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width="1.25rem" xmlns="http://www.w3.org/2000/svg"><polyline points="6 9 6 2 18 2 18 9"></polyline><path d="M6 18H4a2 2 0 0 1-2-2v-5a2 2 0 0 1 2-2h16a2 2 0 0 1 2 2v5a2 2 0 0 1-2 2h-2"></path><rect x="6" y="14" width="12" height="8"></rect></svg></a></button></div></div><div><div class="flex flex-wrap"><p class=" text-primary font-semibold">News</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1"></div><p class=" text-primary font-semibold">Article</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1 "></div><time class="text-gray-500 " dateTime="2024-10-21T21:00:03.237">Published: October 21, 2024</time><time class="text-gray-500 " dateTime="2024-10-24T17:53:00.000"> | Updated: October 24, 2024</time></div><h1 class="text-[26px] font-medium leading-8">Lower Diagnostic Error Rates Found Among Hospitalized Patients During Care Transitions </h1><div class="py-3 text-gray-600 md:flex flex-col md:justify-between"><div class="flex flex-col xs:flex-row"><p class="mr-1 self-start">Author(s):</p><div class="flex flex-col xs:flex-row mb-3 md:mb-0"><div class="flex flex-wrap"><span class="text-md mr-2"><a class="text-author text-gray-500 hover:text-primary underline hover:no-underline decoration-gray-400" href="/authors/brooke-mccormick">Brooke McCormick</a></span></div></div></div><div class="max-w-full"><div class="flex flex-wrap sm:flex-nowrap items-center w-fit my-2"></div><div class="w-full flex flex-col sm:flex-row justify-between mt-2"><div class="block md:hidden "><div class="mt-2 flex items-center max-w-fit"><button title="Lower Diagnostic Error Rates Found Among Hospitalized Patients During Care Transitions " aria-label="facebook" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#3b5998"></circle><path 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audio::-webkit-media-controls-time-remaining-display { font-size: 12px; } </style></div></div></div><div class=" lg:w-full flex flex-col lg:flex-row lg:items-center lg:justify-end"></div><div class="w-full flex flex-col px-4 py-4 border-t border-b border-solid border-gray-400 my-4 "><h3 class="text-primary text-xl font-semibold">Key Takeaways</h3><ul class="list-disc px-8"><li class="py-2 "> Care transitions offer a more accurate method for identifying diagnostic errors compared with traditional clinical triggers. </li><li class="py-2 "> The study found a lower prevalence of diagnostic errors, with missed electronic health record information being the most common cause. </li><li class="py-2 hidden"> Few diagnostic errors were associated with harm, and most involved infectious, cardiovascular, and neurologic conditions. </li><li class="py-2 hidden"> The study's single-site nature and varying transition practices across hospitals limit generalizability, but findings remain promising.</li></ul><span class="text-xs font-bold text-primary underline cursor-pointer mt-2 ml-4">SHOW MORE</span></div><p class="py-2 mb-2 text-sm italic text-gray-600">Examining care transitions in hospitalized patients revealed lower diagnostic error rates compared with traditional methods, highlighting the effectiveness of this approach in identifying diagnostic challenges.</p><div class="py-2"><div class="blockText_blockContent__TbCXh"><p class="pb-2">A lower prevalence of diagnostic errors was observed among hospitalized patients when examining errors during care transitions, suggesting that this approach may offer a more precise understanding of diagnostic challenges, according to a research letter published in<em> <a rel="nofollow noreferrer noopener" target="_blank" href="https://www.acpjournals.org/doi/10.7326/ANNALS-24-00563">Annals of Internal Medicine</a></em>.<sup class="text-inherit">1</sup></p><p class="pb-2"></p><p class="pb-2">Although diagnostic errors are common, the optimal identification approach remains unknown. For example, <a rel="nofollow noreferrer noopener" target="_blank" href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2813854">previous studies used</a> triggers, like death or intensive care unit transfer, to identify patients who may have experienced diagnostic errors.<sup class="text-inherit">2</sup> However, using clinical triggers may introduce hindsight bias, potentially influencing the reported rates of harm associated with diagnostic errors.<sup class="text-inherit">1</sup></p><p class="pb-2"></p><p class="pb-2">Conversely, care transitions represent opportunities for error recognition since the oncoming clinician can <a rel="nofollow noreferrer noopener" target="_blank" href="https://shmpublications.onlinelibrary.wiley.com/doi/10.12788/jhm.3262">review</a> and reassess the previous clinician’s care.<sup class="text-inherit">3</sup> Consequently, the researchers aimed to develop a program to leverage end-of-week clinician care transitions to identify diagnostic errors and possible causes in hospitalized patients.<sup class="text-inherit">1</sup></p><div class=""><div style="width:39%;float:right;max-width:525px;margin:0 0 1.5rem 1.5rem;clear:both;cursor:" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%275107%27%20height=%273404%27/%3e"/></span><img alt="Clinician giving patient a diagnosis | Image Credit: Pcess609 - stock.adobe.com" title="Clinician giving patient a diagnosis | Image Credit: Pcess609 - stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="Clinician giving patient a diagnosis | Image Credit: Pcess609 - stock.adobe.com" title="Clinician giving patient a diagnosis | Image Credit: Pcess609 - stock.adobe.com" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F70a41b427e3ba8b6d6044d291f38bd6f75f8945a-5107x3404.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 1x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F70a41b427e3ba8b6d6044d291f38bd6f75f8945a-5107x3404.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">Examining care transitions in hospitalized patients revealed lower diagnostic error rates compared to traditional methods. | Image Credit: Pcess609 - stock.adobe.com</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/ajmc/70a41b427e3ba8b6d6044d291f38bd6f75f8945a-5107x3404.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">Therefore, the researchers conducted a single-center study at Northwestern University, an 897-bed teaching hospital, from April 2019 to August 2021. In this practice, clinicians work 7-day rotations, with handoffs to the oncoming physician conducted via telephone.</p><p class="pb-2"></p><p class="pb-2">Those assuming care received an electronic questionnaire on day 2 of their service week, identifying 1 to 2 randomly selected patients who had been admitted 2 to 5 days before their transition. The questionnaire asked whether any diagnoses had changed, and subsequently about descriptions of the original and new diagnoses, respectively.</p><p class="pb-2"></p><p class="pb-2">Cases with a diagnostic change were independently reviewed by 2 physicians using the <a rel="nofollow noreferrer noopener" target="_blank" href="https://www.degruyter.com/document/doi/10.1515/dx-2019-0012/html">Revised Safer Dx Instrument</a> to determine if the changes may be attributed to a diagnostic error.<sup class="text-inherit">4 </sup>The reviewers also used the National Coordinating Council for Medication Error Reporting and Prevention Index to classify potential harm.<sup class="text-inherit">1</sup></p><p class="pb-2"></p><p class="pb-2">Overall, the reviewers reported the number of diagnostic changes, errors, and the severity of harm. Each study team member independently reviewed the cases and provided open-ended descriptions of the causes of errors. The team members then met to discuss these assessments and generated 4 final labels for the causes of diagnostic errors: missed information from the electronic health record, missed examination finding, failure to order a test or consultation, and failure to consider a diagnosis.</p><p class="pb-2"></p><p class="pb-2">Of 641 questionnaires, 621 (96.9%) were completed by 36 clinicians. Among 1011 patients, 184 (18.2%) had a diagnostic change and 59 (5.8%) were associated with a diagnostic error. The researchers found that the most common cause of error was missed information from the electronic health record (34 of 68; 50.0%).</p><p class="pb-2"></p><p class="pb-2">They noted that few errors were associated with harm (10 of 59; 16.9%), and only 1 likely contributed to death. Conversely, most missed diagnoses involved infectious diseases (16 of 59; 27.1%), followed by cardiovascular (15 of 59; 25.4%) and neurologic (7 of 59; 11.8%) conditions.</p><p class="pb-2"></p><p class="pb-2">The percentage of patients experiencing diagnostic errors was lower than previously reported. The researchers suggested that this discrepancy may stem from the triggers used in previous studies, which may have overestimated error rates. Consequently, they noted that using care transitions as a trigger provides a more accurate estimate of missed or delayed diagnoses.</p><p class="pb-2"></p><p class="pb-2">However, the researchers acknowledged their study’s limitations, including its small single-site sample. They also noted that transition practices may vary across hospital medicine groups, limiting generalizability. Despite these limitations, Gopi J. Astik, lead investigator and hospitalist at Northwestern Medical Group, told <em>The American Journal of Managed Care<sup class="text-inherit">®</sup></em> <em>(AJMC<sup class="text-inherit">®</sup>) </em>that<em> </em>their findings demonstrate the value of care transitions.</p><p class="pb-2"></p><p class="pb-2">"Now that more of our care is shift- or time-based, I think there are care transitions that are just inherent to the practice of hospital medicine," she said<em>.</em> "This provides a good opportunity to prompt that review...rather than just carrying forward what was previously done. Care transitions have always been seen as negative and vulnerable, but I think they're actually a valuable asset to health care."</p><p class="pb-2"></p><p class="pb-2"><strong>References</strong></p><ol class="my-2"><li class="list-decimal ml-8">Astik GJ, Olson APJ, Steker D, et al. Utilizing care transitions for diagnostic error detection in hospital medicine patients. <em>Ann Intern Med</em>. doi:10.7326/ANNALS-24-00563 </li><li class="list-decimal ml-8">Auerbach AD, Lee TM, Hubbard CC, et al. Diagnostic errors in hospitalized adults who died or were transferred to intensive care. <em>JAMA Intern Med</em>. 2024;184(2):164–173. doi:10.1001/jamainternmed.2023.7347</li><li class="list-decimal ml-8">Lane KP, Chia C, Lessing JN, et al. Improving resident feedback on diagnostic reasoning after handovers: the LOOP Project. <em>J Hosp Med. </em>2019;14(10):622-625. doi:10.12788/jhm.3262</li><li class="list-decimal ml-8">Singh H, Khanna A, Spitzmueller C, Meyer AND. Recommendations for using the Revised Safer Dx Instrument to help measure and improve diagnostic safety. <em>Diagnosis (Berl)</em>. 2019;6(4):315-323. doi:10.1515/dx-2019-0012</li></ol><p class="pb-2"></p><p class="pb-2"></p><p class="pb-2"></p></div></div><div class="flex items-center lg:w-3/4 mb-4 pb-12"></div><div class="jsx-19ede9f0a5a45918 py-4 relative bg-primary md:px-8 -ml-6 xs:ml-0 w-screen xs:w-auto"><div class="jsx-19ede9f0a5a45918 px-4 sm:px-0"><div class="flex justify-between items-center py-1 space-x-4 border-0 select-none sm:border-b border-secondary"><div class="text-3xl text-white text-lg sm:text-3xl">Related Videos</div></div></div><div style="scroll-snap-type:none" class="jsx-19ede9f0a5a45918 flex items-start overflow-x-auto space-x-4 py-4 relative mx-auto w-full pl-4"><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" 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Resonance Highlights Sex-Specific Characteristics in Aortic Stenosis</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kyle-munz">Kyle Munz</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/cardiovascular-magnetic-resonance-highlights-sex-specific-characteristics-in-aortic-stenosis?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">This multicenter study sheds more light on sex-based differences in aortic stenosis (AS) and argues the benefits of using cardiovascular magnetic resonance (CMR) to assess sex-based risks in AS. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/promising-potential-for-fgf21-analogs-in-mash-management?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/d4c6f424c89bd761e1d8de63e30607ba4d7fab47-8000x6000.jpg?fit=crop&auto=format" alt="Fibroblast growth factor 21 | image credit: Juan Gärtner - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 19th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/promising-potential-for-fgf21-analogs-in-mash-management?utm_source=www.ajmc.com&utm_medium=relatedContent">Promising Potential for FGF21 Analogs in MASH Management </a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kyle-munz">Kyle Munz</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/promising-potential-for-fgf21-analogs-in-mash-management?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Emerging evidence suggests that fibroblast growth factor 21 (FGF21) could play a future part in the treatment of metabolic dysfunction-associated steatohepatitis (MASH). </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="relative hidden sm:block"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end 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md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/nsclc-advancements-offer-hope-but-disparities-persist?utm_source=www.ajmc.com&utm_medium=relatedContent">NSCLC Advancements Offer Hope, but Disparities Persist</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kyle-munz">Kyle Munz</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/ioana-bonta-md">Ioana Bonta, MD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/nsclc-advancements-offer-hope-but-disparities-persist?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Ioana Bonta, MD, Georgia Cancer Specialists, discusses the evolving state of non-small cell lung cancer (NSCLC) treatments, their impact on patient outcomes, and the need to address ongoing disparities in these populations. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9de113904a026205cbaf84d08420c4065d52fd67-1000x563.jpg?fit=crop&auto=format" alt="Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 11th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent">Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/maggie-l-shaw">Maggie L. Shaw</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/george-jones">George Jones</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">George Jones of UpScript Health discusses telemedicine's evolution from basic e-prescribing to real-time video consultations, expanding treatment beyond primary care.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/ovarian-cancer-remission-rates-remained-stable-before-after-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/b494e9799158e243f77a0a93a8c86b5ea820d210-6908x3933.jpg?fit=crop&auto=format" alt="COVID-19 pandemic illustration | Image Credit: James Thew - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/ovarian-cancer-remission-rates-remained-stable-before-after-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent">Ovarian Cancer Remission Rates Remained Stable Before, After COVID-19 Pandemic</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/ovarian-cancer-remission-rates-remained-stable-before-after-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The comparable rates of remission pre- and post-pandemic suggest that COVID-19 did not negatively impact the outcomes of patients with ovarian cancer. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/the-evolving-annual-wellness-visit?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4d74ae04b0508977864936ec08f2aaa199758e5c-1000x563.jpg?fit=crop&auto=format" alt="managed care cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">January 28th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/the-evolving-annual-wellness-visit?utm_source=www.ajmc.com&utm_medium=relatedContent">The Evolving Annual Wellness Visit</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/laura-joszt">Laura Joszt, MA</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/christopher-wheelock-md">Christopher Wheelock, MD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/the-evolving-annual-wellness-visit?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The annual wellness visit is beneficial for patients, providers, and payers with an emphasis on preventive care for early intervention.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/cardiovascular-magnetic-resonance-highlights-sex-specific-characteristics-in-aortic-stenosis?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/e698939a89913035de334b260a3360bb6dd3ca21-5376x3584.jpg?fit=crop&auto=format" alt="Aortic Stenosis remains a serious, worldwide cardiovascular complication | image credit: Pumpala - stock.adobe.come" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 19th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/cardiovascular-magnetic-resonance-highlights-sex-specific-characteristics-in-aortic-stenosis?utm_source=www.ajmc.com&utm_medium=relatedContent">Cardiovascular Magnetic Resonance Highlights Sex-Specific Characteristics in Aortic Stenosis</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kyle-munz">Kyle Munz</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/cardiovascular-magnetic-resonance-highlights-sex-specific-characteristics-in-aortic-stenosis?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">This multicenter study sheds more light on sex-based differences in aortic stenosis (AS) and argues the benefits of using cardiovascular magnetic resonance (CMR) to assess sex-based risks in AS. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/promising-potential-for-fgf21-analogs-in-mash-management?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/d4c6f424c89bd761e1d8de63e30607ba4d7fab47-8000x6000.jpg?fit=crop&auto=format" alt="Fibroblast growth factor 21 | image credit: Juan Gärtner - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 19th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/promising-potential-for-fgf21-analogs-in-mash-management?utm_source=www.ajmc.com&utm_medium=relatedContent">Promising Potential for FGF21 Analogs in MASH Management </a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kyle-munz">Kyle Munz</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/promising-potential-for-fgf21-analogs-in-mash-management?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Emerging evidence suggests that fibroblast growth factor 21 (FGF21) could play a future part in the treatment of metabolic dysfunction-associated steatohepatitis (MASH). </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="pb-24"></div></div><script type="application/ld+json">{"@context":"https://schema.org","@type":"NewsArticle","headline":"Lower Diagnostic Error Rates Found Among Hospitalized Patients During Care Transitions ","datePublished":"2024-10-21T21:00:03.237Z","dateModified":"2024-10-24T17:53:00.000Z","inLanguage":"en-US","image":"https://cdn.sanity.io/images/0vv8moc6/ajmc/70a41b427e3ba8b6d6044d291f38bd6f75f8945a-5107x3404.jpg?fit=crop&auto=format","mainEntityOfPage":{"@type":"WebPage","@id":"https://www.ajmc.com/view/lower-diagnostic-error-rates-found-among-hospitalized-patients-during-care-transitions"},"publisher":{"@type":"Organization","name":"AJMC","logo":{"@type":"ImageObject","url":"https://www.ajmc.com/ajmc_logo_inverted.png"}},"keywords":"diagnostic error,electronic health record,care transition","articleBody":"A lower prevalence of diagnostic errors was observed among hospitalized patients when examining errors during care transitions, suggesting that this approach may offer a more precise understanding of diagnostic challenges, according to a research letter published in Annals of Internal Medicine.1\n\n\n\nAlthough diagnostic errors are common, the optimal identification approach remains unknown. For example, previous studies used triggers, like death or intensive care unit transfer, to identify patients who may have experienced diagnostic errors.2 However, using clinical triggers may introduce hindsight bias, potentially influencing the reported rates of harm associated with diagnostic errors.1\n\n\n\nConversely, care transitions represent opportunities for error recognition since the oncoming clinician can review and reassess the previous clinician’s care.3 Consequently, the researchers aimed to develop a program to leverage end-of-week clinician care transitions to identify diagnostic errors and possible causes in hospitalized patients.1\n\n\n\nTherefore, the researchers conducted a single-center study at Northwestern University, an 897-bed teaching hospital, from April 2019 to August 2021. In this practice, clinicians work 7-day rotations, with handoffs to the oncoming physician conducted via telephone.\n\n\n\nThose assuming care received an electronic questionnaire on day 2 of their service week, identifying 1 to 2 randomly selected patients who had been admitted 2 to 5 days before their transition. The questionnaire asked whether any diagnoses had changed, and subsequently about descriptions of the original and new diagnoses, respectively.\n\n\n\nCases with a diagnostic change were independently reviewed by 2 physicians using the Revised Safer Dx Instrument to determine if the changes may be attributed to a diagnostic error.4 The reviewers also used the National Coordinating Council for Medication Error Reporting and Prevention Index to classify potential harm.1\n\n\n\nOverall, the reviewers reported the number of diagnostic changes, errors, and the severity of harm. Each study team member independently reviewed the cases and provided open-ended descriptions of the causes of errors. The team members then met to discuss these assessments and generated 4 final labels for the causes of diagnostic errors: missed information from the electronic health record, missed examination finding, failure to order a test or consultation, and failure to consider a diagnosis.\n\n\n\nOf 641 questionnaires, 621 (96.9%) were completed by 36 clinicians. Among 1011 patients, 184 (18.2%) had a diagnostic change and 59 (5.8%) were associated with a diagnostic error. The researchers found that the most common cause of error was missed information from the electronic health record (34 of 68; 50.0%).\n\n\n\nThey noted that few errors were associated with harm (10 of 59; 16.9%), and only 1 likely contributed to death. Conversely, most missed diagnoses involved infectious diseases (16 of 59; 27.1%), followed by cardiovascular (15 of 59; 25.4%) and neurologic (7 of 59; 11.8%) conditions.\n\n\n\nThe percentage of patients experiencing diagnostic errors was lower than previously reported. The researchers suggested that this discrepancy may stem from the triggers used in previous studies, which may have overestimated error rates. Consequently, they noted that using care transitions as a trigger provides a more accurate estimate of missed or delayed diagnoses.\n\n\n\nHowever, the researchers acknowledged their study’s limitations, including its small single-site sample. They also noted that transition practices may vary across hospital medicine groups, limiting generalizability. Despite these limitations, Gopi J. Astik, lead investigator and hospitalist at Northwestern Medical Group, told The American Journal of Managed Care® (AJMC®) that their findings demonstrate the value of care transitions.\n\n\n\n\"Now that more of our care is shift- or time-based, I think there are care transitions that are just inherent to the practice of hospital medicine,\" she said. \"This provides a good opportunity to prompt that review...rather than just carrying forward what was previously done. Care transitions have always been seen as negative and vulnerable, but I think they're actually a valuable asset to health care.\"\n\n\n\nReferences\n\nAstik GJ, Olson APJ, Steker D, et al. Utilizing care transitions for diagnostic error detection in hospital medicine patients. Ann Intern Med. doi:10.7326/ANNALS-24-00563 \n\nAuerbach AD, Lee TM, Hubbard CC, et al. Diagnostic errors in hospitalized adults who died or were transferred to intensive care. JAMA Intern Med. 2024;184(2):164–173. doi:10.1001/jamainternmed.2023.7347\n\nLane KP, Chia C, Lessing JN, et al. Improving resident feedback on diagnostic reasoning after handovers: the LOOP Project. J Hosp Med. 2019;14(10):622-625. doi:10.12788/jhm.3262\n\nSingh H, Khanna A, Spitzmueller C, Meyer AND. Recommendations for using the Revised Safer Dx Instrument to help measure and improve diagnostic safety. Diagnosis (Berl). 2019;6(4):315-323. doi:10.1515/dx-2019-0012\n\n\n\n\n\n","description":"Examining care transitions in hospitalized patients revealed lower diagnostic error rates compared with traditional methods, highlighting the effectiveness of this approach in identifying diagnostic challenges.","author":[{"@type":"Person","name":"Brooke McCormick"}]}</script></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div id="div-gpt-ad-pixel" style="width:1px;height:1px" class=""></div><noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-NK5KQXS" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript><div id="footerOuterWrap" class=" mx-auto flex"><div class="bg-[#00598D] xl:w-[70%] w-[70%] py-12 pl-auto"><div class="xxl:w-[75%] 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In this practice, clinicians work 7-day rotations, with handoffs to the oncoming physician conducted via telephone."}]},{"_key":"9581ca45a268","markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"","_key":"3bffddc1f7c50"}],"_type":"block","style":"normal"},{"uploadAudio":null,"medias":null,"style":"normal","_key":"6b138df5fa80","markDefs":[],"children":[{"marks":[],"text":"Those assuming care received an electronic questionnaire on day 2 of their service week, identifying 1 to 2 randomly selected patients who had been admitted 2 to 5 days before their transition. 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Each study team member independently reviewed the cases and provided open-ended descriptions of the causes of errors. The team members then met to discuss these assessments and generated 4 final labels for the causes of diagnostic errors: missed information from the electronic health record, missed examination finding, failure to order a test or consultation, and failure to consider a diagnosis.","_key":"e7e09cccc8e00"}],"_type":"block","style":"normal","upload_doc":null},{"children":[{"_type":"span","marks":[],"text":"","_key":"600d45549c430"}],"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null,"style":"normal","_key":"60a0597667df","markDefs":[]},{"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Of 641 questionnaires, 621 (96.9%) were completed by 36 clinicians. Among 1011 patients, 184 (18.2%) had a diagnostic change and 59 (5.8%) were associated with a diagnostic error. 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Consequently, they noted that using care transitions as a trigger provides a more accurate estimate of missed or delayed diagnoses.","_key":"4bf8eda5b91e0"}],"_type":"block","style":"normal","_key":"cf2a85714a71","markDefs":[],"upload_doc":null,"uploadAudio":null},{"_key":"e169b6c497b1","markDefs":[],"children":[{"text":"","_key":"14f995ac5a9a0","_type":"span","marks":[]}],"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null,"style":"normal"},{"uploadAudio":null,"medias":null,"children":[{"_key":"8c435e0e14ef0","_type":"span","marks":[],"text":"However, the researchers acknowledged their study’s limitations, including its small single-site sample. They also noted that transition practices may vary across hospital medicine groups, limiting generalizability. Despite these limitations, Gopi J. 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So, I really think immunotherapy is one of the main advancements. I don't know what other words to use, but also more recently, combinations of immunotherapy with targeted therapy, also ADCs seem to make a difference in progression-free survival, and hopefully overall survival soon.","_key":"5760493229a0"}],"_type":"block"},{"_type":"block","style":"normal","_key":"9dbe6fbb25f9","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"cda90ad70f20"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Bispecific therapies are also coming into the field of non-small cell lung cancer. In terms of what is the impact? What we look at is the quality of life. Are those therapies better tolerated by our patients? Are the side effects more tolerable than our conventional cytotoxic chemotherapy? And yes, we do see an improvement in the quality of life and also, very importantly, in the outcome such as progression-free survival and, very important, overall survival of our patients","_key":"f6b9cd5e0e3c"}],"_type":"block","style":"normal","_key":"423105f492e3"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"5b311cba7a8d","_type":"span"}],"_type":"block","style":"normal","_key":"c75bebe9bb40"},{"children":[{"marks":["strong"],"text":"How have recent advancements in NSCLC helped address care gaps or reduce disparities in access and outcomes?","_key":"3937a223852e","_type":"span"}],"_type":"block","style":"normal","_key":"7d3c0ce18d37","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"27805b6b02dc"}],"_type":"block","style":"normal","_key":"cc11f0dd144a"},{"children":[{"marks":[],"text":"First of all, it allowed us to identify those disparities, to see their differences. 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","_key":"a4b2ac97a45c","_type":"span"}],"_type":"block","style":"normal","_key":"ece065daf223"},{"_type":"block","style":"normal","_key":"b514239c46b6","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"54d0caccee57"}]},{"style":"normal","_key":"1f08b932b452","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Consequently, the researchers assessed the association between the COVID-19 pandemic and cancer remission after initial treatment in patients newly diagnosed with epithelial ovarian cancer to determine whether remission rates remained consistent amid these challenges.","_key":"ee9925d93132"}],"_type":"block"},{"_key":"a88b9fa4afdd","disableTextWrap":false,"imgcaption":[{"_key":"85c36e26b4fb","markDefs":[],"children":[{"marks":[],"text":"The comparable rates of remission pre- and post-pandemic suggest that COVID-19 did not negatively impact the outcomes of patients with ovarian cancer. | Image Credit: James Thew - stock.adobe.com","_key":"b1675695283a","_type":"span"}],"_type":"block","style":"normal"}],"alignment":"right","asset":{"_type":"reference","_ref":"image-b494e9799158e243f77a0a93a8c86b5ea820d210-6908x3933-jpg"},"widthP":40,"disableLightBox":true,"_type":"figure","alt":"COVID-19 pandemic illustration | Image Credit: James Thew - stock.adobe.com"},{"_key":"a9106b7bb43b","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Eligible patients were diagnosed with epithelial ovarian cancer between January 1, 2017, and June 30, 2021, at Kaiser Permanente Southern California, which serves a racially, ethnically, and socioeconomically diverse population. They were also required to complete chemotherapy and/or surgery as first-line treatment.","_key":"6460b5df387b"}],"_type":"block","style":"normal"},{"_key":"a1c58cae1ea2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"1c9f1d7a9a0f"}],"_type":"block","style":"normal"},{"style":"normal","_key":"367c82d67618","markDefs":[],"children":[{"marks":[],"text":"The researchers designated pre- and post-pandemic periods using March 4, 2020, as the cut-off; this was when California implemented the stay-at-home order. Additionally, they collected data on complete and clinical remission outcomes by manual chart reviews. Complete remission was considered no evidence of disease; clinical remission included both complete remission and partial response, defined as an incomplete or partial response to therapy.","_key":"0b7235781e80","_type":"span"}],"_type":"block"},{"_key":"1dc33447ddcc","markDefs":[],"children":[{"text":"","_key":"14579ad65616","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"_key":"519f027a496f","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Modified Poisson regression was used to evaluate the association between remission and the COVID-19 pandemic. The researchers also assessed effect modification by race and ethnicity.","_key":"036e6d14cd16"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"","_key":"e29079a44ced"}],"_type":"block","style":"normal","_key":"4e85ffbc506b","markDefs":[]},{"_type":"block","style":"normal","_key":"095f66d6a8a6","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The study population consisted of 748 patients with ovarian cancer, 72.7% of whom were diagnosed during the pre-pandemic period and 27.3% during the pandemic. The researchers found that patients diagnosed during the pandemic were slightly younger than those diagnosed in the pre-pandemic period (mean age, 60.9 vs 62.6 years; ","_key":"d90f86403143"},{"_type":"span","marks":["em"],"text":"P ","_key":"6f849d93aecd"},{"_type":"span","marks":[],"text":"= .11).","_key":"51cdfb16f2e0"}]},{"markDefs":[],"children":[{"text":"","_key":"59a6947336b1","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"3a0039ae2438"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"As for race and ethnicity, 46.8% of patients were non-Hispanic White, 33.0% Hispanic, 12.4% Asian/Pacific Islander/other races, and 7.5% non-Hispanic Black patients. In terms of disease stage, as defined by the International Federation of Gynecology and Obstetrics (FIGO), stage III was the most common at diagnosis (39.6%), followed by stage I (27.8%), stage IV (21.5%), and stage II (11.1%). However, no statistically significant differences in race/ethnicity (","_key":"983d8ed5df49"},{"_type":"span","marks":["em"],"text":"P ","_key":"945ac7b3f746"},{"_key":"3953f2258de3","_type":"span","marks":[],"text":"= .09) or FIGO stage ("},{"_type":"span","marks":["em"],"text":"P ","_key":"f85fff790750"},{"_type":"span","marks":[],"text":"= .65) were observed before or during the pandemic.","_key":"4407673361e1"}],"_type":"block","style":"normal","_key":"cb6a22722a8f"},{"_type":"block","style":"normal","_key":"200338e7e98b","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ce5f62fa84b3"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"After initial therapy completion, 87.2% of patients achieved clinical remission, and 75.1% achieved complete remission. Conversely, 12.8% did not respond to treatment. The researchers determined that the proportion of patients achieving complete remission before and during the pandemic was 75.7% and 73.5%, respectively (","_key":"2f65e1a272f4"},{"_type":"span","marks":["em"],"text":"P ","_key":"b8fecee16fa0"},{"marks":[],"text":"= .53).","_key":"e14ea8d82ea0","_type":"span"}],"_type":"block","style":"normal","_key":"dd47ea0f3b15"},{"_key":"c1e4d6a48ea0","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"57b10dca9589"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"The pandemic period was not associated with complete remission in the bivariate (risk ratio [RR], 0.97; 95% CI, 0.88-1.07) or multivariate (adjusted RR, 0.98; 95% CI, 0.90-1.06) models. Similarly, the pandemic period was not associated with clinical remission in either the bivariate (RR, 0.98; 95% CI, 0.92-1.04) or multivariate (adjusted RR, 0.98; 95% CI, 0.92-1.04) models.","_key":"2441edcd3de7"}],"_type":"block","style":"normal","_key":"7b095a0a8d17","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"0f2a2d8cd45b"}],"_type":"block","style":"normal","_key":"5babce5b3aa1"},{"children":[{"marks":[],"text":"However, race and ethnicity modified the association between the pandemic period and complete remission (","_key":"ac3b99afbb2f","_type":"span"},{"_type":"span","marks":["em"],"text":"P ","_key":"8e0e133d7de1"},{"_type":"span","marks":[],"text":"\u003c .01). After adjusting for various factors, non-Hispanic White patients were 13% more likely to achieve complete remission during the pandemic than in the pre-pandemic period (RR, 1.13; 95% CI, 1.00-1.28). In contrast, race/ethnicity did not influence the association between the pandemic and clinical remission (","_key":"c5810d9f40bd"},{"_type":"span","marks":["em"],"text":"P ","_key":"49631294e06e"},{"_type":"span","marks":[],"text":"= .90).","_key":"f89426ecb43a"}],"_type":"block","style":"normal","_key":"aafbbdf1d695","markDefs":[]},{"style":"normal","_key":"e0edfd4c41e5","markDefs":[],"children":[{"marks":[],"text":"","_key":"fc60e997268d","_type":"span"}],"_type":"block"},{"_type":"block","style":"normal","_key":"7494ee9854d2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The researchers acknowledged their study’s limitations, including that the cohort consisted of insured patients within an integrated health care system. Therefore, their findings may not be generalizable to uninsured patients or those within other types of health care systems. Despite its limitations, the researchers expressed confidence in their study.","_key":"9bee276985e3"}]},{"children":[{"_type":"span","marks":[],"text":"","_key":"60678675f63c"}],"_type":"block","style":"normal","_key":"1d414c0296aa","markDefs":[]},{"children":[{"text":"“Comparable rates of complete and clinical remission before and after the onset of the pandemic offer some reassurance that outcomes of patients with ovarian cancer were not negatively impacted during the pandemic in our integrated health care system,” the authors concluded.","_key":"336333341ff3","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"17b596fa1a85","markDefs":[]},{"style":"normal","_key":"c0bde55b3020","markDefs":[],"children":[{"text":"","_key":"061c2069133a","_type":"span","marks":[]}],"_type":"block"},{"_type":"block","style":"normal","_key":"fa0aa2eaa885","markDefs":[],"children":[{"_key":"d8172850561c","_type":"span","marks":["strong"],"text":"References"}]},{"listItem":"number","markDefs":[],"children":[{"marks":[],"text":"Mukherjee A, Ayoub N, Xu L, et al. Clinical remission rates in patients with epithelial ovarian cancer before and after the onset of the COVID 19 pandemic in an integrated healthcare delivery system. ","_key":"b166f5163b61","_type":"span"},{"_type":"span","marks":["em"],"text":"Cancer Manag Res","_key":"e5e345ee8d23"},{"_type":"span","marks":[],"text":". 2025;17:281-291. doi:10.2147/CMAR.S487894","_key":"97a039e381f5"}],"level":1,"_type":"block","style":"normal","_key":"42f35071c27e"},{"level":1,"_type":"block","style":"normal","_key":"0cbca8201fbc","listItem":"number","markDefs":[],"children":[{"_key":"7a706adc2836","_type":"span","marks":[],"text":"Fader AN, Huh WK, Kesterson J, et al. When to operate, hesitate and reintegrate: Society of gynecologic oncology surgical considerations during the COVID-19 pandemic. "},{"text":"Gynecol Oncol","_key":"a567c554fcaa","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":". 2020;158(2):236-243. doi:10.1016/j.ygyno.2020.06.001","_key":"5db5aac653a3"}]}],"authors":[{"displayName":"Brooke McCormick","url":"brooke-mccormick"}],"gptSummary":"The study evaluated the impact of the COVID-19 pandemic on remission rates in patients with epithelial ovarian cancer. Despite challenges such as delayed surgeries and altered treatment protocols, remission rates remained consistent before and after the pandemic. The study involved 748 patients from Kaiser Permanente Southern California, with no significant differences in remission rates observed between pre- and post-pandemic periods. However, race and ethnicity influenced complete remission outcomes, with non-Hispanic White patients showing a higher likelihood of achieving complete remission during the pandemic. The study's findings may not be generalizable to uninsured populations.","contentCategory":{"_type":"contentCategory","name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2","_updatedAt":"2023-09-29T14:32:27Z","_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh"},"_createdAt":"2025-02-19T19:56:12Z","targeting":{"content_placement":["news","topic/clinical","compendium/ovarian-cancer","compendium/covid-19"],"document_url":["ovarian-cancer-remission-rates-remained-stable-before-after-covid-19-pandemic"],"document_group":null,"rootDocumentGroup":[],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"Disease Activity, Safety Remain Following Switch From Infliximab Biosimilar to Originator in IBD","url":{"current":"disease-activity-safety-remain-following-switch-from-infliximab-biosimilar-to-originator-in-ibd","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"Image credit: Chinnapong - stock.adobe.com","asset":{"_ref":"image-c47d1001b06db553ad12b402fa8d787f080c3245-3600x2057-jpg","_type":"reference"}},"published":"2025-02-20T21:24:50.268Z"},{"title":"First Insulin Aspart Biosimilar Receives FDA Approval","url":{"current":"first-insulin-aspart-biosimilar-receives-fda-approval","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"FDA Approved. | Image Credit: Nirusmee - stock.adobe.com ","caption":"Merilog (insulin-aspart-szjj) is the first rapid-acting insulin biosimilar to Novolog (insulin aspart) that is designated to improve glycemic control in adults and adolescents with type 2 diabetes. | Image Credit: Nirusmee - stock.adobe.com ","asset":{"_ref":"image-810623d48ff46e24c0bbbb69ff21d2a810f29e02-6000x4000-jpg","_type":"reference"}},"published":"2025-02-20T20:12:00.000Z"},{"title":"Getting More Doctors to Record a Life-Saving Prostate Cancer Calculation","url":{"current":"getting-more-doctors-to-record-a-life-saving-prostate-cancer-calculation","_type":"slug"},"thumbnail":{"asset":{"_ref":"image-8aceeba5763fb50cb7e3fc6c5a174b0ffc43a652-566x487-jpg","_type":"reference"},"_type":"mainImage","alt":"Alicia Morgans MD, MPH | Image credit: Dana-Farber","caption":"Alicia Morgans MD, MPH | Image credit: Dana-Farber"},"published":"2025-02-20T19:13:01.182Z"},{"title":"Redesigning Inpatient Dermatology to Address Costs, Improve Access","url":{"current":"redesigning-inpatient-dermatology-to-address-costs-improve-access","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"Inpatient dermatology. | Image Credit: Seventyfour - stock.adobe.com ","caption":"The clinical and financial implications of inpatient dermatology were examined, highlighting the need for systemic changes to improve care, reduce costs, and address health equity for patients with skin diseases. | Image Credit: Seventyfour - stock.adobe.com ","asset":{"_ref":"image-9f5ebb7c99d79d5bab3a92b62039a58829d9f6cf-6720x4480-jpg","_type":"reference"}},"published":"2025-02-20T18:09:00.000Z"},{"title":"Older, Sexually Active High School Students More Likely to Receive HIV, STI Testing","url":{"current":"older-sexually-active-high-school-students-more-likely-to-receive-hiv-sti-testing","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"HIV test | Image credit: jarun011 - stock.adobe.com","caption":"HIV test | Image credit: jarun011 - stock.adobe.com","asset":{"_type":"reference","_ref":"image-9e2c4c1275ef08b1562b457c5b6bf5c19b327dcc-3078x2052-jpg"}},"published":"2025-02-20T17:33:00.000Z"},{"title":"Trump Endorses Budget That Would Slash Medicaid Funding","url":{"current":"trump-endorses-budget-that-would-slash-medicaid-funding","_type":"slug"},"thumbnail":{"asset":{"_ref":"image-ed26226475ed09729d58659b4f69dee0505dbd2a-6000x4000-jpg","_type":"reference"},"_type":"mainImage","alt":"Medicaid | Image credit: Tada Images - stock.adobe.com","caption":"Medicaid | Image credit: Tada Images - stock.adobe.com"},"published":"2025-02-20T17:03:27.199Z"}]},{"documentGroupMapping":[{"isShow":true,"parent":{"name":"SAP Partners","_id":"fe99fa76-7982-425c-96bb-30c90951f3b1","isShow":true,"parent":null,"_createdAt":"2020-04-23T14:18:14Z","_rev":"BQFrvRf4X3oJFULv3BebwA","_type":"documentGroup","_updatedAt":"2023-01-16T18:39:02Z","identifier":{"current":"partners","_type":"slug"}},"name":"Highmark","_id":"3837b9b6-f9a9-482c-8bc1-74f8e5fce318","_updatedAt":"2023-03-14T17:50:40Z","thumbnail":{"blank":false,"_type":"mainImage","asset":{"_ref":"image-cbeb880d2c866e65faec50a243150c8c73e4e20c-1046x164-jpg","_type":"reference"}},"identifier":{"current":"highmark","_type":"slug"},"_rev":"dKurSrNM1UXZ9FalzsvkWx","_createdAt":"2020-10-08T14:59:17Z","_type":"documentGroup","description":[{"children":[{"text":"This information is issued on behalf of Highmark Blue Shield and its affiliated Blue companies, which are independent licensees of the Blue Cross Blue Shield Association. 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The study highlights sex-specific differences in left ventricular (LV) remodeling, with women showing more favorable patterns and less myocardial fibrosis. Cardiovascular magnetic resonance (CMR) is emphasized for its potential in guiding early aortic valve replacement (AVR) decisions and sex-based risk stratification. 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","articleType":"News","gptTakeaways":"• Myocardial fibrosis measurement is a useful prognostic tool in severe aortic stenosis for both sexes, with women showing lower LGE levels.\n\n• Women with AS exhibit more favorable LV remodeling patterns and less myocardial fibrosis than men, despite similar ECV%.\n\n• Cardiovascular magnetic resonance (CMR) can guide early AVR decisions and sex-based risk stratification in AS patients.\n\n• Women have superior survival rates compared to men, attributed to cardiovascular complications, with no significant difference in non-cardiovascular mortality.","ExcludeFromPubMedXML":false,"factCheckAuthors":null,"body":[{"_key":"c153a4d6e502","markDefs":[{"href":"https://www.ajmc.com/compendium/cardiovascular","_key":"3a52b528d666","_type":"link"},{"_type":"link","href":"https://jamanetwork.com/journals/jamacardiology/fullarticle/2830473","_key":"23107019bfa2"}],"children":[{"_type":"span","marks":[],"text":"Measuring myocardial fibrosis in male and female patients with more severe forms of ","_key":"141498d167c3"},{"_type":"span","marks":["3a52b528d666"],"text":"aortic stenosis","_key":"1f8aacf3c98f"},{"text":" (AS) was a useful prognostic tool for each sex, according to new study results. Additionally, male and female patients had comparable extracellular volume fraction (ECV%), although women exhibited lower levels of late gadolinium enhancement (LGE). These findings were published in ","_key":"9eee2c40ef62","_type":"span","marks":[]},{"_key":"502297a93217","_type":"span","marks":["em","23107019bfa2"],"text":"JAMA Cardiology"},{"_type":"span","marks":[],"text":" in a new study investigating sex-specific differences in the AS population.","_key":"d8e7c7e75caa"},{"_key":"8c4675627456","_type":"span","marks":["sup"],"text":"1"}],"_type":"block","style":"normal"},{"_type":"figure","_key":"2d6717532a56","widthP":30,"alt":"Aortic Stenosis remains a serious, worldwide cardiovascular complication | image credit: Pumpala - stock.adobe.come","asset":{"_ref":"image-644c2c3c9398827d61ce7a5656960b49d9f8835d-5824x3264-jpg","_type":"reference"},"imgcaption":[{"style":"normal","_key":"1ec803076d1c","markDefs":[],"children":[{"text":"Aortic Stenosis remains a serious, worldwide cardiovascular complication | image credit: Pumpala - stock.adobe.come","_key":"cfc17272f96f","_type":"span","marks":[]}],"_type":"block"}],"disableTextWrap":false,"disableLightBox":true,"alignment":"left"},{"children":[{"_type":"span","marks":[],"text":"AS remains a serious cardiovascular complication that contributes to a great deal of morbidity and mortality around the world. As one’s aortic valve becomes too narrow and blood flow more restricted, left ventricle (LV) hypertrophy develops to maintain heart function; this condition progresses over time and increases individual risk of heart failure, resulting from greater degrees of myocardial fibrosis, myocyte death, and eventually more severe cardiac symptoms.","_key":"f2bb51ac57f2"},{"text":"2-4","_key":"7c87888fe3e9","_type":"span","marks":["sup"]}],"_type":"block","style":"normal","_key":"4895c6dbb9ed","markDefs":[]},{"_type":"block","style":"normal","_key":"8b4aca82c968","markDefs":[],"children":[{"_key":"27c38bbdea43","_type":"span","marks":[],"text":"Prior research has established ECV% and LGE as strong predictors of patient mortality in AS. Expanding on this, the present authors detail the growing interest in the utility of cardiovascular magnetic resonance (CMR) for assessing myocardial fibrosis and LV degeneration in patients with AS. Notably, they see the potential for these CMR evaluations to guide decisions about whether a patient needs an early aortic valve replacement (AVR)."},{"_type":"span","marks":["sup"],"text":"1","_key":"d0812ed0b436"}]},{"style":"normal","_key":"666ad3e6ad70","markDefs":[],"children":[{"marks":[],"text":"Yet, distinguishable characteristics related to individual sex remain poorly documented and defined. Research of this sort is necessary for evaluating the AS population, as the authors point to conflicting studies that suggest one of the sexes develops more myocardial fibrosis—or less—than the other. As such, an international, multicenter study was conducted to analyze these outcomes in a larger cohort of patients with AS who were going through CMR before AVR.","_key":"01d1f301e51c","_type":"span"}],"_type":"block"},{"markDefs":[],"children":[{"_key":"53450efd218d","_type":"span","marks":[],"text":"Patients were included throughout the US, Canada, UK, Belgium, Germany, and South Korea, featuring a total of 822 individuals. The cohort was 41.6 female (n = 342) and 58.4% male (n = 480). Body mass index, age, and severity of AS was similar in both groups, as was the presence of hypertension, diabetes, and atrial fibrillation. Female patients registered higher scores on the Society of Thoracic Surgeons Predicted Risk of Mortality (median of 1.8 vs 1.3; "},{"_key":"f31853ab1915","_type":"span","marks":["em"],"text":"P "},{"_key":"a976811b8f7f","_type":"span","marks":[],"text":"\u003c .001)."}],"_type":"block","style":"normal","_key":"b0bfb7737440"},{"_key":"e6cf57a57185","markDefs":[],"children":[{"_type":"span","marks":[],"text":"There were 670 patients who did not exhibit obstructive coronary artery disease (302 women vs 360 men).","_key":"436495150bd9"}],"_type":"block","style":"normal"},{"_key":"db857ad98056","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The authors pointed out that there was minimal variation when it came to ECV% and LGE between the sexes, but women presented with lower ratios of LV mass index, LV wall thickness, and LV mass volume compared with men. Women also exhibited lesser LV volumes and greater LV ejection fractions than men, but LV stroke volume indices were similar.","_key":"73265ee106c8"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_key":"415739ded2ba","_type":"span","marks":[],"text":"Women also experienced superior overall survival rates vs men (32 deaths [9.4%] vs 71 deaths [14.8%]; "},{"_type":"span","marks":["em"],"text":"P ","_key":"93d2fae94f22"},{"_type":"span","marks":[],"text":"= .02). These instances were attributed to cardiovascular complications; the authors note that survival rates unrelated to cardiovascular mortality did not significantly vary.","_key":"74e4693eeec0"}],"_type":"block","style":"normal","_key":"c3ecc23d6541"},{"_type":"block","style":"normal","_key":"0842812e6441","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Greater ECV% was linked with mortality for both sexes (women: adjusted HR, 1.08 per 1% increase in ECV%; 95% CI, 1.04-1.12; ","_key":"8f45c86e475a"},{"_type":"span","marks":["em"],"text":"P ","_key":"4dd278bc20ef"},{"text":"\u003c .001); men: adjusted HR, 1.01; 95% CI, 0.96-1.06; ","_key":"30ea35392248","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"P ","_key":"8f84bc71887f"},{"_type":"span","marks":[],"text":"= .66; ","_key":"13b690559323"},{"_type":"span","marks":["em"],"text":"P ","_key":"8e1874dd5ffc"},{"_type":"span","marks":[],"text":"by interaction by sex = .09), as was LGE (women: adjusted HR, 2.49 by the presence of LGE; 95% CI, 1.07-5.8; ","_key":"6ef63c99e261"},{"_type":"span","marks":["em"],"text":"P ","_key":"ee04db650f63"},{"_type":"span","marks":[],"text":"= .03; men: adjusted HR, 1.82; 95% CI, 1.0-3.32; ","_key":"c1f582898de9"},{"_type":"span","marks":["em"],"text":"P ","_key":"5e6a4d34bf1e"},{"_type":"span","marks":[],"text":"= .04; ","_key":"a98b1183ae44"},{"_type":"span","marks":["em"],"text":"P ","_key":"dd0313728689"},{"_type":"span","marks":[],"text":"by interaction by sex = .68).","_key":"883ad83a8996"}]},{"style":"normal","_key":"100bde3cfe20","markDefs":[],"children":[{"_type":"span","marks":[],"text":"“Our data highlight important sex differences in LV remodeling in AS and provide a notable advance in our understanding of how the ventricle starts to decompensate in men and women with AS,” the authors concluded. “In particular, we have demonstrated that women have more favorable patterns of remodeling and less replacement myocardial fibrosis than men while having similar degrees of ECV%,” they added, advocating for the potential benefits that CMR can provide for sex-based risk stratification in AS. ","_key":"20608c04181d"}],"_type":"block"},{"children":[{"text":"References","_key":"f9c97e99638c","_type":"span","marks":["strong"]}],"_type":"block","style":"normal","_key":"f080f86acc7c","markDefs":[]},{"_key":"ce76dce00612","markDefs":[],"children":[{"_type":"span","marks":[],"text":"1. Kwak S, Singh A, Everett RJ, et al. Sex-specific association of myocardial fibrosis with mortality in patient with aortic stenosis. ","_key":"7efae9d8514e"},{"_type":"span","marks":["em"],"text":"JAMA Cardiol","_key":"f0af3088fd8d"},{"_type":"span","marks":[],"text":". Published online February 19, 2025. doi:10.1001/jamacardio.2024.5593","_key":"63d6e11689eb"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"94fcb78add51","markDefs":[],"children":[{"_type":"span","marks":[],"text":"2. Coffey S, Roberts-Thomson R, Brown A, et al. Global epidemiology of valvular heart disease. ","_key":"00b569ec9f71"},{"marks":["em"],"text":"Nat Rev Cardiol","_key":"2de58cdbed23","_type":"span"},{"_type":"span","marks":[],"text":". 2021;18(12):853-864. doi:10.1038/s41569-021-00570-z","_key":"6104d0959de5"}]},{"_key":"53a4689960c9","markDefs":[],"children":[{"marks":[],"text":"3. Bing R, Cavalcante JL, Everett RJ, Clavel MA, Newby DE, Dweck MR. Imaging and impact of myocardial fibrosis in aortic stenosis. ","_key":"3e2ee97f64ee","_type":"span"},{"_type":"span","marks":["em"],"text":"JACC Cardiovasc Imaging","_key":"325e7da242bb"},{"_type":"span","marks":[],"text":". 2019;12(2):283-296. doi:10. 1016/j.jcmg.2018.11.026 3.","_key":"e065c86ef934"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"836f399fc68c","markDefs":[],"children":[{"_type":"span","marks":[],"text":"4. Dweck MR, Boon NA, Newby DE. Calcificaortic stenosis: a disease of the valve and the myocardium. ","_key":"56341a605973"},{"_type":"span","marks":["em"],"text":"J Am Coll Cardiol","_key":"7f380eda34f5"},{"_key":"f5a87eb23c56","_type":"span","marks":[],"text":". 2012;60(19):18541863. doi:10.1016/j.jacc.2012.02.093"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"bd3046e12f8e"}],"_type":"block","style":"normal","_key":"5df3b8208ecf"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"1bb90bfa1fdd","_type":"span"}],"_type":"block","style":"normal","_key":"de3e5a23a454"},{"_key":"e337e7398fe8","markDefs":[],"children":[{"marks":[],"text":"","_key":"8ad5f080864a","_type":"span"}],"_type":"block","style":"normal"}],"targeting":{"content_placement":["compendium/cardiovascular","news","compendium/cardiorenalmetabolic","topic/technology","topic/healthcare-delivery"],"document_url":["cardiovascular-magnetic-resonance-highlights-sex-specific-characteristics-in-aortic-stenosis"],"document_group":null,"rootDocumentGroup":[],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"Disease Activity, Safety Remain Following Switch From Infliximab Biosimilar to Originator in IBD","url":{"current":"disease-activity-safety-remain-following-switch-from-infliximab-biosimilar-to-originator-in-ibd","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"Image credit: Chinnapong - 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These findings were published in ","_key":"3666acbc9654","_type":"span"},{"_type":"span","marks":["em","7d525db0d0a3"],"text":"Annals of Nutrition and Metabolism","_key":"48f46da3563c"},{"text":" and demonstrated the need to expand clinical knowledge about the role and financial nuances of FGF21 in the MASH treatment landscape.","_key":"a9a20963015a","_type":"span","marks":[]},{"marks":["sup"],"text":"1","_key":"7e42c0fd13ce","_type":"span"}],"_type":"block","style":"normal","_key":"5d2998a2faa8"},{"_key":"508c3e392705","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Today, MASH remains a complicated disease. For instance, the magnitude of a patient’s fibrosis is a great way to assess their risk for liver-related or all-cause mortality; yet, the mechanisms that influence MASH progressing to fibrosis are not fully understood. Steatosis is thought to be an early precursor here, as it leads to liver inflammation and oxidation, which contributes to necroinflammation and subsequent fibrosis. However, as the present authors outlined, not all patients with steatosis progress to fibrosis. Amid this complexity, emerging research has started exploring the influence of metabolic, immunologic, genetic, cellular, and endocrine pathways on this process.","_key":"6bbb288b1a00"},{"_type":"span","marks":["sup"],"text":"2","_key":"8e317392e790"}],"_type":"block","style":"normal"},{"disableLightBox":true,"_type":"figure","alt":"Fibroblast growth factor 21 | image credit: Juan Gärtner - stock.adobe.com","disableTextWrap":false,"asset":{"_ref":"image-77d1b7d9d71cacfd729dcbfba2df35f2eb49458f-8000x6000-jpg","_type":"reference"},"widthP":30,"imgcaption":[{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Fibroblast growth factor 21 | image credit: Juan Gärtner - stock.adobe.com","_key":"cbee5f4f8af0"}],"_type":"block","style":"normal","_key":"5034ec22f0a6"}],"_key":"0cdf1ab22428","alignment":"right"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Previous studies, the present authors noted, have shown that FGF21 can influence great glucose uptake by promoting lipolysis. Other research in animal models has demonstrated the capacity for FGF21 to counteract hyperglycemia, diet-related obesity, hyperlipidemia, and hepatic steatosis. Considering these emerging findings, the researchers conducted a systematic review and meta-analysis to assess how effective and safe FDF21 is compared with placebos in MASH interventions.","_key":"3f87432bc15d"},{"_type":"span","marks":["sup"],"text":"1","_key":"d249bb2296bf"}],"_type":"block","style":"normal","_key":"4f868078efec"},{"_key":"c82000e5ceff","markDefs":[],"children":[{"marks":[],"text":"","_key":"e5a163848b58","_type":"span"}],"_type":"block","style":"normal"},{"style":"normal","_key":"f612ffae081f","markDefs":[],"children":[{"_key":"9b9d753bd7fe","_type":"span","marks":[],"text":"Using the Cochrane Library, Embase, and PubMed databases, data from randomized control trials (RCTs) were gathered leading up to February 8, 2024."}],"_type":"block"},{"markDefs":[],"children":[{"_key":"b0a1fed096cc","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"3a3ab471ae44"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"In total, 886 patients were included, spanning 7 RCTs. Of these studies, 1 featured pegozafermin (BIO89-100, 89bio), 3 featured pegbelfermin (BMS-986036, Bristol-Myers Squibb), and the remaining 3 featured efruxifermin (AKR-001, Akero Therapeutics).","_key":"a4e2f2018330"}],"_type":"block","style":"normal","_key":"2d2de3dbbff4"},{"children":[{"_type":"span","marks":[],"text":"Fibrosis improvement at or above stage 1, without MASH progression, was achieved by approximately 25% (95% CI, 21%-29%) of those in the FGF21 groups vs 14% in placebo groups (95% CI, 9%-19%). Patients receiving an FGF21 were significantly more likely to achieve this outcome than those receiving placebo (n = 673; risk ratio [RR]: 1.54; 95% CI, 1.07-2.22; ","_key":"20058593a419"},{"marks":["em"],"text":"P","_key":"573ad0c734cb","_type":"span"},{"text":" = .02).","_key":"a53f515f8218","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"10cd242aa53a","markDefs":[]},{"children":[{"_key":"277f45e05771","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"5854cc4543b4","markDefs":[]},{"children":[{"_key":"794a5a34c2b4","_type":"span","marks":[],"text":"MASH resolution rates, without fibrosis progression, were 24% (95% CI, 20%-28%) for patients in the FGF21 groups vs 6% (95% CI, 3%-10%) for those in placebo groups. The treatment groups additionally had a significantly greater chance of achieving MASH resolution while avoiding fibrosis progression compared with placebo groups (n"},{"_type":"span","marks":["em"],"text":" ","_key":"390e7de27670"},{"_key":"1da677a5e384","_type":"span","marks":[],"text":"= 519; RR: 3.31; 95% CI, 1.80-6.06; "},{"_type":"span","marks":["em"],"text":"P","_key":"8a740557a4c9"},{"_type":"span","marks":[],"text":" = .0001).","_key":"effff3b62c7b"}],"_type":"block","style":"normal","_key":"8b3061ed141a","markDefs":[]},{"style":"normal","_key":"3ac2ed76ccb3","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"279bc21c8cd5"}],"_type":"block"},{"markDefs":[],"children":[{"marks":[],"text":"A hepatic fat fraction (HFF) ≥ 30%, which was measured by an MRI-derived proton density fat fraction (MRI-PDFF), was achieved for nearly half of those receiving an FGF21 (49%; 95% CI, 44%-54%) vs 16% (95% CI, 10%-22%) for those receiving a placebo. 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