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Understanding research on artificial intelligence in healthcare. 了解医疗保健领域人工智能的研究。
IF 9.3
BMJ medicine Pub Date : 2025-05-11 eCollection Date: 2025-01-01 DOI: 10.1136/bmjmed-2025-001614
Chris Paton
{"title":"Understanding research on artificial intelligence in healthcare.","authors":"Chris Paton","doi":"10.1136/bmjmed-2025-001614","DOIUrl":"10.1136/bmjmed-2025-001614","url":null,"abstract":"","PeriodicalId":72433,"journal":{"name":"BMJ medicine","volume":"4 1","pages":"e001614"},"PeriodicalIF":9.3,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Monitoring complete hydatidiform molar pregnancies after normalisation of human chorionic gonadotrophin: national retrospective population study. 人绒毛膜促性腺激素正常后监测完全葡萄胎妊娠:全国回顾性人群研究。
BMJ medicine Pub Date : 2025-04-23 eCollection Date: 2025-01-01 DOI: 10.1136/bmjmed-2024-001017
Brenna E Swift, Leonoor Coopmans, Kam Singh, Christopher Coyle, Edmund H Wilkes, Imran Jabbar, Geoffrey Maher, Xianne Aguiar, Lina Salman, Julia E Palmer, Naveed Sarwar, Reece Caldwell, Eshan Ghorani, Baljeet Kaur, Nienke E van Trommel, Christianne A R Lok, Matthew Winter, Michael J Seckl
{"title":"Monitoring complete hydatidiform molar pregnancies after normalisation of human chorionic gonadotrophin: national retrospective population study.","authors":"Brenna E Swift, Leonoor Coopmans, Kam Singh, Christopher Coyle, Edmund H Wilkes, Imran Jabbar, Geoffrey Maher, Xianne Aguiar, Lina Salman, Julia E Palmer, Naveed Sarwar, Reece Caldwell, Eshan Ghorani, Baljeet Kaur, Nienke E van Trommel, Christianne A R Lok, Matthew Winter, Michael J Seckl","doi":"10.1136/bmjmed-2024-001017","DOIUrl":"https://doi.org/10.1136/bmjmed-2024-001017","url":null,"abstract":"<p><strong>Objective: </strong>To provide evidence for a reduced surveillance protocol to detect gestational trophoblastic neoplasia after normalisation of human chorionic gonadotrophin (hCG) levels following uterine evacuation of a complete hydatidiform mole.</p><p><strong>Design: </strong>National retrospective population study.</p><p><strong>Setting: </strong>Two UK Trophoblastic Disease Treatment Centres (Sheffield and London), 1 January 1980 to 30 November 2020.</p><p><strong>Participants: </strong>17 424 patients with hCG normalisation after evacuation of their complete hydatidiform mole were included. Complete hydatidiform moles were verified by centralised pathological review. Patients were excluded if lost to follow-up or required treatment before normalisation of hCG levels.</p><p><strong>Main outcome measures: </strong>Incidence and clinical presentation of gestational trophoblastic neoplasia after normalisation of hCG levels following uterine evacuation of a complete hydatidiform mole.</p><p><strong>Results: </strong>Of 17 424 patients whose hCG normalised after complete hydatidiform mole evacuation, 99.8% (n=17 393 of 17 424) did not subsequently develop gestational trophoblastic neoplasia. The overall risk of gestational trophoblastic neoplasia after previous normalisation of hCG levels was 0.2% (n=31 of 17 424 patients). The risk of developing gestational trophoblastic neoplasia after uterine evacuation was substantially lower if hCG levels returned to normal in <56 days rather than ≥56 days (posterior medians 0.06%, 95% credible interval 0.01% to 0.14% <i>v</i> 0.22%, 0.15% to 0.31%), with a posterior relative risk of 0.25 (0.06 to 0.72). Most patients who developed gestational trophoblastic neoplasia (71.0%, n=22 of 31) had received a diagnosis after the current six month surveillance protocol. The cumulative risk of developing gestational trophoblastic neoplasia in patients whose hCG levels normalised early increased minimally with time. If a patient had normal hCG levels in <56 days, a clinically relevant time point, the risk of developing gestational trophoblastic neoplasia was small (0.04%, about 1 in 2619 patients) at 39 months after normalisation. The equivalent risk for a patient who had normal hCG levels in ≥56 days was 0.16% (about 1 in 642 patients). All 31 women who developed gestational trophoblastic neoplasia achieved sustained remission after subsequent treatment.</p><p><strong>Conclusions: </strong>The findings of the study indicate that surveillance protocols could safely change to one confirmatory normal hCG value for patients whose hCG levels return to normal in <56 days of evacuation of a complete hydatidiform mole. Patients whose hCG levels return to normal in ≥56 days should be counselled on the remaining risk of gestational trophoblastic neoplasia over time to help decide the length of subsequent follow-up.</p>","PeriodicalId":72433,"journal":{"name":"BMJ medicine","volume":"4 1","pages":"e001017"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prognostic value of cervical length for spontaneous preterm birth in asymptomatic women with twin pregnancy: meta-analysis of individual participant data. 宫颈长度对无症状双胎妊娠妇女自发性早产的预后价值:个体参与者数据的荟萃分析
BMJ medicine Pub Date : 2025-04-16 eCollection Date: 2025-01-01 DOI: 10.1136/bmjmed-2024-000877
Kelly Margaret Hughes, Mason Aberoumand, Anna Lene Seidler, Phoebe Swan, Mona Aboulghar, Maria de Lourdes Brizot, Clifton Brock, Marta Benito Vielba, Nathan Fox, Cynthia Gyamfi-Bannerman, Lindsay Kindinger, Giorgio Pagani, Alfredo Perales Marin, Viola Seravalli, Mariarosaria Di Tommaso, Omer Weitzner, Katharina Worda, Lukas Staub, Shaun Brennecke, Shakila Thangaratinam, Ben W Mol, Rui Wang
{"title":"Prognostic value of cervical length for spontaneous preterm birth in asymptomatic women with twin pregnancy: meta-analysis of individual participant data.","authors":"Kelly Margaret Hughes, Mason Aberoumand, Anna Lene Seidler, Phoebe Swan, Mona Aboulghar, Maria de Lourdes Brizot, Clifton Brock, Marta Benito Vielba, Nathan Fox, Cynthia Gyamfi-Bannerman, Lindsay Kindinger, Giorgio Pagani, Alfredo Perales Marin, Viola Seravalli, Mariarosaria Di Tommaso, Omer Weitzner, Katharina Worda, Lukas Staub, Shaun Brennecke, Shakila Thangaratinam, Ben W Mol, Rui Wang","doi":"10.1136/bmjmed-2024-000877","DOIUrl":"https://doi.org/10.1136/bmjmed-2024-000877","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the prognostic value of mid-trimester cervical length for spontaneous preterm birth in asymptomatic women with twin pregnancy and to assess whether other factors may modify any association.</p><p><strong>Designs: </strong>A two stage meta-analysis of individual participant data in a Cox proportional hazard model was performed using cervical length as a continuous variable.</p><p><strong>Data sources: </strong>Medline, Embase, Cochrane, and LILACS, among others, were searched to identify eligible studies; the search was from 1 January 2000 to 30 September 2020. Risk of bias was assessed with the QUIPS tool. Studies were from eight countries between 2001 and 2018.</p><p><strong>Eligibility criteria: </strong>Individual participant data were sought for eligible studies that reported mid-trimester (defined between 16 and 26 weeks) transvaginal sonographic cervical length and also gestational age at birth in asymptomatic women with twin pregnancy. The primary outcome was spontaneous preterm birth before 37 weeks.</p><p><strong>Results: </strong>Among 29 eligible studies, authors of 17 studies provided individual participant data for 6437 women with a twin pregnancy (69.1% of individual participant data). Mean cervical length measurement was 39 mm (SD=9, range 1-74 mm). 2889 women (44.9%) delivered before 37 weeks' gestation, and 934 (14.9%) delivered before 34 weeks. Each 1 mm increase in cervical length was associated with a 4.0% reduction in the rate of spontaneous preterm birth before 37 weeks (hazard ratio 0.96 (95% confidence interval 0.95 to 0.97)), and a 6.8% reduction in the rate of spontaneous preterm birth before 34 weeks' gestation (0.93 (0.92 to 0.95)). The prognostic value remained stable in models adjusting for different sets of variables.</p><p><strong>Conclusion: </strong>The prognostic value of cervical length for spontaneous preterm birth in twin pregnancy is on a continuous scale. No specific cervical length has been identified that can reliably predict or exclude all spontaneous preterm births.</p><p><strong>Study registration: </strong>CRD42020146987.</p>","PeriodicalId":72433,"journal":{"name":"BMJ medicine","volume":"4 1","pages":"e000877"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Overactive bladder drugs and the risk of dementia. 膀胱药物过度活跃和痴呆的风险。
BMJ medicine Pub Date : 2025-04-15 eCollection Date: 2025-01-01 DOI: 10.1136/bmjmed-2025-001520
Carolyn Michelle Tan, David Juurlink
{"title":"Overactive bladder drugs and the risk of dementia.","authors":"Carolyn Michelle Tan, David Juurlink","doi":"10.1136/bmjmed-2025-001520","DOIUrl":"10.1136/bmjmed-2025-001520","url":null,"abstract":"","PeriodicalId":72433,"journal":{"name":"BMJ medicine","volume":"4 1","pages":"e001520"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Statins for primary prevention of cardiovascular events in people with HIV: target trial and modelling study. 他汀类药物用于艾滋病毒感染者心血管事件的一级预防:目标试验和模型研究。
IF 1
BMJ medicine Pub Date : 2025-04-15 eCollection Date: 2025-01-01 DOI: 10.1136/bmjmed-2024-001132
Henock G Yebyo, Huldrych F Guenthard, Eva A Rehfuess, Nicola Serra, Sarah R Haile, Oliver Senn, Gregory M Lucas, Oliver Langselius, Jennifer E Thorne, Vincent C Marconi, Sally B Coburn, Raynell Lang, Jonathan A Colasanti, Michael J Silverberg, Sonia Napravnik, Mona Loutfy, Maile Karris, Timothy R Sterling, Greer A Burkholder, Keri N Althoff, Milo A Puhan
{"title":"Statins for primary prevention of cardiovascular events in people with HIV: target trial and modelling study.","authors":"Henock G Yebyo, Huldrych F Guenthard, Eva A Rehfuess, Nicola Serra, Sarah R Haile, Oliver Senn, Gregory M Lucas, Oliver Langselius, Jennifer E Thorne, Vincent C Marconi, Sally B Coburn, Raynell Lang, Jonathan A Colasanti, Michael J Silverberg, Sonia Napravnik, Mona Loutfy, Maile Karris, Timothy R Sterling, Greer A Burkholder, Keri N Althoff, Milo A Puhan","doi":"10.1136/bmjmed-2024-001132","DOIUrl":"10.1136/bmjmed-2024-001132","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness and benefit-harm balance of various statins for the primary prevention of cardiovascular disease in people with HIV.</p><p><strong>Design: </strong>Target trial and modelling study.</p><p><strong>Setting: </strong>North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), 1995 to 2019. NA-ACCORD integrates individual level data from >20 HIV cohorts across the US and Canada from people with HIV who have successfully linked into care.</p><p><strong>Participants: </strong>157 699 people with HIV enrolled in one of the cohorts of NA-ACCORD. 54 165 eligible individuals, aged 40-75 years, were enrolled in the target trial.</p><p><strong>Main outcome measures: </strong>The primary outcomes for the target trial were the 10 year effects of statins on cardiovascular disease events (fatal and non-fatal myocardial infarction, hospital admission for unstable angina, coronary or arterial revascularisation, fatal and non-fatal stroke, or transient ischaemic attack) and harm outcomes (type 2 diabetes, mild cognitive impairment, rhabdomyolysis, and myopathy). The secondary outcome was the 10 year risk threshold where the reduction in cardiovascular disease outweighed the increased risk of harm outcomes, showing an overall net benefit of statins.</p><p><strong>Results: </strong>Participants who first started receiving treatment with statins (statin initiators) had a 21% reduction in cardiovascular disease events (hazard ratio 0.79, 95% confidence interval (CI) 0.72 to 0.87) and a 26% reduction in the combined risk of stroke and myocardial infarction (0.74, 0.56 to 0.98), but a 12% increase in the risk of type 2 diabetes (1.12, 1.01 to 1.25) compared with participants who developed the indication but did not take statins (non-initiators). The effects on cognitive impairment (hazard ratio 1.13, 95% CI 0.82 to 1.56), myopathy (1.10, 0.76 to 1.61), and rhabdomyolysis (1.09, 0.68 to 1.75) were not statistically significant. On average, the benefit of statins exceeded harms for individuals with a 10 year baseline risk of cardiovascular disease of ≥13.8%. Subgroup specific thresholds included men (14.2%), women (11.1%), ages 40-64 years (13.8%) versus 65-75 years (15.1%), and CD4 count >200 cells/mm³ (13.6%) versus <200 cells/mm³ (15.3%). Varying weights for cardiovascular disease yielded thresholds ranging from 11.6% to 54.0%, whereas weights for harm outcomes resulted in thresholds ranging from 5.0% to >30.0%.</p><p><strong>Conclusions: </strong>In this study, statins benefitted individuals with HIV with a moderate or high risk of cardiovascular disease, but the threshold for net benefit varied by patient subgroup and preference, implying the need to customise statin treatment to individual risks, preferences, and treatment goals. Given the limitations of observational data, further controlled studies are needed to evaluate the efficacy and safety of statins in people with HIV receiving mode","PeriodicalId":72433,"journal":{"name":"BMJ medicine","volume":"4 1","pages":"e001132"},"PeriodicalIF":10.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Design differences and variation in results between randomised trials and non-randomised emulations: meta-analysis of RCT-DUPLICATE data. 修正:随机试验和非随机模拟结果的设计差异和变异:随机对照试验重复数据的荟萃分析。
BMJ medicine Pub Date : 2025-04-14 eCollection Date: 2025-01-01 DOI: 10.1136/bmjmed-2023-000709corr1
{"title":"Correction: Design differences and variation in results between randomised trials and non-randomised emulations: meta-analysis of RCT-DUPLICATE data.","authors":"","doi":"10.1136/bmjmed-2023-000709corr1","DOIUrl":"https://doi.org/10.1136/bmjmed-2023-000709corr1","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1136/bmjmed-2023-000709.].</p>","PeriodicalId":72433,"journal":{"name":"BMJ medicine","volume":"4 1","pages":"e000709corr1"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of stress management and relaxation interventions for management of hypertension and prehypertension: systematic review and network meta-analysis. 压力管理和放松干预对高血压和高血压前期管理的有效性:系统回顾和网络荟萃分析。
BMJ medicine Pub Date : 2025-04-08 eCollection Date: 2025-01-01 DOI: 10.1136/bmjmed-2024-001098
Katie E Webster, Monika Halicka, Russell J Bowater, Thomas Parkhouse, Dara Stanescu, Athitya Vel Punniyakotty, Jelena Savović, Alyson Huntley, Sarah Dawson, Christopher E Clark, Rachel Johnson, Julian Pt Higgins, Deborah M Caldwell
{"title":"Effectiveness of stress management and relaxation interventions for management of hypertension and prehypertension: systematic review and network meta-analysis.","authors":"Katie E Webster, Monika Halicka, Russell J Bowater, Thomas Parkhouse, Dara Stanescu, Athitya Vel Punniyakotty, Jelena Savović, Alyson Huntley, Sarah Dawson, Christopher E Clark, Rachel Johnson, Julian Pt Higgins, Deborah M Caldwell","doi":"10.1136/bmjmed-2024-001098","DOIUrl":"10.1136/bmjmed-2024-001098","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Objective: </strong>To assess whether relaxation and stress management techniques are useful in reducing blood pressure in individuals with hypertension and prehypertension.</p><p><strong>Design: </strong>Systematic review and network meta-analysis.</p><p><strong>Data sources: </strong>Medline, PsycInfo, and CENTRAL (Cochrane Central Register of Controlled Trials) from inception to 23 February 2024, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) from inception to 27 February 2024.</p><p><strong>Eligibility criteria for selecting studies: </strong>Studies published in English of adults with hypertension (blood pressure ≥140/90 mm Hg) or prehypertension (blood pressure ≥120/80 mm Hg but <140/90 mm Hg). Studies that compared non-pharmacological interventions used to promote relaxation or reduce stress with each other, or with a control group (eg, no intervention, waiting list, or standard care). Where possible, network meta-analysis was used to compare the efficacy of the different interventions. Studies were assessed with the risk of bias 2 tool (RoB2), and those at high risk of bias were excluded from the primary analysis. The certainty of the evidence was assessed with CINeMA (Confidence in Network Meta-Analysis) and GRADE (Grading of Recommendations Assessment, Development, and Evaluation).</p><p><strong>Results: </strong>182 studies were included (166 for hypertension and 16 for prehypertension). Results from a random effects network meta-analysis showed that, at short term follow-up (≤3 months), most relaxation interventions appeared to have a beneficial effect on systolic and diastolic blood pressure for individuals with hypertension. Between study heterogeneity was moderate (τ=2.62-4.73). Compared with a passive comparator (ie, no intervention, waiting list, or usual care), moderate reductions in systolic blood pressure were found for breathing control (mean difference -6.65 mm Hg, 95% credible interval -10.39 to -2.93), meditation (mean difference -7.71 mm Hg, -14.07 to -1.29), meditative movement (including tai chi and yoga, mean difference -9.58 mm Hg, -12.95 to -6.17), mindfulness (mean difference -9.90 mm Hg, -16.44 to -3.53), music (mean difference -6.61 mm Hg, -11.62 to -1.56), progressive muscle relaxation (mean difference -7.46 mm Hg, -12.15 to -2.96), psychotherapy (mean difference -9.83 mm Hg, -16.24 to -3.43), and multicomponent interventions (mean difference -6.78 mm Hg, -11.59 to -1.99). Reductions were also seen in diastolic blood pressure. Few studies conducted follow-up for more than three months, but effects on blood pressure seemed to lessen over time. Limited data were available for prehypertension; only two studies compared short term follow-up of relaxation therapies with a passive comparator, and the effects on systolic blood pressure were small (mean difference -3.84 mm Hg, 95% credible interval -6.25 to -1.43 for meditative movement; mean difference ","PeriodicalId":72433,"journal":{"name":"BMJ medicine","volume":"4 1","pages":"e001098"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Loneliness and all cause mortality in Australian women aged 45 years and older: causal inference analysis of longitudinal data. 澳大利亚45岁及以上妇女的孤独和全因死亡率:纵向数据的因果推理分析。
BMJ medicine Pub Date : 2025-04-06 eCollection Date: 2025-01-01 DOI: 10.1136/bmjmed-2024-001004
Neta HaGani, Philip Clare, Dafna Merom, Ben J Smith, Ding Ding
{"title":"Loneliness and all cause mortality in Australian women aged 45 years and older: causal inference analysis of longitudinal data.","authors":"Neta HaGani, Philip Clare, Dafna Merom, Ben J Smith, Ding Ding","doi":"10.1136/bmjmed-2024-001004","DOIUrl":"10.1136/bmjmed-2024-001004","url":null,"abstract":"<p><strong>Objective: </strong>To examine the causal effects of loneliness on mortality among Australian women aged 45 years and older.</p><p><strong>Design: </strong>Causal inference analysis of longitudinal data.</p><p><strong>Participants: </strong>A population based sample of Australian women aged 45 years and older (n=11 412).</p><p><strong>Main outcome measures: </strong>Targeted maximum likelihood estimations were used to analyse the causal relationship between loneliness and all cause mortality over 18 years. The adjusted risk of death associated with the total number of loneliness waves (loneliness persistency) and the consecutive number of loneliness waves (loneliness chronicity) was presented using risk ratios and risk differences with 99.5% confidence intervals (CIs).</p><p><strong>Results: </strong>The association between the number of waves of reported loneliness and mortality risk showed a dose-dependent pattern. Compared with women who did not report loneliness in any wave, people who reported loneliness at two, four, and six waves had an incrementally higher risk of dying during the follow-up period: risk ratio 1.49 (99.5% CI 1.26 to 1.75) at two waves, 2.18 (1.79 to 2.66) at four waves, and 3.15 (2.35 to 4.23) at six waves. The risk difference showed a similar trend to the risk ratios with higher excess mortality among women who reported experiencing loneliness for six waves compared with those who did not report loneliness at all (10.86% (99.5% CI 10.58% to 11.15%)). Similar trends were found when loneliness was experienced across consecutive waves.</p><p><strong>Conclusions: </strong>Loneliness seems to be causally linked to mortality risk with a dose-dependent relationship. Acknowledging loneliness as an independent health risk underscores the importance of screening for loneliness and incorporating public health interventions into healthcare practices.</p>","PeriodicalId":72433,"journal":{"name":"BMJ medicine","volume":"4 1","pages":"e001004"},"PeriodicalIF":0.0,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Benefits, burden, and harms of computer aided polyp detection with artificial intelligence in colorectal cancer screening: microsimulation modelling study. 基于人工智能的计算机辅助息肉检测在结直肠癌筛查中的益处、负担和危害:微模拟模型研究。
BMJ medicine Pub Date : 2025-03-27 eCollection Date: 2025-01-01 DOI: 10.1136/bmjmed-2025-001446
Natalie Halvorsen, Cesare Hassan, Loredana Correale, Nastazja Pilonis, Lise M Helsingen, Marco Spadaccini, Alessandro Repici, Farid Foroutan, Per Olav Vandvik, Shanaz Sultan, Magnus Løberg, Mette Kalager, Yuichi Mori, Michael Bretthauer
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引用次数: 0
Between promise and peril: role of suzetrigine as a non-opioid analgesic. 在希望与危险之间:舒三嗪作为非阿片类镇痛药的作用。
BMJ medicine Pub Date : 2025-03-25 eCollection Date: 2025-01-01 DOI: 10.1136/bmjmed-2025-001431
Jay Karri, Ryan S D'Souza, Steven P Cohen
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引用次数: 0
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