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Audit Complete

Results for https://jamanetwork.com

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Brazil Brazil · Sao Paulo Completed: Apr 21, 2026 18:59 UTC
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Mobile 375 × 812

Screenshot of the audited page (Mobile 375×812)

Desktop 1440 × 900

Screenshot of the audited page (Desktop 1440×900)
C75

Site Health

Score: 75 / 100

Based on 8 categories, 0 sections

Decent speed, but optimizing further could improve engagement.

Good foundation, but a few gaps could be exploited.

Several issues make your site difficult for assistive technology users.

Missing signals may be hurting your search visibility.

Solid infrastructure — fast server responses across the board.

Mostly compliant — a few items need attention.

Missing metadata means poor previews on social media and search.

Reasonable footprint with room for optimization.

How is this calculated?

The overall score is a weighted average of individual category scores. Categories with more impact on user experience and security carry more weight.

Performance 25%Security 25%Accessibility 15%SEO 10%Infrastructure 10%Compliance 8%Content 5%Sustainability 2%

Weights reflect general web best practices. Individual needs may differ.

How the composite score is calculated

How you compare

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You 75
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0 50 100
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Cloudflare Bot Management · 437 peers
You 75
·
Avg 74
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Top Priorities (5)

1

'unsafe-eval' found in script source

Security gaps expose your site and users to attacks, eroding trust.

Security › Content Security Policy
2

HSTS header is missing

Security gaps expose your site and users to attacks, eroding trust.

Security › Security Headers
3

No favicon or icon links detected

Accessibility issues exclude users with disabilities — up to 15% of your potential audience.

Accessibility › Favicon & Branding
4

135 third-party resources (98% of weight)

Performance issues directly impact user engagement and conversion rates.

Performance › Page Weight Inventory
5

148 HTTP requests — consider bundling or reducing

Performance issues directly impact user engagement and conversion rates.

Performance › Page Weight Budget
View fix priority matrix

Fix Priority Matrix

5 findings

Quick Wins

2

High impact, low effort — start here.

Strategic

3

High impact, requires investment.

Easy Improvements

0

Small gains, minimal effort.

Nothing in this quadrant — good news.

Deprioritize

0

Low impact, high effort — do last.

Nothing in this quadrant — good news.

← Low effort High effort →
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What fixing these means

Your site performs reasonably well, but a few targeted fixes could meaningfully improve results. Your LCP of 18.8s exceeds Google's 2.5s 'Good' threshold and the 2 performance issues below directly contribute to it. Accessibility issues exclude users who rely on assistive technology — an estimated 15% of your potential audience. Addressing the critical issues below would have the most immediate impact on your user trust.

2 security gaps detected — browsers may warn visitors about your site.
1 accessibility issue excludes users who rely on assistive technology.
Your LCP is 18.8s — fixing the 2 performance criticals could bring it under Google's 2.5s 'Good' threshold.

Conversion Barriers

2 critical 7 warning

9 barrier(s) likely increasing bounce by ~31%.

Speed (2)

Page takes 18.8s to load

+12% bounce

Users abandon at ~3s — you're 16.3s over the 2.5s threshold

Fix: Optimize render-blocking resources, preload the hero image, and compress images

Page feels frozen for 3.9s

+5% bounce

Clicks on the primary CTA are ignored while JavaScript runs

Fix: Break up long tasks; defer non-critical JavaScript to post-hydration

Trust (2)

No HSTS header

+1% bounce

Returning visitors are briefly exposed to downgrade attacks on first request

Fix: Set Strict-Transport-Security: max-age=31536000; includeSubDomains

No Content-Security-Policy header

+1% bounce

Higher XSS blast radius — one compromised script can exfiltrate the checkout form

Fix: Ship a reporting-only CSP first, then enforce once violations are clean

Content (4)

No Open Graph tags

+2% bounce

Links shared on LinkedIn / Slack / Facebook show bare URLs — referral clicks drop

Fix: Add og:title, og:description, og:image, og:url to the page head

No structured data

+2% bounce

No rich-result eligibility in Google — lower SERP CTR vs competitors with stars and prices

Fix: Add JSON-LD for your page type (Product, Article, FAQPage, LocalBusiness, …)

Thin content

+3% bounce

Under 300 words — visitors bounce looking for substance, search engines rank competitors first

Fix: Add a substantive FAQ, product detail, or case-study section

Content is hard to read

+2% bounce

Graduate-level reading difficulty — limits the addressable audience for product or blog pages

Fix: Shorten sentences; replace jargon with plain language; target Flesch ease ≥60

Navigation (1)

No skip-to-content link

+1% bounce

Keyboard and screen-reader users must tab through the entire header on every page

Fix: Add a visible-on-focus <a href="#main">Skip to content</a> as the first focusable element

Preliminary CRO audit — each barrier links to the tab with detailed analysis.

Return on Investment

$650 investment → $0.64/month returns + USD 150,000 risk avoided

Payback period: > 2 years First-year ROI: -99%

Investment

$650

6h · 5 findings

Monthly returns

$0.64 /mo

~$7.63 / year

  • Bandwidth savings $0.64

Regulatory risk avoided

USD 150,000

if kept compliant

  • ADA Title III USD 150,000

$100 — in quick wins — start here for the fastest payback

Figures combine localized regulatory fine ceilings, search/conversion value priced against local CPC, and bandwidth waste estimates. Results depend on implementation quality and audience composition. Not legal or financial advice.

Full methodology & sources

Estimated Remediation Cost

$650

6.5 developer hours at $100/hr

Based on United States rates ($100/hr)

Quick wins
$100 2 fixes in ~60 minutes

Start here for the best return on investment

Cost by category

Cost by effort level

Adjust assumptions
$ /hr

Rates reflect fully-loaded developer cost including overhead

How developer rates are sourced

What Inaction Is Costing You

$12,501 / month at risk

~$150,008 / year if left unfixed

Compliance Risk

$150,000

ADA Title III
  • No <nav> landmark found
    ADA Title III: USD 25,000 – USD 150,000
  • Skip navigation link is missing (WCAG 2.4.1)
    ADA Title III: USD 25,000 – USD 150,000

Bandwidth Waste

$0.64 /mo

7944.8 MB/mo × 0.080 USD/GB

  • Optimize transfer: save ~794 KB per page load
    Saves $0.64/mo

Compliance figures represent the statutory maximum fine for the most severe triggered category, capped per regulation — not the sum of per-finding penalties. Based on published regulatory fine ranges. This is not legal advice.

Compliance methodology · SEO assumptions · Bandwidth model

Your performance is already good — improvements may show diminishing returns

Unique monthly visitors from your analytics

Purchases, signups, or key actions

Optional — for revenue estimation

additional conversions/month

more engaged visitors from reduced bounce

potential monthly revenue
Current bounce (est.)
After fixes (est.)
Estimated bounce reduction

Fix 3 critical issues to capture this value

How this is calculated

Based on Google/Deloitte research ("Milliseconds Make Millions") showing a ~7% bounce rate increase per additional second of LCP above the 2.5s "Good" threshold.

Your site's LCP: → estimated after fixes.

These are estimates based on industry research — actual results vary

Bounce-rate model & assumptions

Your data stays in your browser — nothing is sent to our servers

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Lighthouse Scores

Industry-standard audits powered by Google Lighthouse.

29
Performance Overall performance score (0–100) based on Core Web Vitals and other metrics. 90+ is good.
86
Accessibility Measures how accessible the page is for users with disabilities. Checks color contrast, ARIA labels, and semantic HTML.
77
Best Practices Checks for modern web development best practices including HTTPS, no console errors, and secure JavaScript.
77
SEO Measures basic SEO optimizations: meta tags, crawlability, link text, and mobile friendliness.

Core Web Vitals

Key metrics that affect user experience.

First Contentful Paint First Contentful Paint — how long until the browser renders the first piece of content. Under 1.8s is good.

5.03 s

Largest Contentful Paint Largest Contentful Paint — how long until the largest visible element loads. Under 2.5s is good.

18.83 s

Total Blocking Time Total Blocking Time — total time the main thread was blocked, preventing user input. Under 200ms is good.

3.86 s

Cumulative Layout Shift Cumulative Layout Shift — measures visual stability. How much the page layout shifts during loading. Under 0.1 is good.

0.053

Speed Index Speed Index — how quickly content is visually displayed during load. Under 3.4s is good.

6.89 s

Time to Interactive Time to Interactive — how long until the page is fully interactive and responds to user input. Under 3.8s is good.

19.47 s

Detailed Report

Audit breakdown by category with detailed findings.

29

Performance

Insights

Remove large, duplicate JavaScript modules from bundles to reduce unnecessary bytes consumed by network activity.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Polyfills and transforms enable older browsers to use new JavaScript features. However, many aren't necessary for modern browsers. Consider modifying your JavaScript build process to not transpile Baseline features, unless you know you must support older browsers. Learn why most sites can deploy ES6+ code without transpiling

Why this matters

Shipping ES5 transpiled code to modern browsers wastes bytes — every user with an evergreen browser pays for compatibility you don't need.

Learn more

Most users today run browsers that natively support ES6+, async/await, optional chaining, and the rest of modern JavaScript. Transpiling to ES5 'just in case' adds 20-40% to your bundle for no benefit. Configure your build to target a modern browserslist, or ship a differential bundle pair (modern + legacy) with the module/nomodule pattern.

Source: Google web.dev / Lighthouse

3rd party code can significantly impact load performance. Reduce and defer loading of 3rd party code to prioritize your page's content.

Why this matters

Performance issues directly impact user engagement and conversion rates.

A forced reflow occurs when JavaScript queries geometric properties (such as offsetWidth) after styles have been invalidated by a change to the DOM state. This can result in poor performance. Learn more about forced reflows and possible mitigations.

Why this matters

Performance issues directly impact user engagement and conversion rates.

headings: [map[key:source label:Source valueType:source-location] map[granularity:1 key:reflowTime label:Total reflow time valueType:ms]]
items: [map[reflowTime:39.235 source:map[column:114 line:2086 type:source-location url:https://jamanetwork.com/ urlProvider:network]] map[reflowTime:34.512 source:map[type:text value:[unattributed]]]]

Each subpart has specific improvement strategies. Ideally, most of the LCP time should be spent on loading the resources, not within delays.

Why this matters

Performance issues directly impact user engagement and conversion rates.

headings: [map[key:label label:Subpart valueType:text] map[key:duration label:Duration valueType:ms]]
items: [map[duration:503 label:Time to first byte subpart:timeToFirstByte] map[duration:2545.677 label:Element render delay subpart:elementRenderDelay]]
lhId: page-0-DIV
nodeLabel: We use cookies and other technologies to collect information about your use of …
path: 1,HTML,1,BODY,22,DIV,1,DIV,0,DIV,0,DIV,0,DIV,0,DIV,1,DIV
selector: div.ot-sdk-row > div#onetrust-group-container > div#onetrust-policy > div#onetrust-policy-text
snippet: <div id="onetrust-policy-text">

Avoid chaining critical requests by reducing the length of chains, reducing the download size of resources, or deferring the download of unnecessary resources to improve page load.

Why this matters

Performance issues directly impact user engagement and conversion rates.

description: [preconnect](https://developer.chrome.com/docs/lighthouse/performance/uses-rel-preconnect/) hints help the browser establish a connection earlier in the page load, saving time when the first request for that origin is made. The following are the origins that the page preconnected to.
title: Preconnected origins
value: no origins were preconnected
description: Add [preconnect](https://developer.chrome.com/docs/lighthouse/performance/uses-rel-preconnect/) hints to your most important origins, but try to use no more than 4.
title: Preconnect candidates

Requests are blocking the page's initial render, which may delay LCP. Deferring or inlining can move these network requests out of the critical path.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Reducing the download time of images can improve the perceived load time of the page and LCP. Learn more about optimizing image size

Why this matters

Performance issues directly impact user engagement and conversion rates.

URLResource SizeEst Savings
div.journals-parent > div.journals-featured > a > img div.journals-parent > div.journals-featured > a > img
/ImageLibrary/channels/publications/250331-jama-feature-c...141.3 KiB123.0 KiB
Laboratory worker holding petri dishes with bacterial growth li.featured > div > a > img.content-img
/ImageLibrary/jama/2026/260418-jama-ec-7x10-900.jpg?versi...91.8 KiB11.0 KiB

These insights are also available in the Chrome DevTools Performance Panel - record a trace to view more detailed information.

Time to Interactive is the amount of time it takes for the page to become fully interactive. Learn more about the Time to Interactive metric.

Why this matters

Performance issues directly impact user engagement and conversion rates.

TTI

The maximum potential First Input Delay that your users could experience is the duration of the longest task. Learn more about the Maximum Potential First Input Delay metric.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Diagnostics

Reduce unused JavaScript and defer loading scripts until they are required to decrease bytes consumed by network activity. Learn how to reduce unused JavaScript.

Why this matters

Multi-megabyte JavaScript bundles delay every interactive feature on the page.

Learn more

This is the Lighthouse audit fired when too much JS is shipped relative to what executes. The fix isn't a config flag — it requires bundle analysis (webpack-bundle-analyzer, rollup-plugin-visualizer), splitting routes into chunks, lazy-loading off-screen components, and removing unused dependencies. Fundamentally different from minification: minifying reduces byte count, this reduces what's downloaded at all.

Source: Google web.dev / Lighthouse

Consider reducing the time spent parsing, compiling, and executing JS. You may find delivering smaller JS payloads helps with this. Learn how to reduce Javascript execution time.

Why this matters

Performance issues directly impact user engagement and conversion rates.

URLTotal CPU TimeScript EvaluationScript Parse
jamanetwork.com/2.1 s93 ms11 ms
Unattributable1.8 s597 ms0.0 ms
cdn.quantummetric.com/qscripts/quantum-ama.js1.1 s949 ms49 ms
/pagead/managed/js/gpt/m202604200101/pubads_impl.js?cb=31...837 ms666 ms87 ms
r451.jamanetwork.com/script.js799 ms737 ms18 ms
cdn.jamanetwork.com/UI/app/vendor/jquery-3.4.1.min.js?v=639102344110797911633 ms459 ms16 ms
www.googletagmanager.com/gtm.js?id=GTM-WNKSNP589 ms469 ms82 ms
jamanetwork.com/cdn-cgi/challenge-platform/scripts/jsd/main.js546 ms523 ms7.7 ms
api.b2c.com/api/init-3133s13tyvo448eled2.js505 ms473 ms2.8 ms
api.b2c.com/api/init-384qixmcp2s94lcpe6l.js?journal=jamanetw433 ms386 ms2.3 ms
cdn.cookielaw.org/scripttemplates/202503.1.0/otBannerSdk.js357 ms214 ms60 ms
www.googletagmanager.com/gtag/js?id=G-CXRFQ9PGSH&cx=c&gtm=4e64h1354 ms274 ms77 ms
/pagead/managed/js/activeview/current/ufs_web_display.js324 ms240 ms33 ms
www.googletagmanager.com/gtag/js?id=G-B4FWHWKMEB&cx=c&gtm=4e64h1309 ms218 ms87 ms
www.googletagmanager.com/gtag/js?id=G-NGYQD9R7ZM&cx=c&gtm=4e64h1268 ms198 ms68 ms
/pagead/managed/js/gpt/m202604200101/pubads_impl_page_lev...259 ms159 ms26 ms
securepubads.g.doubleclick.net/tag/js/gpt.js207 ms142 ms64 ms
cdn.jamanetwork.com/UI/app/dist/app.min.js?v=639116193382194938196 ms123 ms39 ms
cdn.jamanetwork.com/UI/app/dist/app.min.css?v=639116192498826604130 ms0.0 ms0.0 ms
cdn.jamanetwork.com/UI/app/dist/head.min.js?v=639116192958682418125 ms49 ms1.9 ms
/scripttemplates/otSDKStub.js?did=574a866b-eba0-49e3-a90a...82 ms68 ms5.5 ms
ep2.adtrafficquality.google/sodar/sodar2.js67 ms59 ms3.0 ms
plugins.blueconic.net/static/scripts/jquery/jquery-3.7.1-BC-v2.min.js55 ms42 ms11 ms

Consider reducing the time spent parsing, compiling and executing JS. You may find delivering smaller JS payloads helps with this. Learn how to minimize main-thread work

Why this matters

Performance issues directly impact user engagement and conversion rates.

CategoryTime Spent
Script Evaluation7.2 s
Other1.9 s
Style & Layout1.1 s
Script Parsing & Compilation798 ms
Rendering677 ms
Parse HTML & CSS284 ms
Garbage Collection202 ms

Many navigations are performed by going back to a previous page, or forwards again. The back/forward cache (bfcache) can speed up these return navigations. Learn more about the bfcache

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failure reasonFailure type
The page has an unload handler in the main frame.Actionable
Pages with WebSocket cannot enter back/forward cache.Pending browser support

Reduce unused rules from stylesheets and defer CSS not used for above-the-fold content to decrease bytes consumed by network activity. Learn how to reduce unused CSS.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Estimated savings: 0.0 ms 18.0 KiB
URLTransfer SizeEst Savings
20.3 KiB18.0 KiB

Set an explicit width and height on image elements to reduce layout shifts and improve CLS. Learn how to set image dimensions

Why this matters

Performance issues directly impact user engagement and conversion rates.

URL
a > div.jcc-promo > picture > img a > div.jcc-promo > picture > img
/ImageLibrary/MarketingImages/jcc/get-there-375.svg?versi...
JAMA Network div.image-display-wrap > div.site-logo > a > img#ama-custom-logo
cdn.jamanetwork.com/UI/app/svg/jn-logo-rgb.svg

More information about the performance of your application. These numbers don't directly affect the Performance score.

Layout shift culprits
Document request latency
Optimize DOM size
Modern HTTP
Optimize viewport for mobile
Minify CSS
Minify JavaScript
Avoids enormous network payloads Total size was 2,586 KiB
User Timing marks and measures 21 user timings
Avoid long main-thread tasks 20 long tasks found
Avoid non-composited animations 3 animated elements found
Network Requests
Network Round Trip Times 130 ms
Server Backend Latencies 230 ms
Tasks
Diagnostics
Metrics
Screenshot Thumbnails
Final Screenshot
Script Treemap Data
Resources Summary
Avoid multiple page redirects
Initial server response time was short Root document took 490 ms
Avoid large layout shifts 15 layout shifts found
INP breakdown
LCP request discovery
86

Accessibility

These checks highlight opportunities to improve the accessibility of your web app. Automatic detection can only detect a subset of issues and does not guarantee the accessibility of your web app, so manual testing is also encouraged.

ARIA

Each ARIA `role` supports a specific subset of `aria-*` attributes. Mismatching these invalidates the `aria-*` attributes. Learn how to match ARIA attributes to their roles.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
MOST VIEWED (30 DAYS) RSS link div.sidebar > div.widget-MostViewedCited > div.most--links > div.most--tab-link
MOST CITED (3 YEARS) RSS Link div.sidebar > div.widget-MostViewedCited > div.most--links > div.most--tab-link

These are opportunities to improve the usage of ARIA in your application which may enhance the experience for users of assistive technology, like a screen reader.

Navigation

Properly ordered headings that do not skip levels convey the semantic structure of the page, making it easier to navigate and understand when using assistive technologies. Learn more about heading order.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
JOB LISTINGS ON JAMA CAREER CENTER® div.widget-JobsAd > div.jobs-ad > div.jobs-ad--text > h6.tt-u

These are opportunities to improve keyboard navigation in your application.

Names and labels

Informative elements should aim for short, descriptive alternate text. Decorative elements can be ignored with an empty alt attribute. Learn more about the `alt` attribute.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
div.journals-parent > div.journals-featured > a > img div.journals-parent > div.journals-featured > a > img

Link text (and alternate text for images, when used as links) that is discernible, unique, and focusable improves the navigation experience for screen reader users. Learn how to make links accessible.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
body.pg_index > form#webform > section.master-main > a#skip-to-navigation body.pg_index > form#webform > section.master-main > a#skip-to-navigation
div > div.journals-parent > div.journals-featured > a div > div.journals-parent > div.journals-featured > a
div.main-content > div.widget-SelfServeContent > div.self-serve > a div.main-content > div.widget-SelfServeContent > div.self-serve > a

These are opportunities to improve the semantics of the controls in your application. This may enhance the experience for users of assistive technology, like a screen reader.

Visible text labels that do not match the accessible name can result in a confusing experience for screen reader users. Learn more about accessible names.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
Navigation div.new-header-row2 > div.new-header_wrap > div.header-nav > a.nav-toggler-25
Privacy Policy. div#onetrust-group-container > div#onetrust-policy > div#onetrust-policy-text > a.ot-cookie-policy-link
Interactive controls are keyboard focusable
Interactive elements indicate their purpose and state
The page has a logical tab order
Visual order on the page follows DOM order
User focus is not accidentally trapped in a region
The user's focus is directed to new content added to the page
HTML5 landmark elements are used to improve navigation
Offscreen content is hidden from assistive technology
Custom controls have associated labels
Custom controls have ARIA roles
`[aria-hidden="true"]` is not present on the document `<body>`
`[role]`s have all required `[aria-*]` attributes
`[role]` values are valid
`[aria-*]` attributes have valid values
`[aria-*]` attributes are valid and not misspelled
Buttons have an accessible name
Input buttons have discernible text.
Form elements have associated labels
`[user-scalable="no"]` is not used in the `<meta name="viewport">` element and the `[maximum-scale]` attribute is not less than 5.
ARIA attributes are used as specified for the element's role
Elements with `role="dialog"` or `role="alertdialog"` have accessible names.
`[aria-hidden="true"]` elements do not contain focusable descendents
Elements use only permitted ARIA attributes
Background and foreground colors have a sufficient contrast ratio
Document has a `<title>` element
`<html>` element has a `[lang]` attribute
`<html>` element has a valid value for its `[lang]` attribute
Links are distinguishable without relying on color.
Lists contain only `<li>` elements and script supporting elements (`<script>` and `<template>`).
List items (`<li>`) are contained within `<ul>`, `<ol>` or `<menu>` parent elements
No element has a `[tabindex]` value greater than 0
Touch targets have sufficient size and spacing.
Skip links are focusable.
Document has a main landmark.
Deprecated ARIA roles were not used
Identical links have the same purpose.
`[accesskey]` values are unique
`button`, `link`, and `menuitem` elements have accessible names
ARIA input fields have accessible names
ARIA `meter` elements have accessible names
ARIA `progressbar` elements have accessible names
Elements with an ARIA `[role]` that require children to contain a specific `[role]` have all required children.
`[role]`s are contained by their required parent element
Elements with the `role=text` attribute do not have focusable descendents.
ARIA toggle fields have accessible names
ARIA `tooltip` elements have accessible names
ARIA `treeitem` elements have accessible names
The page contains a heading, skip link, or landmark region
`<dl>`'s contain only properly-ordered `<dt>` and `<dd>` groups, `<script>`, `<template>` or `<div>` elements.
Definition list items are wrapped in `<dl>` elements
ARIA IDs are unique
No form fields have multiple labels
`<frame>` or `<iframe>` elements have a title
`<html>` element has an `[xml:lang]` attribute with the same base language as the `[lang]` attribute.
`<input type="image">` elements have `[alt]` text
The document does not use `<meta http-equiv="refresh">`
`<object>` elements have alternate text
Select elements have associated label elements.
Cells in a `<table>` element that use the `[headers]` attribute refer to table cells within the same table.
`<th>` elements and elements with `[role="columnheader"/"rowheader"]` have data cells they describe.
`[lang]` attributes have a valid value
`<video>` elements contain a `<track>` element with `[kind="captions"]`
Tables have different content in the summary attribute and `<caption>`.
All heading elements contain content.
Uses ARIA roles only on compatible elements
Image elements do not have `[alt]` attributes that are redundant text.
Tables use `<caption>` instead of cells with the `[colspan]` attribute to indicate a caption.
`<td>` elements in a large `<table>` have one or more table headers.
77

Best Practices

General

Deprecated APIs will eventually be removed from the browser. Learn more about deprecated APIs.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Deprecation / WarningSource
SharedStorage
StorageType.persistent is deprecated. Please use standardized navigator.storage instead.
Fledge
Unload event listeners are deprecated and will be removed.

Errors logged to the console indicate unresolved problems. They can come from network request failures and other browser concerns. Learn more about this errors in console diagnostic audit

Why this matters

Performance issues directly impact user engagement and conversion rates.

Description
ReferenceError: interstitial is not defined at <anonymous>:2:1 at <anonymous>:1:108 at d (https://securepubads.g.doubleclick.net/pagead/managed/js/gpt/m202604200101/pubads_impl.js?cb=31097964:19:572436) at tha (https://securepubads.g.doubleclick.net/pagead/managed/js/gpt/m202604200101/pubads_impl.js?cb=31097964:19:572693) at O_.l (https://securepubads.g.doubleclick.net/pagead/managed/js/gpt/m202604200101/pubads_impl.js?cb=31097964:19:572176) at f_.render (https://securepubads.g.doubleclick.net/pagead/managed/js/gpt/m202604200101/pubads_impl.js?cb=31097964:19:520739) at N.id [as f] (https://securepubads.g.doubleclick.net/pagead/managed/js/gpt/m202604200101/pubads_impl.js?cb=31097964:19:573342) at PV.K (https://securepubads.g.doubleclick.net/pagead/managed/js/gpt/m202604200101/pubads_impl.js?cb=31097964:19:331969) at eE.j (https://securepubads.g.doubleclick.net/pagead/managed/js/gpt/m202604200101/pubads_impl.js?cb=31097964:19:331055) at gE (https://securepubads.g.doubleclick.net/pagead/managed/js/gpt/m202604200101/pubads_impl.js?cb=31097964:19:200908)
Uses HTTPS
Avoids third-party cookies
Allows users to paste into input fields
Avoids requesting the geolocation permission on page load
Avoids requesting the notification permission on page load
Displays images with correct aspect ratio
Serves images with appropriate resolution
Page has the HTML doctype
Properly defines charset
No issues in the `Issues` panel in Chrome Devtools
Ensure CSP is effective against XSS attacks
Use a strong HSTS policy
Ensure proper origin isolation with COOP
Mitigate DOM-based XSS with Trusted Types
Detected JavaScript libraries
Page has valid source maps
Redirects HTTP traffic to HTTPS
Mitigate clickjacking with XFO or CSP
77

SEO

These checks ensure that your page is following basic search engine optimization advice. There are many additional factors Lighthouse does not score here that may affect your search ranking, including performance on Core Web Vitals. Learn more about Google Search Essentials.

Content Best Practices

Descriptive link text helps search engines understand your content. Learn how to make links more accessible.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Informative elements should aim for short, descriptive alternate text. Decorative elements can be ignored with an empty alt attribute. Learn more about the `alt` attribute.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
div.journals-parent > div.journals-featured > a > img div.journals-parent > div.journals-featured > a > img

Format your HTML in a way that enables crawlers to better understand your app’s content.

Crawling and Indexing

Search engines may use `href` attributes on links to crawl websites. Ensure that the `href` attribute of anchor elements links to an appropriate destination, so more pages of the site can be discovered. Learn how to make links crawlable

Why this matters

Performance issues directly impact user engagement and conversion rates.

Uncrawlable Link
body.pg_index > form#webform > div#revealModal > a.close-reveal-modal body.pg_index > form#webform > div#revealModal > a.close-reveal-modal

To appear in search results, crawlers need access to your app.

Structured data is valid
Page isn’t blocked from indexing
Document has a `<title>` element
Document has a meta description
Page has successful HTTP status code
robots.txt is valid
Document has a valid `hreflang`
Document has a valid `rel=canonical`

Lighthouse Scores

Industry-standard audits powered by Google Lighthouse. — Desktop

54
Performance Overall performance score (0–100) based on Core Web Vitals and other metrics. 90+ is good.
87
Accessibility Measures how accessible the page is for users with disabilities. Checks color contrast, ARIA labels, and semantic HTML.
81
Best Practices Checks for modern web development best practices including HTTPS, no console errors, and secure JavaScript.
77
SEO Measures basic SEO optimizations: meta tags, crawlability, link text, and mobile friendliness.

Core Web Vitals

Key metrics that affect user experience. — Desktop

First Contentful Paint First Contentful Paint — how long until the browser renders the first piece of content. Under 1.8s is good.

1.69 s

Largest Contentful Paint Largest Contentful Paint — how long until the largest visible element loads. Under 2.5s is good.

4.06 s

Total Blocking Time Total Blocking Time — total time the main thread was blocked, preventing user input. Under 200ms is good.

315 ms

Cumulative Layout Shift Cumulative Layout Shift — measures visual stability. How much the page layout shifts during loading. Under 0.1 is good.

0.037

Speed Index Speed Index — how quickly content is visually displayed during load. Under 3.4s is good.

2.57 s

Time to Interactive Time to Interactive — how long until the page is fully interactive and responds to user input. Under 3.8s is good.

4.55 s

Detailed Report

Audit breakdown by category with detailed findings.

54

Performance

Insights

Remove large, duplicate JavaScript modules from bundles to reduce unnecessary bytes consumed by network activity.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Polyfills and transforms enable older browsers to use new JavaScript features. However, many aren't necessary for modern browsers. Consider modifying your JavaScript build process to not transpile Baseline features, unless you know you must support older browsers. Learn why most sites can deploy ES6+ code without transpiling

Why this matters

Shipping ES5 transpiled code to modern browsers wastes bytes — every user with an evergreen browser pays for compatibility you don't need.

Learn more

Most users today run browsers that natively support ES6+, async/await, optional chaining, and the rest of modern JavaScript. Transpiling to ES5 'just in case' adds 20-40% to your bundle for no benefit. Configure your build to target a modern browserslist, or ship a differential bundle pair (modern + legacy) with the module/nomodule pattern.

Source: Google web.dev / Lighthouse

3rd party code can significantly impact load performance. Reduce and defer loading of 3rd party code to prioritize your page's content.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Your first network request is the most important. Reduce its latency by avoiding redirects, ensuring a fast server response, and enabling text compression.

Why this matters

Performance issues directly impact user engagement and conversion rates.

A forced reflow occurs when JavaScript queries geometric properties (such as offsetWidth) after styles have been invalidated by a change to the DOM state. This can result in poor performance. Learn more about forced reflows and possible mitigations.

Why this matters

Performance issues directly impact user engagement and conversion rates.

headings: [map[key:source label:Top function call valueType:source-location] map[granularity:1 key:reflowTime label:Total reflow time valueType:ms]]
items: [map[reflowTime:33.247 source:map[column:29748 line:2 type:source-location url:https://cdn.jamanetwork.com/UI/app/vendor/jquery-3.4.1.min.js?v=639102344110797911 urlProvider:network]]]
headings: [map[key:source label:Source valueType:source-location] map[granularity:1 key:reflowTime label:Total reflow time valueType:ms]]
items: [map[reflowTime:168.46 source:map[type:text value:[unattributed]]] map[reflowTime:14.071 source:map[column:80286 line:1 type:source-location url:https://cdn.jamanetwork.com/UI/app/vendor/jquery-3.4.1.min.js?v=639102344110797911 urlProvider:network]] map[reflowTime:17.274 source:map[column:51353 line:1 type:source-location url:https://cdn.jamanetwork.com/UI/app/vendor/jquery-3.4.1.min.js?v=639102344110797911 urlProvider:network]] map[reflowTime:1.393 source:map[column:51375 line:1 type:source-location url:https://cdn.jamanetwork.com/UI/app/vendor/jquery-3.4.1.min.js?v=639102344110797911 urlProvider:network]] map[reflowTime:0.509 source:map[column:85935 line:1 type:source-location url:https://cdn.jamanetwork.com/UI/app/vendor/jquery-3.4.1.min.js?v=639102344110797911 urlProvider:network]] map[reflowTime:0.442 source:map[column:1568 line:0 type:source-location url:https://jamanetwork.com/cdn-cgi/challenge-platform/scripts/jsd/main.js urlProvider:network]] map[reflowTime:0.987 source:map[column:48581 line:18 type:source-location url:https://securepubads.g.doubleclick.net/pagead/managed/js/gpt/m202604170101/pubads_impl.js?cb=31097963 urlProvider:network]]]

Reducing the download time of images can improve the perceived load time of the page and LCP. Learn more about optimizing image size

Why this matters

Performance issues directly impact user engagement and conversion rates.

URLResource SizeEst Savings
div.journals-parent > div.journals-featured > a > img div.journals-parent > div.journals-featured > a > img
/ImageLibrary/channels/publications/250331-jama-feature-c...141.3 KiB133.6 KiB
body > div#google_image_div > a#aw0 > img.img_ad body > div#google_image_div > a#aw0 > img.img_ad
tpc.googlesyndication.com/simgad/595387921243780240571.6 KiB59.4 KiB
body > div#google_image_div > a#aw0 > img.img_ad body > div#google_image_div > a#aw0 > img.img_ad
tpc.googlesyndication.com/simgad/1253641128386151255346.2 KiB35.5 KiB
Laboratory worker holding petri dishes with bacterial growth li.featured > div > a > img.content-img
/ImageLibrary/jama/2026/260418-jama-ec-7x10-900.jpg?versi...91.8 KiB4.9 KiB

Each subpart has specific improvement strategies. Ideally, most of the LCP time should be spent on loading the resources, not within delays.

Why this matters

Performance issues directly impact user engagement and conversion rates.

headings: [map[key:label label:Subpart valueType:text] map[key:duration label:Duration valueType:ms]]
items: [map[duration:497.253 label:Time to first byte subpart:timeToFirstByte] map[duration:2097.988 label:Element render delay subpart:elementRenderDelay]]
lhId: page-2-DIV
nodeLabel: Practice-Changing Updates in the New Lipid Guidelines
path: 1,HTML,1,BODY,9,FORM,5,SECTION,4,DIV,2,DIV,4,DIV,1,DIV,0,DIV,0,DIV,0,UL,0,LI,1,DIV
selector: div.widget-ArticleListMostReadViewed > ul.featured-list--contents > li.article > div.article--meta
snippet: <div class="article--meta">

Avoid chaining critical requests by reducing the length of chains, reducing the download size of resources, or deferring the download of unnecessary resources to improve page load.

Why this matters

Performance issues directly impact user engagement and conversion rates.

description: [preconnect](https://developer.chrome.com/docs/lighthouse/performance/uses-rel-preconnect/) hints help the browser establish a connection earlier in the page load, saving time when the first request for that origin is made. The following are the origins that the page preconnected to.
title: Preconnected origins
value: no origins were preconnected
description: Add [preconnect](https://developer.chrome.com/docs/lighthouse/performance/uses-rel-preconnect/) hints to your most important origins, but try to use no more than 4.
title: Preconnect candidates

Requests are blocking the page's initial render, which may delay LCP. Deferring or inlining can move these network requests out of the critical path.

Why this matters

Performance issues directly impact user engagement and conversion rates.

These insights are also available in the Chrome DevTools Performance Panel - record a trace to view more detailed information.

Redirects introduce additional delays before the page can be loaded. Learn how to avoid page redirects.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Estimated savings: 360 ms
URLTime Spent
jamanetwork.com/360 ms
jamanetwork.com/0.0 ms

Time to Interactive is the amount of time it takes for the page to become fully interactive. Learn more about the Time to Interactive metric.

Why this matters

Performance issues directly impact user engagement and conversion rates.

TTI

The maximum potential First Input Delay that your users could experience is the duration of the longest task. Learn more about the Maximum Potential First Input Delay metric.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Diagnostics

Reduce unused JavaScript and defer loading scripts until they are required to decrease bytes consumed by network activity. Learn how to reduce unused JavaScript.

Why this matters

Multi-megabyte JavaScript bundles delay every interactive feature on the page.

Learn more

This is the Lighthouse audit fired when too much JS is shipped relative to what executes. The fix isn't a config flag — it requires bundle analysis (webpack-bundle-analyzer, rollup-plugin-visualizer), splitting routes into chunks, lazy-loading off-screen components, and removing unused dependencies. Fundamentally different from minification: minifying reduces byte count, this reduces what's downloaded at all.

Source: Google web.dev / Lighthouse

Consider reducing the time spent parsing, compiling and executing JS. You may find delivering smaller JS payloads helps with this. Learn how to minimize main-thread work

Why this matters

Performance issues directly impact user engagement and conversion rates.

CategoryTime Spent
Script Evaluation2.2 s
Other571 ms
Style & Layout323 ms
Rendering204 ms
Script Parsing & Compilation191 ms
Garbage Collection102 ms
Parse HTML & CSS79 ms

Many navigations are performed by going back to a previous page, or forwards again. The back/forward cache (bfcache) can speed up these return navigations. Learn more about the bfcache

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failure reasonFailure type
The page has an unload handler in the main frame.Actionable
Pages with WebSocket cannot enter back/forward cache.Pending browser support

Reduce unused rules from stylesheets and defer CSS not used for above-the-fold content to decrease bytes consumed by network activity. Learn how to reduce unused CSS.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Estimated savings: 0.0 ms 17.7 KiB
URLTransfer SizeEst Savings
20.3 KiB17.7 KiB

Set an explicit width and height on image elements to reduce layout shifts and improve CLS. Learn how to set image dimensions

Why this matters

Performance issues directly impact user engagement and conversion rates.

URL
a > div.jcc-promo > picture > img a > div.jcc-promo > picture > img
/ImageLibrary/MarketingImages/jcc/get-there-1024.svg?vers...
JAMA Network div.image-display-wrap > div.site-logo > a > img#ama-custom-logo
cdn.jamanetwork.com/UI/app/svg/jn-logo-rgb.svg

More information about the performance of your application. These numbers don't directly affect the Performance score.

Layout shift culprits
Optimize DOM size
Modern HTTP
Optimize viewport for mobile
Minify CSS
Minify JavaScript
User Timing marks and measures 21 user timings
Avoid long main-thread tasks 15 long tasks found
Avoid non-composited animations 1 animated element found
Network Requests
Network Round Trip Times 120 ms
Server Backend Latencies 170 ms
Tasks
Diagnostics
Metrics
Screenshot Thumbnails
Final Screenshot
Script Treemap Data
Resources Summary
Initial server response time was short Root document took 470 ms
Avoid large layout shifts 15 layout shifts found
INP breakdown
LCP request discovery
87

Accessibility

These checks highlight opportunities to improve the accessibility of your web app. Automatic detection can only detect a subset of issues and does not guarantee the accessibility of your web app, so manual testing is also encouraged.

ARIA

Each ARIA `role` supports a specific subset of `aria-*` attributes. Mismatching these invalidates the `aria-*` attributes. Learn how to match ARIA attributes to their roles.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
MOST VIEWED (30 DAYS) RSS link div.sidebar > div.widget-MostViewedCited > div.most--links > div.most--tab-link
MOST CITED (3 YEARS) RSS Link div.sidebar > div.widget-MostViewedCited > div.most--links > div.most--tab-link

These are opportunities to improve the usage of ARIA in your application which may enhance the experience for users of assistive technology, like a screen reader.

Navigation

Properly ordered headings that do not skip levels convey the semantic structure of the page, making it easier to navigate and understand when using assistive technologies. Learn more about heading order.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
JOB LISTINGS ON JAMA CAREER CENTER® div.widget-JobsAd > div.jobs-ad > div.jobs-ad--text > h6.tt-u

These are opportunities to improve keyboard navigation in your application.

Names and labels

Informative elements should aim for short, descriptive alternate text. Decorative elements can be ignored with an empty alt attribute. Learn more about the `alt` attribute.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
div.journals-parent > div.journals-featured > a > img div.journals-parent > div.journals-featured > a > img

Link text (and alternate text for images, when used as links) that is discernible, unique, and focusable improves the navigation experience for screen reader users. Learn how to make links accessible.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
body.pg_index > form#webform > section.master-main > a#skip-to-navigation body.pg_index > form#webform > section.master-main > a#skip-to-navigation
div > div.journals-parent > div.journals-featured > a div > div.journals-parent > div.journals-featured > a
div.main-content > div.widget-SelfServeContent > div.self-serve > a div.main-content > div.widget-SelfServeContent > div.self-serve > a

These are opportunities to improve the semantics of the controls in your application. This may enhance the experience for users of assistive technology, like a screen reader.

Visible text labels that do not match the accessible name can result in a confusing experience for screen reader users. Learn more about accessible names.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
Navigation div.new-header-row2 > div.new-header_wrap > div.header-nav > a.nav-toggler-25
Privacy Policy. div#onetrust-group-container > div#onetrust-policy > div#onetrust-policy-text > a.ot-cookie-policy-link
Interactive controls are keyboard focusable
Interactive elements indicate their purpose and state
The page has a logical tab order
Visual order on the page follows DOM order
User focus is not accidentally trapped in a region
The user's focus is directed to new content added to the page
HTML5 landmark elements are used to improve navigation
Offscreen content is hidden from assistive technology
Custom controls have associated labels
Custom controls have ARIA roles
`[aria-hidden="true"]` is not present on the document `<body>`
`[role]`s have all required `[aria-*]` attributes
`[role]` values are valid
`[aria-*]` attributes have valid values
`[aria-*]` attributes are valid and not misspelled
Buttons have an accessible name
Input buttons have discernible text.
Form elements have associated labels
`[user-scalable="no"]` is not used in the `<meta name="viewport">` element and the `[maximum-scale]` attribute is not less than 5.
ARIA attributes are used as specified for the element's role
Elements with `role="dialog"` or `role="alertdialog"` have accessible names.
`[aria-hidden="true"]` elements do not contain focusable descendents
Elements use only permitted ARIA attributes
Background and foreground colors have a sufficient contrast ratio
Document has a `<title>` element
`<frame>` or `<iframe>` elements have a title
`<html>` element has a `[lang]` attribute
`<html>` element has a valid value for its `[lang]` attribute
Links are distinguishable without relying on color.
Lists contain only `<li>` elements and script supporting elements (`<script>` and `<template>`).
List items (`<li>`) are contained within `<ul>`, `<ol>` or `<menu>` parent elements
No element has a `[tabindex]` value greater than 0
Touch targets have sufficient size and spacing.
Skip links are focusable.
Document has a main landmark.
Deprecated ARIA roles were not used
Identical links have the same purpose.
`[accesskey]` values are unique
`button`, `link`, and `menuitem` elements have accessible names
ARIA input fields have accessible names
ARIA `meter` elements have accessible names
ARIA `progressbar` elements have accessible names
Elements with an ARIA `[role]` that require children to contain a specific `[role]` have all required children.
`[role]`s are contained by their required parent element
Elements with the `role=text` attribute do not have focusable descendents.
ARIA toggle fields have accessible names
ARIA `tooltip` elements have accessible names
ARIA `treeitem` elements have accessible names
The page contains a heading, skip link, or landmark region
`<dl>`'s contain only properly-ordered `<dt>` and `<dd>` groups, `<script>`, `<template>` or `<div>` elements.
Definition list items are wrapped in `<dl>` elements
ARIA IDs are unique
No form fields have multiple labels
`<html>` element has an `[xml:lang]` attribute with the same base language as the `[lang]` attribute.
`<input type="image">` elements have `[alt]` text
The document does not use `<meta http-equiv="refresh">`
`<object>` elements have alternate text
Select elements have associated label elements.
Cells in a `<table>` element that use the `[headers]` attribute refer to table cells within the same table.
`<th>` elements and elements with `[role="columnheader"/"rowheader"]` have data cells they describe.
`[lang]` attributes have a valid value
`<video>` elements contain a `<track>` element with `[kind="captions"]`
Tables have different content in the summary attribute and `<caption>`.
All heading elements contain content.
Uses ARIA roles only on compatible elements
Image elements do not have `[alt]` attributes that are redundant text.
Tables use `<caption>` instead of cells with the `[colspan]` attribute to indicate a caption.
`<td>` elements in a large `<table>` have one or more table headers.
81

Best Practices

General

Deprecated APIs will eventually be removed from the browser. Learn more about deprecated APIs.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Deprecation / WarningSource
SharedStorage
StorageType.persistent is deprecated. Please use standardized navigator.storage instead.
Fledge
Unload event listeners are deprecated and will be removed.
jamanetwork.com/ line 113, col 8711
Uses HTTPS
Avoids third-party cookies
Allows users to paste into input fields
Avoids requesting the geolocation permission on page load
Avoids requesting the notification permission on page load
Displays images with correct aspect ratio
Serves images with appropriate resolution
Page has the HTML doctype
Properly defines charset
No browser errors logged to the console
No issues in the `Issues` panel in Chrome Devtools
Ensure CSP is effective against XSS attacks
Use a strong HSTS policy
Ensure proper origin isolation with COOP
Mitigate DOM-based XSS with Trusted Types
Detected JavaScript libraries
Page has valid source maps
Redirects HTTP traffic to HTTPS
Mitigate clickjacking with XFO or CSP
77

SEO

These checks ensure that your page is following basic search engine optimization advice. There are many additional factors Lighthouse does not score here that may affect your search ranking, including performance on Core Web Vitals. Learn more about Google Search Essentials.

Content Best Practices

Descriptive link text helps search engines understand your content. Learn how to make links more accessible.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Informative elements should aim for short, descriptive alternate text. Decorative elements can be ignored with an empty alt attribute. Learn more about the `alt` attribute.

Why this matters

Performance issues directly impact user engagement and conversion rates.

Failing Elements
div.journals-parent > div.journals-featured > a > img div.journals-parent > div.journals-featured > a > img

Format your HTML in a way that enables crawlers to better understand your app’s content.

Crawling and Indexing

Search engines may use `href` attributes on links to crawl websites. Ensure that the `href` attribute of anchor elements links to an appropriate destination, so more pages of the site can be discovered. Learn how to make links crawlable

Why this matters

Performance issues directly impact user engagement and conversion rates.

Uncrawlable Link
body.pg_index > form#webform > div#revealModal > a.close-reveal-modal body.pg_index > form#webform > div#revealModal > a.close-reveal-modal

To appear in search results, crawlers need access to your app.

Structured data is valid
Page isn’t blocked from indexing
Document has a `<title>` element
Document has a meta description
Page has successful HTTP status code
robots.txt is valid
Document has a valid `hreflang`
Document has a valid `rel=canonical`

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