JAMA (Journal of the American Medical Association)

Landmark Significance and Future Directions of the RAPID-TEST Trial https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854545 To the Editor The RAPID-TEST trial by Hay et al represents to our knowledge the first pragmatic randomized clinical trial to evaluate the use of multiplex molecular point-of-care testing (POCT) for respiratory tract infections in primary care. It establishes a rigorous evidence benchmark for the field. At the same time, its design limitations and evidence gaps provide a critical roadmap for future advancement.

Expiration of Pandemic Food Assistance and Food Insufficiency in Adults With Disabilities https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854546 This cross-sectional study explores the prevalence of food insufficiency following the end of SNAP emergency allotments among adults with disabilities in 22 US states.

From Positive FIT Result to Colonoscopy—Closing a Gap in Care https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2854548 Colorectal cancer screening is effective, yet underused. Fortunately, patients have a variety of options. They can select screening colonoscopy as the initial step, which offers the greatest sensitivity for advanced neoplasia, or take a 2-step approach that begins with a stool test. An advantage of the stool tests, such as the fecal immunochemical test (FIT), is that 9 out of 10 patients will have a negative test result and will not require a follow-up colonoscopy.

Low-Dose Rivaroxaban, Cardiovascular Events, and Kidney Disease—Reply https://jamanetwork.com/journals/jama/fullarticle/2854849 In Reply TRACK was designed against a background of evidence that rivaroxaban at a dose far lower than required for therapeutic anticoagulation may provide cardiovascular protection with a favorable benefit-risk profile in advanced kidney disease. We agree with Dr Coppi that the results of our trial demonstrated that much of the cardiovascular disease in advanced kidney disease may not be atherothrombotic in nature and therefore may not be modifiable by atherothrombotic treatments. However, we do not concur with other assertions made by Dr Coppi. Patients with advanced kidney disease have been systematically excluded from cardiovascular outcome trials of antiplatelet agents. Observational studies have reported increased mortality with aspirin and clopidogrel use in patients receiving hemodialysis. Until dedicated cardiovascular outcome trials of antiplatelet agents in advanced kidney disease are completed and reported (eg, the Aspirin in Reducing Events in Dialysis [ASPIRED] trial), it is premature to assume that these therapies are safe or beneficial for broad cardiovascular risk reduction in this population.

Medicare and Bureau of Health Workforce and Funded Primary Care Residency Positions https://jamanetwork.com/journals/jama/fullarticle/2854850 To the Editor We are writing about the Research Letter “Changes in Specialty and Geography of Medicare’s New Residency Positions,” which reported that Medicare-funded expansion has not substantially increased primary care or rural training capacity. However, we would like to highlight an important limitation of specialty-based workforce estimates: residency positions labeled as primary care may not accurately reflect the production of physicians who enter primary care practice. Because these estimates rely on specialty designation, they may overstate primary care workforce contributions and fail to capture graduates’ postresidency practice.

Low-Dose Rivaroxaban, Cardiovascular Events, and Kidney Disease https://jamanetwork.com/journals/jama/fullarticle/2854851 To the Editor I read with great interest the Treatment of Cardiovascular Disease With Low-Dose Rivaroxaban in Advanced Chronic Kidney Disease (TRACK) trial and the insightful accompanying editorial regarding the use of low-dose rivaroxaban in patients with advanced chronic kidney disease (CKD). Although the investigators should be commended for undertaking this trial in a historically excluded population, the lack of cardiovascular efficacy and significant increase in major bleeding events highlight critical methodological limitations that warrant a strategic paradigm shift in future trial designs involving direct oral anticoagulants (DOACs) in end-stage kidney disease.

Opportunities and Challenges in Tobacco Treatment https://jamanetwork.com/journals/jama/fullarticle/2854853 Evidence-based treatments and comprehensive tobacco control policies have driven a marked decline in cigarette smoking among US adults over time. Approximately 25 million adults in the US continue to smoke, a prevalence of 9.9%. The declines in cigarette smoking have not been evenly distributed, with higher smoking rates, reduced access to cessation support, and higher tobacco-related mortality among individuals with lower socioeconomic status, certain racial and ethnic minority populations, and those with mental health and/or substance use disorders.

Ten Years of Ocrelizumab in Relapsing Multiple Sclerosis https://jamanetwork.com/journals/jamaneurology/fullarticle/2854792 The open-label extension of the OPERA I and II randomized clinical trials assesses 10-year safety and efficacy of ocrelizumab in patients with relapsing multiple sclerosis.

Blood-Based Biomarkers, Diagnostic Certainty, and Clinical Management https://jamanetwork.com/journals/jamaneurology/fullarticle/2854793 This randomized clinical trial evaluates whether earlier disclosure of plasma phosphorylated tau at threonine 217 and neurofilament light chain affects diagnostic certainty and clinical management.

Rapid Whole-Genome Sequencing in Pediatric Neurology Inpatients https://jamanetwork.com/journals/jamaneurology/fullarticle/2854794 This cohort study investigates the diagnostic yield and clinical impact of rapid whole-genome sequencing in pediatric neurology inpatients, and which clinical features are associated with a phenotype-concordant diagnosis.

Precision Care for Children With Neurologic Disease https://jamanetwork.com/journals/jamaneurology/fullarticle/2854795 Diagnostic uncertainty hinders appropriate management, counseling, and holistic family care in children with pediatric neurological diseases. Whole-genome sequencing is now providing a new light in a dark tunnel for these children and their families. This is of greater relevance as genetic precision therapies, such as N-of-1 gene therapy programs, continue to emerge with efficacy greatest before irreversible neuronal injury.

Error in Figure https://jamanetwork.com/journals/jamaneurology/fullarticle/2854796 The Research Letter titled “Temporal Patterns in Stroke Recurrence at Younger Ages: A Systematic Review and Meta-Analysis,” published online April 27, 2026, and in the June issue, had decimal errors in a portion of the y-axis labels in all 3 panels in the Figure. This article was corrected online.

Autism Incidence Has Remained Stable, Study Finds https://jamanetwork.com/journals/jama/fullarticle/2854953 The incidence of autism spectrum disorder in South Korea remained stable across cohorts born from 1998 to 2010, according to a study published in JAMA Pediatrics.

Semaglutide Demonstrates Benefits Across Frailty Levels https://jamanetwork.com/journals/jama/fullarticle/2854954 The glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide demonstrated safety and efficacy regardless of frailty status, a study published in JAMA Cardiology found.

PREVENT Equations Integrated Into Electronic Health Record Platform https://jamanetwork.com/journals/jama/fullarticle/2854955 The American Heart Association (AHA) announced that its PREVENT equations are now integrated into Epic’s electronic health record platform.

JAMA Editors' Summary Podcast October 2, 2026 https://jamanetwork.com/journals/jama/fullarticle/2855018 Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.

Treating In-Hospital Cardiac Arrest With Sodium Bicarbonate—Reply https://jamanetwork.com/journals/jama/fullarticle/2854748 In Reply In their letter about our recent BIHCA trial, Dr Gelbenegger and colleagues focus on the numerical differences in 30-day survival (12% vs 9.1%) and 30-day favorable neurological outcome (8.1% vs 5.4%) between groups. As noted, the trial was not powered for these outcomes and the results are uncertain. The 95% CIs for the risk ratio for 30-day survival ranged from 0.84 to 1.88 and for 30-day favorable neurological outcome from 0.82 to 2.34. As such, our results were compatible with harm, no effect, and benefit. Until well-conducted and sufficiently powered randomized clinical trials establish a benefit of sodium bicarbonate during cardiac arrest, consistent with international guidelines, we do not believe it should be administered routinely.

End-of-Life Care for People Who Are Incarcerated https://jamanetwork.com/journals/jama/fullarticle/2854749 To the Editor Dr Mushero and colleagues highlight the need to improve hospice and end-of-life care for people who are incarcerated. For patients with advanced cancer, this discussion should explicitly include access to palliative radiotherapy.

Treating In-Hospital Cardiac Arrest With Sodium Bicarbonate https://jamanetwork.com/journals/jama/fullarticle/2854750 To the Editor The Bicarbonate for In-Hospital Cardiac Arrest (BIHCA) trial demonstrated no significant improvement in return of spontaneous circulation with sodium bicarbonate administration, supporting current guidelines that do not recommend routine bicarbonate use during cardiac arrest. Nevertheless, several findings from the trial warrant further discussion.

Error in Results https://jamanetwork.com/journals/jama/fullarticle/2854752 The Original Investigation titled “Adjuvant Nivolumab vs Observation in Resected Non–Small Cell Lung Cancer: A Randomized Clinical Trial,” published on June 1, 2026, was corrected to fix typographical errors in the text, including indicating that the trial was stopped for futility at 75% information, rather than 78%, and the number of participants lost to follow-up in the nivolumab group in Figure 1. This article was corrected online.