Internal Medicine

‘Personalized’ RCTs are heterogeneous, non-genomic, and often biased

Review of 262 RCTs (2020–2022) found 'personalized', 'individualized', and 'precision' labels applied interchangeably across diverse interventions. Most trials compared personalized versus non-personalized controls and reported favorable conclusions in 70.6% of abstracts. Genetic or omics features were uncommon and transparency was poor, with only 5.0% sharing data and 0.4% sharing code. Overall, 68.6% of trials were judged at high risk of bias, limiting confidence in reported benefits. 1

REDCap-triggered suicide-risk alerts enabled timely clinical outreach in trials

Two trials used REDCap and validated measures to trigger automated alerts when participants met suicide-risk thresholds. In the FAAST trial, 54 of 55 alerts (98.2%) resulted in clinical outreach; in cCBT, 125 of 200 alerts (62.5%) triggered outreach. The approach was feasible and supported including individuals at intermediate/high suicide risk in diverse trials. Implementing similar systems requires defined thresholds, licensed responders, and procedures for unreachable participants. 2

Transitional care modestly improves confidence and reduces HF-specific readmissions

Systematic review of 8 RCTs (967 older adults) found improved self-care confidence with transitional care interventions. Transitional care reduced heart failure–specific readmissions, though effect sizes varied across studies. There were no consistent benefits for self-care maintenance, management, or HF knowledge. Certainty of evidence ranged from very low to moderate, so further high-quality trials are needed before broad policy change. 3