Tag: nevin manimala

Otolaryngol Head Neck Surg. 2026 Jun 17. doi: 10.1002/ohn.70313. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether contemporary large language models can match clinician performance in evaluating the urgency of emergency otolaryngology referrals.

STUDY DESIGN: Blinded cross-sectional diagnostic reasoning study.

SETTING: Simulated emergency referral environment modeled on tertiary care otolaryngology practice.

METHODS: Thirty emergency referral scenarios spanning the spectrum of otolaryngologic urgency were independently evaluated by 4 large language models (GPT-5, GPT-4, DeepSeek, and Grok) and 4 clinicians (otolaryngology attending and resident, emergency attending and resident). Outputs were anonymized and scored by 10 blinded otolaryngologists for appropriateness of urgency and quality of explanation using a three-point scale. Statistical analyses included nonparametric group comparisons, adjusted ordinary least squares modeling with case-level control, and correlation of each entity’s case profile with that of the otolaryngology attending.

RESULTS: Inter-rater reliability was excellent. The otolaryngology attending achieved the highest overall performance. GPT-5 demonstrated comparable mean performance, with no statistically significant difference in either domain. GPT-4 scored modestly lower but received higher mean ratings than both emergency clinicians. DeepSeek and the otolaryngology resident demonstrated intermediate performance, while Grok and the emergency clinicians performed lowest. Group-level analyses showed no significant difference between the large language model and otolaryngology cohorts; both were rated higher than emergency clinicians in this sample.

CONCLUSION: GPT-5 demonstrated triage performance comparable to the otolaryngology attending in this controlled sample. Large language models may support emergency decision-making and education when specialist consultation is limited, but require supervision, transparency, and local calibration.

PMID:42307998 | DOI:10.1002/ohn.70313

Otolaryngol Head Neck Surg. 2026 Jun 17. doi: 10.1002/ohn.70304. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether COVID-19 is a risk factor for developing airway stenosis in intubated patients.

STUDY DESIGN: Retrospective case-control study with planned chart review.

SETTING: Temple University Health Systems hospitals in Philadelphia, PA.

METHODS: Chart review of patients 18 to 90 years old diagnosed with COVID-19 who underwent endotracheal intubation and had a post-extubation CT scan at our institution between February 2020 and December 2022 was performed. Patients without COVID-19 matched for age, sex, and BMI who were intubated within one year served as a control group. Outcome variables included endoscopic and radiographic evidence of airway stenosis. Descriptive statistics were analyzed using Chi-squared and unpaired two-tailed T-test analyses for cohort comparison.

RESULTS: One hundred five COVID-positive and 101 COVID-negative met inclusion criteria. The mean age was 58.6 years. Mean endotracheal tube size was 8.05 for COVID-positive and 7.72 for COVID-negative patients (P = .0075). Twenty-six (24.76%) COVID-positive and 45 (44.55%) COVID-negative patients had COPD (P = .0016). Length of intubation was 8.8 days in COVID-positive patients and 3.5 days for COVID-negative patients (P < .0001). Thirty-five (33.98%) COVID-positive and 1 (0.99%) COVID-negative patient were ventilated while prone (P = .0002). Seventy-eight (75%) COVID-positive and 38 (41.76%) COVID-negative patients received intravenous steroids (P = .0001). Mean length of stay was 38.81 days for COVID-positive and 17.16 days for COVID-negative patients (P < .0004). Six (5.77%) COVID-positive and 2 (1.3%) COVID-negative patients developed airway stenosis (P = .202).

CONCLUSION: Patients with COVID-19 infection were not at an increased risk for intubation-related airway stenosis.

LEVEL OF EVIDENCE: IV.

PMID:42307991 | DOI:10.1002/ohn.70304

J Prim Care Community Health. 2026 Jan-Dec;17:21501319261462668. doi: 10.1177/21501319261462668. Epub 2026 Jun 17.

ABSTRACT

BackgroundDespite substantial global progress in HIV prevention and treatment, mother-to-child transmission (MTCT) of HIV remains a major public health challenge in sub-Saharan Africa, which accounts for approximately 65% of the world’s 39.9 million people living with HIV. Vertical transmission rates vary substantially across regions and over time. We conducted a systematic review and meta-analysis to estimate the overall, temporal, regional, and country level prevalence of HIV MTCT in sub-Saharan Africa.MethodsThis research was conducted between June 2024 and May 2025, in accordance with PRISMA guidelines and a protocol registered in PROSPERO (CRD42025637989). We systematically searched six databases (MEDLINE, Embase, PubMed, ScienceDirect, Web of Science, and the Cochrane Library) for articles published in English or French. We included cross-sectional, cohort, and case-control studies involving HIV-positive pregnant women aged ≥18 years that reported MTCT prevalence. Two reviewers independently screened, extracted data, and assessed study quality (Joanna Briggs Institute and Newcastle-Ottawa Scale). Pooled prevalence and 95% CI were calculated using a random-effects model in STATA 17. Heterogeneity (I²), subgroup analyses (by period, region, country), sensitivity analysis, and funnel plots for publication bias were performed.ResultsFrom 5,848 records, 48 studies (86,376 mothers; 2,875,104 infants) across 15 countries were included. The pooled MTCT prevalence was 7.0% (95% CI 5.2-9.4%; I² = 99.1%). Temporal trends showed a decline from 26.0% (1993-2000) to 8.0% (2001-2010) and 5.0% (2011-2023). Regionally, West Africa had the highest prevalence (12.1%; 95% CI 6.5-21.6%), Southern Africa had the lowest (4.7%; 95% CI 2.6-8.1%). Approximately 9% of HIV-exposed infants were infected by 24-48 months, 6% were infected by 24 months after enrolment, and 7% tested positive at their first HIV test conducted between 1 and 12 weeks of age.ConclusionAlthough MTCT rates have declined, the current 7.0% remains above the WHO target (<5%) with noted significant regional and national disparities. However, this rate should be interpreted cautiously due to the extremely high heterogeneity (I² = 99.1%) knowing it’s a directional synthesis of available evidence rather than a precise population-level figure.

PMID:42307974 | DOI:10.1177/21501319261462668

Pharmacogenet Genomics. 2026 Jun 18. doi: 10.1097/FPC.0000000000000609. Online ahead of print.

ABSTRACT

Major depressive disorder (MDD) is a multifactorial psychiatric disorder increasingly associated with immune-inflammatory mechanisms. Pro-inflammatory cytokines, particularly tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β), have been implicated in the pathophysiology of MDD through their influence on neuroinflammation, neurotransmitter regulation, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction. This systematic review aimed to evaluate the association between TNF-α and IL-1β gene polymorphisms and susceptibility to MDD, treatment response, and related clinical outcomes. A systematic literature search was conducted in PubMed, Embase, and ScienceDirect databases from inception to March 2026, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies investigating TNF-α and IL-1β gene polymorphisms in clinically diagnosed MDD patients were included. Case-control studies published in English involving adult human participants were considered eligible. Data regarding study design, population, polymorphisms, and clinical outcomes were extracted and qualitatively synthesized. A total of 172 records were identified, of which nine studies met the inclusion criteria. Included studies primarily investigated TNF-α rs1800629 and IL-1β rs16944 polymorphisms across diverse populations. Several studies reported significant associations between these polymorphisms and increased susceptibility to MDD, suicide risk, severity of depressive symptoms, age of onset, and antidepressant treatment response. However, some studies reported no statistically significant associations, indicating heterogeneity across ethnic groups and study populations. Variability in age, medication status, and environmental stressors may have contributed to inconsistent findings. The findings of this systematic review support the involvement of inflammatory cytokine gene polymorphisms in the pathophysiology of MDD, particularly TNF-α and IL-1β variants. These polymorphisms may contribute to depression susceptibility and treatment response through immune-inflammatory mechanisms. Further large-scale, ethnically diverse studies incorporating gene-environment interactions and next-generation sequencing approaches are needed to validate cytokine-related genetic biomarkers in MDD.

PMID:42307972 | DOI:10.1097/FPC.0000000000000609

Dent Med Probl. 2026 Jun 17. doi: 10.17219/dmp/213852. Online ahead of print.

ABSTRACT

BACKGROUND: Dental biofilms, primarily driven by Streptococcus mutans, are the main etiological agents of caries and restorative failure.

OBJECTIVES: The aim of the study was to design and synthesize a novel polystyrene (PS)-based nanocomposite reinforced with hydroxyapatite (HAp), zirconia (ZrO2) and silver nanoparticles (AgNPs).

MATERIAL AND METHODS: Hydroxyapatite, ZrO2 and AgNPs were synthesized via wet precipitation, sol-gel and citrate reduction methods, respectively. The nanoparticles (5 wt% total loading) were uniformly dispersed in a toluene-based PS matrix using ultrasonic-assisted solution casting. The resulting films were characterized in terms of morphology (scanning electron microscopy (SEM), transmission electron microscopy (TEM), atomic force microscopy (AFM)), composition (energy-dispersive X-ray spectroscopy (EDX)), thermal stability (thermogravimetric analysis (TGA)), mechanical properties (tensile strength, Young’s modulus, Vickers hardness), surface wettability (water contact angle (WCA)), antibacterial efficacy (zone of inhibition (ZOI), minimum inhibitory concentration/minimum bactericidal concentration (MIC/MBC), colony-forming unit (CFU) assay), and antibiofilm activity (crystal violet staining, confocal laser scanning microscopy (CLSM)). Statistical analysis was performed using one-way analysis of variance (ANOVA) and Tukey’s honestly significant difference (HSD) test (p < 0.05).

RESULTS: The nanocomposite exhibited a 30% increase in tensile strength (32.5 MPa vs. 25 MPa for pure PS) and a 25% rise in elastic modulus (1.5 GPa vs. 1.2 GPa). The water contact angle increased from 85° ±2° (pure PS) to 115° ±3° (nanocomposite), confirming significantly enhanced hydrophobicity. The composite demonstrated strong antibacterial activity, with a ZOI of 15.3 mm, MIC of 6.25 mg/mL, MBC of 12.5 mg/mL, and 99.8% bacterial reduction within 24 h. Antibiofilm performance was also notable, showing a 91.2% reduction in biofilm biomass after 72 h and 74.8% decrease in biofilm thickness (from 32.5 μm to 8.2 μm). Confocal laser scanning microscopy revealed a marked shift in the live/dead cell ratio (from 4.7:1 to 0.6:1), confirming bactericidal rather than bacteriostatic action. All nanoparticles were homogeneously distributed without agglomeration, as confirmed by SEM/EDX and TEM.

CONCLUSIONS: The HAp-ZrO2-AgNP-reinforced PS nanocomposite integrates enhanced mechanical properties, self-cleaning surface characteristics, and potent, long-lasting antibiofilm activity against S. mutans. While further biocompatibility and clinical translation studies are warranted, this material represents a significant leap toward durable, infection-resistant dental applications.

PMID:42307960 | DOI:10.17219/dmp/213852

JAMA Netw Open. 2026 Jun 1;9(6):e2618199. doi: 10.1001/jamanetworkopen.2026.18199.

ABSTRACT

IMPORTANCE: Violent injuries are the leading cause of death among children and young adults in the United States. Violent injury may increase the risk of subsequent injury (ie, violent reinjury), but it is unclear how this risk varies across different injury types (eg, blunt assault, stabbing, firearm).

OBJECTIVE: To describe patterns of violent reinjury across different injury types to inform tailored prevention strategies.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter cohort study included patients who presented with violent injuries to 2 adult and 2 pediatric level I trauma centers in St Louis, Missouri, from January 2016 to December 2023.

EXPOSURES: Violent injuries were classified into 3 injury types: blunt assault, stabbing, and firearm.

MAIN OUTCOMES AND MEASURES: The main outcome was time to recurrent violent injury in years. We used Kaplan-Meier time-to-event analyses to estimate the probability of violent reinjury across different initial (index) and recurrent injury types at 1, 5, and 7 years from index injury.

RESULTS: There were 29 810 individuals with violent injuries during the study period. The age distribution was as follows: 17 228 (57.8%) older than 26 years; 7690 (25.8%), 18 to 26 years; and 4727 (15.8%) younger than 18 years. Most were male (19 933 [66.9%]), and there were 21 126 (70.9%) Black and 7031 (23.6%) White individuals, with 792 (2.7%) belonging to an additional racial group (American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, other, or multiracial), having unknown race, or declining to disclose race. Among 29 038 patients (97.4%) who survived their index injury, 3899 (13.4%) experienced reinjury. The 7-year probability of any reinjury was highest among individuals with index stabbing (19.5% [95% CI, 17.5%-21.8%]) and blunt assault (17.4% [95% CI, 16.6%-18.2%]) injuries. Patients with index blunt assault injuries were more likely to experience blunt assault reinjury (7-year probability: 13.2% [95% CI, 12.6%-13.8%]) compared with other reinjury types. The 7-year probability of firearm reinjury was highest among those with index firearm injuries (12.6% [95% CI, 11.8%-13.4%]).

CONCLUSIONS AND RELEVANCE: In this cohort study of individuals with violent injuries, reinjury was common, but this risk varied across injury types, which may be due to differing contextual factors. Preventing violent reinjury requires attention to these issues to better address the root causes of repeated violence exposure.

PMID:42307949 | DOI:10.1001/jamanetworkopen.2026.18199

JAMA Netw Open. 2026 Jun 1;9(6):e2618581. doi: 10.1001/jamanetworkopen.2026.18581.

ABSTRACT

IMPORTANCE: Antigenically drifted influenza A(H3N2) J.2.4.1 (subclade K) viruses predominated during the 2025-2026 Northern Hemisphere influenza season.

OBJECTIVE: To describe influenza activity and burden, characterize subclade K, evaluate susceptibility to influenza antivirals and postinfluenza vaccination antibodies, and estimate vaccine effectiveness.

DESIGN, SETTING, AND PARTICIPANTS: This surveillance study used multiple data sources, including (1) national surveillance of influenza-positive respiratory specimens collected by approximately 300 clinical laboratories and 100 public health laboratories from October 1, 2025, through March 14, 2026, a subset of which were further characterized; (2) serologic data of people who received 2025-2026 influenza vaccines; (3) influenza admissions data from the Influenza Hospitalization Surveillance Network (ie, 10% of US population) and the associated estimates of US burden; and (4) test-negative, case-control vaccine effectiveness estimates from the Virtual SARS-CoV-2, Influenza, and Other Respiratory Viruses Network.

EXPOSURES: Influenza infection, hospitalization, and vaccination.

MAIN OUTCOMES AND MEASURES: Outcomes included influenza virus type, subtype, and clade; antiviral susceptibility; immunogenicity; influenza-associated outpatient and emergency department visits, hospitalizations, and mortality; estimated influenza illnesses, hospitalizations, and death; and estimated vaccine effectiveness.

RESULTS: As of March 14, 2026, of the 55 318 influenza-positive respiratory specimens tested by public health laboratories, most (50 291 specimens [90.9%]) were influenza A, of which 40 779 (81.1%) were subtyped and 35 801 (87.8%) were A(H3N2). Of the 1754 characterized A(H3N2) viruses, most (1626 specimens [92.7%]) were subclade K. Postinfluenza vaccination neutralizing geometric mean antibody titers against subclade K were reduced 1.62 (95% CI, 1.29-2.02)-fold compared with the vaccine virus. All 1729 tested A(H3N2) viruses were sensitive to antivirals. Of the 27 881 recorded influenza hospitalizations, 15 426 (54.7%) were among female patients, and 15 051 (54.0%) were among patients aged 65 years or older. The estimated cumulative influenza-associated hospitalization rate was 80.0 per 100 000 which would correlate with estimates of between 28 000 000 to 49 000 000 illnesses, 360 000 to 740 000 hospitalizations, and 22 000 to 74 000 deaths in the US during the 2025-2026 season. Adjusted interim vaccine effectiveness estimates against influenza-associated emergency department or urgent care encounters and hospitalizations were 35% (95% CI, 33%-38%) and 27% (95% CI, 21%-34%), respectively.

CONCLUSIONS AND RELEVANCE: This surveillance study found that while antigenically drifted viruses predominated and caused substantial morbidity and mortality, influenza vaccines were associated with a reduced risk of influenza among those who were vaccinated, and recommended antivirals remained effective.

PMID:42307948 | DOI:10.1001/jamanetworkopen.2026.18581

JAMA Netw Open. 2026 Jun 1;9(6):e2618883. doi: 10.1001/jamanetworkopen.2026.18883.

ABSTRACT

IMPORTANCE: Gestational environmental chemical exposures are widespread. Some chemicals are known to adversely affect birth outcomes, but many remain understudied.

OBJECTIVE: To evaluate associations of gestational exposure to a priori identified chemicals in 10 classes with birth outcomes in a large, diverse US cohort.

DESIGN, SETTING, AND PARTICIPANTS: In the prospective Environmental influences on Child Health Outcomes Cohort study, 5318 mother-child pairs were enrolled from January 1, 2000, to December 31, 2021, with data on gestational urinary chemical concentrations, gestational age at birth, and birth weight. Statistical analysis was performed from January 2024 to February 2026.

EXPOSURES: In single, midgestation (median, 25 weeks [IQR, 21-30 weeks]) urine samples, concentrations of 113 analytes (chemicals or their metabolites) from 10 chemical classes were simultaneously measured: fungicides and herbicides (n = 11), insecticides (n = 20), halogenated phenols (n = 5), organophosphate esters (n = 10), benzophenones (n = 6), bisphenols (n = 14), parabens (n = 6), antimicrobials (n = 2), phthalates or alternative plasticizers (n = 32), and polycyclic aromatic hydrocarbons (PAHs) (n = 7).

MAIN OUTCOMES AND MEASURES: Linear mixed-effects regression models with a random effect for site were used to estimate covariate-adjusted differences in gestational age at birth (days) and birth weight-for-gestational age (BW-GA) z scores per IQR increase in urinary analyte concentrations. In secondary analyses, odds ratios (ORs) for preterm birth and small for gestational age (SGA) were estimated.

RESULTS: In the sample of 5318 mother-child pairs, most infants (2667 female [50%]; median gestational age at birth, 39.0 weeks [IQR, 38.0-40.0 weeks]) were born to college-educated (67% [3218 of 4785]), parous (56% [2815 of 5007]) mothers (median age at delivery, 30.7 years [IQR, 26.1-34.3 years]). A total of 43 of 113 analytes (38%) were detected in 50% or more of samples. Multiple phthalates or alternative plasticizers were associated with younger gestational age at birth or lower BW-GA z scores; for example, summed diisononyl phthalate metabolites were associated with a 0.6-day (95% CI, -1.0 to -0.1 days) younger gestational age (preterm birth OR, 1.16 [95% CI, 1.01-1.34]), and summed phthalate or alternative plasticizers were associated with a 0.06 (95% CI, -0.11 to -0.02) lower BW-GA z score (SGA OR, 1.09 [95% CI, 0.93-1.27]). Two halogenated phenols, benzophenone 8, bisphenol F, and several PAHs were associated with lower BW-GA z scores; for example, 1- and 9-hydroxphenanthrene were associated with a 0.04 (95% CI, -0.08 to -0.01) lower BW-GA z score (SGA OR, 1.13 [95% CI, 1.01-1.27]).

CONCLUSIONS AND RELEVANCE: This large cohort study of diverse US pregnancies found widespread exposure to 10 classes of environmental chemicals, many of which were associated with differences in gestational age at birth or lower BW-GA z scores. These findings indicate that reducing gestational exposure to chemicals, particularly phthalates or alternative plasticizers and PAHs, could promote healthy deliveries and better child outcomes.

PMID:42307947 | DOI:10.1001/jamanetworkopen.2026.18883

JAMA Netw Open. 2026 Jun 1;9(6):e2619054. doi: 10.1001/jamanetworkopen.2026.19054.

ABSTRACT

IMPORTANCE: With increasing abortion restrictions, more people self-manage their abortions with medications. Little is known about geographic and demographic characteristics of those self-managing abortions in the US, particularly after the Dobbs v Jackson Women’s Health Organization decision.

OBJECTIVE: To describe requests for self-managed medication abortion support in the US through Mexico-based accompaniment collectives.

DESIGN, SETTING, AND PARTICIPANTS: This is a cross-sectional study of records from 2023 from 2 Mexico-based accompaniment collectives. Participants were people in the US requesting support from Mexico-based accompaniment collectives to self-manage an abortion.

EXPOSURES: State abortion policy context (complete abortion bans, 6-week and/or embryonic cardiac activity bans, 12- to 15-week bans, and abortion available past 15 weeks), sociodemographic characteristics (poverty, insurance status, and Spanish language), and driving distance from the nearest abortion facility.

MAIN OUTCOMES AND MEASURES: The primary outcomes were the sociodemographic characteristics of those requesting support from accompaniment collectives and the rate of requests to these collectives by zip code tabulation areas (ZCTAs). Demographic characteristics, pregnancy characteristics, and state policy context were described. Differences in request characteristics by state-level abortion policy category were tested using χ2 tests. Also, rates of requests per 100 000 female individuals aged 15 to 49 years within categories of ZCTA-level characteristics were estimated.

RESULTS: A total of 2850 requests were analyzed, with 700 requests (24.6%) from people aged 20 to 24 years, 995 (34.9%) from people aged 25 to 34 years, and 192 (6.7%) from people younger than 20 years. Pregnancy duration was 6 weeks or less for 1441 requests (50.6%), 7 to 9 weeks for 677 requests (23.8%), and 12 weeks or more for 160 requests (5.6%). In total, 2363 requests (82.9%) were from states with complete abortion bans. Requests with pregnancies at 12 weeks or more ranged from 98 (4.2%) in complete-ban states to 36 requests (14.8%) in states where abortion was available past 15 weeks (P < .001). Spanish was spoken with accompaniers by 65 requesters (38.0%) in states where abortion was available past 15 weeks and by 282 requesters (13.2%) in complete-ban states (P < .001). The mean ZCTA-level request rate was 2.44 (95% CI, 1.81-3.08) per 100 000 female individuals aged 15 to 49 years and increased with ZCTA-level poverty (from 0.35 [95% CI, 0.23-0.53] to 1.63 [95% CI, 1.14-2.34] requests per 100 000 female individuals aged 15 to 49 years) and Spanish-speaking population share (from 0.25 [95% CI, 0.12-0.54] to 1.56 [95% CI, 1.03-2.39] requests per 100 000 female individuals aged 15 to 49 years). ZCTAs more than 8 hours from an abortion facility in complete ban states had the highest request rate (7.85 [95% CI, 4.53-13.61] requests per 100 000 female individuals aged 15 to 49 years).

CONCLUSIONS AND RELEVANCE: In this cross-sectional study of accompaniment network records, requests for Mexico-based accompaniment support were highest in states with abortion bans and in communities with elevated poverty, uninsurance, and Spanish-speaking populations, underscoring the role of accompaniment collectives in serving communities facing the greatest structural barriers to facility-based abortion care.

PMID:42307945 | DOI:10.1001/jamanetworkopen.2026.19054

JAMA Netw Open. 2026 Jun 1;9(6):e2619285. doi: 10.1001/jamanetworkopen.2026.19285.

ABSTRACT

IMPORTANCE: Validating polygenic risk scores (PRSs) as a breast cancer (BC) risk stratification tool in high-risk clinical settings is essential for potential clinical implementation.

OBJECTIVE: To evaluate the performance of African-ancestry PRSs for overall BC and triple-negative BC (TNBC) in an independent African American cohort at elevated familial risk.

DESIGN, SETTING, AND PARTICIPANTS: This case-control study was conducted among women with self-reported African ancestry in a clinical hereditary cancer genetic testing setting who had negative results for pathogenic or likely pathogenic variants in known BC-associated genes between 2016 to 2024. Analyses were performed from September 2025 to April 2026.

EXPOSURE: Six African-ancestry PRSs and a European-ancestry PRS (PRS-313).

MAIN OUTCOMES AND MEASURES: Performance of the PRSs was measured with covariate-adjusted area under the receiver operating characteristic curve (AUC) and adjusted odds ratio (OR) per 1 SD from logistic regression adjusting for age, top 10 genetic principal components, and family history.

RESULTS: This study included 31 522 women (mean [SD] age, 47.1 [13.3] years): 12 067 women with BC (2311 with TNBC) and 19 455 women unaffected by BC. Women unaffected by BC were younger at testing than women with BC at diagnosis (mean [SD] age, 42.1 [11.7] years vs 55.2 [11.8] years) and were more likely to report a first- and second-degree family history of BC than women with BC (14 524 women [74.7%] vs 6483 women [53.7%]). For overall BC, PRS-313 showed an AUC of 0.567 (95% CI, 0.560-0.574) and an OR of 1.28 (95% CI, 1.25-1.31) per 1 SD of individuals unaffected by BC. In comparison, the African overall BC models 1 (2 324 063-variant model) and 2 (175 173-variant model) performed better, with AUCs of 0.588 (95% CI, 0.580-0.595) and 0.584 (95% CI, 0.576-0.591) and ORs of 1.39 (95% CI, 1.35-1.43) and 1.37 (95% CI, 1.34-1.41) per 1 SD of individuals unaffected by BC, respectively. Importantly, for TNBC, one 162-variant PRS consistently outperformed all other models, with an AUC of 0.609 (95% CI, 0.596-0.622) and an OR of 1.47 (95% CI, 1.40-1.55) per 1 SD of individuals unaffected by BC.

CONCLUSIONS AND RELEVANCE: In this clinically ascertained case-control study of self-reported Black or African American women, the PRSs demonstrated good performance among women with a strong family history of BC, reflecting populations in whom early PRS testing is most relevant. The high accuracy of the 162-variant TNBC PRS supported its potential as a cost-effective risk assessment tool to promote equitable care.

PMID:42307944 | DOI:10.1001/jamanetworkopen.2026.19285