Preventive Medicine

Recent frequent ambulatory visits double odds of harmful diagnostic errors in high-risk admissions

Among 569 high-risk general medicine admissions, 83 harmful diagnostic errors were found (weighted prevalence 9.1%). Having ≥2 ambulatory encounters within 14 days before admission was independently associated with harmful diagnostic errors (adjusted wOR 2.26, 95% CI 1.12–4.56). Other evaluated pre-admission factors were not statistically associated with harmful diagnostic errors in multivariable analysis. Pre-admission ambulatory activity may serve as a practical EHR signal for targeted diagnostic safety surveillance. 1

Trials labeled ‘personalized’ are heterogeneous, poorly transparent, and often biased

A MEDLINE survey of 262 RCTs (2020–2022) found the terms 'personalized', 'individualized', or 'precision' applied interchangeably to diverse, mostly non-genomic interventions. Most trials compared personalized versus non-personalized controls and reported favorable conclusions in 70.6% of abstracts. Transparency was rare (data sharing 5.0%, code sharing 0.4%) and 68.6% of trials were judged high risk of bias. Labeling as personalized does not guarantee methodological rigor; evaluate tailoring methods and bias before changing practice. 2

REDCap automated alerts plus licensed outreach feasible for including higher suicide-risk trial participants

Two trials used REDCap with validated measures to trigger automated alerts when participants crossed suicide-risk thresholds. In the FAAST trial, 55 triggers occurred across 279 participants and 98.2% (54) resulted in clinical outreach by licensed providers. In the cCBT trial, 200 triggers across 69 participants generated outreach in 125 (62.5%) instances. This approach appears feasible to monitor risk and enable inclusion of intermediate/high-risk individuals while prioritizing safety. 3