Original Investigation  Prophylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With Cirrhosis: A Systematic Review and Bayesian Meta-Analysis Connor Prosty, Dean Noutsios, Laurie-Rose Dubé, et al JAMA Intern Med 2025;185;(10):1194-1203. doi:10.1001/jamainternmed.2025.3832 Key Points Question  Are shorter durations (including 0 days) noninferior to longer durations of antibiotic prophylaxis ...

Using Nonpatient Features in Machine Learning for Hospital-Onset Bacteraemia  In ICU Wed, 9 Jul 2025 Hospital-onset bacteraemia and fungaemia (HOB) are frequent, often preventable hospital complications linked to high mortality, morbidity, and costs. While many studies have focused on patient-related, non-modifiable factors (e.g., demographics, comorbidities), these offer limited prevention opportunities.  Since up to two-thirds of HOB cas...

Prolonged Mechanical Ventilation in ICU Patients In ICU Tue, 15 Jul 2025 About 25% of ICU patients require mechanical ventilation, with most discontinuing it after 3–4 days. However, around 5% need prolonged mechanical ventilation (PMV), typically defined as ventilation for 21 or more days or 4+ days with tracheostomy.  The number of PMV patients has been rising. PMV is associated with high in-hospital mortality (~29%), a 50% weaning ...

Original Investigation  Nephrology AI-Based System for Analysis of Electron Microscope Images in Glomerular Disease Pengcheng Ma, Jinbang Li, Zhengyu Zhang, et al JAMA Netw Open 2025;8;(10):e2534985. doi:10.1001/jamanetworkopen.2025.34985 Key Points Question  What is the performance of an artificial intelligence (AI) system for the analysis of kidney transmission electron microscopy (TEM) images for diagn...

Imaging and Pulmonary Function Techniques in ARDS In ICU Wed, 9 Jul 2025 Acute Respiratory Distress Syndrome (ARDS) is a complex and heterogeneous condition requiring precise diagnosis and personalised treatment based on a thorough assessment of lung structure and function. Traditional physiological measures, such as respiratory compliance, driving pressure, transpulmonary pressure, and mechanical power, offer valuable insights for guiding therapy. How...

Original Investigation  Medical Education Trainee-Physician Milestones Ratings and Patient Experience Surveys in Early Unsupervised Practice Jenny X. Chen, Deirdre Mylod, Yuezhou Jing, et al JAMA Netw Open 2025;8;(10):e2536380. doi:10.1001/jamanetworkopen.2025.36380 Key Points Question  Are professionalism and interpersonal and communication skills Milestones ratings from the final 6 months of training as...

JAMA Insights  Extracorporeal Life Support in Accidental Hypothermia Konrad Mendrala, Paweł Podsiadło, Tomasz Darocha JAMA Published Online: October 8, 2025 doi: 10.1001/jama.2025.14593 Definition, Classification, and Temperature Measurement Accidental hypothermia is defined as an unintentional core temperature of less than 35 °C (95 °F).1 Although commonly associated with exposure to extreme cold in outdoor settings, hypothermia can occur in a...

Original Investigation  Neurology Open-Label Placebos as Adjunct for the Preventive Treatment of Migraine: A Randomized Clinical Trial Julian Kleine-Borgmann, Katharina Schmidt, Linda Ludwig, et al JAMA Netw Open 2025;8;(10):e2535739. doi:10.1001/jamanetworkopen.2025.35739 Key Points Question  Can open-label placebos (OLPs), administered without deception, reduce headache days or improve related outcomes in pa...

Longitudinal Ordinal Outcome for Clinical Trials in ECMO Patients In ICU Thu, 3 Jul 2025 Most critical care trials studying mortality have inconclusive results due to factors like ineffective interventions, small sample sizes, treatment heterogeneity, and unrealistic assumptions about effect sizes in power calculations. Determining sample size requires balancing statistical power with feasibility. Many ICU trials are underpowered, using mortality as th...

Articles A clinical decision tool including a decision tree, point-of-care testing of CRP, and safety-netting advice to guide antibiotic prescribing in acutely ill children in primary care in Belgium (ARON): a pragmatic, cluster-randomised, controlled trial Jan Yvan Verbakel, Ruben Burvenich, Erinn D'hulster, et al Lancet 2025; 406: 1599-1610 Summary Background Antimicrobial resistance is a global health threat. Many children with acute illness in ambula...