JAMA Editors' Summary JAMA at ESICM, AI-Powered Diabetes Prevention, H-1B Visas and Health Care, and more
Oct 31, 2025
Christopher W. Seymour, a JAMA Associate Editor and critical care researcher, dives into fascinating ICU studies. He discusses the SOFA-2 score’s development, showcasing its significant clinical applications. The podcast also highlights the Andromeda Shock 2 trial, revealing how tailored capillary refill protocols improved outcomes in septic shock. Plus, an AI-powered diabetes prevention program proves as effective as human coaching. Finally, insights into H-1B visa sponsorship reveal its impact on healthcare in vulnerable communities.
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SOFA Score Modernized With SOFA-2
- The SOFA score lacked updates despite decades of advances in ICU care and organ support.
- SOFA-2 uses 3 million encounters and modernizes thresholds and supports like high-flow nasal oxygen and new vasopressors.
Use SOFA-2 For Bedside Monitoring
- Use SOFA-2 both for research comparisons and as a clinical guide to quantify daily organ dysfunction at the bedside.
- Track delta SOFA scores to assess deterioration and prognostic trajectory in ICU patients.
Capillary Refill–Guided Resuscitation Helps
- Personalized hemodynamic resuscitation targeting capillary refill time improved patient-centered outcomes in early septic shock.
- The Andromeda Shock 2 trial enrolled >1,500 patients across 86 centers and used bedside echo and fluid responsiveness in a tiered protocol.