Internal Medicine

GIM admissions rose and imaging use increased without consistent rises in measured complexity

Across 687,512 general internal medicine hospitalizations in 21 Ontario hospitals, admissions rose 17% from 2015–2016 to 2021–2022. Use of CT increased from 49% to 61% and MRI from 11% to 14%, with adjusted rate ratios ~1.45 and 1.46 respectively. Other patient characteristics and short-term outcomes did not show consistent increases over the study period. The COVID‑19 period (Apr 2020–Jun 2022) was associated with higher length of stay, mortality, laboratory use, and costs, suggesting episodic resource intensity. 1

LLM-enabled CDS in Kenyan primary care was safe but did not reduce 14‑day treatment failures

In a pragmatic cluster RCT of 9,691 primary‑care visits, LLM assistance yielded treatment failure in 102/4,693 (2.2%) versus 94/4,654 (2.0%). Adjusted odds ratio for the composite 14‑day treatment failure was 0.77 (95% CI 0.55–1.08; P=0.13), not statistically significant. No serious adverse events were attributed to the intervention, and independent review found no safety signal. Any clinical benefit, if present, is likely modest and not proven in this trial setting. 2

US cancer trial reports rarely include rurality or socioeconomic measures

Systematic review of 441 US randomized cancer trials (2020–2025) found age and sex nearly universally reported. Race or ethnicity appeared in most reports (82.8% reported >1 category), increasing from 62.3% in 2020 to 93.9% in 2025. No trials reported rurality, income, or area deprivation; only 2 reported education and 1 reported insurance. Lack of geographic and socioeconomic data limits assessment of trial generalizability to diverse populations. 3