141. GRADE Guidance: Update on Developing Good Practice Statements in Guidelines.
作者: Omar Dewidar.;Elie A Akl.;Gian Paolo Morgano.;Elena Parmelli.;Zuleika Saz-Parkinson.;Miranda W Langendam.;Joerg J Meerpohl.;Melanie Marti.;Martin Mayer.;Benjamin Djulbegovic.;Romina Brignardello-Petersen.;Derek K Chu.;M Hassan Murad.;Carlos Canelo-Aybar.;Joseph L Mathew.;Pablo Alonso-Coello.;Amir Qaseem.;Lukas Schwingshackl.;Antonio Bognanni.;Maria Ximena Rojas-Reyes.;Rebecca L Morgan.;Miloslav Klugar.;David Rigau Comas.;Elena Stallings.;Alfonso Iorio.;Peter Tugwell.;Andrea Darzi.;Alexis F Turgeon.;Tatyana A Shamliyan.;Zachary Munn.;Alexander G Mathioudakis.;Thomas Piggott.;Tamara Lotfi.;Kevin Pottie.;Gordon Guyatt.;Holger J Schünemann.
来源: Ann Intern Med. 2026年179卷3期430-439页
Despite published guidance by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group on the use of good practice statements (GPSs), their appropriate development remains challenging. This article provides updated guidance with nuanced operationalization. The updated guidance was developed on the basis of examples and iterative discussions. The lead authors refined the approach according to the feedback from GRADE Working Group meetings and presented the summary of the results to all attendees of the GRADE Working Group meeting for feedback in September 2023 and for final approval in September 2024. The 5 signaling questions from the original guidance were leveraged, and the authors recommend that guideline developers select relevant Evidence to Decision criteria to assess the potential downstream consequences of implementing the statement. They have updated the definition of a GPS, classifying GPSs into the following 3 categories: those grounded in ethics and human rights; those grounded in essential principles, practices, and protocols; and those grounded in established scientific evidence. Practical examples accompany the steps as they relate to each type of GPS. In addition, the authors introduce a tool to streamline GPS development and enhance the reporting process. This GRADE guidance article provides an update on when and how to develop a GPS. Adherence to the guidance will add to the trustworthiness of guidelines and may facilitate reducing the inappropriate use or overuse of the GPS.
142. Long-Term Mpox Sequelae 11 to 18 Months After Acute Illness : A Cohort Study in Two U.S. Cities.
作者: Preetam A Cholli.;Jason Zucker.;Karen J Vigil.;Faisal S Minhaj.;Paul J Weidle.;Melanie M Taylor.;Brett Gray.;Dana L Haberling.;Agha Ajmal.;Agam K Rao.;Anyelina Cantos.;Sarah Anne J Guagliardo.;Max Flanagan.;Gilhen H Rodriguez.;Irene Tamí-Maury.;Siobhán M O'Connor.; .
来源: Ann Intern Med. 2026年179卷3期362-371页
Little was known about persistent sequelae of mpox before the 2022 multinational clade II mpox virus outbreak.
145. Effect of Social Vulnerability on Efficacy of Bariatric Surgery Versus Medical and Lifestyle Intervention for Type 2 Diabetes: Analysis of the ARMMS-T2D Consortium of Randomized Trials.
作者: Mary Elizabeth Patti.;Bo Hu.;Sarah Kirschling.;Hanna J Wang.;Kathleen Foster.;Yael Sarig.;Donald C Simonson.;Danielle Wolfs.;David Arterburn.;Matthew J O'Brien.;Ashley H Vernon.;John M Jakicic.;Lori Laffel.;Sando Ojukwu.;Sangeeta R Kashyap.;Ali Aminian.;Philip R Schauer.;David E Cummings.;William F Gourash.;Anita Courcoulas.;John P Kirwan.
来源: Ann Intern Med. 2026年179卷3期353-361页
Social determinants of health (SDOH) can affect metabolic health.
149. Predicting Long-Term Risk for Prostate Cancer Mortality Following a Prostate-Specific Antigen Screening Test: Prognostic Model Development and External Validation.
作者: Patrick Lewicki.;Ralph Jiang.;Archana Radhakrishnan.;Alex Bryant.;Matthew Schipper.;Todd M Morgan.;Kristian Stensland.
来源: Ann Intern Med. 2026年179卷3期321-329页
Despite the scale of prostate-specific antigen (PSA) testing for prostate cancer (PCa) screening, prediction models do not predict time-to-event end points or adjust for patient life expectancy.
150. The Prevalence and Characteristics of Difficult Patient Encounters : A Systematic Review and Meta-analysis.
作者: Jeffrey L Jackson.;Akira Kuriyama.;Jeff Whittle.;Anthony Davis-Maxwell.;Michelle Thompson.;Mary G Murphy.;Suma Gondi.;Kristen Brennan.;Cory Ganshert.;Kathlyn E Fletcher.
来源: Ann Intern Med. 2026年179卷3期382-393页
Patients are sometimes experienced as difficult by their providers.
152. Iron Deficiency Anemia.
Iron deficiency anemia (IDA) is caused by iron deficiency, a common yet underrecognized clinical entity. Populations at greatest risk include children, menstruating and pregnant persons, and people of low socioeconomic status. Timely diagnosis and management of iron deficiency are key to preventing IDA and require thorough assessment of the underlying cause and appropriate iron repletion through either oral or parenteral therapy. Blood transfusion does not provide adequate elemental iron but is sometimes indicated along with iron therapy in patients with cardiovascular compromise, active bleeding, or severe anemia where more rapid correction is warranted. Alternative causes of anemia can be differentiated by red blood cell morphology and reticulocyte count and should be considered if anemia persists despite adequate repletion of iron stores.
154. In HFrEF, adding digitoxin to standard care reduced a composite of death or first worsening HF hospitalization at a median 36 mo.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].
155. GLP-1RAs increase risk for cholelithiasis and GERD but not other GI or biliary adverse events vs. placebo.
GIM/FP/GP: [Formula: see text] Endocrinology: [Formula: see text] Gastroenterology: [Formula: see text].
156. Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists on Diabetic Foot Disease : An Emulated Target Trial.
作者: Frederik P B Kristensen.;Diana H Christensen.;Brian C Callaghan.;Jens S Nielsen.;Henning Andersen.;Henrik T Sørensen.;Reimar W Thomsen.
来源: Ann Intern Med. 2026年179卷3期340-352页
The effects of sodium-glucose cotransporter-2 inhibitors (SGLT-2is) on diabetic foot disease have been mixed in prior trials of SGLT-2is compared with placebo. The comparative risk for diabetic foot disease with SGLT-2is compared with glucagon-like peptide-1 receptor agonists (GLP-1RAs) is unknown.
157. In adults at high risk for ventricular arrhythmia, treatment to increase potassium to high-normal levels improved a composite outcome.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].
159. In adults hospitalized with acute HF, predischarge influenza vaccination reduced a composite of mortality or readmission at 1 y.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Infectious Disease: [Formula: see text].
160. In older adults, high- vs. standard-dose influenza vaccine reduced hospitalization for influenza or pneumonia.
GIM/FP/GP: [Formula: see text] Public Health: [Formula: see text].
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