JAMA (Journal of the American Medical Association)

Finerenone and Blood Pressure in Heart Failure With Mildly Reduced or Preserved Ejection Fraction https://jamanetwork.com/journals/jamacardiology/fullarticle/2851277 This randomized clinical trial analyzes whether finerenone lowers blood pressure and whether its cardiovascular benefits in patients with mildly reduced or preserved ejection fraction heart failure depend on baseline blood pressure or blood-pressure reduction.

Expansion of Civil Commitment for Substance Use Disorders https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850883 This Viewpoint discusses the ethics of civil commitment for substance use disorders and advocates for expansion of access to voluntary treatment instead.

Respiratory Outbreak Mitigation With Point-of-Care Testing in Long-Term Care https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850884 This cluster randomized trial examines the effect of an on-site point-of-care respiratory multiplex polymerase chain reaction instrument on outbreaks of SARS-CoV-2, influenza, and respiratory syncytial virus in nursing homes.

Potential Biases in Assessment of Smallest Worthwhile Difference for Statin Therapy—Reply https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850885 In Reply We thank Fischer for his thoughtful comments regarding our Research Letter. First, he states that the smallest worthwhile difference (SWD) should be independent of baseline risk because benefits and harms must be weighed in absolute terms. We agree that clinical decisions should be based on absolute effects, which is why we presented participants with absolute risk reductions using graphical displays and questions framed as, “If the risk is reduced from X% to Y%, would you accept treatment?” (eMethods in Supplement 1), making confusion with relative risk reduction unlikely. However, this does not necessarily imply that SWD should be constant across baseline risks.

Potential Biases in Assessment of Smallest Worthwhile Difference for Statin Therapy https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850886 To the Editor In their Research Letter, Luo et al attempted to define the smallest worthwhile difference (SWD) that would justify statin therapy for primary prevention of atherosclerotic cardiovascular disease (ASCVD) from the patient perspective. Interestingly, they found that the SWD for most patients differed from current guideline recommendations. Moreover, the variability in SWD observed among individuals underscores the importance of incorporating values and preferences into evidence-based clinical decision-making.

Point-of-Care Polymerase Chain Reaction Testing for Respiratory Viruses Among Nursing Home Residents to Reduce Hospital Transfers https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850887 In this issue of JAMA Internal Medicine, Kandel et al share the results of a cluster randomized trial leveraging point-of-care polymerase chain reaction (PCR) testing in nursing homes (NHs) to improve early detection of infections caused by SARS-CoV-2, influenza, and respiratory syncytial virus. While number or size of outbreaks and mortality did not differ, the proportion of residents transferred to acute care for confirmed and suspected viral respiratory infections decreased at intervention sites compared with control sites. The authors determined that this would result in 4 fewer transfers per 100 beds during the winter and spring respiratory virus seasons, a substantial benefit for NH residents.

The Machine Is Just as Loud https://jamanetwork.com/journals/jamaneurology/fullarticle/2850992 This essay describes the author’s experience with postseizure workups and scans and the protection that she felt was attached to professional status on both occasions.

Tofersen Distribution in the Central Nervous System of SOD1 -ALS Autopsy Tissue Donors https://jamanetwork.com/journals/jamaneurology/fullarticle/2850993 This autopsy tissue case series determines the tissue distribution of tofersen and provides estimates of SOD1 reduction in human somatic motor systems tissues among deceased patients with SOD1–amyotrophic lateral sclerosis (SOD1-ALS).

PCSK9 Inhibitor Price Reductions and Medicare Part D Utilization and Spending https://jamanetwork.com/journals/jamacardiology/fullarticle/2850829 This cross-sectional study evaluates price reductions and subsequent Medicare Part D utilization and spending for proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors.

Late Complication in Cardiac Sarcoidosis in a 40-Year-Old Female https://jamanetwork.com/journals/jamacardiology/fullarticle/2850830 This case report discusses a rare complication in a female patient in her 40s with cardiac sarcoidosis who underwent repeated ventricular tachycardia ablations.

Swinging Heart and an Intrapericardial Nodule in a 52-Year-Old Male https://jamanetwork.com/journals/jamacardiology/fullarticle/2850831 This case report discusses a rare cause of cardiac tamponade in a male patient aged 52 years who presented with progressive dyspnea, chest pain, and palpitations over 3 months.

Football-Specific On-Pitch Concussion Assessment Protocol https://jamanetwork.com/journals/jamaneurology/fullarticle/2851047 This Special Communication discusses the development of a football-specific, standardized on-pitch concussion assessment protocol informed by research evidence and expert opinion using an international consensus process and steering committee deliberation.

Health Equity: JAMA Internal Medicine Call for Papers https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2851086 Research on health differences by social class and economic status dates back to the mid-19th century. Early European publications examined differences in health by social class; then, during the next 100 years, the US produced the bulk of the evidence describing persistent and substantive differences in health across a broader range of social factors. During this descriptive period, scientists and clinicians came to realize that the differences noted in health care settings resulted from an array of structural, environmental, and social factors that spanned well beyond individual patients or the health care system. These broader factors are directly related to historical and current systemic inequities disadvantaging multiple population groups. The US is a fitting setting for this descriptive work, given its particularly stark social and economic inequities despite unparalleled national spending on research and health care. More recently, this research has evolved to explore underlying mechanisms of inequities and to test interventions to improve outcomes. This evolution has also marked a shift in nomenclature from health disparities (descriptive) to health equity (advancing health for all) research. However, despite progress during the last 75 years in the US, research in this field has continued to focus overwhelmingly on describing the number and scope of health inequities and defining the groups most adversely affected, at times relying heavily on conjectures about underlying etiology framed by the sociopolitical context.

Acetaminophen Use in Pregnancy and Neurodevelopmental Outcomes https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850980 In September 2025, the US administration held a press conference stating that its ongoing investigation into the causes of autism had identified maternal use of acetaminophen (paracetamol) during pregnancy as a potential causal factor. This was concerning given that acetaminophen is among the most used medications in pregnancy for the management of pain and fever, in part because alternative options are limited or contraindicated (eg, nonsteroidal anti-inflammatory medications and opioids).

Expanding Access to Mindfulness for Pain https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850981 Back pain is among the most widespread and disabling conditions treated in primary care in the US, yet its management remains challenging and costly. Untreated and undertreated chronic low back pain (cLBP) has left many patients without adequate relief, contributing to the overprescribing and overuse of opioids and other medications, despite known adverse effects and risks of dependence and overdose. Guidelines for treating cLBP now recommend evidence-based nonpharmacologic pain treatments, including complementary and integrative health approaches, of which mindfulness-based interventions are among the most popular. Mindfulness-based interventions are especially well suited for treating cLBP, with evidence that they can improve common co-occurring conditions, such as depression, anxiety, and sleep disorders, that can contribute to and exacerbate pain. However, mindfulness and other complementary and integrative health approaches remain underused, partially because of the difficulties in integrating them into usual clinical practice.

Texting in Health Care https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850974 This Viewpoint offers strategies to help ensure that health care text messaging remains impactful rather than intrusive for patients.

Wide-Complex Tachycardia With Diffuse ST-Segment Elevation https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850982 This case report describes the electrocardiogram findings of an older adult man with acute chest pain, dyspnea, and altered consciousness.

In Defense of Novel Autoantibody Discovery https://jamanetwork.com/journals/jamaneurology/fullarticle/2850849 This Viewpoint discusses the discovery of numerous neuronal autoantibodies and how autoimmune encephalitis is diagnosed and treated.

Novel Autoantibody Discovery in Encephalitis https://jamanetwork.com/journals/jamaneurology/fullarticle/2850850 This Viewpoint describes a plateau in the discovery of clinically meaningful autoantibodies in autoimmune encephalitis (AE) and suggests efforts that are likely to offer greater benefits to patients living with AE.

Prior Traumatic Brain Injury and Alzheimer Disease Blood Biomarkers https://jamanetwork.com/journals/jamaneurology/fullarticle/2850851 This diagnostic study investigates the accuracy of the plasma phosphorylated tau 217 (p-tau217)/amyloid-β 42 (Aβ42) ratio test for detecting amyloid–positron emission tomography positivity for an Alzheimer disease diagnosis in older veterans with and without a history of traumatic brain injury.