Journal of General Internal Medicine最新文献

{"title":"Investments in Hospitalist Research Could Deliver Financial Returns to Academic Medical Centers.","authors":"Teryl K Nuckols, Andrew D Auerbach","doi":"10.1007/s11606-024-09148-0","DOIUrl":"https://doi.org/10.1007/s11606-024-09148-0","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370836","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":"Diagnosis Documentation Done Right: Cross-Specialty Standard for the Diagnosis Section in German Discharge Summaries - A Mixed-Methods Study.","authors":"Julian Frings, Paul Rust, Sven Meister, Christian Prinz, Leonard Fehring","doi":"10.1007/s11606-025-09395-9","DOIUrl":"https://doi.org/10.1007/s11606-025-09395-9","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis section in hospital discharge summaries is critical for continuity of care and patient safety, yet it varies widely in quality, format, and content due to a lack of standards.</p><p><strong>Objective: </strong>This study aims to develop a cross-specialty standard for the structure and content of the diagnosis section, based on the preferences of German physicians. The study examines physicians' satisfaction with the diagnosis section, their rating of its importance, and their preferences for its specific elements, comparing perspectives between inpatient and outpatient physicians.</p><p><strong>Design, participants, approach: </strong>This mixed-methods study integrated a scoping review, focus group discussion, and a nationwide survey of 602 physicians (317 outpatient primary care and 285 inpatient physicians; 4.1% response rate), most trained in internal medicine. Quantitative analyses evaluated physician satisfaction and preferences, while qualitative feedback provided deeper insights regarding preferred content and format.</p><p><strong>Key results: </strong>Although 95.7% of physicians considered the diagnosis section crucial for follow-up care, only 36.9% were satisfied with its current content and format. 91.2% supported standardizing the diagnosis section, identifying 18 content elements to be included for every current treatment diagnosis. Strong consensus (> 95.0% agreement) was reached for \"name of the diagnosis,\" \"severity/stage/classification/TNM,\" \"localization/extent/pattern of involvement,\" \"course e.g., acute, chronic, recurrent,\" \"expression,\" \"complications,\" \"date of initial diagnosis,\" and \"etiology/cause.\" 86.4% preferred separating current and chronic/prior diagnoses with headings. Outpatient physicians were more likely than inpatient physicians to rate \"ICD-10 codes\" as mandatory (46.2% vs. 14.8%, p < 0.001) and to consider \"recommendations for further procedures\" (76.6% vs. 63.6%, p < 0.001) and \"follow-up appointments\" (77.3% vs. 63.5%, p < 0.001) as necessary. Additionally, a list of practical recommendations for clinicians to better document diagnoses was derived.</p><p><strong>Conclusions: </strong>This study proposes a cross-specialty standard for the diagnosis section based on physician preferences for a clearly structured format and 18 key content elements.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365065","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":"Emphysematous Cholecystitis.","authors":"Aldo Barajas-Ochoa","doi":"10.1007/s11606-025-09409-6","DOIUrl":"https://doi.org/10.1007/s11606-025-09409-6","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255689","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 Longitudinal Analysis of Patient Perspectives on Data Use in Healthcare: Desire for Notification and Concern About Data Sharing.","authors":"Anjelica Gangaram, Paige Nong","doi":"10.1007/s11606-025-09408-7","DOIUrl":"https://doi.org/10.1007/s11606-025-09408-7","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255690","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 Association Between Sleep Duration and the Risk of Hypertension: A Systematic Review and Meta-analysis of Cohort Studies.","authors":"Jianghan Qi, Meiling Yang, Shanyuan Zhang, Chenchen He, Xiaodan Bao, Baochang He, Yao Lin, Jianfeng Chu, Keji Chen","doi":"10.1007/s11606-025-09398-6","DOIUrl":"https://doi.org/10.1007/s11606-025-09398-6","url":null,"abstract":"<p><strong>Background: </strong>Hypertension onset is linked to sleep, but the precise sleep duration affecting it remains unclear. Our goal is to pinpoint the sleep duration impacting hypertension incidence, offering valuable insights for prevention and management.</p><p><strong>Methods: </strong>We conducted a systematic search in PubMed, Embase, Web of Science, CNKI, Cqvip, and Wanfang Database, up to May 30, 2023, focusing on cohort studies examining the association between nighttime sleep duration and hypertension risk in adults aged 18 and above. Two authors independently performed data extraction, quality assessment, and synthesis based on predefined criteria. A random-effects model was used to estimate pooled effect sizes with 95% confidence intervals (CIs). Heterogeneity was quantified using the I² statistic, with potential sources explored through subgroup and sensitivity analyses to validate the robustness of the results.</p><p><strong>Results: </strong>Out of the 173,734 participants included in the meta-analysis, 41,528 eventually developed hypertension. The analysis revealed a correlation between short sleep duration and increased risk of hypertension: 1.07 (95% CI 1.00-1.14) for those sleeping ≤ 7 h, 1.04 (95% CI 1.02-1.07) for 6-7 h, and 1.17 (95% CI 1.06-1.28) for < 6 h. For women, with sleep duration 6-7 and < 6 h, the pooled risk of hypertension incidence was 1.07 (1.02-1.12) and 1.12 (1.06-1.19). In individuals under 60 years of age, an elevated risk of hypertension was observed with sleep durations of less than 6 h and between 6 and 7 h, with pooled risks of 1.24 (95% CI 1.10-1.39) and 1.05 (95% CI 1.00-1.11), respectively.</p><p><strong>Conclusions: </strong>Hypertension is significantly correlated with sleep duration under 7 h, especially in women and those under 60, highlighting the importance of sleep management in hypertension prevention and treatment strategies.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42022345513.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189389","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":"A Slow Reveal.","authors":"Sabrina L Browning, Gurpreet Dhaliwal, Anna Dill, Binny Khandakar, André N Sofair","doi":"10.1007/s11606-025-09373-1","DOIUrl":"https://doi.org/10.1007/s11606-025-09373-1","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122831","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":"Building an Inclusive Future: Equity in Health and Health Services Research Workforce.","authors":"Alliric I Willis, Krys E Foster, Said A Ibrahim","doi":"10.1007/s11606-025-09376-y","DOIUrl":"https://doi.org/10.1007/s11606-025-09376-y","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122833","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":"Inpatient Metformin Utilization and Post-hospitalization Clinical Outcomes: An Observational Cohort Study.","authors":"Robert J Gallo, Shoutzu Lin, Daniel Z Fang, Peter A Glassman, Anju Sahay, Paul A Heidenreich","doi":"10.1007/s11606-025-09384-y","DOIUrl":"https://doi.org/10.1007/s11606-025-09384-y","url":null,"abstract":"<p><strong>Background: </strong>Metformin is the first-line treatment for diabetes, with multiple long-term benefits. However, there is limited evidence for its use in the inpatient setting, and clinical guidelines have historically recommended holding oral diabetes medications during acute hospitalization. While studies have not found evidence of harm from continuing metformin during hospitalization, withholding may lead to unnecessary insulin prescriptions, which in turn may lead to hypoglycemia events after discharge and other associated complications.</p><p><strong>Objective: </strong>To investigate the association between metformin use during hospitalization and post-hospitalization outcomes.</p><p><strong>Design: </strong>Observational cohort study from January 2016 to January 2022, emulating a target trial.</p><p><strong>Participants: </strong>Adults with type 2 diabetes admitted to a Veterans Health Administration hospital for common medical conditions.</p><p><strong>Interventions: </strong>Continuation of an outpatient metformin prescription during hospitalization.</p><p><strong>Main measures: </strong>Hypoglycemia within 90 days of discharge. Secondary outcomes included insulin prescriptions at discharge, 90-day readmissions, and 90-day mortality.</p><p><strong>Key results: </strong>The propensity-matched cohort included 67,162 hospitalizations, equally split between those who did and did not have metformin continued during hospitalization. Within 90 days of hospital discharge, those that received metformin had lower risk of hypoglycemia (1.5% vs 1.8%; OR 0.83, 95% CI 0.73-0.93; p = 0.003), readmissions (29.4% vs 30.6%; OR 0.96, 95% CI 0.92-1.00; p= 0.03), and mortality (6.4% vs 7.4%; OR 0.86, 95% CI 0.80-0.92; p <0.001). Patients receiving metformin also had lower risk of insulin prescriptions at discharge (18.5% vs 20.3%; OR 0.89, 95% CI 0.84-0.95; p<0.001).</p><p><strong>Conclusions: </strong>Continuation of metformin during hospitalization for patients with type 2 diabetes was associated with decreased risk of post-hospitalization insulin prescriptions and 90-day hypoglycemia, readmissions, and mortality. These findings question clinical guideline recommendations to hold metformin during hospitalization.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122835","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":"Sacred Moments During Mentorship.","authors":"Sanjay Saint","doi":"10.1007/s11606-025-09399-5","DOIUrl":"https://doi.org/10.1007/s11606-025-09399-5","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122837","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":"Global Health Collection.","authors":"D Michael Elnicki, Joe Conigliaro, Lenny López","doi":"10.1007/s11606-024-09223-6","DOIUrl":"10.1007/s11606-024-09223-6","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":"301"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}