Staying #Up2Date 🚨

1. Cardiovascular disease (CVD) risk stratification

This study from CMAJ incorporated anxiety and depression into the PREVENT score and found that depressive sx score was associated with CVD after adjusting for the PREVENT predictors and anxiety/depression hx. Though depressive sx scores showed slight increases in C-index (0.005) and specificity (0.89%), sensitivity remained unchanged, suggesting that the mental health modifications had little incremental benefit for CVD risk stratification at a population level. 

2. Nicotine replacement therapy (NRT) approaches

This RCT compared 3 quitting strategies in 630 lung cancer screening-eligible current smokers: quitline referral with NRT (QL), quitline referral with NRT or prescribed medications (QL+), and integrated care with more counselling and tailored tx (IC). The IC model had the highest abstinence rates: (32.4%), followed by QL+ at 58 (27.6%) and QL at 43 (20.5%) at 6 mo. The QL+ approach may be a viable option in low-resource settings.

3.  Aspirin (ASA) in left ventricular assist device (LVAD)

In a prespecified analysis of the ARIES-HM3 trial, LVAD recipients with a history of conditions that typically require ASA (prior PCI, CABG, stroke, or PVD) were randomized 1:1 to receive ASA vs. placebo. Thrombotic events were rare with no differences between groups (P for interaction = .77). Avoiding ASA was associated with fewer nonsurgical bleeding events compared to those who continued on ASA (RR placebo vs ASA, 0.52; 95% CI, 0.35-0.79). 

AI Slacks Behind 🤖

How COVID-19 might’ve affected more than just immune systems

What happened: It turns out the AI that’s supposed to help doctors, is actually costing them.

Why it’s interesting: In 2022 a study was released found the AI that predicts the chances of death for cancer patients slacked off during the pandemic, getting seven percentage points worse at predicting who would die.

The failing grade likely had real life impacts as the lead author of the study noted that the tool’s mistake caused doctors to tell patients their chance of survival was low, or they might’ve told sicker patients that they didn’t need chemotherapy right away.

But: This isn’t the only type of AI that worsened due to COVID-19. One oncologist said he believes several health care related technology suffered during the pandemic. AI systems require constant monitoring and staffing to ensure it’s always up to date and working the way it’s supposed to. Unfortunately the influx of patients meant that the machines fell behind.

While there’s no denying that AI in healthcare brings money (like the tech assistant that summarizes patients visits bringing in $353 million for investors) small errors make a huge difference. Even on their best days some medical AI ‘s have a 35% error rate. There have been some ideas floating around on how to fix this growing issue, one being creating an artificial intelligence that monitors the health care AI (with the help of humans monitoring them both). So far no actual technology has been made.

Bottom line: It can be silly to think that something as popular and efficient as AI could make such large mistakes, but what’s most important is finding the problem and fixing it as it could save lives.

Hot Off The Press

1: ☕ Coffee lovers this ones for you. A new study suggests that drinking the beverage in the morning only may help people live longer compared to drinking it during the day. Those who enjoy a morning pick me up had a 16% lower chance of dying from any cause than whose don’t drink coffee.

2: 🏥 A study has found that by 2060 US dementia cases will double to about 1 million. Scientists found that the hike is due to the aging of the US population. Women, Black Americans, and people with the APOE4 gene are at greater risk of having the disease. The authors of the study said there is a need for policies that promote healthy aging and focus on the risks of dementia.

3: 🔴 The FDA has officially moved to ban the use of Red No. 3 dye in food and drinks. Food manufacturers will have until 2027 to change the ingredients in their products while drugmakers have til 2028.

4: 💊 A recent study looked at doxycycline postexposure prophylaxis (doxyPEP) use among people on HIV PrEP in California, and showed impressive results. In this cohort of over 11,500 individuals, doxyPEP was linked to big drops in chlamydia (79%), syphilis (80%), and a modest decline (12%) in gonorrhea rates. DoxyPEP could make a real difference in reducing STI transmission on a larger scale, especially for people on PrEP, making it worth considering as part of the strategy for STI prevention in this group.

Notable Numbers 🔢

15,000: the number of doctors that have singed a letter rejecting RFK Jr. as health secretary. The letter read that RFK Jr. is “dangerous” as he’s known for promoting false medical claims. So far he hasn’t commented on the backlash and would need 3 Republican votes if all the Senate’s Democrats vote against him.

12: how many hours norovirus can survive on surfaces, contributing to a spike in cases across Canada, the US, and the UK. Experts warn that alcohol-based hand sanitizers are ineffective against this "winter vomiting bug," which spreads rapidly through contaminated surfaces and food. Vaccines are in development — including a Moderna mRNA candidate currently in phase 3 trials.

50%: how much US iodine levels dropped from the 1970s to the 1990s. Once nearly eradicated, iodine deficiency is reemerging due to changing diets and the rise of noniodized salts. While most Americans still get enough, doctors are increasingly seeing mild deficiencies in pregnant women and children, raising concerns about developmental impacts like lower IQ and language delays.

Postcall Picks

🤣 Laugh: at “If Medicine Was Multiple Choice.”

🧠 Learn: about balancing personal risk vs. reward in both money and in life — from the latest White Coat Investor podcast episode.

🤑 Save: in the mood for a good night sleep? Save up to $200 on mattresses and get two free pillows with every mattress purchase at Layla.

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