documentation by listening in the background and drafting notes during clinical encounters—have rapidly moved from novelty into clinical infrastructure, motivated by a pressing goal: reducing the clerical burden that threatens workforce sustainability. While these tools have the potential to meaningfully advance parts of the quintuple aim—improving population outcomes, reducing costs, enhancing patient experience, addressing clinician burnout, and advancing health equity—the evidence supporting their ability to do so remains uneven across domains.
Prioritizing Time from Diagnosis to Quadruple Therapy in Heart Failure Care
https://jamanetwork.com/journals/jamacardiology/fullarticle/2846903
Heart failure (HF) affects more than 7 million individuals in the US and carries a 5-year mortality rate of approximately 75% following hospitalization. To lower the risk of morbidity and mortality, guidelines recommend that patients with HF with reduced ejection fraction (HFrEF) receive quadruple therapy, consisting of β-blockers, angiotensin receptor–neprilysin inhibitors (ARNI), mineralocorticoid receptor antagonists (MRA), and sodium-glucose cotransporter-2 inhibitors (SGLT2i). Together, these 4 pillars of therapy are projected to reduce the relative risk of all-cause mortality by over 70%. Despite their proven benefits and commensurate class I guideline recommendation, uptake of these medications remains low with fewer than 1 in 6 medically eligible patients receiving quadruple therapy in a recent national registry analysis.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2846903
Heart failure (HF) affects more than 7 million individuals in the US and carries a 5-year mortality rate of approximately 75% following hospitalization. To lower the risk of morbidity and mortality, guidelines recommend that patients with HF with reduced ejection fraction (HFrEF) receive quadruple therapy, consisting of β-blockers, angiotensin receptor–neprilysin inhibitors (ARNI), mineralocorticoid receptor antagonists (MRA), and sodium-glucose cotransporter-2 inhibitors (SGLT2i). Together, these 4 pillars of therapy are projected to reduce the relative risk of all-cause mortality by over 70%. Despite their proven benefits and commensurate class I guideline recommendation, uptake of these medications remains low with fewer than 1 in 6 medically eligible patients receiving quadruple therapy in a recent national registry analysis.
Statin Eligibility According to Atherosclerotic Cardiovascular Disease Risk in the US
https://jamanetwork.com/journals/jamacardiology/fullarticle/2846902
To the Editor Khan and colleagues grapple with how to define statin eligibility in light of evolving cardiovascular disease (CVD) risk prediction algorithms. A conceptual problem lies in the approach Khan et al used to represent the underlying US population, as reflected in the National Health and Nutrition Examination Survey (NHANES) population survey. Using NHANES data, they identified a US population group who were not taking statins and also did not have a clinical characteristic, including diabetes, hypercholesterolemia, or prior atherosclerotic CVD (ASCVD), that clearly indicated the drug. Using data among this untreated group, representing 70.2 million US adults, they argue for the use of a threshold of at least 5% future 10-year risk of ASCVD, as estimated by the PREVENT equation, to identify the population who would achieve a substantial overall clinical benefit from use of statins.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2846902
To the Editor Khan and colleagues grapple with how to define statin eligibility in light of evolving cardiovascular disease (CVD) risk prediction algorithms. A conceptual problem lies in the approach Khan et al used to represent the underlying US population, as reflected in the National Health and Nutrition Examination Survey (NHANES) population survey. Using NHANES data, they identified a US population group who were not taking statins and also did not have a clinical characteristic, including diabetes, hypercholesterolemia, or prior atherosclerotic CVD (ASCVD), that clearly indicated the drug. Using data among this untreated group, representing 70.2 million US adults, they argue for the use of a threshold of at least 5% future 10-year risk of ASCVD, as estimated by the PREVENT equation, to identify the population who would achieve a substantial overall clinical benefit from use of statins.
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Statin Eligibility According to Atherosclerotic Cardiovascular Disease Risk in the US—Reply
https://jamanetwork.com/journals/jamacardiology/fullarticle/2846901
In Reply We appreciate the thoughtful engagement by Kaplan and Kim in response to our article that evaluated different risk thresholds for the newer predicting risk of cardiovascular disease events (PREVENT) equations and the older pooled cohort equations (PCEs). The premise for our analysis was that with the development of new risk models, new risk thresholds are needed. We identify 3 key areas for clarification: (1) our selected analytic sample based on US adults not currently taking statin treatment, (2) comparison of the number of adults eligible for statin initiation based on varying risk thresholds with PREVENT and PCEs, and (3) emphasis on clinician-patient discussions based on predicted risk and benefit.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2846901
In Reply We appreciate the thoughtful engagement by Kaplan and Kim in response to our article that evaluated different risk thresholds for the newer predicting risk of cardiovascular disease events (PREVENT) equations and the older pooled cohort equations (PCEs). The premise for our analysis was that with the development of new risk models, new risk thresholds are needed. We identify 3 key areas for clarification: (1) our selected analytic sample based on US adults not currently taking statin treatment, (2) comparison of the number of adults eligible for statin initiation based on varying risk thresholds with PREVENT and PCEs, and (3) emphasis on clinician-patient discussions based on predicted risk and benefit.
Blood Pressure Genetic Risk and Incident Hypertension at 2 to 7 Years Post Partum
https://jamanetwork.com/journals/jamacardiology/fullarticle/2846900
This cohort study investigates if genetic risk for high systolic blood pressure is associated with the risk of new-onset hypertension after pregnancy, beyond clinical characteristics and history of hypertensive disorders of pregnancy.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2846900
This cohort study investigates if genetic risk for high systolic blood pressure is associated with the risk of new-onset hypertension after pregnancy, beyond clinical characteristics and history of hypertensive disorders of pregnancy.
Time to Quadruple Therapy After Diagnosis of HFrEF
https://jamanetwork.com/journals/jamacardiology/fullarticle/2846899
This cohort study investigates the association of contemporary patterns and factors with time to quadruple therapy among veterans with newly diagnosed heart failure with reduced ejection fraction (HFrEF).
https://jamanetwork.com/journals/jamacardiology/fullarticle/2846899
This cohort study investigates the association of contemporary patterns and factors with time to quadruple therapy among veterans with newly diagnosed heart failure with reduced ejection fraction (HFrEF).
Drugging in the Dark
https://jamanetwork.com/journals/jama/fullarticle/2847334
Such is the practice complained of by a correspondent of a contemporary, who finds that many physicians administer medicines in what seems to be a reckless and unscientific manner,—“Strychnine, arsenic, digitalis and aconite, are favorite remedies in all sorts of diseases.” Used in this connection, we may very well object to the word remedies; in other respects we must agree with the complainant, adding that in America quinine seems to hold a high place in the list of drugs that are prescribed when there is some little doubt as to the diagnosis. “Pills and mixtures containing many poisonous drugs are commonly prescribed, even when the practitioner is quite in the dark as to what the cause of the disease may be. With some, the rule is, when the cause is unknown, to mix a great many poisonous stuffs, in the hope that one of them may hit the enemy. A wiser and safer course would be, when the diagnosis is uncertain, to give, in the name of remedy, something that cannot possibly injure the patient.”
https://jamanetwork.com/journals/jama/fullarticle/2847334
Such is the practice complained of by a correspondent of a contemporary, who finds that many physicians administer medicines in what seems to be a reckless and unscientific manner,—“Strychnine, arsenic, digitalis and aconite, are favorite remedies in all sorts of diseases.” Used in this connection, we may very well object to the word remedies; in other respects we must agree with the complainant, adding that in America quinine seems to hold a high place in the list of drugs that are prescribed when there is some little doubt as to the diagnosis. “Pills and mixtures containing many poisonous drugs are commonly prescribed, even when the practitioner is quite in the dark as to what the cause of the disease may be. With some, the rule is, when the cause is unknown, to mix a great many poisonous stuffs, in the hope that one of them may hit the enemy. A wiser and safer course would be, when the diagnosis is uncertain, to give, in the name of remedy, something that cannot possibly injure the patient.”
Audio Highlights April 3, 2026
https://jamanetwork.com/journals/jama/fullarticle/2847562
Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.
https://jamanetwork.com/journals/jama/fullarticle/2847562
Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.
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FDA Approves Higher Dose Injectable Semaglutide
https://jamanetwork.com/journals/jama/fullarticle/2847412
The US Food and Drug Administration (FDA) approved a higher-dose version of weekly injectable semaglutide, marketed as Wegovy HD, for adults with obesity or overweight with at least 1 weight-related condition.
https://jamanetwork.com/journals/jama/fullarticle/2847412
The US Food and Drug Administration (FDA) approved a higher-dose version of weekly injectable semaglutide, marketed as Wegovy HD, for adults with obesity or overweight with at least 1 weight-related condition.
Premature Menopause Linked With Higher Heart Attack Risk
https://jamanetwork.com/journals/jama/fullarticle/2847411
Premature menopause was associated with a 40% higher lifetime risk of coronary heart disease, according to a study published in JAMA Cardiology.
https://jamanetwork.com/journals/jama/fullarticle/2847411
Premature menopause was associated with a 40% higher lifetime risk of coronary heart disease, according to a study published in JAMA Cardiology.
US COVID-19 Deaths May Have Been Underreported, Study Finds
https://jamanetwork.com/journals/jama/fullarticle/2847410
COVID-19 may have caused about 19% more deaths in the US from March 2020 to December 2021 than officially recorded, a new study suggests.
https://jamanetwork.com/journals/jama/fullarticle/2847410
COVID-19 may have caused about 19% more deaths in the US from March 2020 to December 2021 than officially recorded, a new study suggests.
Interstitial Lung Disease as a Late Occurrence in Ocrelizumab-Treated Patients With Multiple Sclerosis
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847194
This case series describes 6 cases of interstitial lung disease among patients with multiple sclerosis receiving long-term treatment with ocrelizumab.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847194
This case series describes 6 cases of interstitial lung disease among patients with multiple sclerosis receiving long-term treatment with ocrelizumab.
Teleneurology vs On-Site Neurology Consultation for Postadmission Hospital Care of Stroke
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847193
This study assesses the noninferiority of teleneurological ward rounds compared with conventional on-site ward rounds during subacute inpatient stroke care, focusing on adherence to guideline-based quality indicators.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847193
This study assesses the noninferiority of teleneurological ward rounds compared with conventional on-site ward rounds during subacute inpatient stroke care, focusing on adherence to guideline-based quality indicators.
Advancing Precision Dementia Care With Genetic-Exposome Risk Assessment
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847192
This Viewpoint advocates for an integrated genetic-exposome risk assessment framework for early identification and targeted treatment of Alzheimer disease.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847192
This Viewpoint advocates for an integrated genetic-exposome risk assessment framework for early identification and targeted treatment of Alzheimer disease.
Navigating Thyroid Hormone Deprescribing in Older Adults
https://jamanetwork.com/journals/jama/fullarticle/2847287
Thyroid hormone medication use is common, with levothyroxine ranking among the 3 most commonly dispensed medications in the US and Europe. Older age is an independent predictor of thyroid hormone initiation. Up to 60% of adults are prescribed levothyroxine for subclinical hypothyroidism (defined as having an elevated thyrotropin [TSH] level and a free thyroxine level within the reference range) or for non–evidence-based indications and generally continue treatment lifelong. Widespread prescribing of levothyroxine and levothyroxine use occur despite 61% of patients with subclinical hypothyroidism spontaneously reverting to euthyroidism and high-certainty evidence failing to demonstrate a benefit from subclinical hypothyroidism treatment. Furthermore, thyroid hormone therapy is associated with increased patient burden and health care expenditures and places patients at risk for iatrogenic thyrotoxicosis (increases the risk for cardiovascular, skeletal, and cognitive adverse effects). Although initiatives exist to prevent the initiation of potentially inappropriate medications in older adults, few have targeted deprescribing, which is the systematic and supervised process of safely reducing or discontinuing a medication.
https://jamanetwork.com/journals/jama/fullarticle/2847287
Thyroid hormone medication use is common, with levothyroxine ranking among the 3 most commonly dispensed medications in the US and Europe. Older age is an independent predictor of thyroid hormone initiation. Up to 60% of adults are prescribed levothyroxine for subclinical hypothyroidism (defined as having an elevated thyrotropin [TSH] level and a free thyroxine level within the reference range) or for non–evidence-based indications and generally continue treatment lifelong. Widespread prescribing of levothyroxine and levothyroxine use occur despite 61% of patients with subclinical hypothyroidism spontaneously reverting to euthyroidism and high-certainty evidence failing to demonstrate a benefit from subclinical hypothyroidism treatment. Furthermore, thyroid hormone therapy is associated with increased patient burden and health care expenditures and places patients at risk for iatrogenic thyrotoxicosis (increases the risk for cardiovascular, skeletal, and cognitive adverse effects). Although initiatives exist to prevent the initiation of potentially inappropriate medications in older adults, few have targeted deprescribing, which is the systematic and supervised process of safely reducing or discontinuing a medication.
Manufacturer-Sponsored Coupon Use and Brand-Name Drug Costs Among Patients With Insurance
https://jamanetwork.com/journals/jama/fullarticle/2847286
This descriptive analysis study examines trends in manufacturer-sponsored coupon use, coupon amounts, and patient out-of-pocket spending among patients with commercial insurance.
https://jamanetwork.com/journals/jama/fullarticle/2847286
This descriptive analysis study examines trends in manufacturer-sponsored coupon use, coupon amounts, and patient out-of-pocket spending among patients with commercial insurance.
Insulin Copay Caps—Impacts Beyond Costs
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847538
Health Care Policy
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847538
Health Care Policy
Self-Selection for Medication Abortion Using a Prototype Drug Facts Label
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847536
This diagnostic study examines whether patients seeking an abortion could accurately self-select their eligibility to use over-the-counter (OTC) medication abortion by using a prototype OTC package and drug facts label.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847536
This diagnostic study examines whether patients seeking an abortion could accurately self-select their eligibility to use over-the-counter (OTC) medication abortion by using a prototype OTC package and drug facts label.
Optimizing Food-Is-Medicine Programs for High Blood Pressure
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847535
To the Editor We read with interest the Healthy Food First randomized trial by Berkowitz et al examining the comparative effectiveness of food-is-medicine interventions to address food insecurity and improve blood pressure. The authors implemented 2 pragmatic interventions, a home-delivered food box and a restricted groceries stipend, with a view to practical implementation through payer support. Both demonstrated improved blood pressure, but, contrary to the authors’ expectations, the stipend lowered systolic blood pressure more than the food box, and blood pressure change was modest despite striking improvements in food security. These findings highlight 2 lessons for future food-is-medicine initiatives targeting food insecurity beyond inadequate calorie intake: the quality and precision of the groceries provided and the importance of choice to promote uptake.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847535
To the Editor We read with interest the Healthy Food First randomized trial by Berkowitz et al examining the comparative effectiveness of food-is-medicine interventions to address food insecurity and improve blood pressure. The authors implemented 2 pragmatic interventions, a home-delivered food box and a restricted groceries stipend, with a view to practical implementation through payer support. Both demonstrated improved blood pressure, but, contrary to the authors’ expectations, the stipend lowered systolic blood pressure more than the food box, and blood pressure change was modest despite striking improvements in food security. These findings highlight 2 lessons for future food-is-medicine initiatives targeting food insecurity beyond inadequate calorie intake: the quality and precision of the groceries provided and the importance of choice to promote uptake.
Optimizing Food-Is-Medicine Programs for High Blood Pressure—Reply
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847534
In Reply We appreciate the thoughtful Letter from Gao et al regarding the Healthy Food First randomized trial. Moreover, we appreciate the important contributions the Letter authors have made to the field of food-is-medicine research, exemplified by their own recent randomized trial. Overall, we completely agree that food-is-medicine studies should (1) provide food resources with a clear biological mechanism for improving health outcomes, (2) incorporate behavioral science knowledge to promote high engagement, (3) maximally incorporate individual preferences regarding diet selection, and (4) be carefully attuned to potential indignities in intervention approaches.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847534
In Reply We appreciate the thoughtful Letter from Gao et al regarding the Healthy Food First randomized trial. Moreover, we appreciate the important contributions the Letter authors have made to the field of food-is-medicine research, exemplified by their own recent randomized trial. Overall, we completely agree that food-is-medicine studies should (1) provide food resources with a clear biological mechanism for improving health outcomes, (2) incorporate behavioral science knowledge to promote high engagement, (3) maximally incorporate individual preferences regarding diet selection, and (4) be carefully attuned to potential indignities in intervention approaches.