Background: Artificial intelligence (AI) platforms can potentially enhance clinical decision-making (CDM) in primary care settings. OpenEvidence (OE), an AI tool, draws from trusted sources to generate evidence-based medicine (EBM) recommendations to address clinical questions. However, its effectiveness in real-world primary care cases remains unknown. Objective: To evaluate the performance of OE in providing EBM recommendations for five common chronic conditions in primary care: hypertension, hyperlipidemia, diabetes mellitus type 2, depression, and obesity. Methods: Five patient cases were retrospectively analyzed. Physicians posed specific clinical questions, and OE responses were evaluated on clarity, relevance, evidence support, impact on CDM, and overall satisfaction. Four independent physicians provided ratings using a 0 to 4 scale. Results: OE provided accurate, evidence-based recommendations in all cases, aligning with physician plans. OE was scored on a scale of zero to four, where zero was very unclear, and four was very clear. Mean scores across cases were clarity (3.55 ± 0.60), relevance (3.75 ± 0.44), support (3.35 ± 0.49), and satisfaction (3.60 ± 0.60). However, the impact on CDM was limited (1.95 ± 1.05), as OE primarily reinforced rather than modified plans. Conclusion: OE was rated high in clarity, relevance, and evidence-based support, reinforcing physician decisions in common chronic conditions. While the impact on CDM was minimal due to the study’s retrospective nature, OE shows promise in augmenting the primary care physician. Prospective trials are needed to evaluate its utility in complex cases and multidisciplinary settings.

Physical activity has been inversely associated with risk of several cancers. We performed a systematic review and meta-analysis to evaluate the association between physical activity and risk of esophageal cancer (esophageal adenocarcinoma [EAC] and/or esophageal squamous cell carcinoma [ESCC]).

S accepted at scientific meetings are often not subsequently published. Data on publication rates are largely from subspecialty and surgical studies. The aims of this study were to 1) determine publication rates of abstracts presented at a general internal medicine meeting; 2) describe research activity among academic general internists; 3) identify factors associated with publication and with the impact factor of the journal of publication; and 4) evaluate for publication bias. Retrospective cohort study. All scientific abstracts presented at the Society of General Internal Medicine 2009 Annual Meeting. Publication rates were determined by searching for full-text publications in MEDLINE. Data were abstracted regarding authors’ institution, research topic category, number of study sites, sample size, study design, statistical significance (p value and confidence interval) in abstract and publication, journal of publication, publication date, and journal impact factor. Of the 578 abstracts analyzed, 274 (47.4%) were subsequently published as a full article in a peer-reviewed journal indexed in MEDLINE. In a multivariable model adjusting for institution site, research topic, number of study sites, study design, sample size, and abstract results, publication rates for academic general internists were highest in the areas of medical education (52.5%, OR 5.05, 95% CI 1.57–17.25, reference group Veterans Affairs (VA)-based research, publication rate 36.7%), mental health/substance use (67.7%, OR 4.16, 95% CI 1.39–13.06), and aging/geriatrics/end of life (65.7%, OR 3.31, 95% CI 1.15–9.94, p = 0.01 across topics). Publication rates were higher for multicenter studies than single-institution studies (52.4% vs. 40.4%, OR 1.66, 95% CI 1.10–2.52, p = 0.04 across categories). Randomized controlled trials had higher publication rates than other study designs (66.7% vs. 45.9%, OR 2.72, 95% CI 1.30–5.94, p = 0.03 across study designs). Studies with positive results did not predict higher publication rates than negative studies (OR 0.89, 95% CI 0.6–1.31, p = 0.21). This study demonstrated that 47.4% of abstracts presented at a general internal medicine national conference were subsequently published in a peer-reviewed journal indexed in MEDLINE.

End-stage renal disease (ESRD) is associated with high morbidity and mortality. A prior study showed that many Canadian patients regretted their decision to start dialysis. We sought to determine if US patients also regretted dialysis. We surveyed hemodialysis patients within 55 miles of Rochester, MN, with a 25-question survey about their perceptions of their health, preparedness for dialysis, advance care planning, and regrets about starting dialysis. Surveys were administered in person at the patients' usual dialysis session from July 1 through December 1, 2014; responses were captured electronically. Of the 198 eligible patients, 128 participated (70% men); 80% received dialysis for more than 1 year; 38% reported their health and 58% described their quality of life as "good" or "very good"; 51% had started dialysis in the hospital; and 68% agreed they were prepared for what to expect. Only 35% of patients reported being offered supportive care without dialysis. Most patients (82%) recalled a discussion about prognosis. Only 43% completed an advance directive, but 72% thought it was at least "very important" to plan for the end of life. Nine (7%) reported regretting the decision to start dialysis. Most of our patients were optimistic about their health and prognosis. Few regretted the decision to start dialysis. .