Original Investigation  April 4, 2023 Differences in Treatment Patterns and Outcomes of Acute Myocardial Infarction for Low- and High-Income Patients in 6 Countries Bruce E. Landon, Laura A. Hatfield, Pieter Bakx, et al JAMA. 2023;329(13):1088-1097. doi:10.1001/jama.2023.1699 Key Points Question  How do treatment patterns and outcomes for older patients presenting with acute myocardial infarction differ for low- vs high-income in...

Predicting Readmission, Death After Discharge From ICU Many machine learning (ML) models have been developed for use in the ICU, but their effectiveness in new settings is uncertain due to a lack of external validation. A study showed that less than one-third of Food and Drug Administration (FDA) approved ML models have undergone multisite assessment. In addition, only 11% of  ICU prediction models have been externally validated.  The ICU is a popular ...

CORRESPONDENCE Stroke, Myocardial Infarction, and Pulmonary Embolism after Bivalent Booster Marie-Joelle Jabagi, Marion Bertrand, Jérémie Botton, et al N Engl J Med March 29, 2023DOI: 10.1056/NEJMc2302134 TO THE EDITOR: A bivalent messenger RNA vaccine targeting both the ancestral and omicron BA.4–BA.5 sublineages of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Pfizer–BioNTech) was introduced in France in early October 2022 and recommended ...

Viewpoint  March 27, 2023 AI-Generated Medical Advice—GPT and Beyond Claudia E. Haupt, Mason Marks JAMA. Published online March 27, 2023. doi:10.1001/jama.2023.5321 For years, experts have speculated about the future role of artificial intelligence (AI) in health care. Some AI tools can outperform physicians on specific tasks in radiology, dermatology, and other fields, which raised concerns that AI might render certain specialists obsolete. ...

SPECIAL ARTICLE Air Pollution and Mortality at the Intersection of Race and Social Class Kevin P. Josey, Scott W. Delaney, Xiao Wu, et al N Engl J Med March 24, 2023DOI: 10.1056/NEJMsa2300523 Abstract BACKGROUND Black Americans are exposed to higher annual levels of air pollution containing fine particulate matter (particles with an aerodynamic diameter of ≤2.5 μm [PM2.5]) than White Americans and may be more susceptible to its health effects. Low-income...

Effect of Higher Protein Dosing in Critically Ill Patients The international critical care nutrition guidelines recommend a wide range of protein doses that are based on low-quality evidence. The impact of high-dose protein in critically ill patients is unknown.  A study was conducted to test the hypothesis that a higher dose of protein improves clinical outcomes in critically ill patients. This was an international, registry-based, single-blinded, randomis...

Editorials Quality improvement in primary care Kath Checkland BMJ 2023; 380 doi: https://doi.org/10.1136/bmj.p582 (Published 22 March 2023)Cite this as: BMJ 2023;380:p582 Lessons from the end of QOF in Scotland The Quality and Outcomes Framework (QOF) pay-for-performance scheme began in the UK National Health Service in the early 2000s.1 Under a new contract, as much as 20% of general practices’ remuneration was initially tied to the achievement of per...

ORIGINAL ARTICLE Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemia Mehdi H. Shishehbor, Richard J. Powell, Miguel F. Montero-Baker, et al N Engl J Med 2023; 388:1171-1180DOI: 10.1056/NEJMoa2212754 Abstract BACKGROUND Approximately 20% of patients with chronic limb-threatening ischemia have no revascularization options, leading to above-ankle amputation. Transcatheter arterialization of the deep veins is a percutaneous appro...

Research Letter  March 28, 2023 Discontinuation of Conventional Synthetic Disease-Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis and Excellent Disease Control Siri Lillegraven, Nina Paulshus Sundlisæter, Anna-Birgitte Aga, et al JAMA. 2023;329(12):1024-1026. doi:10.1001/jama.2023.0492 With advances in rheumatoid arthritis (RA) therapy, more patients achieve sustained remission. Treatment recommendations suggest considerin...

ICU Management & Practice, Volume 22 - Issue 5, 2022 Point of Care Ultrasound: The Critical Imaging Tool for the Critically Unwell This article aims to discuss the specific role of point of care ultrasound (POCUS) in the diagnosis and management of pathology in the critical care setting, as well as a specific tool to aid in invasive procedures. We discuss the ABCDE assessment of patients within critical care using POCUS. Introduction Since its introdu...