Kaiser Permanente

Predicting Self-Harm Events After Emergency Department Visits Associated With Mental or Substance Use Disorder Diagnoses

OBJECTIVE: Using a machine learning model, the authors aimed to predict self-harm events within 90 days of an emergency department (ED) visit associated with a mental or substance use disorder diagnosis. METHODS: Electronic health record and claims data of patients ages ≥11 years...

Health Care Use Among Recently Enrolled Young Adults in an Integrated Health Plan

INTRODUCTION: Early establishment of a primary care practitioner (PCP) may enhance young adults' ability to navigate the health care system, particularly those new to integrated care. METHODS: The study population included 18- to 26-year-old individuals newly enrolled in 2023 at...

Modifiable risk factors, tenofovir use and incident chronic kidney disease among people with HIV and people without HIV

The association of modifiable risk factors with incident chronic kidney disease (CKD) among persons with HIV (PWH) and without HIV (PWoH), including alcohol use disorder, diabetes, dyslipidemia, hypertension, smoking, and potentially tenofovir (alafenamide compared with disoproxi...

Patient Characteristics and Outcomes Associated With Home‐Based Cardiac Rehabilitation

Background Referrals to and participation in cardiac rehabilitation programs remain suboptimal. We examined factors associated with home‐based cardiac rehabilitation (HBCR) referral and participation and associations of referral and participation with outcomes. Methods In this re...

Continuous Glucose Monitoring and Long-Term Glycemic and Kidney Outcomes

Importance Real-time continuous glucose monitoring (rtCGM) improves short-term glycemic control in diabetes. However, scant evidence exists regarding rtCGM’s longer-term benefits for glycemia or kidney health. Objective To evaluate whether rtCGM initiation and sustained use is as...

Development of insulin resistance in women over the menopause transition

BACKGROUND. Body weight and insulin resistance in women increase in midlife. It is not known whether this is driven by the menopause transition or solely by chronological aging. We aimed to determine the role of the menopause transition and menopause-related BMI changes in the de...

Identifying incident medication‐related osteonecrosis of the jaw and antiresorptive drug holidays using natural language processing on clinical notes in men and women prescribed bisphosphonates or denosumab for fracture prevention

OBJECTIVE: Medication-related osteonecrosis of the jaw (MRONJ) is a rare complication of antiresorptive therapy for osteoporosis, with risk potentially influenced by "drug holidays" around dentoalveolar procedures. MRONJ risk is higher in rheumatic diseases. Epidemiologic studies...

Evaluating the Reliability, Accuracy, and Readability of ChatGPT-3.5 and GPT-4 in Providing Patient Education Related to Glenohumeral Joint Osteoarthritis.

OBJECTIVES: Chatbots have been increasingly recognized as modern tools that provide patients with reliable health-related information. This study aimed to evaluate and compare ChatGPT-3.5 and GPT-4's ability to answer glenohumeral osteoarthritis-related questions. METHODS: Fiftee...

Trends in annual medication possession in older adults with type 2 diabetes

BACKGROUND: Older adults (≥65 years) make up a substantial portion of individuals with type 2 diabetes (T2D) and frequently experience multimorbidity requiring complex, costly medication regimens. Cost-related nonadherence is prevalent in this population because of fixed incomes,...

Clinical Practice Guideline for the Diagnosis and Treatment of Urinary Tract Infection in Children From 8 Days to 5 Years of Age

Urinary tract infection (UTI) is one of the most common bacterial infections in infants and young children, with a prevalence of 7% in infants with fever. This clinical practice guideline (CPG) provides an update of the literature and clinical recommendations of the 2011 American...

Brain Penetrant Calcium Channel Blockers Were Not Associated With Reduced Alcohol Consumption: Converging Results From Two Large Independent Cohort Studies Using Electronic Health Records

ABSTRACT Purpose Alcohol use disorder (AUD) remains a major public health problem, with few effective treatments. L‐type calcium channel blockers (LTCCBs) have genetic and preclinical support as potential treatments for AUD. Methods We evaluated whether brain penetrant (BP)‐LTCCB...

Impact of Visit Modality on Utilization and Outcomes in Primary Care: Initial Assessments of Low Back Pain

INTRODUCTION: Little is known about how the modality of an initial primary care visit affects downstream health care utilization and resource use. Low back pain is an ideal condition to examine this question given its high prevalence and well-characterized natural history. This s...

Rosacea in Patients with Skin of Color: Diagnosis and Management

Rosacea is a chronic central face dermatosis caused by a combination of dysregulated innate and adaptive immunity and hyperreactive cutaneous neurovasculature. Although classically associated with lighter skin phototypes, rosacea may affect up to 2–4% of Black, Asian, Pacific Isl...

Bivalent RSVpreF Effectiveness Against Respiratory Syncytial Virus (RSV)-Related Respiratory Disease Hospitalization and Emergency Department Visits Across Three RSV Seasons

Respiratory syncytial virus (RSV) protein subunit vaccines reduce the risk of severe outcomes such as hospitalization and emergency department (ED) visits for at least two RSV seasons following vaccination. No data have been published on real-world RSV vaccine effectiveness (VE)...

2025 AHA/ACC blood pressure guideline and HEARTS 2.0: implications for the future evolution of integrated cardiovascular–kidney–metabolic care in the Americas

ABSTRACT Hypertension is the leading modifiable risk factor for cardiovascular disease. In 2025, two major evidence-based frameworks evolved in parallel: HEARTS 2.0, an implementation-oriented clinical pathway for integrated cardiovascular–kidney–metabolic (CKM) care through prim...

Menopausal hormone therapy and primary liver cancer: long-term follow-up of the women’s health initiative randomized trials

Abstract Background: Long-term results on liver cancer incidence and mortality are reported from two Women’s Health Initiative randomized trials evaluating menopausal hormone therapy. Methods: 16,608 postmenopausal women with a uterus were randomized to conjugated equine estrogen...

Can Artificial Intelligence Deliver in Real-World Health Systems? Early Insights From Augmented Intelligence in Medicine and Healthcare Initiative’s 5 Funded Projects

INTRODUCTION: Artificial intelligence (AI) holds tremendous promise to improve clinical decision-making across diagnosis, risk assessment, and patient care. However, most prior work has focused on model development in controlled settings with limited evidence on real-world implem...

A multi-site benchmarking framework for scalable extraction of geriatric care constructs from electronic health records

Current Natural Language Processing (NLP) algorithms for detecting geriatric conditions are largely limited to domain-specific models that fail to capture the interdependent, multidimensional nature of comprehensive geriatric assessment. This study aimed to develop and evaluate a...

High-grade astrocytoma with piloid features: a clinical and genomic analysis of prognostic factors using a large cohort

BACKGROUND: High-grade astrocytoma with piloid features (HGAP) is a recently defined tumor type that is not well-understood. Prognostic factors of clinical outcomes are not well-established. METHODS: Methylation profiling was performed on tumor samples, many at the National Cance...

Natural Language Processing to Improve Vertebral Fracture Identification in Older Adults Receiving Osteoporosis Therapy

INTRODUCTION: Vertebral fracture identification using administrative codes is challenging because diagnoses often occur outside hospital and orthopedic care settings. Outpatient diagnoses improve capture but increase misclassification. Accurate methods are important for populatio...