1. Development and Validation of Body Mass Index-Specific Waist Circumference Thresholds in Postmenopausal Women : A Prospective Cohort Study.
作者: Aaron K Aragaki.;JoAnn E Manson.;Erin S LeBlanc.;Rowan T Chlebowski.;Lesley F Tinker.;Matthew A Allison.;Bernhard Haring.;Andrew O Odegaard.;Sylvia Wassertheil-Smoller.;Nazmus Saquib.;Kamal Masaki.;Holly R Harris.;Leah R Jager.;Jennifer W Bea.;Jean Wactawski-Wende.;Garnet L Anderson.
来源: Ann Intern Med. 2025年
A 2020 consensus statement proposed body mass index (BMI)-specific waist circumference (WC) thresholds to improve patient care.
2. Differences Between Trial Populations and Approved Label Populations of New Drugs in the United States and Europe (2012 to 2023) : A Cross-Sectional Study.
作者: Kerstin N Vokinger.;Miquel Serra-Burriel.;Camille E G Glaus.;Lara Welti.;Joseph S Ross.;Aaron S Kesselheim.
来源: Ann Intern Med. 2025年
Drugs are approved when their benefits outweigh their risks based on the results of clinical trials. It remains unclear how often regulatory agencies extrapolate or restrict the approval compared with the trial.
3. Implications of the European Association for the Study of Obesity's New Framework Definition of Obesity: Prevalence and Association With All-Cause Mortality.
The European Association for the Study of Obesity (EASO) recently introduced a new framework to define obesity that incorporates anthropometric measures beyond body mass index (BMI) and clinical comorbidities. However, this framework has not been validated.
4. In COVID-19 acute hypoxemic respiratory failure, awake prone positioning vs. supine positioning increases survival without intubation.
GIM/FP/GP: [Formula: see text] Critical Care: [Formula: see text] Pulmonology: [Formula: see text].
5. Catheter and Surgical Ablation for Atrial Fibrillation : A Systematic Review and Meta-analysis.
作者: Bryce Montané.;Shiyang Zhang.;Jonathan D Wolfe.;Sabrina Prime.;Chongliang Luo.;Daniel H Cooper.;Michelle Doering.;Carina Blomstrom-Lundqvist.;Samer A M Nashef.;Pavel Osmancik.;Jason G Andrade.;Emanuele Bertaglia.;Ratika Parkash.;Daniel B Mark.;Jens C Nielsen.;Linda D Sharples.;Brian F Gage.
来源: Ann Intern Med. 2025年
Ablation of atrial fibrillation can restore normal heart rhythm, but its effect on clinical outcomes is uncertain.
7. 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].
8. 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
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.
9. 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].
13. 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].
14. 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
Several medications have been identified as potential risk factors for microscopic colitis (MC), but evidence so far is hampered by methodological limitations.
15. 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].
17. 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
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.
18. 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.
19. Assessing the System-Instruction Vulnerabilities of Large Language Models to Malicious Conversion Into Health Disinformation Chatbots.
作者: Natansh D Modi.;Bradley D Menz.;Abdulhalim A Awaty.;Cyril A Alex.;Jessica M Logan.;Ross A McKinnon.;Andrew Rowland.;Stephen Bacchi.;Kacper Gradon.;Michael J Sorich.;Ashley M Hopkins.
来源: Ann Intern Med. 2025年
Large language models (LLMs) offer substantial promise for improving health care; however, some risks warrant evaluation and discussion. This study assessed the effectiveness of safeguards in foundational LLMs against malicious instruction into health disinformation chatbots. Five foundational LLMs-OpenAI's GPT-4o, Google's Gemini 1.5 Pro, Anthropic's Claude 3.5 Sonnet, Meta's Llama 3.2-90B Vision, and xAI's Grok Beta-were evaluated via their application programming interfaces (APIs). Each API received system-level instructions to produce incorrect responses to health queries, delivered in a formal, authoritative, convincing, and scientific tone. Ten health questions were posed to each customized chatbot in duplicate. Exploratory analyses assessed the feasibility of creating a customized generative pretrained transformer (GPT) within the OpenAI GPT Store and searched to identify if any publicly accessible GPTs in the store seemed to respond with disinformation. Of the 100 health queries posed across the 5 customized LLM API chatbots, 88 (88%) responses were health disinformation. Four of the 5 chatbots (GPT-4o, Gemini 1.5 Pro, Llama 3.2-90B Vision, and Grok Beta) generated disinformation in 100% (20 of 20) of their responses, whereas Claude 3.5 Sonnet responded with disinformation in 40% (8 of 20). The disinformation included claimed vaccine-autism links, HIV being airborne, cancer-curing diets, sunscreen risks, genetically modified organism conspiracies, attention deficit-hyperactivity disorder and depression myths, garlic replacing antibiotics, and 5G causing infertility. Exploratory analyses further showed that the OpenAI GPT Store could currently be instructed to generate similar disinformation. Overall, LLM APIs and the OpenAI GPT Store were shown to be vulnerable to malicious system-level instructions to covertly create health disinformation chatbots. These findings highlight the urgent need for robust output screening safeguards to ensure public health safety in an era of rapidly evolving technologies.
20. Improvements in Cardiometabolic Risk Factors by Weight Reduction: A Post Hoc Analysis of Adults With Obesity Randomly Assigned to Tirzepatide.
作者: Bruno Linetzky.;Naveed Sattar.;Subodh Verma.;Harlan M Krumholz.;Cathy Chang Xie.;Hunter T Hoffmann.;Sarah Zimner-Rapuch.;Amelia Torcello-Gómez.;Adam Stefanski.
来源: Ann Intern Med. 2025年
Tirzepatide reduced weight and improved cardiometabolic risk factors for participants in the SURMOUNT-1 trial. The changes in cardiometabolic risk factors by degree of tirzepatide-induced weight reduction across a wide spectrum of weight loss have not been reported.
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