Recurrent kidney stones are unpleasant and may lead to kidney damage, sepsis, or invasive procedures.

Firearm acquisitions in the United States surged after the onset of the pandemic. The increase, sustained through at least early 2021, resulted from a modest increase in the proportion of long-standing gun owners who purchased firearms (most were White and men) and an unprecedented increase in the proportion of adults who became new gun owners (half were women; half were Hispanic and/or people of color). Little is known about firearm acquisitions beyond 2021.

Evidence-based decision making in health often requires comparison of multiple options for a given condition. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) evidence-to-decision (EtD) framework provides a structured approach for moving from evidence to decisions but was originally designed for pairwise comparisons. Hence, there is a need to accommodate decision making based on multiple comparisons, especially with the increasing use of systematic reviews and network meta-analyses in guideline development. Furthermore, since the original EtD framework was developed, further relevant GRADE guidance has been developed. The aim of this work was to develop a new EtD framework to accommodate multiple comparisons and reflect current GRADE guidance. The new EtD framework was revised and developed through iterative discussion, feedback, and refinement by the GRADE EtD Project Group and the GRADE Working Group. Experiences and examples from guideline developers, methodological experts, and other stakeholders informed improvements in its structure and usability for multiple comparisons and were subsequently approved by the GRADE Working Group. This article describes the new EtD framework, which now includes 2 corresponding parts for reviews of pairwise and multiple comparisons. The authors describe application to a review with multiple comparisons for the different parts of the EtD framework: the question definition, which now includes the presentation of values of health outcomes and decision thresholds; the assessment section, where the new "net effect" criterion has been included; and the conclusion section, which includes an adaptation for multiple comparisons. The article provides examples and suggestions for presentation of findings. The framework does have limitations, in that its usability has not been tested across a broad spectrum of guideline development contexts.

In the United States, people with disabilities experience disparities in health and health care. Disparities stem from inadequate insurance coverage, physically and culturally inaccessible health care facilities, pervasive harmful misconceptions about disability, and incomprehensive epidemiologic data regarding disability. In this position paper, the American College of Physicians offers recommendations to alleviate health disparities among people with disabilities through policy changes in areas such as health insurance coverage, accessibility of health care facilities, health professional education, research participation, and data collection.

Over the past several decades, federal laws have instituted sweeping antidiscrimination protections to foster inclusion for people with disabilities in education and employment, but substantial barriers remain to full and meaningful inclusion in the practice of medicine. In this position paper, the American College of Physicians (ACP) highlights the barriers to entering medicine and offers policy recommendations to improve the accessibility of medical schools, training programs, and the practice of medicine. ACP affirms that a diverse physician workforce, inclusive of disability, is a key component of reducing disparities in health and health care.