Tag: United States

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Effects of Patient Portal Message Framing on Treatment Preferences and Expectations for Degenerative Meniscus Tears: Randomized Exploratory Cross-Sectional Survey Study

<strong>Background:</strong> Degenerative meniscus tears are common in middle-aged and older adults, and current guidelines favor nonoperative care. As patients increasingly turn to portal systems to view imaging results and communicate with their physicians, patient-facing wording may shape downstream treatment preferences and expectations. <strong>Objective:</strong> This study aimed to determine whether subtle differences in physician message framing about an identical degenerative meniscus tear influence preferred management, expectations for improvement with conservative therapy, and satisfaction when a physician recommends a different plan. <strong>Methods:</strong> A cross-sectional 37-question survey was developed de novo and distributed in January 2026 to lay adults in the United States (≥18 years) recruited via Amazon Mechanical Turk. Respondents were presented with a standardized vignette of an adult aged 60 years with knee pain due to a degenerative meniscus tear. Participants were randomized in a 1:1:1 fashion into 3 physician portal message framing groups: neutral, degenerative, and damage. Outcomes were the preferred next step in treatment, expected improvement with physical therapy, and retained satisfaction under physician-respondent disagreement. Chi-square and Fisher exact tests were used to compare categorical variables. Multivariable logistic regression analyses were used to assess associations between framing groups. <strong>Results:</strong> Of the 266 completed responses, 195 (73.3%) were included for analysis (neutral: n=67, 34.4%; degenerative: n=63, 32.3%; damage: n=65, 33.3%). Treatment preferences differed significantly across groups (<i>χ</i><sup>2</sup><sub>2</sub>=6.1; <i>P</i>=.047), and the damage group was significantly more likely to prefer aggressive interventions (odds ratio 2.43, 95% CI 1.17-5.06; <i>P</i>=.02). Expectations for physical therapy success differed significantly (<i>χ</i><sup>2</sup><sub>4</sub>=12.3; <i>P</i>=.02), with the damage group being most pessimistic about conservative care. Retained satisfaction under physician-respondent disagreement did not differ by framing group (<i>χ</i><sup>2</sup><sub>6</sub>=6.7; <i>P</i>=.35) but did differ significantly by initial treatment preference (<i>P</i>=.03) and was the lowest among respondents preferring steroid injection. <strong>Conclusions:</strong> In this exploratory investigation, subtle differences in physician portal message framing regarding a magnetic resonance imaging impression of a degenerative meniscus tear were associated with shifts in treatment preferences and confidence in conservative care. These findings suggest that brief physician portal communications may be associated with shifts in hypothetical patient expectations and treatment preferences before clinical counseling occurs. <strong>Trial Registration:</strong>
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STAT+: In the battle of sepsis algorithms, performance alone doesn’t predict victory

Five years ago, the bottom fell out of sepsis prediction software. Hundreds of hospitals had adopted an algorithm from electronic health record company Epic that promised to alert physicians to predicted cases of sepsis, a life-threatening reaction to infection that kills more than 350,000 people in the United States every year. 

The AI was a technical flop. Despite its results on paper, the technology failed to perform in the real world, and sent so many alerts that doctors tuned them out or hospitals turned them off. 

Half a decade on, new sepsis models are hitting the scene. Epic released a retooled version of its own algorithm. Startups are testing their models in health systems. A team uses large language models to mine clinical notes for signs of sepsis. And on Tuesday, a sepsis flagging device from Bayesian Health, with origins at Johns Hopkins, announced it has received clearance from the Food and Drug Administration.

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Opinion: STAT+: Pharma and biotech leaders are destroying their own industry

In early 2025, biotech experienced a “DeepSeek moment” when biotech and pharma leaders alike realized how quickly China was gaining ground with innovation, speed of drug development, and share of licensing deals. In 2020, global pharmaceutical companies spent about $9 billion on licensed drug assets from China. In 2025, that number shot to more than $137 billion. The first two months of 2026 alone accounted for nearly $50 billion in deals. As a December 2025 report from the National Security Commission on Emerging Biotechnology put it, “in just three years, China’s biopharmaceutical industry rose from near irrelevance to dominance.”

China’s rise is happening with the blessing of U.S. pharmaceutical executives, who are allowing their own industry to be destroyed.

I am a co-chair of a working group at the Council on Foreign Relations investigating the U.S.’s generic pharmaceutical dependence on China. An estimated 60% of our generic medications have an active ingredient that originates in China; some estimates have this figure as high as 80-90%. (The exact percentage is unknown because the Food and Drug Administration doesn’t formally track this information, and because a significant percentage of our drugs are imported from India, which in turn imports chemical precursors from China.)

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STAT+: Colombia wins a key court ruling over a compulsory license issued for an HIV medicine

A South American court upheld the steps taken by the Colombian government when it issued a compulsory license two years ago for an HIV medicine, a move that confirmed the legal framework for using such an approach in the future.

The Court of Justice of the Andean Community — a tribunal that settles trade, intellectual property, and labor disputes for Bolivia, Colombia, Ecuador, and Peru — also ruled that the Colombian government had properly justified the reasons for issuing a license and appropriately set an expiration date for its license.

“The court concluded that Colombia did not incur a breach of Andean regulations, since such measures are valid when there are reasons of public interest,” the health ministry said in a statement. “Colombia adequately complied with the obligation to determine the duration of the compulsory license” for the medicine, which is sold by ViiV Healthcare.

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Factors Predicting Poor Outcomes in Hypertrophic Cardiomyopathy Uncovered

Five factors predicting death or serious complications in hypertrophic cardiomyopathy, a heart condition where the heart muscle becomes abnormally thick, have been uncovered in a study led by the University of Virginia.

“Hypertrophic cardiomyopathy, with a prevalence of one in 500 in the U.S., is the most frequent cause of sudden cardiac death in young individuals,” explain lead author Christopher Kramer, MD, a researcher at University of Virginia Health, in JAMA.

“Although some patients remain asymptomatic, others develop effort intolerance, exertional angina, progressive heart failure, atrial and ventricular arrhythmias, and sudden cardiac death.”

There is some disagreement about how best to predict risk in patients diagnosed with this condition, which is inherited in 60% of cases, with different factors used for assessment in different places and current guidelines focusing on sudden cardiac death risk and not other serious adverse events such as the risk for heart failure.

This study enrolled 2,698 hypertrophic cardiomyopathy patients from 44 sites across North America and Europe between 2014 and 2017 and followed them for an average of 6.9 years. The participants underwent wide ranging tests on enrollment including cardiac magnetic resonance imaging with core laboratory analysis, genetic testing of 36 cardiomyopathy genes, blood biomarker analysis, and detailed clinical assessments. Patients with pre-existing implantable cardioverter defibrillators, often prescribed to patients with this condition to avert sudden cardiac death, were excluded.

Patients were reviewed once a year by telephone, with an average follow-up time of around seven years. Records were reviewed if events occurred during the study.

Overall, 117 events—death, nonfatal sustained ventricular arrhythmias requiring cardioversion or defibrillation, left ventricular assist device implant or heart transplant—occurred in 104 participants during the follow up period.

Five factors were significant predictors of a poor outcome. These included the extent of scarring on the heart measured by imaging, heart muscle size, and heart chamber size with all three predicting worse outcomes with greater measures. The other two factors were history of heart failure and higher levels of a blood protein marker of heart stress, NT-proBNP.

“Current risk prediction guidelines for hypertrophic cardiomyopathy are imperfect, as they predict only sudden cardiac death, and not heart failure or other fatal and nonfatal cardiac adverse events,” said Kramer in a press statement. “This study is a major advance in that it provides evidence that incorporating these additional assessment methods better predicts risk of adverse outcomes.”

The team plan to continue this work and to develop a risk score as well as to seek external validation from independent databases and researchers using similar measures of risk.

The post Factors Predicting Poor Outcomes in Hypertrophic Cardiomyopathy Uncovered appeared first on Inside Precision Medicine.

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STAT+: Medicare’s miss on Alzheimer’s drug spending

This is the online version of STAT’s weekly email newsletter Health Care Inc. Sign up here.

Did you know the U.S. Mint requires gold coins to be made with American-made gold, but instead it gets illegally mined gold that can be traced back to a Colombian drug cartel? Truly mind-blowing stuff from this New York Times investigation. Let me know what the health care angle is on that one: bob.herman@statnews.com.

It’s tough to make predictions, especially about the future

Two years ago, my old pal Rachel Cohrs Zhang and I reported how Medicare’s actuaries predicted the new Alzheimer’s drug Leqembi would cost the program $3.5 billion in 2025. It turns out that prediction was way off.

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Three things in AI to watch, according to a Nobel-winning economist

This story originally appeared in The Algorithm, our weekly newsletter on AI. To get stories like this in your inbox first, sign up here.

A few months before he was awarded the Nobel Prize in economics in 2024, Daron Acemoglu published a paper that earned him few fans in Silicon Valley. Contrary to what Big Tech CEOs had been promising—an overhaul of all white-collar work—Acemoglu estimated that AI would give only a small boost to US productivity and would not obviate the need for human work. It’s okay at automating certain tasks, he wrote, but some jobs will be perfectly fine.

Two years later, Acemoglu’s measured take has not caught on. Chatter about an AI jobs apocalypse pops up everywhere from Senator Bernie Sanders’s rallies to conversations I overhear in line at the grocery store. Some previously skeptical economists have gotten more open to the idea that something seismic could be coming with AI. A California gubernatorial candidate said last week that he wants to tax corporate AI use and pay victims of “AI-driven layoffs.” 

On the one hand, the data is still on Acemoglu’s side; studies repeatedly find that AI is not affecting employment rates or layoffs. But the technology has advanced quite a bit since his cautious predictions. I spoke with him to understand if any of the latest developments in AI have changed his thesis, and to find out what does worry him these days if not imminent AGI.

AI agents

One of the biggest technical leaps in AI since Acemoglu’s paper has been agentic AI, or tools that can go beyond chatbots and operate on their own to complete the goal you give them. Because they can work independently rather than just answering questions, companies are increasingly pitching agents as a one-to-many replacement for human workers.

“I think that’s just a losing proposition,” Acemoglu says. He thinks agents are better thought of as tools to augment particular pieces of someone’s work than something malleable enough to handle a person’s whole job.

One reason has to do with all the various tasks that go into a job, something Acemoglu has been researching in his work on AI since 2018. For example, an x-ray technician juggles 30 different tasks, from taking down patient histories to organizing archives of mammogram images. A worker can naturally switch between formats, databases, and working styles to do this, Acemoglu says, but how many individual tools or protocols would an AI require to do the same?

Whether or not agents will supercharge AI’s impact on jobs will come down to whether they can eventually handle the orchestration between tasks that humans do naturally. AI companies are in heated competition to prove that their AI agents can work independently for ever longer periods without making mistakes, sometimes exaggerating the results—but Acemoglu says many jobs will be spared from an AI takeover if agents can’t fluidly switch between tasks.

The new hiring spree

For years Big Tech has been offering staggering salaries to recruit AI researchers. But I asked Acemoglu about a different hiring spree I’ve noticed: AI companies are all building in-house economics teams.

OpenAI hired Ronnie Chatterji from Duke University in 2024 to be its chief economist and announced last year that Chatterji will work with Jason Furman—Harvard economist and former advisor to Barack Obama—to research AI and jobs. Anthropic has convened a group of 10 leading economists to do similar work. And just last week, Google DeepMind announced it had hired Alex Imas, an economist from the University of Chicago, to be its “director of AGI economics.”

Acemoglu has noticed colleagues getting snatched up for these roles too. “It makes sense,” he says: AI companies are well aware that public skepticism about AI, in large part due to job concerns, is growing. And they have strong incentives to shape the economic narrative around their technology (consider OpenAI’s latest proposal for a new era of industrial policy).

“What I hope we won’t get,” Acemoglu says, “is that they’re interested in economists just to further their viewpoints or further the hype.” That tension hangs over the emerging field of “AI economics”; it’s concerning that some of the most influential research about AI’s impact on work may increasingly come from the companies with the most to gain from favorable conclusions.

AI apps

I don’t think of AI as hard to use; most of us interact with it via chatbots that use plain language. But Acemoglu says we should consider how it compares with the sort of software that kicked off earlier tech transformations, like PowerPoint for slide decks and Word for documents. 

“Anybody could install these on their computer and get them to do the things that they want them to do,” he says. They spread accordingly. 

“We have not seen the development of apps based on AI that have the same usability,” he says. Even if anyone can chat with an AI model, it tends to take a while for the average worker to get practical and productive use out of it. That’s part of the reason why AI has not yet shown any seismic impact on the job market or the economy. One of the key signals Acemoglu is watching, then, is the creation of apps that make AI easier to use. 

But he acknowledges that for a while, we’re going to see all sorts of conflicting evidence about AI: anecdotes that college grads are finding the job market worse and worse, but no noticeable effect of AI on productivity, for example. “There’s a huge amount of uncertainty,” he says. And that’s the most telling thing about the AI economy right now: the certainty of the rhetoric alongside the uncertainty of everything else.

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No FDA permission, no problem: New flavored vape policy worries experts

The tobacco industry chalked up another win on Friday with a new policy announced by the Food and Drug Administration that gives what one expert called a “get-out-of-jail-free card” to some manufacturers illegally selling e-cigarettes and nicotine pouches.

The FDA has a significant backlog of applications from the makers of vapes and nicotine pouches seeking authorization to sell their products. Some have gone ahead and put their products on sale anyway while awaiting word from the agency. In the new guidance, first reported by the New York Times, the agency said it will not prioritize cracking down on illegal sales under two conditions.

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Endometriosis May Increase Risk of Birth Defects

Women with endometriosis have a small but significant increased risk for having babies with birth defects, such as those affecting the heart, gastric, genital, or musculoskeletal system, compared with women without the condition.

As reported in the Canadian Medical Association Journal, 6.3% of infants born to women with endometriosis included in the study had a congenital anomaly, compared with 5.4% of infants born to those without the condition.

Notably, only around 11% of the increased risk could be attributed to fertility treatment meaning that the condition itself is likely responsible for the small increase in risk. It suggests that endometriosis itself, likely through inflammatory pathways, oxidative stress, or epigenetic mechanisms, may directly disrupt fetal organogenesis.

Endometriosis is a chronic condition where tissue similar to the uterine lining grows outside the uterus, causing severe pelvic pain, painful periods, and often infertility. It affects an estimated 6.5 million women in the U.S., though many go undiagnosed for years.

“Endometriosis can trigger inflammation and oxidative stress, which have been linked to abnormal organogenesis in offspring. This disruption in organogenesis can lead to functional or structural anomalies that occur in utero, which typically develop in the first trimester of gestation,” write lead author Bailey Milne, Queen’s University, Kingston, Ontario, and colleagues.

“Some studies have reported an increased risk of genital defects among infants born to women with endometriosis; however, data are lacking on the risk of other congenital anomalies.”

To investigate this further, Milne and team conducted a large population-based cohort study using Ontario health administrative data, examining over 1.46 million births between 2006 and 2021. The aim was to quantify the risk of congenital anomalies in infants born to women with a pre-existing diagnosis of endometriosis.

Overall, 33,619 (2.3%) women included in the study had endometriosis. Women with endometriosis had a 16% increase in risk for having a baby with a congenital birth defect compared with women without the condition and 89% of this risk could be attributed to the presence of endometriosis and not possible confounding factors like fertility treatment. The most common associated defects were cleft palate, male genitourinary malformations, and cardiovascular abnormalities.

“Although this study contributes to accumulating data on a potential increased risk of birth defects for infants born to patients with endometriosis, the specific mechanistic pathways remain largely unknown,” write Milne and coauthors.

“A theorized mechanism by which endometriosis might increase risk of any congenital anomaly is through inflammatory pathways. The existing literature suggests a need for more comprehensive models that integrate genetic, epigenetic, and environmental factors to better understand this.”

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