Surgery topics in top 2025 JAMA studies

Editor's Note

A December 12 roundup of top studies published in JAMA Medical News from 2025 included articles relevant to perioperative care, such as a systematic review of AI tools in healthcare, a randomized controlled trial on blood transfusion in neurosurgery, and a study on surgery sparing in certain low-risk breast cancer patients.

In the systematic review of studies on large language model applications to evaluate if the right questions about AI tools are being asked, investigators found only 5% of relevant studies used real patient data. And there was less focus on applications tied to administrative tasks such as documentation.

A study featured on covering findings from the Transfusion Strategies in Acute Brain Injured Patients (TRAIN) randomized clinical trial identified the effects of a more liberal red blood cell transfusion threshold to improve neurological outcomes. Within the multicenter, phase 3 trial, 800 patients with acute brain injury and a hemoglobin level lower than 9 g/dL within the first 10 days after injury were assigned to a liberal transfusion strategy—triggered by hemoglobin lower than 9 g/dL—or a restrictive strategy, where patients only received transfusion if hemoglobin dropped to lower than 7 g/dL. After 6 months, 63% of people in the liberal treatment group had unfavorable neurological outcomes, compared with 73% in the restrictive group. About 14% of patients in the restrictive group had at least 1 cerebral ischemic event vs 9% in the liberal transfusion group. The investigators suggested these findings could lead to a change in practice.

Another article explored trial findings comparing treatment approaches, including surgery, or surgery-sparing for women aged 40 and older with newly diagnosed hormone receptor (HR)–positive, ERBB2-receptor negative, low-risk DCIS.