Assessing risk of bias and applicability is critical in diagnostic test accuracy reviews to ensure valid, relevant findings that can inform decision making and policy. This article introduces QUADAS-3, an updated version of the widely used QUADAS-2 tool that was developed in response to the latest evidence, feedback from users of QUADAS-2, and comprehensive piloting. The QUADAS-3 tool comprises 6 phases: 1) define the systematic review synthesis question, 2) define the ideal test accuracy trial for each synthesis question, 3) draw a flow diagram, 4) identify estimates of accuracy for assessment, 5) assess risk of bias and applicability, and 6) make an overall judgment. Risk of bias is assessed across 4 domains: Participants, Index Test, Target Condition, and Analysis. The first 3 domains are also assessed in terms of concerns regarding applicability to the synthesis question. Signaling questions are included to help judge risk of bias. The QUADAS-3 tool incorporates several changes compared with the previous version (QUADAS-2) which will ideally improve its validity, usability, and usefulness. Key changes from QUADAS-2 include introduction of the concept of an ideal test accuracy trial, assessment at the estimate level rather than the study level, replacement of the "Flow and Timing" domain with a new "Analysis" domain, introduction of sections on the rationale for judgments, and formal introduction of overall judgment of risk of bias and concerns regarding applicability. Some changes to domains and signaling questions have also been made.

The U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DOD) updated the 2019 joint clinical practice guideline (CPG) for the primary care management of asthma. This synopsis provides primary care providers with a summary of the updated 2025 recommendations regarding evaluation and management of veterans and military members with asthma.

Assessing risk of bias and applicability is essential in diagnostic test accuracy reviews to produce reliable and relevant evidence that can guide clinical and policy decisions. To support this process, the authors have developed QUADAS-3, the latest version of the QUADAS tool, which is designed to assess the methodological strength and relevance of diagnostic test accuracy studies included in systematic reviews. This article explains how to use the QUADAS-3 tool. The article guides the reviewer through the initial stages of defining the questions and conceptualizing the ideal test accuracy trial, how the domains and signaling questions should be interpreted and assessed, and how judgments of risk of bias and concerns regarding applicability should be made. Authors of systematic reviews of diagnostic test accuracy studies should use this article as a guide for applying the QUADAS-3 tool.

Acute pancreatitis is among the most frequent gastroenterologic reasons for hospitalization in the United States. This condition is associated with significant morbidity, including recurrent acute pancreatitis and chronic pancreatitis. Although most patient cases are due to biliary disease and ethanol, approximately 18% are idiopathic. Diagnostic and management options for idiopathic acute pancreatitis include genetic testing for a number of associated mutations and cholecystectomy to treat subclinical or undetected biliary disease. Endoscopic retrograde cholangiopancreatography, often with concomitant endoscopic sphincterotomy, is also sometimes considered in the management of idiopathic recurrent acute pancreatitis, although the role of this invasive procedure is generally limited. Here, 2 pancreatologists and coauthors of a recent American College of Gastroenterology guideline on the management of acute pancreatitis discuss issues related to genetic testing, cholecystectomy, and endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy for patients with acute idiopathic pancreatitis in general, and for a young woman recently diagnosed with this condition.

Frailty is a syndrome of decreased reserve across multiple physiologic systems that is associated with greater risk for hospitalizations, disability, institutionalization, and other adverse outcomes, including mortality. Patients with frailty, most of whom are older adults, may be more likely to experience adverse outcomes due to iatrogenic causes, such as higher-risk medications or procedures. Guidelines recommend frailty screening for both chronic disease management and in-hospital care, as identification of frailty allows for risk mitigation and alignment of care with patients' goals. In addition, some interventions may delay or reverse frailty, thus increasing physiologic reserve and improving day-to-day function. This article reviews frailty definitions, approaches to assessment in different care settings, and management.

More than 25 years ago, Pellegrino and Relman noted the increasing commercialization of the learned professions, anticipating what many physicians are increasingly experiencing today: an impairment of their ability to practice in accordance with standards of medical ethics and professionalism. These hurdles to the physician's ability to do right by the patient contribute to what leaders in medicine and the American College of Physicians have called deprofessionalization. An example is the use of the term provider to describe physicians and other health professionals. The use of this terminology has been reviewed in medical journal articles but has not been adequately explored as a matter of ethics and professionalism. Through that lens, this paper examines the trends, significance, and implications for patients, physicians, and health care of the use of the term provider.

The American College of Physicians (ACP) maintains living, rapid practice points on antiviral treatment in the outpatient setting for COVID-19.

Clinicians and patients need updated information on antiviral treatments for COVID-19.

Anemia affects up to 50% of pregnancies. The relation between early pregnancy maternal hemoglobin concentration and important perinatal outcomes in high-income countries is largely unknown.

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

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

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

Widespread vaccination for human papillomavirus (HPV) alters the landscape of cervical cancer (CC) risk, requiring adaptations to the CC screening program.

Emergency Med: [Formula: see text] Neurology: [Formula: see text].

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

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

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

GIM/FP/GP: [Formula: see text] Phys Med & Rehab: [Formula: see text].

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

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