Vineet Chopra, M Todd Greene, Jason M Engle, Karen E Fowler, Sanjay Saint
{"title":"Mentorship in General Internal Medicine: Results from a National Survey.","authors":"Vineet Chopra, M Todd Greene, Jason M Engle, Karen E Fowler, Sanjay Saint","doi":"10.1007/s11606-025-09862-3","DOIUrl":"https://doi.org/10.1007/s11606-025-09862-3","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shuanghao Zhou, Xueying Ma, Fei Tian, Hong Ji, Yunpeng Li, Jiahui Zou, Zechao He, Xinyu Ge, Minghua Li, Xiangming Ma
{"title":"The Correlation Between Serum Uric Acid and Metabolic Dysfunction-Associated Fatty Liver Disease: An Updated Systematic Review and Meta-Analysis.","authors":"Shuanghao Zhou, Xueying Ma, Fei Tian, Hong Ji, Yunpeng Li, Jiahui Zou, Zechao He, Xinyu Ge, Minghua Li, Xiangming Ma","doi":"10.1007/s11606-025-09904-w","DOIUrl":"https://doi.org/10.1007/s11606-025-09904-w","url":null,"abstract":"<p><strong>Objective: </strong>Recent epidemiological evidence suggests that serum uric acid (SUA) levels are believed to be strongly associated with the onset and development of metabolic dysfunction-associated fatty liver disease (MAFLD). Although existing meta-analyses have explored the relationship between the two, new research data continue to emerge, and it is necessary to conduct updated meta-analyses to provide more comprehensive evidence.</p><p><strong>Methods: </strong>From the inception of the database until March 2025, we performed an extensive search for pertinent observational studies within the PubMed, Embase, and Web of Science databases. To evaluate the association between SUA levels and MAFLD, random effects models were employed to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Publication bias was assessed using Egger's test.</p><p><strong>Results: </strong>In total, 61 studies were analyzed, encompassing 2,151,925 participants. MAFLD prevalence in individuals with hyperuricemia was 59% (between 50 and 69%), with an incidence rate of 28% (between 17 and 47%). Participants exhibiting elevated SUA levels demonstrated a pooled OR of 1.90(95%CI:1.77-2.04) for MAFLD in comparison to those with lower SUA levels. Subgroup analyses further revealed a consistent positive association between SUA levels and MAFLD across various categories, including study design, study quality, sample size, publication year, and geographic location.</p><p><strong>Conclusion: </strong>This meta-analysis further confirmed the positive correlation between high SUA levels and the risk of MAFLD, suggesting that SUA may be a potential biomarker and therapeutic target for MAFLD.</p><p><strong>Registration number: </strong>PROSPERO-CRD42024568760.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prabhava Bagla, Jasmah Hanna, John Hanfelt, Stacey Watkins
{"title":"Phone Calls Over Clicks: A Survey Study Assessing Nurses' Communication Preferences During Inpatient Physician Rounds.","authors":"Prabhava Bagla, Jasmah Hanna, John Hanfelt, Stacey Watkins","doi":"10.1007/s11606-025-09805-y","DOIUrl":"https://doi.org/10.1007/s11606-025-09805-y","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mytien Nguyen, Suchita Rastogi, Karina Pereira-Lima, Amy Addams, Christopher J Moreland, Dowin B Boatright, Lisa M Meeks
{"title":"Correction: Intersectionality of Disability Status, Family Income, Race, and Ethnicity with Taking a Leave of Absence During Medical School.","authors":"Mytien Nguyen, Suchita Rastogi, Karina Pereira-Lima, Amy Addams, Christopher J Moreland, Dowin B Boatright, Lisa M Meeks","doi":"10.1007/s11606-025-09893-w","DOIUrl":"https://doi.org/10.1007/s11606-025-09893-w","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leonard E Egede, Joni S Williams, Rebecca G Knapp, Rebekah J Walker
{"title":"Technology-Intensified Diabetes Education Study (TIDES) for African American Adults with Type 2 Diabetes: A Randomized Controlled Trial.","authors":"Leonard E Egede, Joni S Williams, Rebecca G Knapp, Rebekah J Walker","doi":"10.1007/s11606-025-09883-y","DOIUrl":"https://doi.org/10.1007/s11606-025-09883-y","url":null,"abstract":"<p><strong>Objective: </strong>Assess the efficacy of a technology-intensified diabetes education and skills training (TIDES) intervention on improving glycemic control among African American (AA) adults with poorly controlled type 2 diabetes (T2DM).</p><p><strong>Methods: </strong>Data from 200 AAs ≥ 21 years of age with T2DM (hemoglobin A1c (HbA1c) ≥ 8%) from the southeastern U.S. were randomized to TIDES or usual care. Participants in TIDES received a home telemonitoring device for daily uploads of blood glucose readings and 12 weeks of telephone-delivered diabetes education and skills training. The primary outcome was HbA1c at 12-months in the intent-to-treat (ITT) population. Participants were assessed at baseline, 3, 6, 9, and 12 months. Baseline adjusted random intercept models evaluated the reduction in HbA1c for TIDES compared to usual care. Per protocol samples and baseline adjusted marginal models were used as sensitivity analyses.</p><p><strong>Results: </strong>Approximately 66.5% of the sample was women; 88.5% were < 70 years of age; and 85.3% had an annual household income < $50,000. The study maintained a 90% retention rate at 12-months. HbA1c at 3 months was marginally statistically significantly lower compared to usual care (p = 0.06); however, at 12-months, there was no statistically significant difference (p = 0.668). Per protocol samples and marginal models showed similar results.</p><p><strong>Conclusions: </strong>Results found a more immediate drop in HbA1c during the intervention period compared to usual care, but no significant difference at 12-months. Possible co-interventions occurring in the primary care clinic at the time of the study and low intensity booster sessions may explain results and have implications for future diabetes multicomponent trials.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steffani R Bailey, Jun Hwang, Jennifer A Lucas, Kristin Lyon-Scott, Miguel Marino, Roopradha Datta, Ana R Quiñones, Brian Chan, John Heintzman
{"title":"Tobacco Use Assessment and Cessation Medication Orders Among Primary Care Patients by Ethnicity, Sex, and Acculturation Indicators.","authors":"Steffani R Bailey, Jun Hwang, Jennifer A Lucas, Kristin Lyon-Scott, Miguel Marino, Roopradha Datta, Ana R Quiñones, Brian Chan, John Heintzman","doi":"10.1007/s11606-025-09836-5","DOIUrl":"https://doi.org/10.1007/s11606-025-09836-5","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is a leading cause of cancer death among Hispanic men and women in the United States. Smoking rates vary among Hispanic subgroups, with higher rates among those with indicators (e.g., language preference, nativity) of greater acculturation. It is recommended that clinicians ask about tobacco use and provide cessation treatment, as warranted. While studies in health care settings note disparities in tobacco-related care by ethnicity and acculturation proxies, we are unaware of studies that have evaluated these relationships among adult patients within community-based health care clinics (CHCs), key settings for provision of care for Hispanic patients.</p><p><strong>Objective: </strong>To examine rates of tobacco use assessment and cessation medication orders among Hispanic patients by language and nativity compared to non-Hispanic White patients in CHCs.</p><p><strong>Design: </strong>Retrospective observational study using electronic health record (EHR) data.</p><p><strong>Patients: </strong>1,016,391 adult patients with ≥ 1 primary care visit to a study CHC between 9/1/2020-9/1/2022.</p><p><strong>Main outcomes: </strong>Outcomes included tobacco use assessment and, among those identified as using tobacco, having a cessation medication ordered. The primary independent variable combined ethnicity and language preference, with sensitivity analyses combining ethnicity and nativity. We used separate generalized estimating equation regressions for each sex to estimate risk differences of each outcome by patient subgroups, adjusting for covariates.</p><p><strong>Key results: </strong>Compared with non-Hispanic White patients, Spanish-preferring Hispanic males and females and English-preferring Hispanic males had higher rates of having tobacco use assessed (covariate-adjusted risk differences [aRD] = 2.23%, 95% CI = 1.78%-2.69%; 1.74%, 95% CI = 1.35%-2.14%; 0.41%, 95% CI = 0.12%-0.70%, respectively). Ethnicity/nativity analyses found higher rates of tobacco assessment among all Hispanic subgroups. Compared with non-Hispanic White patients, all Hispanic patient subgroups had lower rates of having a cessation medication ordered.</p><p><strong>Conclusions: </strong>Efforts are needed to inform, develop and test culturally-appropriate and patient-centered interventions for tobacco cessation among Hispanic patients.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Economic Case for Hospital-Initiated Medications for Opioid Use Disorder in Incarcerated Populations.","authors":"Kevan Shah, Aakash K Shah","doi":"10.1007/s11606-025-09903-x","DOIUrl":"https://doi.org/10.1007/s11606-025-09903-x","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steven K Dobscha, Meike Niederhausen, Kathleen F Carlson, Nazanin Bahraini, Robert Handley, Apoorva Salvi, Victoria Elliott, Annabelle Rynerson, Lauren M Denneson
{"title":"Inaccurate Disclosure of Suicidal Thoughts During Population-Based Suicide Risk Screening in Primary Care in the Veterans Health Administration.","authors":"Steven K Dobscha, Meike Niederhausen, Kathleen F Carlson, Nazanin Bahraini, Robert Handley, Apoorva Salvi, Victoria Elliott, Annabelle Rynerson, Lauren M Denneson","doi":"10.1007/s11606-025-09822-x","DOIUrl":"https://doi.org/10.1007/s11606-025-09822-x","url":null,"abstract":"<p><strong>Background: </strong>Prior research suggests that disclosure of suicidal thoughts in healthcare settings may be low.</p><p><strong>Objectives: </strong>Describe frequency of self-reported inaccurate disclosure of suicidal ideation during population-based screening and evaluation in primary care and identify patient characteristics associated with inaccurate disclosure.</p><p><strong>Design: </strong>National survey study examining veteran experiences with the Veterans Health Administration's (VHA) suicide risk screening program, Risk ID.</p><p><strong>Participants: </strong>A national sample of 2001 veterans screened in primary care between February and October 2021 were mailed surveys. Eight-hundred sixty-eight surveys were returned, and 734 respondents recalled being screened.</p><p><strong>Main measures: </strong>Several survey items which asked to what extent respondents had accurately responded to clinicians or nurse/medical assistants when asked about suicidal thoughts.</p><p><strong>Key results: </strong>Fourteen percent and 18% of screen-negative participants and 40% and 48% of screen-positive participants reported responding less than very accurately to questions about suicidal thoughts when asked by nurses/medical assistants and providers, respectively. Among screen-negative participants, factors associated with inaccurate disclosure included being Black, American Indian/Alaska Native, Hispanic, Asian, or Multi-racial; higher levels of psychological distress and greater barriers to care; and lower ratings of the clinician-patient relationship. Factors associated with inaccurate disclosure in screen-positive participants included greater barriers to care, perceptions that screening questions did not make sense, perceptions that they would not be taken seriously, and lower ratings of satisfaction with the screening process.</p><p><strong>Conclusion: </strong>Inaccurate disclosure during VHA population-based suicide risk evaluation is not uncommon. Patients who are Black, American Indian/Alaska Native, Hispanic, Asian, or Multi-racial, are in more distress, report more barriers to care, or are less satisfied with the screening process may be less likely to disclose accurately. The results highlight that clinicians should not overly rely on screening results for clinical decision-making, and reinforce the value of strong clinician-patient treatment relationships and positive screening experiences in promoting accurate disclosure.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David H Yang, Lindy Zhang, B U K Li, Joyce Pang, Jiun-Ruey Hu, Alexandra M Hajduk, Sarwat I Chaudhry, Stella S Yi, Lan N Đoàn, Simona C Kwon, Dowin Boatright
{"title":"Underrepresentation of Filipino, Laotian, Cambodian, and Indonesians Among US Allopathic Medical Students.","authors":"David H Yang, Lindy Zhang, B U K Li, Joyce Pang, Jiun-Ruey Hu, Alexandra M Hajduk, Sarwat I Chaudhry, Stella S Yi, Lan N Đoàn, Simona C Kwon, Dowin Boatright","doi":"10.1007/s11606-025-09880-1","DOIUrl":"https://doi.org/10.1007/s11606-025-09880-1","url":null,"abstract":"<p><strong>Background: </strong>With increasing efforts to cultivate and foster a diverse physician workforce to improve the delivery of culturally responsive care, the accurate representation of Asian medical students continues to be obscured by aggregation of over 40 ethnic groups that are categorized as Asian race.</p><p><strong>Objective: </strong>To describe representation of Asian ethnic groups among applicants and matriculants to US allopathic medical schools. DESIGN AND PARTICIPANTS: Cross-sectional study of applicant and matriculant data from 2020 to 2023, provided by the Association of American Medical Colleges, on self-reported Asian ethnic group and sex of medical school applicants and matriculants, compared with the American Community Survey population estimates of the typical medical school-aged population.</p><p><strong>Main measures: </strong>For each academic year, Asian ethnic group, and sex, the representation quotient (RQ), defined as the proportion of an ethnic group in the total population of medical school applicants or matriculants relative to the corresponding estimated proportion of that ethnic group in the US population, was calculated. We compared differences in applicant and matriculant RQs using t-tests for those with an RQ less than one.</p><p><strong>Key results: </strong>Cambodian, Filipino, Indonesian, and Laotian applicants and matriculants were underrepresented in medicine with an RQ less than one. The RQ of Filipino females was lower than Filipino males among applicants and matriculants (p = 0.04 and 0.04, respectively). The RQ of Laotian and Filipino matriculants were lower than their respective applicant representation (p = 0.01 and 0.02, respectively).</p><p><strong>Conclusions: </strong>With disaggregated race and ethnicity data, we found significant variation in representation of Asian ethnic groups among medical school applicants and matriculants relative to the US population. Aggregating Asians into a single racial group conceals a more nuanced picture of representation in medicine, hindering efforts for a diverse workforce and improved patient care.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pi-I D Lin, Sheryl L Rifas-Shiman, Joshua Petimar, Han Yu, Matthew F Daley, David M Janicke, William J Heerman, L Charles Bailey, Carlos Maeztu, Kristina H Lewis, Jessica G Young, Jason P Block
{"title":"Emulation of a Target Trial of Antihypertensive Medications on Weight Change.","authors":"Pi-I D Lin, Sheryl L Rifas-Shiman, Joshua Petimar, Han Yu, Matthew F Daley, David M Janicke, William J Heerman, L Charles Bailey, Carlos Maeztu, Kristina H Lewis, Jessica G Young, Jason P Block","doi":"10.1007/s11606-025-09787-x","DOIUrl":"10.1007/s11606-025-09787-x","url":null,"abstract":"<p><strong>Background: </strong>Weight gain after starting antihypertensive medications is a frequent concern for patients, but there is limited data on expected weight change after initiation of these medications. A comparative effectiveness trial to evaluate this outcome would not be feasible.</p><p><strong>Objective: </strong>To estimate and compare average weight change under initiating and adhering to commonly prescribed, first-line antihypertensive medications as monotherapy by emulating a target trial.</p><p><strong>Design: </strong>Retrospective observational cohort study over 24 months of follow-up using electronic health records (EHR).</p><p><strong>Participants: </strong>141,260 patients prescribed one of seven antihypertensives between 2010 and 2019 across 8 US health systems.</p><p><strong>Main outcome and measures: </strong>We examined mean weight change associated with initiation of and adherence to amlodipine, atenolol, hydrochlorothiazide, losartan, metoprolol, or propranolol, relative to lisinopril, at 6, 12, and 24 months after initiation. To adjust for baseline confounding and informative outcome measurement, we used inverse probability weighting with repeated outcome marginal structural models.</p><p><strong>Key results: </strong>After baseline and time-varying covariate adjustment, initiation of and adherence to lisinopril were associated with mean weight loss at 6 months (- 0.69 kg, 95% CI - 0.92, - 0.47), 12 months (- 0.58 kg, 95% CI - 1.05, - 0.30), and 24 months (- 1.121 kg, 95% CI - 2.013, - 0.46). Compared to lisinopril, the estimated 6-month weight change was higher for patients prescribed hydrochlorothiazide (0.68 kg, 95% CI 0.31, 1.04), losartan (0.54 kg, 95% CI 0.17, 0.93), metoprolol (1.38 kg, 95% CI 0.95, 1.76), and propranolol (1.03 kg, 95% CI 0.346, 1.62). At 12 months, metoprolol (1.74 kg, 95% CI 1.03, 2.41) and propranolol (1.72 kg, 95% CI 0.06, 3.235) continued to show higher weight change compared to lisinopril.</p><p><strong>Conclusion: </strong>We observed small differences in weight change across antihypertensive medications, with lisinopril leading to weight loss and metoprolol and propranolol to modest weight gain. Clinicians should consider potential weight gain when selecting antihypertensive medications.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}