In the Editor’s Page for the JACC October 14, 2025 issue, JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, critiques the current physician certification system, arguing it is outdated, misaligned with real-world clinical practice, and contributes to physician burnout without clear evidence of improved patient outcomes. He proposes a modernized, two-tiered framework for certification—distinguishing between essential, instantly recallable knowledge (Type 1) and complex, reasoning-based skills (Type 2)—that emphasizes continuous learning, relevance, and support over high-stakes testing.

In this week's Editor's Page, Dr Harlan Krumholz explains how the rise of AI writing tools marks a turning point in scientific communication, offering support for grammar, clarity, and structure—especially benefiting those less fluent in English or academic conventions.

Artificial intelligence is rapidly transforming cardiovascular medicine, offering breakthroughs in diagnosis, treatment personalization, and research acceleration. However, its responsible integration requires guiding principles: focusing on clinical problems over technology, rigorous evaluation, bias mitigation, thoughtful implementation, and building trust. If applied wisely, AI can become a powerful partner in advancing equitable and effective cardiovascular care.

In June 2025, the White House introduced "Gold Standard Science" principles to enhance the rigor, transparency, and trustworthiness of federally funded research—values long embraced by top journals like JACC. These include reproducibility, openness to null results, interdisciplinary collaboration, and unbiased peer review, all of which align with JACC's ongoing commitment to scientific integrity. The journal is advancing efforts to improve transparency, peer review, and reproducibility through clearer data policies, stronger editorial oversight, and new tools like AI to support integrity and efficiency. Ultimately, JACC views these principles not as a shift, but as a reaffirmation of its mission to uphold scientific excellence while remaining independent, accountable, and open to challenge and debate.

This week's Editor’s Page outlines JACC’s expectations for AI research manuscripts in cardiovascular care, emphasizing the need for clinical relevance, real-world feasibility, and responsible evaluation beyond retrospective model performance. We present a framework focusing on three core domains: addressing a genuine clinical need, using fit-for-purpose evaluation methods across different development stages, and ensuring transparency, interpretability, and reproducibility. JACC prioritizes submissions that demonstrate real-world impact, responsible innovation, and a clear path to improving patient care—especially those that go beyond early model development.

JACC’s September 2 issue features a new editor’s page from Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC. In it, he brings up a troubling stagnation and reversal in U.S. cardiovascular health progress since 2010, despite advances in medical treatments and increased healthcare spending. Click here to listen to this call for a shift from individual interventions to systemic accountability, equity, and prevention, urging a bold, coordinated effort to improve population-level outcomes and close persistent disparities.

This update to the JACC Report Card highlights ongoing disparities in cardiovascular mortality between Black and White Americans. While some metrics, such as ischemic heart disease, show modest improvement, excess age-adjusted mortality rates and years of potential life lost remain alarmingly high for Black Americans. These findings reinforce the urgent need for structural reform, sustained investment, and accountability to close persistent gaps in cardiovascular outcomes.

Cardiovascular devices are at the heart of modern clinical practice, yet gaps in surveillance, reporting, and clinician awareness continue to pose serious risks to patient safety. This week’s Editor’s Page highlights the urgent need for improved transparency, stronger reporting systems, and clinician-led engagement around device recalls. With expert perspectives on FDA oversight, the role of unique device identifiers (UDI), and opportunities for real-time communication and consensus-building, this commentary challenges the cardiovascular community to take an active role in shaping the future of device safety. By addressing long-standing misconceptions and systemic limitations, it calls for smarter systems, faster responses, and shared accountability in delivering safe and effective cardiovascular care.