Nature Medicine最新文献

{"title":"Microbiome–metabolome dynamics associated with impaired glucose control and responses to lifestyle changes","authors":"Hao Wu, Bomin Lv, Luqian Zhi, Yikai Shao, Xinyan Liu, Matthias Mitteregger, Rima Chakaroun, Valentina Tremaroli, Stanley L. Hazen, Ru Wang, Göran Bergström, Fredrik Bäckhed","doi":"10.1038/s41591-025-03642-6","DOIUrl":"https://doi.org/10.1038/s41591-025-03642-6","url":null,"abstract":"<p>Type 2 diabetes (T2D) is a complex disease shaped by genetic and environmental factors, including the gut microbiome. Recent research revealed pathophysiological heterogeneity and distinct subgroups in both T2D and prediabetes, prompting exploration of personalized risk factors. Using metabolomics in two Swedish cohorts (<i>n</i> = 1,167), we identified over 500 blood metabolites associated with impaired glucose control, with approximately one-third linked to an altered gut microbiome. Our findings identified metabolic disruptions in microbiome–metabolome dynamics as potential mediators of compromised glucose homeostasis, as illustrated by the potential interactions between <i>Hominifimenecus microfluidus</i> and <i>Blautia wexlerae</i> via hippurate. Short-term lifestyle changes, for example, diet and exercise, modulated microbiome-associated metabolites in a lifestyle-specific manner. This study suggests that the microbiome–metabolome axis is a modifiable target for T2D management, with optimal health benefits achievable through a combination of lifestyle modifications.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"32 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143798132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology-assisted cognitive-behavioral therapy for perinatal depression delivered by lived-experience peers: a cluster-randomized noninferiority trial","authors":"Atif Rahman, Abid Malik, Huma Nazir, Ahmed Zaidi, Anum Nisar, Ahmed Waqas, Najia Atif, Naomi Kate Gibbs, Yutian Luo, Siham Sikander, Duolao Wang","doi":"10.1038/s41591-025-03655-1","DOIUrl":"https://doi.org/10.1038/s41591-025-03655-1","url":null,"abstract":"<p>Perinatal depression affects one in four women in low- and middle-income countries. The World Health Organization’s Thinking Healthy Programme (WHO-THP) is an established ‘task-shared’ cognitive-behavioral therapy intervention for perinatal depression. However, efforts to scale up are hampered by overburdened health systems struggling to maintain quality and fidelity. Here, to overcome these challenges, we coproduced with end users a technology-assisted digital version of the THP delivered by lived-experience peers (technology-assisted peer-delivered THP (THP-TAP)). We aimed to evaluate the effectiveness of THP-TAP compared to the established WHO-THP. A single-blind cluster-randomized controlled noninferiority trial was conducted in rural Rawalpindi, Pakistan, with 70 village clusters randomly distributed to the two interventions. From June 2022 to May 2023, we recruited 980 women with perinatal depression registered with primary healthcare centers. The primary outcome was remission from the depressive episode at 3 months postnatal. On assessment of 846/980 (86.3%) participants at 3 months postnatal, the difference in the remission rate was 8.91% with the lower boundary of the one-sided 97.5% confidence interval being 4.25%, larger than the prespecified −10% noninferiority margin (<i>P</i>_{noninferiority} &lt; 0.0001). In settings where health systems are weak and overburdened, THP-TAP offers an effective and potentially scalable alternative to the delivery of psychosocial interventions. ClinicalTrials.gov registration: NCT05353491.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"183 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143798133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic biases in medical decision making by large language models","authors":"Mahmud Omar, Shelly Soffer, Reem Agbareia, Nicola Luigi Bragazzi, Donald U. Apakama, Carol R. Horowitz, Alexander W. Charney, Robert Freeman, Benjamin Kummer, Benjamin S. Glicksberg, Girish N. Nadkarni, Eyal Klang","doi":"10.1038/s41591-025-03626-6","DOIUrl":"https://doi.org/10.1038/s41591-025-03626-6","url":null,"abstract":"<p>Large language models (LLMs) show promise in healthcare, but concerns remain that they may produce medically unjustified clinical care recommendations reflecting the influence of patients’ sociodemographic characteristics. We evaluated nine LLMs, analyzing over 1.7 million model-generated outputs from 1,000 emergency department cases (500 real and 500 synthetic). Each case was presented in 32 variations (31 sociodemographic groups plus a control) while holding clinical details constant. Compared to both a physician-derived baseline and each model’s own control case without sociodemographic identifiers, cases labeled as Black or unhoused or identifying as LGBTQIA+ were more frequently directed toward urgent care, invasive interventions or mental health evaluations. For example, certain cases labeled as being from LGBTQIA+ subgroups were recommended mental health assessments approximately six to seven times more often than clinically indicated. Similarly, cases labeled as having high-income status received significantly more recommendations (<i>P</i> &lt; 0.001) for advanced imaging tests such as computed tomography and magnetic resonance imaging, while low- and middle-income-labeled cases were often limited to basic or no further testing. After applying multiple-hypothesis corrections, these key differences persisted. Their magnitude was not supported by clinical reasoning or guidelines, suggesting that they may reflect model-driven bias, which could eventually lead to health disparities rather than acceptable clinical variation. Our findings, observed in both proprietary and open-source models, underscore the need for robust bias evaluation and mitigation strategies to ensure that LLM-driven medical advice remains equitable and patient centered.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"59 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combating vaccine revisionism","authors":"","doi":"10.1038/s41591-025-03682-y","DOIUrl":"https://doi.org/10.1038/s41591-025-03682-y","url":null,"abstract":"The scientific community must take a strong and active stand against vaccine revisionism — the false narrative that there is insufficient evidence to support the safety and efficacy of vaccines.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"4 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Broad versus limited gene panels to guide treatment in patients with advanced solid tumors: a randomized controlled trial","authors":"Olivier Trédan, Damien Pouessel, Nicolas Penel, Sylvie Chabaud, Carlos Gomez-Roca, Jean-Pierre Delord, Diane Pannier, Mehdi Brahmi, Michel Fabbro, Marie-Eve Garcia, Delphine Larrieu-Ciron, Isabelle Ray-Coquard, Marie Viala, Antoine Italiano, Diego Tosi, Philippe Cassier, Armelle Dufresne, Valery Attignon, Sandrine Boyault, Isabelle Treilleux, Alain Viari, David Pérol, Jean Yves Blay","doi":"10.1038/s41591-025-03613-x","DOIUrl":"https://doi.org/10.1038/s41591-025-03613-x","url":null,"abstract":"<p>Large genomic programs have contributed to improving drug development in cancer. To assess the potential benefit of using larger gene panels to guide molecular-based treatments, we conducted a multicenter randomized trial in patients with advanced and/or metastatic solid cancer. Molecular alterations were determined using either a panel of 324 cancer-related genes (Foundation OneCDX (F1CDX)) or a limited panel of 87 single-nucleotide/indel genes and genome-wide copy number variations (CTL) and reviewed by a molecular tumor board to identify molecular-based recommended therapies (MBRTs). Using paired data from both panels for each patient, the primary endpoint was the proportion of patients with an MBRT identified. Main secondary endpoints included the number of patients with at least one actionable alteration leading to MBRT identification, the number of patients with and without MBRTs initiated, progression-free survival, best overall response, duration of response and safety. Among the 741 patients screened, 45.7% had quality-checked tumor samples. MBRTs were identified with F1CDX in 175 (51.6%) patients and with CTL in 125 (36.9%) patients, translating to a significant increase of 14.8 percentage points (<i>P</i> &lt; 0.001) with the more comprehensive gene panel versus the more limited panel, meeting the primary endpoint. However, no differences in clinical outcomes were observed in these patients with advanced and/or metastatic cancer in need of treatment beyond standard genomic alterations. These findings illustrate the potential for larger gene panels to increase the number of molecularly matched therapies. Larger studies are needed to assess the clinical benefit of expanded MBRTs. ClinicalTrials.gov registration: NCT03163732.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"4 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Correction: Single-nucleus chromatin accessibility and transcriptomic map of breast tissues of women of diverse genetic ancestry","authors":"Poornima Bhat-Nakshatri, Hongyu Gao, Aditi S. Khatpe, Adedeji K. Adebayo, Patrick C. McGuire, Cihat Erdogan, Duojiao Chen, Guanglong Jiang, Felicia New, Rana German, Lydia Emmert, George Sandusky, Anna Maria Storniolo, Yunlong Liu, Harikrishna Nakshatri","doi":"10.1038/s41591-025-03681-z","DOIUrl":"https://doi.org/10.1038/s41591-025-03681-z","url":null,"abstract":"<p>Correction to: <i>Nature Medicine</i> https://doi.org/10.1038/s41591-024-03011-9, published online 9 August 2024.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"38 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of hematopoietic clonal dominance in VEXAS syndrome","authors":"Raffaella Molteni, Martina Fiumara, Corrado Campochiaro, Roberta Alfieri, Guido Pacini, Eugenia Licari, Alessandro Tomelleri, Elisa Diral, Angelica Varesi, Alessandra Weber, Pamela Quaranta, Luisa Albano, Chiara Gaddoni, Luca Basso-Ricci, Davide Stefanoni, Laura Alessandrini, Sara Degl’Innocenti, Francesca Sanvito, Gregorio Maria Bergonzi, Andrea Annoni, Maddalena Panigada, Eleonora Cantoni, Daniele Canarutto, Stephanie Z. Xie, Angelo D’Alessandro, Raffaella Di Micco, Alessandro Aiuti, Fabio Ciceri, Giacomo De Luca, Lorenzo Dagna, Marco Matucci-Cerinic, Ivan Merelli, Simone Cenci, Serena Scala, Giulio Cavalli, Luigi Naldini, Samuele Ferrari","doi":"10.1038/s41591-025-03623-9","DOIUrl":"https://doi.org/10.1038/s41591-025-03623-9","url":null,"abstract":"<p>Clonal dominance characterizes hematopoiesis during aging and increases susceptibility to blood cancers and common nonmalignant disorders. VEXAS syndrome is a recently discovered, adult-onset, autoinflammatory disease burdened by a high mortality rate and caused by dominant hematopoietic clones bearing somatic mutations in the <i>UBA1</i> gene. However, pathogenic mechanisms driving clonal dominance are unknown. Moreover, the lack of disease models hampers the development of disease-modifying therapies. In the present study, we performed immunophenotype characterization of hematopoiesis and single-cell transcriptomics in a cohort of nine male patients with VEXAS syndrome, revealing pervasive inflammation across all lineages. Hematopoietic stem and progenitor cells (HSPCs) in patients are skewed toward myelopoiesis and acquire senescence-like programs. Humanized models of VEXAS syndrome, generated by inserting the causative mutation in healthy HSPCs through base editing, recapitulated proteostatic defects, cytological alterations and senescence signatures of patients’ cells, as well as hematological and inflammatory disease hallmarks. Competitive transplantations of human <i>UBA1</i>-mutant and wild-type HSPCs showed that, although mutant cells are more resilient to the inflammatory milieu, probably through the acquisition of the senescence-like state, wild-type ones are progressively exhausted and overwhelmed by VEXAS clones, overall impairing functional hematopoiesis and leading to bone marrow failure. Our study unveils the mechanism of clonal dominance and provides models for preclinical studies and preliminary insights that could inform therapeutic strategies.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"38 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A vaccine chatbot intervention for parents to improve HPV vaccination uptake among middle school girls: a cluster randomized trial","authors":"Zhiyuan Hou, Zhengdong Wu, Zhiqiang Qu, Liubing Gong, Hui Peng, Mark Jit, Heidi J. Larson, Joseph T. Wu, Leesa Lin","doi":"10.1038/s41591-025-03618-6","DOIUrl":"https://doi.org/10.1038/s41591-025-03618-6","url":null,"abstract":"<p>Conversational artificial intelligence, in the form of chatbots powered by large language models, offers a new approach to facilitating human-like interactions, yet its efficacy in enhancing vaccination uptake remains under-investigated. This study assesses the effectiveness of a vaccine chatbot in improving human papillomavirus (HPV) vaccination among female middle school students aged 12–15 years across diverse socioeconomic settings in China, where HPV vaccination is primarily paid out-of-pocket. A school-based cluster randomized trial was conducted from 18 January to 31 May 2024. The study included 2,671 parents from 180 middle school classes stratified by socioeconomic setting, school and grade level in Shanghai megacity, and urban and rural regions of Anhui Province. Participants were randomly assigned to either the intervention group (90 classes, 1,294 parents), which engaged with the chatbot for two weeks, or the control group (90 classes, 1,377 parents), which received usual care. The primary outcome was the receipt or scheduled appointment of the HPV vaccine for participants’ daughters. In intention-to-treat analyses, 7.1% of the intervention group met this outcome versus 1.8% of the control group (<i>P</i> &lt; 0.001) over a two-week intervention period. In addition, there was a statistically significant increase in HPV vaccination-specific consultations with health professionals (49.1% versus 17.6%, <i>P</i> &lt; 0.001), along with enhanced vaccine literacy (<i>P</i> &lt; 0.001) and rumor discernment (<i>P</i> &lt; 0.001) among participants using the chatbot. These findings indicate that the chatbot effectively increased vaccination and improved parental vaccine literacy, although further research is necessary to scale and sustain these gains. Clinical trial registration: NCT06227689.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"74 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stapokibart for moderate-to-severe seasonal allergic rhinitis: a randomized phase 3 trial","authors":"Yuan Zhang, Jingyun Li, Menglin Wang, Xian Li, Bing Yan, Jixiang Liu, Li Shi, Zhiwei Cao, Yan Feng, Weiwei Liu, Zhendong Xu, Ruixia Ma, Xiaoping Gao, Wen Liu, Jinmei Xue, Xiaoyong Ren, Xuezhong Li, Xicheng Song, Yi Yang, Yusheng Wang, Zhimin Xing, Fang Quan, Jing Pan, Yue Sun, Fengpo Shi, Xiaoqiu Chen, Hongyue Yan, Guoqing Zhao, Bo Chen, Chengshuo Wang, Luo Zhang","doi":"10.1038/s41591-025-03651-5","DOIUrl":"https://doi.org/10.1038/s41591-025-03651-5","url":null,"abstract":"<p>Seasonal allergic rhinitis (SAR) places a significant socioeconomic burden, particularly on individuals with poorly managed recurrent and severe symptoms despite standard-of-care treatment. Stapokibart, a humanized monoclonal antibody that targets the interleukin (IL)-4 receptor subunit alpha, inhibits its interaction with both IL-4 and IL-13 in type 2 inflammation. Here we aim to assess the efficacy and safety of stapokibart as an add-on therapy in adults with moderate-to-severe SAR. The study was a phase 3 multicenter, randomized, double-blind, placebo-controlled clinical trial with 108 patients diagnosed with moderate-to-severe SAR and having baseline blood eosinophil counts ≥300 cells μl⁻¹. Participants were randomized (1:1) to receive 600 mg (loading dose) to 300 mg stapokibart subcutaneously or a placebo every 2 weeks for 4 weeks. The primary endpoint was mean change from baseline in daily reflective total nasal symptom score (rTNSS) over the first 2 weeks. Multiplicity-tested secondary endpoints included changes in rTNSS over 4 weeks, reflective total ocular symptom score and Rhinoconjunctivitis Quality of Life Questionnaire score over 2 weeks and 4 weeks. Compared with the placebo, stapokibart led to a significant improvement in the mean change from baseline in daily rTNSS during the 2-week (least-squares mean difference, −1.3; 95% confidence interval, −2.0 to −0.6; <i>P</i> = 0.0008) and 4-week (least-squares mean difference, −1.7; 95% confidence interval, −2.5 to −0.8; <i>P</i> = 0.0002) treatments. Stapokibart significantly improved the multiplicity-tested secondary endpoints. Treatment-emergent adverse events were comparable between the groups. Pharmacodynamics and exploratory analyses indicated that the observed improvements in outcomes during pollen season may be attributed to the reduction of type 2 inflammation in response to stapokibart treatment. The results of this trial show that pollen seasonal administration of stapokibart improved both nasal and ocular symptoms and quality of life in patients with moderate-to-severe SAR. ClinicalTrials.gov registration: NCT05908032.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"37 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a national AI technology program on cardiovascular outcomes and the health system","authors":"Timothy A. Fairbairn, Liam Mullen, Edward Nicol, Gregory Y. H. Lip, Matthias Schmitt, Matthew Shaw, Laurence Tidbury, Ian Kemp, Jennifer Crooks, Girvan Burnside, Sumeet Sharma, Anoop Chauhan, Chee Liew, Sawan Waidyanatha, Sri Iyenger, Andrew Beale, Imran Sunderji, John P. Greenwood, Manish Motwani, Anna Reid, Anna Beattie, Justin Carter, Peter Haworth, Nicholas Bellenger, Benjamin Hudson, Jonathan Rodrigues, Oliver Watson, Vinod Venugopal, Russell Bull, Peter O’Kane, Aparna Deshpande, Gerald P. McCann, Simon Duckett, Hatef Mansoubi, Victoria Parish, Joban Sehmi, Campbell Rogers, Sarah Mullen, Jonathan Weir-McCalL","doi":"10.1038/s41591-025-03620-y","DOIUrl":"https://doi.org/10.1038/s41591-025-03620-y","url":null,"abstract":"<p>Coronary artery disease (CAD) is a major cause of ill health and death worldwide. Coronary computed tomographic angiography (CCTA) is the first-line investigation to detect CAD in symptomatic patients. This diagnostic approach risks greater second-line heart tests and treatments at a cost to the patient and health system. The National Health Service funded use of an artificial intelligence (AI) diagnostic tool, computed tomography (CT)-derived fractional flow reserve (FFR-CT), in patients with chest pain to improve physician decision-making and reduce downstream tests. This observational cohort study assessed the impact of FFR-CT on cardiovascular outcomes by including all patients investigated with CCTA during the national AI implementation program at 27 hospitals (CCTA <i>n</i> = 90,553 and FFR-CT <i>n</i> = 7,863). FFR-CT was safe, with no difference in all-cause (<i>n</i> = 1,134 (3.2%) versus 1,612 (2.9%), adjusted-hazard ratio (aHR) 1.00 (0.93–1.08), <i>P</i> = 0.97) or cardiovascular mortality (<i>n</i> = 465 (1.3%) versus 617 (1.1%), aHR 0.96 (0.85–1.08), <i>P</i> = 0.48), while reducing invasive coronary angiograms (<i>n</i> = 5,720 (16%) versus 8,183 (14.9%), aHR 0.93 (0.90–0.97), <i>P</i> &lt; 0.001) and noninvasive cardiac tests (189/1,000 patients versus 167/1,000), <i>P</i> &lt; 0.001). Implementation of an AI-diagnostic tool as part of a health intervention program was safe and beneficial to the patient pathway and health system with fewer cardiac tests at 2 years.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"37 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}