INTRODUCTION: Bile acid sequestrants (BAS) are an option for microscopic colitis (MC) refractory or intolerant to budesonide. There are inconsistent data on the prevalence of bile acid malabsorption (BAM) and utility of bile acid testing in MC. The aim of this systematic review and meta-analysis was to evaluate these outcomes. METHODS: A systematic search of randomized control trials and observational studies of adults with MC treated with BAS was conducted using MEDLINE, Embase, Cochrane, and Scopus from inception to January 22, 2024. Data were extracted on (i) prevalence of BAM, (ii) clinical response and adverse events, and (iii) recurrence after BAS discontinuation. Data were pooled using random-effects models to determine weighted pooled estimates and 95% confidence intervals (CIs). RESULTS: We included 23 studies (1 randomized control trial, 22 observational), with 1,011 patients with MC assessed for BAM and 771 treated with BAS. The pooled prevalence of BAM was 34% (95% CI 0.26–0.42, I ² = 81%). The pooled response rate with BAS induction for all patients with MC, irrespective of BAM, was 62% (95% CI 0.55–0.70, I ² = 71%). There was a higher pooled response rate in patients with BAM compared with those without BAM (P < 0.0001). The pooled rate of BAS-related adverse effects was 9% (95% CI 0.05–0.14, I ² = 58%). DISCUSSION: One-third of patients with MC had BAM, and almost two-thirds of all patients responded to BAS with limited side effects. Patients with MC and BAM were more likely to respond to therapy, supporting the value of bile acid testing.

Educating authors and clinicians about predatory publishing and its consequences is vital to protect scholarship and evidence-based practice and is particularly important for those early in their health care careers. Librarians at Mayo Clinic in Rochester, MN have incorporated this important topic into ongoing literature searching training for internal medicine residents. This article summarizes the level of existing awareness of predatory publishing and the effectiveness of discussing it in small group educational sessions. It is crucial for all health care professionals to be informed about the serious threat to the integrity of scientific literature and the potential adverse impact on patient care.

Low health literacy is well documented in East Tennessee. Before addressing the issue, librarians at the Preston Medical Library, University of Tennessee Medical Center in Knoxville, Tennessee, conducted a needs assessment of hospital staff to determine their knowledge of health literacy and the need for training. As a follow-up, library staff conducted training sessions for nurses through classes, small group meetings, and staff huddles. The result is an increased dialogue of health literacy at the hospital, along with new research projects, a forum, and a summit meeting.