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BRAND AUDIT REPORT FOR THE 12 MONTH PERIOD ENDED JANUARY 2018 No attempt has been made to rank the information contained in this report in order of importance, since BPA Worldwide believes this is a judgment which must be made by the user of the report.

American Medical Association 330 N Wabash Chicago, IL 60611 Tel.: (312) 464-5000 Fax: (312) 464-5834 www.jama.com

As one of the most widely circulated peer-reviewed general medical journals in the world, JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION provides subscribers throughout the world with essential medical information and a unique forum for discussions shaping the future of medical practice and public health. FIELD SERVED JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION is directed primarily to physicians in office-based practice, hospital based practices, and other professional activities. DEFINITION OF RECIPIENT QUALIFICATION Qualified recipients are physicians with those specialties reported in Paragraph 3a. Also qualified are a limited number of medical students, hospitals, and firms allied to the medical profession.

CHANNELS JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION

48 Issues in the period 300,167 average circulation

EXECUTIVE SUMMARY Below are the Average contacts per occurrence, including frequency per period reported

JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (48 issues in the period)

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Non-Paid

Paid

Average

164,139

136,028

300,167

3b. QUALIFICATION SOURCE BREAKOUT OF QUALIFIED NON-PAID CIRCULATION FOR ISSUE OF JANUARY 2, 2018 Qualified Within QUALIFICATION SOURCE

1 Year

Direct Request: Request from recipient’s company: Membership Benefit: Communication from recipient or recipient’s company (other than request): V. TOTAL – Sources other than above (listed alphabetically): *Association rosters and directories Business directories Manufacturer’s, distributor’s, and wholesaler’s lists Other sources VI. Single Copy Sales: TOTAL QUALIFIED CIRCULATION PERCENT *See Additional Data

Total Qualified* -

Percent

-

2 Years -

3 Years -

-

-

-

-

-

157,916 157,916 157,916 100.0

-

-

157,916 157,916 157,916 100.0

100.0 100.0 100.0

I. II. III. IV.

-

GEOGRAPHICAL BREAKOUT OF QUALIFIED CIRCULATION FOR ISSUE OF JANUARY 2, 2018 State Maine New Hampshire Vermont Massachusetts Rhode Island Connecticut NEW ENGLAND New York New Jersey Pennsylvania MIDDLE ATLANTIC Ohio Indiana Illinois Michigan Wisconsin EAST NO. CENTRAL Minnesota Iowa Missouri North Dakota South Dakota Nebraska Kansas WEST NO. CENTRAL Delaware Maryland Washington, DC Virginia West Virginia North Carolina South Carolina Georgia Florida SOUTH ATLANTIC

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Total Qualified 1,480 1,316 698 12,578 1,337 4,369 21,778 23,119 9,686 14,043 46,848 11,630 5,236 13,260 11,636 5,058 46,820 6,325 2,692 5,387 658 859 2,027 2,726 20,674 847 6,750 1,417 7,539 1,719 7,987 4,648 7,539 18,808 57,254

State

Percent Kentucky Tennessee Alabama Mississippi

EAST SO. CENTRAL 7.3

Arkansas Louisiana Oklahoma Texas WEST SO. CENTRAL

15.6

15.6

Montana Idaho Wyoming Colorado New Mexico Arizona Utah Nevada MOUNTAIN Alaska Washington Oregon California Hawaii PACIFIC UNITED STATES

6.9 U.S. Territories Canada Mexico Other International APO/FPO

TOTAL QUALIFIED CIRCULATION

Total Qualified 3,668 6,045 3,814 2,200 15,727 2,415 3,997 3,109 20,936 30,457 731 1,095 375 4,802 1,592 5,147 2,217 2,006 17,965 586 5,771 3,437 29,688 1,267 40,749 298,272 906 121 5 29 299,333

Percent

5.3

10.2

6.0

13.6 99.6

100.0

19.1

JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION /January 2018

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ADDITIONAL DATA PARAGRAPH 1: Qualified paid Membership Benefit subscriptions averaging 132,821 copies were sold to qualified recipients at the following subscription prices: $31.00. Members yearly subscription price is included in the dues and is non-deductible therefrom. PARAGRAPH 3b: Paragraph 3b includes 157,916 qualified non-paid circulation. Qualified paid circulation of 141,417 combined with the qualified non-paid circulation equals 299,333 total qualified circulation for the analyzed issue. Association rosters and directories include 2 sources of circulation for quantities of 15,915 copies or 10.1% to 142,001 copies or 89.9%, including The American Medical Association Directory and the Osteopathic Directory.

As a result of the January 2018 circulation audit, the following adjustments have been made to the previously released unaudited July 2017 and January 2018 Circulation Statements. ADDITIONAL DATA: Due to a clerical error, the Average Annual Order Price was incorrectly reported on the July 2017 and January 2018 Brand Reports. The correct figure for the 12-month period is reported herein: $678.02.

The data found within this Brand Report has been audited and certified by BPA Worldwide. All claims in the Brand Report are the responsibility of the media company’s management. It is the responsibility of BPA Worldwide to express an opinion on the data reported based upon audit results. The audit was conducted in accordance with generally accepted industry audit standards. Accordingly, the audit included testing of all demographic qualifications claimed, age/source of audience, proof of manufacture and distribution, confirmation of selected recipients of each channel and such other auditing procedures that were considered necessary at the time of audit. In the opinion of BPA Worldwide, the media owner’s claims set forth in this report present objectively and accurately the composition of the brand’s database(s) as reported herein.

BPA Worldwide Shelton, CT March 28, 2018

TYPE: BA ID Number: J001BAD7

About BPA Worldwide: A not-for-profit organization since 1931, BPA Worldwide is governed by a tripartite board comprised of media owners, advertising agencies and advertisers. Headquartered in Shelton, Connecticut, USA, BPA has the largest membership of any media-auditing organization in the world, spanning more than 30 countries. Globally, BPA audits media properties including consumer magazines, newspapers, web sites, events, email newsletters, databases, wireless, social media and other advertiser-supported media—as well as advertiser and agency members. Visit www.bpaww.com for the latest audit reports, membership information and publishing and advertising industry news. www.bpaww.com

Recycled Paper Copyright © 2017 BPA Worldwide. All rights reserved.

JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION /January 2018

MAGAZINE CHANNEL AVERAGE NON-QUALIFIED CIRCULATION NON-QUALIFIED Not Included Elsewhere Copies Other Paid Circulation

-

Advertiser and Agency

384

Allocated for Trade Shows and Conventions All Other

3,360

TOTAL

3,744

Official Publication of: American Medical Association Established: 1883/Issues Per Year: 48 1. AVERAGE QUALIFIED CIRCULATION BREAKOUT FOR THE PERIOD Total Qualified Qualified Non-Paid QUALIFIED CIRCULATION Copies Percent Copies Percent Individual 167,346 55.8 164,139 54.7 Sponsored Individually Addressed *Membership Benefit 132,821 44.2 Multi–Copy Same Addressee Single Copy Sales TOTAL QUALIFIED 300,167 100.0 164,139 54.7 CIRCULATION *See Additional Data

2. QUALIFIED CIRCULATION BY ISSUES FOR PERIOD 2017/2018 Issue Total Qualified February 7 310,411 February 14 310,801 February 21 309,871 February 28 310,969 March 7 309,669 March 14 311,617 March 21 312,148 March 28 312,488 April 4 313,094 April 11 314,523 April 18 315,075 April 25 315,285 May 2 274,165 May 9 274,325 May 16 275,292 May 23 276,088 June 6 286,649 June 13 287,648 June 20 288,208 June 27 288,716 July 4 289,497 July 11 289,968 July 18 290,549 July 25 290,988 *Analyzed Issue

Qualified Paid Copies 3,207

Percent 1.1

-

-

132,821

44.2

-

-

-

-

136,028

45.3

3a. BUSINESS/OCCUPATION BREAKOUT OF QUALIFIED CIRCULATION FOR ISSUE OF JANUARY 2, 2018 This issue is 0.3% or 852 copies below the average of the other 47 issues reported in Paragraph 2.

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28.

ADM ADL AM A AI ALI AN CCA CD CCM D DMP DOL DIA EM END FPS FP FPG GE GP GO GYN HEM IG ID IM ICE ILI IMG LM MFM MM NPM NCC NEP N CHN NM NR NTR OBS OBG OCC OM ON OPH OAR

TOTAL PROFESSIONAL CLASSIFICATION QUALIFIED Addiction Medicine 156 Adolescent Medicine 57 Aerospace Medicine 73 Allergy 125 Allergy & Immunology 667 Allergy & Immunology/Diagnostic Laboratory 5 Immunology Anaesthesiology 5,519 Anaesthesiology, Critical Care 188 Cardiovascular Diseases 18,119 Critical Care Medicine 300 Dermatology 2,770 Dermatopathology 198 Dermatological Immunology/Diagnostic Laboratory 1 Immunology Diabetes 40 Emergency Medicine 4,091 Endocrinology 1,004 Facial Plastic Surgery, Otolaryngology 101 Family Practice 71,335 Family Practice, Geriatric Medicine 202 Gastroenterology 2,274 General Practice 3,536 Gynecological Oncology 116 Gynecology 474 Hematology 171 Immunology 13 Infectious Diseases 6,567 Internal Medicine 87,158 Internal Medicine, Cardiac Electrophysiology 453 Internal Medicine/ Diagnostic Laboratory 2 Immunology Internal Medicine, Geriatrics 631 Legal Medicine 32 Maternal & Fetal Medicine 161 Medical Microbiology 14 Neonatal-Perinatal Medicine 496 Neurological Surgery, Critical Care Nephrology 1,682 Neurology 2,424 Neurology, Child 189 Nuclear Medicine 172 Nuclear Radiology 19 Nutrition 20 Obstetrics 29 Obstetrics & Gynecology 5,128 Obstetrics & Gynecology/Critical Care Medicine 2 Occupational Medicine 453 Oncology, Medical 894 Opthalmology 3,384 Orthopedic Surgery, Adult Reconstructive 60 Orthopedics Orthopedic Surgery, Hand Surgery 141 Orthopedic Surgery, Musculoskeletal Oncology 17 Orthopedic Surgery, Pediatric Orthopedics 89 Orthopedic Surgery, Sports Medicine 277 Orthopedic Surgery, Trauma 43

29. CHANNEL CIAL MEDIA 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53.

HSO OMO OP OSM OTR

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PERCENT OF TOTAL 0.1 0.2 1.8 0.1 6.1 0.1 0.9 0.1 1.4 0.3 23.8 0.1 0.8 1.2 0.2 0.1 2.2 29.1 0.2 0.2 0.1 0.2 0.6 0.8 0.1 0.1 1.7 0.2 0.3 1.1 0.1 0.1 -

Qualified Non-Paid 5 1 3 3 16 243 14,225 23 62 1 2 445 154 1 58,052 48 180 2,525 2 2 6 5,452 70,598 26 94 1 1 3 145 92 10 4 2 229 43 12 46 2 5 1

2017/2018 Issue August 1 August 8 August 15 August 22 September 5 September 12 September 19 September 26 October 3 October 10 October 17 October 24 November 7 November 14 November 21 November 28 December 5 December 12 December 19 December 26 *January 2 January 9 January 16 January 23

Total Qualified 291,479 291,951 291,379 292,779 298,905 300,125 301,618 302,474 303,405 304,510 304,746 304,624 306,151 306,743 307,066 307,536 307,960 308,442 308,640 309,361 299,333 299,833 300,267 300,646

MAJOR PROFESSIONAL ACTIVITY FOR THE UNITED STATES & PROFESSIONS INCLUDING APO & FPO PATIENT CARE OTHER PROFESSIONAL ACTIVITY Hospital Based Practice

Single 4 3 1 9 14 28 2 56 9 17 1 3 42 23 2 75 3 12 26 3 6 2 37 238 1 27 2 5 1 9 11 23 1 7 1 31 14 8 23 -

Association 147 53 69 113 637 5 5,248 186 3,838 268 2,691 196 1 35 3,604 827 98 13,208 151 2,082 985 111 466 163 13 1,078 16,322 426 2 510 29 156 12 484 1,526 2,309 178 161 19 19 27 4,868 2 396 874 3,315 60 141 17 87 272 42

Office Based Practice (A) 45 13 5 59 447 3 2,425 79 13,960 117 1,806 113 1 10 1,240 508 80 53,196 97 1,282 1,838 49 193 70 1 4,604 65,081 228 282 3 77 4 189 998 1,195 56 52 7 7 17 3,055 2 126 438 2,173 43

Interns and/or 1st Year Residents (B) 75 1 4 5 131 3 207 1 3 3 544 1 2 2 36 5 1 79 1 3 -

106 7 53 197 25

JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION /January 2018

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2

Residents (C) 1 18 1 37 831 34 2,134 55 267 17 590 139 3,706 6 335 13 10 582 10,915 104 72 20 1 62 178 357 65 10 2 286 14 211 4

Full-Time Hospital Staff (D) 5 5 12 3 23 1 767 43 513 63 124 25 2 898 73 4 1,592 12 145 70 21 23 23 1 950 2,946 38 71 27 1 121 91 215 24 34 5 3 1 393 38 143 152 7

16 7 16 www.bpaww.com

10 5 19 36 6

Total (Hospital Based) (E) 6 23 13 3 60 1 1,673 78 2,651 118 396 42 2 1,619 215 4 5,505 19 483 83 31 23 23 1 1,535 14,405 143 145 47 2 183 271 608 94 45 7 3 1 758 38 158 366 11 26 5 26 53 6

TOTAL (PATIENT CARE) (F) 51 36 18 62 507 4 4,098 157 16,611 235 2,202 155 1 12 2,859 723 84 58,701 116 1,765 1,921 80 216 93 2 6,139 79,486 371 427 3 124 6 372 1,269 1,803 150 97 14 10 18 3,813 2 164 596 2,539 54 132 12 79 250 31

Medical Teaching (G) 4 2 3 1 50 1 37 5 13 3 1 61 14 277 6 6 3 2 5 6 23 183 15 9 8 5 25 1 4 1 58 6 3 23 1 1 1 3

Administration (H) 7 2 12 1 4 50 4 52 2 7 2 139 13 1 290 8 13 15 4 7 4 1 50 416 1 1 27 1 4 2 14 30 30 2 2 66 48 18 26 -

Research (I) 1 1 1 1 8 16 2 57 1 13 2 6 6 32 26 1 21 4 3 1 18 5 52 142 13 1 1 2 8 10 52 6 7 17 2 34 14 -

Other (K) 90 10 34 60 113 891 18 821 32 399 33 18 436 158 13 2,034 21 302 498 19 230 44 4 200 3,692 42 1 81 25 19 3 70 219 365 26 52 5 8 7 802 179 210 721 1 5 4 6 7 5

OSTEOPATHIC PHYSICIAN

TOTAL (OTHER PROFESSIONAL Office Based Hospital Based ACTIVITY) Practice Practice (L) (M) (N) 98 7 17 4 49 2 2 62 1 128 25 3 1 1,007 247 131 25 2 2 967 412 83 40 15 10 432 102 21 38 4 27 1 642 274 264 217 48 9 14 3 2,627 8,351 960 36 42 3 342 131 31 520 875 91 28 3 4 243 7 1 72 5 10 1 325 73 21 4,433 2,423 567 43 23 13 2 136 54 3 27 33 1 2 7 100 10 9 264 119 17 472 89 41 35 2 2 65 5 2 5 8 1 8 2 943 284 66 235 36 4 265 23 6 784 50 4 2 4 5 5 7 7 8

4 3 18 4

-

Other Professional Activity (O) 2 4 36 2 46 13 1 52 7 696 5 5 129 1 7 1 9 249 3 11 2 1 1 5 13 19 3 1 1 22 14 4 7 2 -

JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION /January 2018

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MAJOR PROFESSIONAL ACTIVITY FOR UNITED STATES & PROFESSIONS INCLUDING APO & FPO PATIENT CARE

OTHER PROFESSIONAL ACTIVITY

Hospital Based Practice

54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. 80. 81. 82. 83. 84. 85. 86. 87. 88. 89. 90. 91. 92. 93. 94. 95. 96. 97. 98. 99. 100. 101. 102. 103. 104. 105. 106.

OTO ATP PTH BBK PCH CLP PCP FOP HMP PIP NP RIP PD PDA PDC PLI PDE PG PHO PN PDP PA PM HSP GPM P CHP PYA PH PUD RO R DR PDR REN RHU AS CDS CRS CCS GS HNS NS ORS PDS PS TS TRS U VS OS US HO

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PROFESSIONAL CLASSIFICATION Otolaryngology Pathology, Anatomic Pathology, Anatomic/Clinical Pathology, Blood Banking Pathology, Chemical Pathology, Clinical Pathology, Cytopathology Pathology, Forensic Pathology, Hemothology Pathology, Immunopathology Pathology, Neuropathology Pathology, Radioisotopic Pediatrics Pediatrics, Allergy Pediatrics, Cardiology Pediatrics/Diagnostic Laboratory Immunology Pediatrics, Endocrinology Pediatrics, Gastroenterology Pediatrics, Hemotology - Oncology Pediatrics, Nephrology Pediatrics, Pulmonology Pharmacology, Clinical Physical Medicine and Rehabilitation Plastic Surgery, Hand Surgery Preventative Medicine, General Psychiatry Psychiatry, Child Psychoanalysis Public Health Pulmonary Diseases Radiation Oncology Radiology Radiology, Diagnostic Radiology, Pediatric Reproductive Endocrinology Rheumatology Surgery, Abdominal Surgery, Cardiovascular Surgery, Colon & Rectal Surgery, Critical Care Surgery, General Surgery, Head & Neck Surgery, Neurological Surgery, Orthopedic Surgery, Pediatric Surgery, Plastic Surgery, Thoracic Surgery, Traumatic Surgery, Urological Surgery, Vascular Other Specialty Other Unspecified Inactive Hemothology and Oncology TOTAL COPIES TO PHYSICIANS PERCENT TO PHYSICIANS Hospitals Medical Libraries, Schools and Associations Medical Students Others Allied to the Field Other Paid Circulation TOTAL QUALIFIED CIRCULATION PERCENT

TOTAL QUALIFIED 2,055 118 1,821 64 2 87 126 124 118 43 5,434 25 247 100 114 135 38 59 35 1,503 22 341 5,331 1,111 40 180 2,530 967 1,525 2,722 109 199 1,097 14 339 267 4,967 42 1,340 3,453 145 1,175 827 55 1,655 609 6,031 4,909 1,725 278,047 92.9 19,514 1,772 299,333 100.0

PERCENT OF TOTAL 0.7 0.6 0.1 1.8 0.1 0.1 0.5 0.1 1.8 0.4 0.1 0.8 0.3 0.5 0.9 0.1 0.4 0.1 0.1 1.7 0.4 1.2 0.4 0.3 0.6 0.2 2.0 1.6 0.6 92.9

Qualified Non-Paid 33 36 1 2 2 2 243 4 2 1 1 80 63 144 11 3 785 17 11 105 2 101 2 2 262 31 89 2 3 2 30 3 694 1,932 157 157,623 52.7

Single 7 2 37 4 4 1 1 64 1 2 1 1 3 1 8 8 13 54 1 23 20 7 19 10 1 2 9 3 1 29 3 10 3 1 7 12 7 54 7 6 1,227 0.4

Association 2,015 116 1,748 59 2 83 124 121 116 42 5,127 24 241 99 111 131 37 58 27 1,415 22 265 5,133 1,099 40 154 1,725 943 1,495 2,607 106 197 987 14 334 264 4,676 42 1,306 3,354 142 1,172 817 53 1,613 599 5,283 2,970 1,562 119,197 39.8

Office Based Practice (A) 1,241 25 419 21 2 11 51 29 38 10 2,587 11 89 37 46 41 8 23 2 777 20 80 2,281 544 18 9 1,434 450 664 1,021 42 130 629 3 211 103 2,069 19 718 1,862 60 803 382 22 897 372 2,795 175 840 180,783 60.4

Interns and/or 1st Year Residents (B) 20 40 101 1 8 2 82 3 2 4 17 3 145 16 57 1 12 1 60 57 1 1,741 0.6

Residents (C) 179 349 8 1 17 5 23 4 785 72 33 28 32 10 11 131 1 48 636 131 1 372 106 98 659 12 6 102 18 41 1,011 156 413 7 56 47 175 39 812 1,864 386 30,001 10.0

Full-Time Hospital Staff (D) 186 24 214 6 12 24 9 24 7 446 2 28 8 16 21 5 9 130 25 645 142 7 230 193 277 345 21 12 80 3 45 69 521 9 189 282 38 103 149 19 141 75 789 32 221 15,617 5.2

Total (Hospital Based) (E) 385 24 603 14 13 41 14 47 11 1,332 2 100 42 44 53 15 20 269 1 75 1,363 276 8 604 303 375 1,021 33 18 185 3 63 110 1,677 9 361 752 45 160 196 19 328 115 1,661 1,953 608 47,359 15.8

TOTAL (PATIENT CARE) (F) 1,626 49 1,022 35 2 24 92 43 85 21 3,919 13 189 79 90 94 23 43 2 1,046 21 155 3,644 820 18 17 2,038 753 1,039 2,042 75 148 814 6 274 213 3,746 28 1,079 2,614 105 963 578 41 1,225 487 4,456 2,128 1,448 228,142 76.2

Medical Teaching (G) 8 4 18 1 3 1 2 2 59 1 1 2 1 2 6 1 7 86 16 2 9 24 6 16 19 5 8 8 2 1 28 1 4 11 1 9 11 2 9 4 46 10 10 1,337 0.4

Administration (H) 10 3 52 3 10 1 3 120 4 1 2 9 2 2 32 21 156 26 42 34 7 16 32 5 11 1 5 4 47 2 6 16 4 5 19 4 13 9 125 10 6 2,256 0.8

Research (I) 3 7 25 2 5 1 1 44 2 5 2 9 3 1 8 1 11 93 12 16 23 2 4 3 2 33 2 15 3 5 2 1 2 7 2 70 4 13 1,031 0.3

Other (K) 347 54 657 22 45 29 69 25 16 1,016 12 42 13 14 15 11 10 21 191 75 1,137 175 20 93 247 176 399 512 24 34 152 7 50 31 937 10 226 637 32 178 202 5 344 77 640 371 126 22,559 7.5

OSTEOPATHIC PHYSICAN TOTAL (OTHER PROFESSIONAL Office Based ACTIVITY) Practice (L) (M) 368 49 68 752 16 28 63 30 2 73 5 28 3 19 1 1,239 164 12 49 3 20 18 3 35 1 14 1 14 33 230 159 1 114 40 1,472 123 229 40 22 160 328 111 191 18 435 32 566 47 29 2 49 2 204 60 8 57 6 38 10 1,027 125 13 1 239 16 669 134 39 193 15 234 8 11 2 373 51 92 22 881 482 395 1,610 155 83 27,183 17,237 9.0 5.8

Hospital Based Practice (N) 7 22 1 2 2 2 2 91 5 1 3 5 1 53 14 61 19 2 37 3 10 50 3 13 2 3 51 5 23 2 3 1 4 3 162 388 34 3,462 1.2

Other Professional Activity (O) 5 1 9 1 21 1 1 15 18 31 3 1 16 2 9 17 6 3 18 1 13 1 2 4 2 5 50 388 5 2,023 0.7

6.5 0.6 100.0

JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION /January 2018

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