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What is the most trusted medical information source? Is semaglutide safe? What is the best treatment for obesity? How long can you be on semaglutide for weight loss?
Our guest is Kirsten Bibbins-Domingo, MD, PhD, editor-in-chief of JAMA and the JAMA Network. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Kirsten Bibbins-Domingo, MD, PhD, editor-in-chief, JAMA and the JAMA Network
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking with JAMA editor in chief Dr. Kirsten Bibbins-Domingo about new and trending research and the latest updates from JAMA. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Bibbins-Domingo, it's great to have you back.
Dr. Bibbins-Domingo: Thank you for having me.
Unger: It's always so much fun talking to you about the latest research. And why don't we talk a little bit about one topic that we've covered a lot over the last year? And that is the issue of trust, specifically, as it relates to physicians. But we're dealing with a lot of misinformation still. We've got some new research from JAMA. Tell us more about what you found.
Dr. Bibbins-Domingo: Sure, so we introduced last month for the first time what we're calling data briefs. So when there's data out there, we also want to tell the story using data. In this case, our news department partnered with KFF. They do surveys periodically. And this was a really important survey. This is, you know, who are the sources of health information that people in the country trust?
And what it revealed, I think, were two important things. There's a lot of mistrust of information. There's a lot of division of who people trust. And some of that is by age, by political affiliation. People might have big mistrust over certain people who are communicating health information.
The great take home message, though, for me, is that regardless of somebody's characteristics, people have a high degree of trust of their physicians. So they trust their physicians. And I think for me personally, as a physician, it's really quite gratifying to see that across all of the different characteristics of people, including in the survey, that people trust their doctors.
What that means for us at JAMA is that we want to help doctors, help clinicians be really effective communicators. And that brings me to another thing that we've launched, which is a series called Communicating Medicine. And this brings the best practices in communication science to help us as doctors, as clinicians, be the best at communicating lots of complex information. We already know our patients trust us. We want to be able to communicate better.
Unger: That's so interesting because I know that we talked about you are trying to innovate in the ways that you communicate. Tell us a little bit more. How is that going? And what new things are you trying?
Unger: Sure, you know, we just finished our big editorial board meeting. So all of the editors get together, and we think about what we're doing well, and also, what we want to be doing better in the future. And our sweet spot really is that intersection of great science and great innovation, but also, how it's applied in clinical practice.
And so we want to constantly be innovating on how we communicate to clinicians, how we make complex materials accessible in a way that a busy clinician can really understand the important findings, understand the implications for their practice, understand where maybe some of the controversy is, understanding what's new on the horizon, but maybe not quite yet ready for prime time.
And we think we can do that. We have some great tools at our disposal across our multimedia, across our graphics platform, ways of synthesizing, ways of making sure if you are an infectious disease doc, but we have something that maybe is published by the oncologist, that we get that information to you.
So we're trying lots of ways in how we package, how we disseminate, how we amplify so that a clinician is getting the information they need for the types of ways in which they want to apply the science.
Unger: And I just ... I love the concept. And I'm just curious because when you took this role, thinking, I'm an ... I'm an editor in chief. This is a publishing business. It's about scientific research. And what I hear you saying is, you're in the communications business.
Dr. Bibbins-Domingo: Yes.
Unger: To a certain extent here, and you're helping physicians communicate and translate this news to their patients.
Dr. Bibbins-Domingo: That's exactly right. You've said it so well. I think in some ways journalists have to do what they've traditionally done, that is vet the science, make sure the science is ready for prime time in the way we've always done. JAMA's 140 years old. That's the whole long tradition.
But in some ways, we have to do everything that understands the way in a modern era we communicate, we communicate effectively, we give information to the people in the way they want to receive it, that we have to do right now and be as innovative as we can possibly be going forward. So it's that balance of what we've always done really well and doing this communication in all of the ways, using all of the tools that are up to date.
Unger: Excellent. Now, again, going back to your crystal ball from—
Dr. Bibbins-Domingo: Yes.
Unger: I think one of the things that you predicted was that weight loss drugs were going to be a very hot topic in the coming year. And they have been. So let's talk about, what is some of the most interesting research or significant findings coming out of what you're seeing about weight loss drugs?
Unger: Sure. You know, these drugs that are on the market are highly effective at helping people to lose weight. They've sort of transformed the landscape and what we think about all of the tools as we tackle the issues of obesity. We are learning that these drugs have benefits beyond weight loss. They seem to have benefits for cardiovascular disease, for other types of things that might make them compelling from a clinical standpoint and for patients.
But we're also trying to understand, does this mean we're all just going to be on these drugs forever? When should we use them? How early should we start them? And does that mean we shouldn't be advocating diet and exercise the way we have?
So this past week in JAMA, we actually published two articles on really traditional ways that behavioral scientists are using to study what types of messages, how do we use text messaging for weight loss, to promote diet, physical activity, those bread and butter things we've always used?
And I think we shouldn't think of these drugs—or what the editorialists who wrote on this topic, a main theme there was, we have to understand the many tools we now have at our disposal. How do we target those for the right patient at the right time? How do we use them together?
So it's not just, how do we understand these really effective, potent drugs? But how do we also understand the other things that are important too, and that for any given patient, that they get the right set of things? And that's where you're going to see more of this on the market. In addition, I'm just going to predict to continued innovation on the weight loss drugs themselves.
Unger: Excellent. You asked a lot of questions in that comment.
Dr. Bibbins-Domingo: Yeah.
Unger: What do you think is going to be the hottest kind of go-forward topics in this arena on weight-loss drugs?
Unger: Well, these therapies right now, the ones that are approved, these are the GLP-1 receptor agonists. They are injectable drugs. They are fairly expensive. They are designed to be used and they're associated with large amount of weight loss when they're used. But once you stop them, the weight comes right back.
And so that means they work really effectively. But they have these other features that make them a little challenging, right? They're expensive. The weight comes back right away. And so some of the innovative ideas are, how do you combine these with the use of diet and exercise? How can you combine them with—how do we decide, if a patient really doesn't want to use them, what other options are there?
Who are the people that we really should push harder on to make sure that they're using them? And that's what our editorialists are writing about. That's what the new—that is what the new science is telling us. And so I think I think you'll see some innovations on exactly continued innovations on new therapies, but also, exactly how we use them and in whom.
Unger: Excellent, you're off to a really fast start this year. Do you look ahead for the rest of the year for JAMA? What else is on your agenda?
Dr. Bibbins-Domingo: Right, so I think about, we are about integrity and impact. And we're trying to publish the types of science that really are going to change how we practice. And that science is going to be new clinical trials. It's going to be also observational studies that tell us a little bit about the context around which we understand diseases and the practice of medicine.
We have some series that we're launching that we continue to work on, Communicating Medicine I already mentioned, climate change. You'll see us talking more about the clinical trials in general. How do clinical trials best provide evidence for practice?
We're always at that intersection of the new in terms of discovery, but how does that translate into practice? And then, like everybody else, we're talking about artificial intelligence, AI, and what that means for the practice of medicine.
Unger: I'm curious, are you are you hearing back from researchers and physicians in the field who are noticing the changes that you're making?
Dr. Bibbins-Domingo: Well, maybe you were listening in on my conversations here. I actually just ran into a physician the other day, though, in all seriousness, who said that he's really excited by what he's reading. I'm saying this in all seriousness.
What he's interested in is that, for many of these topics, there's both new innovation, but there's also many different ways of looking at it. And what he's interested in is in a journal of hearing and reading about different ways to look at a problem from different angles.
And I think that was actually very gratifying to hear because I think we want to be publishing great science, but we recognize it's complicated. The world is complicated. And we want to be able to give voice to many of the ideas that are out there.
Unger: I know that the combination of integrity and impact, like you talked about, and that balancing basically research and application to really speed up what had been a very traditionally very long separate line between research and application. Dr. Bibbins-Domingo, it's always so great to have you on here. Thanks so much for being part of this. It's absolutely so crucial to keep up with the latest scientific and medical research.
That's why AMA members get unlimited access to the JAMA Network. And only members get access to the JAMA print edition. So to become an AMA member, visit ama-assn.org/join. That wraps up today's episode. And we'll be back soon with another AMA Update. Be sure to subscribe for all of our new episodes. And you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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