Electronic health record (EHR) data are increasingly used to develop prediction models that guide clinical decision making at the point of care. These include algorithms that use high-frequency data, like in sepsis prediction, as well as simpler equations, such as the Pooled Cohort Equations for cardiovascular outcome prediction. Although EHR data used in prediction models are often highly granular and more current than other data, there is systematic and nonsystematic missingness in EHR data as there is with most data. Despite growing use for clinical decisions, algorithms implemented in EHRs are mostly unregulated and are often opaque to the user. Guidelines about the development, validation, implementation, and reporting on clinical prediction models are sparse in their recommendations regarding missing data. This article characterizes missingness in EHR data, summarizes methods for attending to missing data when developing prediction models, makes recommendations about validation and implementation of models in practice when data are missing, and identifies research needs in this field.

Nearly 14% of Americans have chronic kidney disease (CKD), which includes persistent decrements in glomerular filtration rate or the presence of albuminuria. Although CKD is commonly attributed to diabetes or hypertension, there is growing awareness of the interplay among cardiovascular, kidney, and metabolic health. Progression of CKD can result in metabolic abnormalities and end-stage kidney disease, but cardiovascular events are even more common. The main goals of CKD treatment include slowing the decline in kidney function, preventing cardiovascular disease, and treating metabolic complications. Recent pharmacologic advancements have yielded effective therapeutic agents capable of concurrently addressing all of these objectives.

With antiretroviral therapy, people with HIV can live a normal lifespan and not transmit HIV. The Ryan White HIV/AIDS Program provides care for over half of people with HIV in the United States.

GIM/FP/GP: [Formula: see text] Gastroenterology: [Formula: see text].

Providing personalized risk information to patients and their providers could improve colorectal cancer (CRC) screening.

GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].

GIM/FP/GP: [Formula: see text] Pulmonology: [Formula: see text].

GIM/FP/GP: [Formula: see text] Public Health: [Formula: see text].

GIM/FP/GP: [Formula: see text] Neurology: [Formula: see text].

Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Neurology: [Formula: see text].

GIM/FP/GP: [Formula: see text] Hematology: [Formula: see text] Neurology: [Formula: see text].

GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].

Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Neurology: [Formula: see text].

GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Endocrinology: [Formula: see text].

This article examines the ethical challenges that medical experts have navigated when mobilizing biological and psychological evidence to advocate for transgender patients in legal proceedings across a quarter of a century. In 2002, clinicians from a private clinic in Galveston, Texas, testified on behalf of Michael Kantaras, a transgender male patient, during his divorce and custody trial. Presenting gender identity as an innate product of neuroendocrine development, medical experts in Kantaras v. Kantaras challenged portrayals of gender dysphoria as a psychological illness resulting from sociocultural factors. Although this biological argument was key to destigmatizing transgender identity and convincing the judge to rule in Michael's favor, transgender advocates have argued that such claims strengthen medical authority over transgender identities. The article draws parallels with L.W. v. Skrmetti, a 2023 case heard by the U.S. Supreme Court concerning bans on gender-affirming care for transgender minors, to analyze how physician experts have referenced neuroimaging and genetic-sequencing studies to support the biological foundations of transgender identity. Transgender advocates have similarly expressed concerns about the medicalization of their identities, criticizing these studies as limited with regard to capturing the diversity and complexity of transgender experiences. Through analysis of historical and contemporary court cases, this article identifies shifting evidence-based methods for studying sex, understanding gender identity, and evaluating gender-affirming care, as well as the rising prominence of patient-centered approaches that seek to move beyond medicalized conceptions of gender identity as key themes clinicians should consider in their advocacy for their transgender patients.