Journal of General Internal Medicine最新文献

{"title":"EBM BLS: Low Dose Aspirin Does Not Reduce the Risk of Cancer in Older Adults.","authors":"Harry B Burke, Stephanie G Wheeler","doi":"10.1007/s11606-026-10876-8","DOIUrl":"https://doi.org/10.1007/s11606-026-10876-8","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182387","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":"Beyond Grammar: A Structural Scientific Writing Workflow for Non-native English Speakers.","authors":"Aldo Barajas-Ochoa, Alicia Vargas Amésquita, Andrea Guerrero-Cignarella, Cesar Ramos-Remus","doi":"10.1007/s11606-026-10917-2","DOIUrl":"https://doi.org/10.1007/s11606-026-10917-2","url":null,"abstract":"<p><p>Scientific writing presents a universal cognitive challenge, but non-native English speakers (NNES) face a dual burden: mastering complex scientific content while navigating a second language within an English-dominated publishing landscape. Despite the global expansion of research, many early-career clinicians and international medical graduates struggle to publish, not due to a lack of scientific merit, but because of unaddressed structural and psychological barriers. Moving beyond traditional interventions that rely strictly on grammar workshops and language editing, this Perspective offers a cognitive and structural framework for academic publishing grounded in three pillars: evidence from scientific writing literature, experience navigating the publication process, and continuous exchange with colleagues and students globally. The article introduces the WRITE-IT workflow, a practical scaffolding tool designed to guide researchers through the phases of establishing mental readiness, structuring the drafting process, using digital tools responsibly, and thinking beyond publication as the endpoint. By addressing challenges such as cognitive overload, confirmation bias, linguistic insecurity, and weak structural scaffolding, this approach shifts the focus from sentence-level polishing to structured reasoning. Scientific writing is framed as a learnable clinical skill that improves through deliberate practice, intellectual humility, and structure, allowing NNES researchers to contribute more confidently to the global scientific community.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182238","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 SCOPE Model: A Framework for Medical Student-Led Action on Social Determinants of Health in Chronic Disease Prevention.","authors":"Alessandro Cigni, Jo Marie Reilly","doi":"10.1007/s11606-026-10902-9","DOIUrl":"https://doi.org/10.1007/s11606-026-10902-9","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182432","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":"Why the 2025 Nobel Prize in Economics Matters at the Bedside: Innovation, Institutions, and Hospitalist Leadership.","authors":"Isabel Pimenta, André Medici","doi":"10.1007/s11606-026-10910-9","DOIUrl":"https://doi.org/10.1007/s11606-026-10910-9","url":null,"abstract":"<p><p>The 2025 Nobel Prize in Economics, awarded to Joel Mokyr, Philippe Aghion, and Peter Howitt for their work on innovation-driven growth, offers an unexpectedly practical framework for hospital medicine. Their scholarship emphasizes that progress depends not only on technological advances, but also on institutions capable of implementing, governing, and adapting innovation in real operational settings. This perspective resonates with hospital medicine, a field born from institutional redesign and now facing a new inflection point driven by digital technology and artificial intelligence. Hospitalists are uniquely positioned to lead this transformation and ensure innovation strengthens, rather than fragments, inpatient care. We conclude with practical recommendations for hospitalists: building durable AI literacy grounded in how these systems work, guarding against deskilling and never-skilling across career stages, and institutionalizing governance and education.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182533","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":"Assessing the Impact of Routine Intervention for Perioperative Hyponatremia on Postoperative Outcomes.","authors":"Gerald Gui Ren Sng, Daniel Yan Zheng Lim, Quan Le, Qihuang Xie, Yong Mong Bee, Hairil Rizal Abdullah","doi":"10.1007/s11606-026-10892-8","DOIUrl":"https://doi.org/10.1007/s11606-026-10892-8","url":null,"abstract":"<p><strong>Background: </strong>Preoperative hyponatremia is associated with poorer outcomes, including increased mortality, ICU admissions, prolonged hospital stays, and readmissions. Whether routine intervention improves outcomes remains unclear.</p><p><strong>Objective: </strong>To assess an institutional protocol requiring internist referral and treatment for serum sodium < 130 mmol/L before surgery.</p><p><strong>Design: </strong>Retrospective registry-based study using a quasi-experimental regression discontinuity design. Sharp, kink, and triangular kernel models estimated effects at the intervention threshold. Subgroup analyses included patients with cardiac disease, chronic kidney disease, moderate operative risk, and emergency surgery.</p><p><strong>Participants: </strong>Of 180,926 adult patients between 2013 and 2020, 24,846 had preoperative serum sodium 125-135 mmol/L. After excluding 43 with incomplete data, 24,803 remained.</p><p><strong>Interventions: </strong>Protocolized internist referral and treatment for preoperative serum sodium < 130 mmol/L.</p><p><strong>Main measures: </strong>The primary outcome was 30-day mortality. Secondary outcomes included 1-year mortality, ICU admissions, length of stay, and rapid postoperative sodium correction.</p><p><strong>Key results: </strong>Compared with serum sodium 130-135 mmol/L, sodium < 130 mmol/L was associated with higher unadjusted 30-day mortality (3.32% vs 1.33%), 1-year mortality (21.25% vs 11.03%), ICU admission (18.65% vs 11.50%), and mean length of stay (20.64 ± 25.51 vs 13.42 ± 21.01 days; all p < 0.001). No significant threshold effects were seen for 30-day mortality (treatment effect = 1.22, p = 0.138), ICU admissions (0.014, p = 0.564), or length of stay (0.184, p = 0.943). Significant discontinuity was observed for 1-year mortality (0.081, p = 0.010), particularly among patients with cardiac disease (0.162, p < 0.001), with chronic kidney disease (0.071, p = 0.012), with moderate operative risk (0.779, p = 0.013), or undergoing emergent surgery (0.100, p = 0.001). Lower preoperative sodium predicted rapid postoperative correction (OR = 1.190, p < 0.001).</p><p><strong>Conclusions: </strong>Protocolized internist referral and treatment for preoperative serum sodium < 130 mmol/L did not affect short-term perioperative outcomes but may have reduced 1-year mortality, particularly in subgroups with cardiac and renal disease. Further studies are required to determine if this reflects treatment of underlying comorbidities rather than the effect of sodium normalization alone.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182316","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":"Virtual Wards for Acute Care Patients: A Scoping Review.","authors":"Sophie M E van Baar de Knegt, Noortje Zelis, Karin A H Kaasjager, Patricia M Stassen","doi":"10.1007/s11606-026-10682-2","DOIUrl":"https://doi.org/10.1007/s11606-026-10682-2","url":null,"abstract":"<p><strong>Background: </strong>Increasing capacity pressures and overcrowding in hospitals and emergency departments (EDs) have led to a global surge in the adoption of technology-enabled hospital-at-home programs, also known as virtual wards (VWs). These models provide hospital-level care in patients' homes supported by remote monitoring, aiming to shorten or avoid hospital admission. While substantial evidence supports the feasibility of VWs for chronic care, evidence for use in patients with acute conditions remains limited. This scoping review aimed to map existing evidence on VWs for acute medical patients within acute care settings.</p><p><strong>Methods: </strong>In February 2025, multiple databases were searched to identify studies evaluating VWs for adult acute care populations. Outcomes included clinical and safety variables, length of stay, functional outcomes, cost and resource use, barriers and facilitators to implementation, user experiences, and qualitative analyses.</p><p><strong>Results: </strong>Twenty-two studies were included (RCTs n = 3, case-controls n = 9, cohort n = 7, qualitative n = 3), with substantial heterogeneity in VW models and telemonitoring approaches. The most common indication was infection (e.g. pneumonia, urinary tract). Results of this narrative synthesis suggest care delivered in VWs may be similar to hospital care for rates of ED visits, readmission, short-term mortality, and adverse events. Length of stay in the hospital tended to be shorter. Functional outcomes may be better in VWs. Cost analyses were limited and showed mixed results. Surveys and qualitative analyses indicated high acceptability and generally positive experiences among patients, carers, and healthcare staff.</p><p><strong>Discussion: </strong>Evidence from the predominantly non-randomized studies included in this review suggests that VWs may be a feasible alternative for selected acute care patients, with outcomes broadly similar to standard hospital care. Substantial heterogeneity in study designs, alongside the descriptive nature of this synthesis, limits the evaluation of evidence strength and comparability. Robust randomized trials and comprehensive cost-effectiveness analyses are needed.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182505","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":"Defining Mental Disorder: Differences in Primary Care Providers' and Psychiatrists' Conceptions of Illness.","authors":"Skye A Miner, Joshua Breslau, Charles Engel, Stacey Yi, Luke J Matthews","doi":"10.1007/s11606-026-10906-5","DOIUrl":"https://doi.org/10.1007/s11606-026-10906-5","url":null,"abstract":"<p><strong>Background: </strong>Increasingly primary care providers (PCPs) play a role in recognizing and diagnosing mental disorders. However, how PCPs conceptualize mental disorders within their patient population and how this conceptualization differs and aligns with a more psychiatric approach to mental disorder remains largely unknown.</p><p><strong>Objective: </strong>To determine 1) how PCPs and psychiatrists describe their patients with suspected mental health conditions; 2) how PCPs and psychiatrists describe easy to treat and diagnose and challenging to treat and diagnose patients; and 3) how PCPs manage referrals to psychiatry.</p><p><strong>Design: </strong>Online qualitative interviews.</p><p><strong>Participants: </strong>41 PCPs and 41 psychiatrists. Participants were recruited from two health networks with different catchment areas: Cambridge Health Alliance is on the East coast and primarily serves urban and suburban patients. University of Washington is on the West coast and serves urban, suburban and rural patients.</p><p><strong>Approach: </strong>The team performed a deductive analysis of the interview notes using a rapid framework analysis approach.</p><p><strong>Key results: </strong>PCPs and psychiatrists describe easy to treat and diagnose patients in similar ways. However, PCPs see complex psychiatric conditions like schizophrenia as more challenging. Those who felt more comfortable managing these complex patients had patients with access to psychiatric services or had access to e-consult services.</p><p><strong>Conclusion: </strong>Examining the differences between PCPs and psychiatrists' conceptualization of patients with mental health disorders highlights gaps in mental health care, including the need for PCPs and psychiatrists to collaborate. Collaborations like psychiatric e-consult services could help improve mental health care access, especially in rural areas, for more complex patients whose PCPs may need assistance with diagnosis or treatment management.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182224","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":"Cannabis as a Nicotine Cessation Aid: Prevalence of Use and Potential Consequences in a Survey of US Adults.","authors":"Deanna M Halliday, Stephanie Wu, Nhung Nguyen, Katherine J Hoggatt, Salomeh Keyhani, Beth E Cohen","doi":"10.1007/s11606-026-10916-3","DOIUrl":"https://doi.org/10.1007/s11606-026-10916-3","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182314","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":"RE: Putting the PASC Score to the Test: Clinical vs. Statistical Accuracy in Long COVID Diagnosis (Azola et al. JGIM).","authors":"Jason D Goldman, Jeffrey N Martin","doi":"10.1007/s11606-026-10852-2","DOIUrl":"https://doi.org/10.1007/s11606-026-10852-2","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182325","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":"Self-Reported Obesity Medicine Competence, Knowledge, and Attitudes Among US Medical Students: An Eight-School Pre- vs. Post-Intervention Study.","authors":"Magdalena Pasarica, Robert F Kushner, Angelina V Leary, Amber Mirando, Ricardo Correa, Monica Agarwal, Eduardo Grunvald, Sadie Trammell Velasquez, Virginia Uhley, Jonathan Q Purnell, Dee-Ann Carpenter, Amanda Velazquez, Gabriel Smolarz, Colleen Croniger, Mark S Johnson, Julie Loza, Andrew Mock, Kim Pfotenhauer","doi":"10.1007/s11606-026-10913-6","DOIUrl":"https://doi.org/10.1007/s11606-026-10913-6","url":null,"abstract":"<p><strong>Background: </strong>Obesity contributes to many chronic diseases that internists manage. Even though there is a documented gap in obesity education, no studies have evaluated competency-based obesity education interventions from the learner perspective.</p><p><strong>Aim: </strong>To develop and implement a pilot, multi-institutional, competency-based obesity medicine curriculum intervention, with the learner perspective as the primary outcome.</p><p><strong>Program description: </strong>We developed and implemented an educational intervention grounded in social constructivist learning theory and guided by the logic model framework. Students provided self-rating on each of the 32 obesity medicine competencies and their beliefs, attitudes, and knowledge of obesity medicine, both pre- and post-interventions.</p><p><strong>Setting and participants: </strong>Eight diverse US medical schools participated (September 2023-October 2025); pre- and post-intervention surveys were completed by 1829 (60%) and 1187 (39%) students, respectively. The dialogue within school-based teams was supported by an expert steering committee that provided scaffolding and expertise.</p><p><strong>Program evaluation: </strong>Following the intervention, students reported significantly (p < 0.001) higher ratings across all 32 obesity medicine competencies (3.15 ± 0.56 vs. 2.79 ± 0.72; mean ± SD), higher knowledge about obesity (3.00 ± 0.29 vs. 2.92 ± 0.29; mean ± SD), lower negative beliefs (2.08 ± 0.41 vs. 2.82 ± 0.44; mean ± SD), and higher positive attitudes toward patients with obesity (3.55 ± 0.40 vs. 1.53 ± 0.41; mean ± SD).</p><p><strong>Discussion: </strong>This large study approach demonstrates feasibility and scalability of a multi-institutional collaborative framework for addressing the curricular gap in obesity medicine education.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182436","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}