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501. In adults with clinically isolated syndrome suggestive of MS, high-dose vitamin D monotherapy reduced disease activity at 2 y.
GIM/FP/GP: [Formula: see text] Neurology: [Formula: see text].
502. In critically ill patients, preoxygenation with NIPPV or HFNC vs. face mask reduces hypoxemia during intubation.
Emergency Med: [Formula: see text] Critical Care: [Formula: see text] Pulmonology: [Formula: see text].
503. Modernizing Risk Adjustment in Health Care: A Position Paper of the American College of Physicians.
作者: Brian E Outland.;Joshua M Liao.;Jason M Goldman.;Anne F Schultz.;William Fox.; .
来源: Ann Intern Med. 2025年178卷8期1157-1159页
Risk adjustment is a critical component of health care reimbursement aimed at ensuring fair compensation on the basis of the characteristics of patients receiving care. Optimizing risk adjustment is not just a matter of improving efficiency or predictive accuracy; it is a crucial step toward achieving health equity by ensuring that resources are directed toward patients who need them most and reducing incentives to exclude or neglect high-risk patients. The authors reviewed available publications from PubMed and Google Scholar published between 2000 and 2025, as well as relevant news articles, policy documents, websites, and other sources related to risk adjustment and application areas. This process yielded 8 recommendations related to standardizing risk adjustment methods, promoting data interoperability, implementing strategies to enable more accurate and continuous reflections of patients' health status, integrating valid and reliable metrics into regular evaluation and feedback mechanisms, limiting "gaming" opportunities and incentives, creating valid ways to measure costs of caring for patients who are experiencing health care disparities and inequities and/or are disproportionately affected by social drivers of health, evaluating and leveraging advanced analytics and machine learning when able to improve risk adjustment models, and promoting research and implementation methods that combine elements of both prospective and concurrent risk adjustment. Implementation of these risk adjustment recommendations has broad implications for various entities in the health care ecosystem.
504. In HF with iron deficiency, IV ferric carboxymaltose did not reduce a composite of first HF hospitalization or CV death at a median 17 mo.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Hematology: [Formula: see text].
510. In adults aged 50 to 69 y, invitation to screening with FIT was noninferior to invitation for colonoscopy for colorectal cancer mortality at 10 y.
GIM/FP/GP: [Formula: see text] Gastroenterology: [Formula: see text] Public Health: [Formula: see text].
512. Medications and Risk for Microscopic Colitis: A Nationwide Study of Older Adults in Sweden.
作者: Hamed Khalili.;Emma E McGee.;Prasanna K Challa.;Bjorn Roelstraete.;Kristina Johnell.;Sebastian Schneeweiss.;Jonas W Wastesson.;Jonas F Ludvigsson.
来源: Ann Intern Med. 2025年178卷8期1106-1115页
Several medications have been identified as potential risk factors for microscopic colitis (MC), but evidence so far is hampered by methodological limitations.
513. In high-risk type 2 diabetes, adding oral semaglutide to standard care reduced MACE at a mean 48 mo.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Endocrinology: [Formula: see text] Nephrology: [Formula: see text].
516. GRADE Certainty Ratings: Thresholds Rather Than Categories of Contextualization (GRADE Guidance 41).
作者: Monica Hultcrantz.;Holger J Schünemann.;Reem A Mustafa.;David M Rind.;M Hassan Murad.;Martin Mayer.;David Tovey.;Brian S Alper.;Elie A Akl.;K M Saif-Ur-Rahman.;Bernardo Sousa-Pinto.;Ignacio Neumann.;Ariel Izcovich.;Gordon Guyatt.
来源: Ann Intern Med. 2025年178卷8期1183-1186页
In 2017, the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group defined the certainty of evidence as the certainty that the true effect lies on one side of a threshold or in a particular range. This definition has proved useful as the basis for rating certainty, facilitating the interpretation of the results for the target audience. However, the categorization of suggested thresholds and ranges as levels of contextualization led to inconsistencies between the initial and subsequent papers and has proved confusing for some GRADE users. Although considering context in choosing thresholds remains worthwhile, the GRADE working group will no longer use the categorization of contextualization. It will instead refer simply to chosen thresholds or ranges for determining the target of certainty rating.
517. Heat-Related Illnesses.
Climate change is anticipated to continue to adversely affect public health, with heat stress the predominant threat. Accordingly, heat-related illness is predicted to increase as extremely hot days become more frequent. Heat stroke, the most serious heat-related illness, is a medical emergency that may be fatal if it is not promptly recognized, addressed with early and rapid cooling, and accompanied by multidisciplinary supportive care as clinically indicated. Heat stroke is a preventable illness that occurs in 2 distinct forms-classic and exertional-that have distinct demographic profiles and clinical courses but similar management paradigms.
519. A Pragmatic Approach to Streamlining Single-Use Plastics in Health Care.
作者: Jeremy A Greene.;Maria W Merritt.;Ligia Paina.;Sarah B Bucic.;Nicholas Dalesio.;Chris Hanley.;Emily Mediate.;Seema Wadhwa.;Melanie Alfonzo Horowitz.;Ursula E Gately.;Margaret Tharp.;Hardeep Singh.; .
来源: Ann Intern Med. 2025年178卷8期1192-1194页 |