Podcast
Author in the Room™ Interviews
Hosted by JAMA Network · ENGLISH
In partnership with the Institute for Healthcare Improvement, this program is designed to bring clinical evidence into practice by connecting practitioners to authors of JAMA articles.
97episodes
Episodes
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JAMA: 2013-02-27, Vol. 309, No. 8, Author in the Room™ Audio Interview
May 15, 201300:53:49Tap to summarizeInterview with Justin B. Dimick, MD, MPH, author of Bariatric Surgery Complications Before vs After Implementation of a National Policy Restricting Coverage to Centers of Excellence. Summary Points: Bariatric surgery has become much safer over the past decade, likely due to better techniques, training in advanced laparoscopy, and tighter credentialing of surgeons. The CMS policy of restricting care to Centers of Excellence has not improved outcomes, but may have had the unintended consequence of reducing access to care. Referring patients to Centers of Excellence for bariatric surgery will not lower the risk of adverse outcomes and decisions should be based on other factors, such as a surgeon’s training, experience, and outcomes.
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JAMA: 2013-03-20, Vol. 309, No. 11, Author in the Room™ Audio Interview
Apr 17, 201300:54:50Tap to summarizeInterview with Phillip M. Boiselle, MD, author of Computed Tomography Screening for Lung Cancer. Summary Points: CT screening reduced lung cancer-specific mortality by 20% in a large randomized trial of a high-risk population. CT is associated with a high false-positive rate, with associated risks and costs associated with follow-up CT and the potential for more invasive diagnostic procedures. Physicians should consider discussing CT screening with their high-risk patients who meet criteria in published guidelines.
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JAMA: 2013-02-20, Vol. 309, No. 7, Author in the Room™ Audio Interview
Mar 21, 201300:54:38Tap to summarizeInterview with Daniel J. Buysse, MD, author of Insomnia. Summary Points: Insomnia is a frequent comorbid condition that increases costs and worsens outcomes. Insomnia is a chronic condition for which there are effective and widely available acute treatments (medications) and effective but hard-to-find long-term treatments (behavioral). Need to consider other health professionals such as nurses, physician assistants, and behavioral health managers (smoking, obesity, diet, exercise, sleep/insomnia).
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JAMA: 2013-01-16, Vol. 309, No. 3, Author in the Room™ Audio Interview
Feb 23, 201300:54:16Tap to summarizeInterview with Daniel S. Chertow, MD, MPH, author of Bacterial Coinfection in Influenza: A Grand Rounds Review. Summary Points: Influenza vaccine remains the best available tool for prevention of severe influenza illness commonly associated with bacterial coinfection. Early empirical antiviral and antibiotic therapy should be administered to all individuals with suspected coinfection. Vancomycin or linezolid should be administered in addition to standard therapy for community-acquired pneumonia to patients with severe or necrotizing pneumonia and/or evidence of sepsis.
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JAMA: 2012-11-28, Vol. 308, No. 20, Author in the Room™ Audio Interview
Jan 17, 201300:51:19Tap to summarizeInterview with Robert H. Shmerling, MD, author of Management of Gout: A 57-Year-Old Man With a History of Podagra, Hyperuricemia, and Mild Renal Insufficiency. Summary Points: Risk factor modification: alcohol intake, excess weight, diet, medications (although overall impact on gout uncertain). Acute gout can be treated with NSAIDs, colchicine, corticosteroids, or a combination of these. Urate-lowering treatment to prevent attacks and tophi is appropriate for certain patients with gout. (In my opinion, allopurinol is the best initial choice to suppress uric acid.) Urate-lowering treatment should suppress uric acid to 6.0 mg/dL or less; allopurinol should start no higher than 100 mg/d but titrate up based on uric acid levels; it is common to require more than 300 mg/d. Concomitant prophylaxis (eg, low-dose colchicine, 0.6 mg/d) is appropriate for 6-9 months or longer. Take home message: We now have new therapies and guidelines for the treatment of gout. Appropriate use of therapeutics for gout—both new and old—will provide optimal outcomes for the increasing number of patients with this common disease.
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JAMA: 2012-11-21, Vol. 308, No. 19, Author in the Room™ Audio Interview
Dec 20, 201200:53:33Tap to summarizeInterview with Laura N. Gitlin, PhD, author of Nonpharmacologic Management of Behavioral Symptoms in Dementia. Summary Points: Attending to behavioral symptoms is part of comprehensive dementia care and requires ongoing long-term management. Use 6 steps to systematically prevent, assess, manage, eliminate or reduce behavioral symptoms. Use combination of nonpharmacologic approaches. Keep trying—nonpharmacologic approaches are relatively adverse free. Create a health professional team to offset time needed for provision of nonpharmacologic approaches.
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JAMA: 2012-10-17, Vol. 308, No. 15, Author in the Room™ Audio Interview
Nov 15, 201200:54:10Tap to summarizeInterview with Nancy A. Rigotti, MD, author of Strategies to Help a Smoker Who Is Struggling to Quit. Summary Points: Treat tobacco use like the chronic disease that it is. Don't give up if your first few efforts do not succeed. Medications and brief counseling are each effective, but combining the two is most effective. Link your smokers to free national resources like the tobacco quit lines (1-800-QUIT-NOW). New noncombustible tobacco products are coming.
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JAMA: 2012-10-03, Vol. 308, No. 13, Author in the Room™ Audio Interview
Oct 11, 201200:52:59Tap to summarizeInterview with Robert W. Haley, MD, author of Controlling Urban Epidemics of West Nile Virus Infection. Summary Points: Epidemics of West Nile neuroinvasive disease have become a serious medical and public health challenge that will be with us for the foreseeable future. Ultra low-volume aerial spraying of urban areas, guided by surveillance of mosquito trap positivity and human cases, is necessary and cost-effective to prevent chronic neurologic disability and death. Complete, accurate, and timely diagnosis of West Nile viral disease in an epidemic is vitally important to spare patients needless prolonged antimicrobial therapy and build support for public health control measures.
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JAMA: 2012-08-22, Vol. 308, No. 8, Author in the Room™ Audio Interview
Sep 21, 201200:51:15Tap to summarizeInterview with Philip Greenland, MD, author of Comparison of Novel Risk Markers for Improvement in Cardiovascular Risk Assessment in Intermediate-Risk Individuals. Summary Points: In comparison with other competing biomarkers and risk factors, coronary artery calcium (CAC) is currently the most potent risk marker of subclinical coronary heart disease (CHD). CAC was shown in several observational studies to improve the prediction of risk beyond traditional risk factors. In this JAMA paper, CAC outperformed various competing risk assessment markers among asymptomatic people at intermediate risk for CHD. Whether CAC should be used in routine clinical practice, however, is still a matter of personal opinion or further research.
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Antiretroviral Treatment of Adult HIV Infection 2012 Recommendations of the International Antiviral Society-USA Panel
Aug 16, 201200:55:10Tap to summarizeInterview with Melanie A. Thompson, MD, and Paul A. Volberding, MD, authors of Antiretroviral Treatment of Adult HIV Infection 2012 Recommendations of the International Antiviral Society-USA Panel. Summary Points: Antiretroviral treatment is recommended and should be offered to all persons with HIV, regardless of CD4 cell count. Particular attention should be paid to the design of an antiretroviral regimen for persons with concurrent conditions, such as viral hepatitis, opportunistic infections, and other medical diseases, because of the potential for drug interactions. Monitoring of entry into and retention in HIV care, adherence to antiretroviral therapy, and quality of care indicators are recommended and should be used to increase care engagement and quality.
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