“Some patient messages are unsolicited questions seeking medical advice, which also take more skill and time to answer than generic messages (eg, scheduling an appointment, accessing test results). Current approaches to decreasing these message burdens include limiting notifications, billing for responses, or delegating responses to less trained support staff. Unfortunately, these strategies can limit access to high-quality health care. For instance, when patients were told they might be billed for messaging, they sent fewer messages and had shorter back-and-forth exchanges with clinicians. Artificial intelligence (AI) assistants are an unexplored resource for addressing the burden of messages. While some proprietary AI assistants show … Read More
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“Over several hours and multiple Zoom and phone calls in April, I spoke with Fauci about that: how he saw the full story of this historic public-health emergency and the role he played in it. At times, he was defensive, even combative, particularly when it came to episodes in which he felt that his own positions had been misconstrued and on the matter of gain-of-function research and the origins of the pandemic. But on the whole, he was reflective, even humble, especially about the way that Covid-19 exposed the limits of public health and, in his telling, kept surprising him … Read More
“Oral anticoagulation reduces thromboembolic events in patients with nonvalvular atrial fibrillation (AF); however, underuse of anticoagulation is a major issue in treating patients with nonvalvular AF at high stroke risk. Prior data from the American College of Cardiology’s (ACC) Practice Innovation and Clinical Excellence Registry (PINNACLE Registry) has found approximately 40% of patients are not receiving anticoagulants, with little change over time, despite the availability of the nonvitamin K antagonists. Studies examining the reasons for nonuse are sparse. Because underuse may relate to both physician prescribing and patient factors, some studies have looked at physician assessment of the risk of bleeding … Read More
The New England Journal of Medicine’s Lisa Rosenbaum speaks with University of Pennsylvania’s internal medicine physicians Paula Chatterjee (also a health services researcher) and Atheen Venkataramani (also a health economist and founder of Penn’s Opportunity for Health lab) about the role of values in health care, social determinants of health and what physicians can do to improve U.S. health care. An excerpt of the audio interview: [Rosenbaum] Atheen, I know that you also had a formative experience, I think when you were a resident at MGH. Can you talk a little bit about that and how that experience informed your … Read More
“we examine real-world data from a cohort based in a UK primary care clinic offering a low-carbohydrate approach to people with T2D [type 2 diabetes] from 2013 to 2021. The physiological mechanisms behind remission induced by dietary weight loss were first demonstrated in 2011. Since then the idea of drug-free T2D remission has gained international momentum. [..] Advice on lowering dietary carbohydrate was offered routinely by our team of nine specially trained GPs and three practice nurses to patients with T2D (defined as HbA1c >48 mmol/mol on two occasions) starting in March 2013. Our protocol includes important information around the deprescribing of … Read More
“In its attempt to explode particular myths, however, Myth America engages in its own mythmaking. The book fundamentally misunderstands the crises facing the U.S. and the world. By implying that misinformation is the principal cause of the partisan rancor, violence, and general dysfunction that mark our current political moment, the collection obscures our much bigger problems. And by localizing the threat of misinformation and disinformation almost exclusively within certain far-right segments of the conservative movement and the Republican Party, Myth America absolves not only other stripes of conservatism, but also the milquetoast technocratic liberalism that helped set the stage for this moment. It’s not … Read More
“[Introduction] According to the Global Burden of Disease Study 2017, unhealthy diet is estimated as one of the leading causes of death globally. [..] using 2 large prospective cohorts with data on repeated measures of dietary habits, we derived dietary scores for 4 healthy dietary patterns, including the Healthy Eating Index 2015 (HEI-2015), Alternate Mediterranean Diet (AMED) score, Healthful Plant-based Diet Index (HPDI), and Alternate Healthy Eating Index (AHEI). We then examined their associations with total and cause-specific mortality. We also specifically examined these associations stratified by race and ethnicity and other potential risk factors. [Methods] This cohort study used … Read More
“Professional sport has been criticised for its role as a vehicle to market addictive products or services. Despite the harmful health effects on society, football audiences are inured to seeing sponsors of such products not only on pitch-side hoardings and shirts, but also embedded in television rights, competition names, prematch build-up, corporate hospitality, and social media. Tobacco’s successful movement into sports sponsorship established the template on which other addictive sponsors, notably the alcohol and gambling industries, built their strategies. The integration of sports and addictive commodities highlights strategies to influence consumption by those within the unhealthy commodities industry. [..] historically … Read More
“While the medical risks of SMA [self-managed] may be few, the legal risks for people attempting SMA may be significant. Although only three states currently have laws explicitly criminalizing SMA, almost half of U.S. states have at least one law in place that could be used to prosecute people attempting or assisting with SMA. These policies include legislation explicitly banning SMA, criminalizing harm to the fetus, and criminalizing abortion. For those who have been targeted with criminalization for SMA, many came into contact with law enforcement following interactions with healthcare professionals. However, to date, legal experts are unaware of any … Read More
Excerpt – No public health decision is purely scientific, so the agency cannot avoid the small-p politics of health policy. No matter what we may yearn for, there is no ethereal scientific plane the CDC can ascend to. “The ‘politicization’ accusation implies that we should just isolate the CDC and let it do its work by itself,” said Gil Eyal, a sociology professor at Columbia University. “But I think that’s wrong. I don’t think we know of an obvious way to organize the relationship between science and politics.” That is, they are always intertwined, especially when it comes to the … Read More