Implementing Best Case/Worst Case-ICU supported family communication and clinician consensus for over 1300 older trauma patients; adherence varied across trauma centers. ja.ma/49FA1Zl

💬 Viewpoint: Robotic surgery has rapidly become the default platform in US surgical training, but widespread adoption may erode core laparoscopic skills essential for safe, adaptable care. ja.ma/3KaT5UU

On December 1 at 10 AM ET, JAMA and JAMA Network Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, will co-chair a public, live-streamed webinar discussing a new @who.int guideline concerning #GLP-1 therapy and adults with #obesity. Register for the webinar: ja.ma/49M0UuK

Among VA patients undergoing lung resection, recent smokers had increased pulmonary complication rates but similar mortality after complications compared to non-smokers. ja.ma/3Xj8HZu

High-markup hospitals are associated with inferior quality and value of care and represent an important initial target for national policy aimed at promoting transparency and regulating hospital pricing. ja.ma/4imFGpd

Neighborhood socioeconomic deprivation had a greater impact on firearm injury rates than protective effects seen with state firearm laws, according to analysis of more than 200 000 incidents nationwide. ja.ma/3XOEnWH

Bariatric surgery was associated with more effective, durable treatment of class II and III obesity at lower costs than #GLP1 receptor agonists. ja.ma/48kmbJm

On December 1 at 10 AM ET, JAMA and JAMA Network Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, will co-chair a public, live-streamed webinar discussing a new WHO guideline concerning #GLP-1 therapy and adults with #obesity. Register for the webinar: ja.ma/3LUxdh8

Optimizing surgical preference cards via regression analysis of historical supply use resulted in notable cost savings and reduced unused items, particularly in colorectal surgery, which saw a 55.8% reduction in supply waste. ja.ma/485QqVO

Following CMS performance reporting, low-performing organ procurement organizations recovered more organs and narrowed donation gaps, but rising discard rates highlight ongoing challenges with organ quality. ja.ma/4o3JxJ7

Transoral endoscopic thyroidectomy vestibular approach is a cosmetically favorable and safe alternative to minimally invasive non-endoscopic thyroidectomy, with potential benefits in nerve and parathyroid preservation. ja.ma/3XEC1JR

Inpatient mortality after above-knee amputation has risen since 2016, likely driven by increasing comorbidity burden, while below-knee amputation mortality continues to decline. ja.ma/48pOwPK

Acute normovolemic hemodilution (ANH) in adult cardiac surgery is associated with lower transfusion rates and costs, yet remains underutilized as a blood conservation strategy. ja.ma/3LHmA15

Surgical procedures led to a 16% increase in financial hardship and an 8-fold rise in out-of-pocket spending for US working-age adults, especially the uninsured and those with private insurance. ja.ma/4i8rMHm

Nearly one-quarter of pediatric firearm-related homicides occurred at home. Young children were more often affected. ja.ma/4nYOXF6

Viewpoint: When integrated into care, patient-reported outcome measures can prioritize patient concerns, reveal unmet needs, and foster goal-concordant care. ja.ma/4qWbEwJ

Global reference values reveal total pancreatectomy carries higher complication and mortality risks than pancreatoduodenectomy, especially for cases involving vascular resection. ja.ma/47ZBcQP

Viewpoint: A separate gynecologic surgery residency and adjusted reimbursement policies are needed to improve surgical outcomes and address pay disparities. ja.ma/4nUNHTM

This noninferiority RCT found laparoscopic and open distal gastrectomy provided similar short-term outcomes in T4a gastric cancer, supporting laparoscopy as a safe, feasible alternative. ja.ma/47PVSuh

Personalized prehabilitation improved physical and cognitive function, altered immune signaling, and reduced postoperative complications compared to standard programs in elective surgery patients. ja.ma/4p0ny6F

Viewpoint: As surgical #AI evolves, transparency, ethical oversight, and open data standards are critical to protect patient safety and ensure innovations reflect professional values. ja.ma/3JHYZMP

Elevated preoperative HbA1c was associated with increased risks of complications, readmissions, and mortality in general surgery patients, supporting routine HbA1c screening for all surgical candidates, regardless of diabetes history. ja.ma/4nGcH0Q

Standardized triage with the AMPT score improved equity in prehospital air transport for trauma patients, reducing disparities and associated mortality regardless of race or ethnicity. ja.ma/3WCKfBY

More than 500,000 patients in the US are hemodialysis dependent. This Review summarizes current knowledge and recommended strategies for managing well-recognized complications associated with AV access. ja.ma/4olA2G7

The JAMA Summit on Firearm Violence gathered experts from medicine, policy, engineering, and community groups to develop a plan for reducing firearm harms by 2040. Learn more in this Special Communication: ja.ma/4oTuJ0D

Viewpoint: The emphasis on "textbook outcomes" underscores the need for honest preoperative discussions, as nearly half of complex surgeries result in setbacks. ja.ma/4hETlru

💬 Viewpoint: Adopting advanced, video-based performance analytics from elite sport could enhance surgical training by measuring technical, tactical, physical, and cognitive skills. ja.ma/49sbsi7

Robotic hiatal hernia repair offered no short-term morbidity or mortality advantage over laparoscopic hiatal hernia repair but incurred longer operative times and a higher pulmonary embolism risk in older adults. ja.ma/47u0dDl

Loss of Medicaid at age 19 is associated with higher mortality for pediatric liver transplant recipients during both short- and long-term follow-up. ja.ma/431i8zZ

Retrospective application of DELTA methodology to a large inguinal hernia mesh database identified safety signals for select mesh brands. ja.ma/4nr4woU

Loss of independence (LOI) and associated factors like frailty and postoperative delirium are linked to increased mortality risk in older adults undergoing emergency general surgery. ja.ma/43rRost

Large language models (#LLMs) can simplify surgical instructions to a similar readability level as human-simplified versions while maintaining fidelity, though physician oversight is necessary. ja.ma/48D908h

Viewpoint: Despite its innovative design, the MAGEC rod has been linked to frequent device failures and metallosis in children, underscoring the need for rigorous premarket evaluation and long-term postmarket surveillance. ja.ma/47EUM5L

Hosting an anal cancer screening unit at an LGBTQ+ community event effectively raised awareness and provided screening opportunities for men and transgender women at increased risk. ja.ma/4njR4TQ

Matched subanalysis found no benefit in percent total body weight loss for preoperative #GLP-1 RA use vs controls at 12 months after bariatric surgery, suggesting the effect of these agents may be limited postoperatively. ja.ma/3J1QRGZ

GLP-1 agonists are not cost-effective compared to gastric bypass for patients with severe obesity if current drug pricing persists, with an incremental cost-effectiveness ratio exceeding $500,000 per QALY over 10 years. ja.ma/3L4u3ac

Increasing the use of pragmatic clinical trials in surgery could address the challenges of conducting RCTs by optimizing generalizability, standardizing data use, and encouraging surgeon participation. ja.ma/3L5BkWX

Low-risk CP-GEP test results were associated with a 7% SLN positivity rate, while high-risk cases had a threefold higher risk—supporting value for shared patient-surgeon decision-making in T1-T3 melanoma. ja.ma/49feINM

In this podcast, Katharine Yao, MD, and Lorraine Tafra, MD, join host Jamie Coleman, MD, to discuss the 2025 guidelines developed by the American Society of Breast Surgeons and Society of Breast Imaging. 🎧 Listen now: ja.ma/49eEOjV

This Special Communication discusses the development of evidence-informed, consensus and expert opinion-based guidelines for the management of benign fibroepithelial lesions of the breast. ja.ma/4nWywKq

Among patients with primary hyperparathyroidism, parathyroidectomy was associated with a lower risk of incident #diabetes. ja.ma/4n2J4Gt

The long-term durability of active surveillance for patients with small, low-risk papillary #thyroidcancer may be greater in patients of older age. ja.ma/4nQ3yne

Standardized clinical care pathways may reduce costs and resource utilization while maintaining clinical outcomes in pediatric surgery. ja.ma/4nOjNBl

Viewpoint: The FDA's new hernia mesh labeling guidance aims to improve transparency, but its voluntary nature and lack of device tracking limit its impact. ja.ma/49brm0d

Enrolling in a hospital-owned #Medicare Advantage plan and undergoing a surgical procedure at the affiliated hospital were associated with improved postsurgical outcomes. ja.ma/3WbWc1m

Among older adults undergoing elective surgery, living alone does not raise the risk of readmission or death but is linked to more frequent discharge to continued care and a slightly longer hospital stay. ja.ma/43oirEW

Nearly 24% of patients with high-grade serous carcinoma missed opportunities for preventive salpingectomy and genetic testing. ja.ma/3KV4qID

Across the JAMA Network, we seek submission of manuscripts describing original research that examines the application of #AI in clinical settings. 🔗 Learn more about submission criteria: ja.ma/48p3TbH

Meshes weighing 45–65 g/m² are associated with the lowest risk of reoperation for recurrence after laparoscopic inguinal hernia repair. ja.ma/46WowuO

From @jama.com: #Microplastics are increasingly detected in human tissues, with potential links to cognitive, cardiovascular, and inflammatory outcomes. 📌 Learn more in this JAMA Insights: ja.ma/4okUx5u