Tag: nevin manimala

Neurol Res Pract. 2025 Nov 14;7(1):88. doi: 10.1186/s42466-025-00450-8.

ABSTRACT

BACKGROUND: Despite current guidelines recommending against intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) patients with direct oral anticoagulants (DOAC) within prior 48 h, latest real-world data indicate no increased bleeding risk. However, these observations are based mainly on alteplase (rt-PA), whereas data for tenecteplase (TNK) are scarce.

METHODS: We retrospectively compared data from our stroke registry of AIS-patients with DOAC (intake within the last 48 h), who received IVT either with rt-PA or TNK without prior antagonization. The primary outcome was the rate of symptomatic intracranial hemorrhage (sICH) per SITS-Most criteria. Secondary outcomes included the rate of any ICH or major bleeding, rate of mortality, neurological and functional outcome at discharge.

RESULTS: 82 AIS-patients were included, with 42 patients receiving TNK und 40 patients receiving rt-PA. Median age was 83 y for TNK patients and 82 y for rt-PA patients. Median NIHSS score at admission for TNK was 9 points for both groups (p = 0.61). Median drug-specific DOAC plasma level was 49 ng/mL for TNK versus 24 ng/mL for rt-PA (p = 0.04). We found no statistically significant increased risk for neither sICH (TNK 2.4% vs. rt-PA 2.5%; p = 1), nor for other safety outcomes for TNK-treated patients compared with rt-PA. The rate of excellent functional outcome (TNK 61.9% vs. rt-PA 52.5%) was similar among both groups. High drug-specific DOAC plasma levels were not related to an increased rate of hemorrhagic complications in our cohort.

CONCLUSION: We report no increased rate of (s)ICH for TNK based IVT compared with rt-PA in AIS-patients with DOAC, indicating a similar safety profile. Moderate to high drug-specific DOAC levels were no surrogates for hemorrhagic complications, supporting the implementation of specific Standard Operating Procedures for IVT in DOAC-treated patients. Contrary to previous studies, we did not observe an increased rate of early recanalization of LVO in TNK-treated patients in this small single-center cohort.

TRIAL REGISTRATION: n/A.

PMID:41239434 | DOI:10.1186/s42466-025-00450-8

Neurol Res Pract. 2025 Nov 14;7(1):89. doi: 10.1186/s42466-025-00448-2.

ABSTRACT

BACKGROUND AND AIMS: Stroke remains a leading cause of mortality and disability in many low- and middle-income countries, where access to diagnostic and treatment resources is often severely constrained. This pilot study investigated the feasibility of telemedicine-based training to integrate carotid artery ultrasound and Holter monitoring into routine diagnostic practices at the stroke unit of the University Teaching Hospital (UTH) in Lusaka, Zambia.

METHODS: Five neurology residents at the University Teaching Hospital in Zambia, without prior clinical experience in carotid artery ultrasound, received remote online training sessions. Subsequently, they were divided into two groups: the first conducted practical examination sessions under on-site supervision of a stroke neurologist, while the second was remotely supervised via screen sharing by a stroke neurologist from Krankenhaus Nordwest in Frankfurt (KHNW), Germany. Handheld portable ultrasound probes (Butterfly IQ+) were used for the examinations. Following the training, each group of residents performed 50 extracranial ultrasound examinations in acute ischemic stroke patients at the UTH stroke unit. Each examined patient was re-examined in a separate session by an experienced stroke neurologist, who was blinded to the results of the residents’ examination. The agreement between raters in the assessment of carotid stenosis was assessed using Cohen’s kappa (κ), a statistical measure that evaluates interrater reliability for categorical items. Similarly, 26 stroke nurses at UTH were trained in Holter monitoring exclusively through video tutorials, without hands-on practice. They recorded 30 Holter examinations on subsequent acute ischemic stroke patients. The quality of the recordings was subsequently compared to 30 Holter recordings from consecutive patients at the stroke unit of KHNW. A cardiologist, blinded to the origin of the recordings, evaluated their quality on a scale of 1 to 10, and the results were analyzed using Welch’s t-test. All participants completed multiple-choice assessments to evaluate their theoretical knowledge, along with a feedback survey on the training program.

RESULTS: 50 patients underwent bilateral carotid artery ultrasound examination, split evenly between the direct and remotely supervised groups. Both groups achieved a high rate of concordance with an experienced stroke neurologist. The directly supervised group achieved 86% concordance for ICA stenosis and 88% for plaque detection, while the remotely supervised group achieved 80% and 84%, respectively. Holter recordings from UTH demonstrated higher quality than those from the stroke unit at KHNW (p < 0.01). Most participants reported enhanced confidence and knowledge, though over 60% preferred face-to-face training formats.

CONCLUSION: Innovative telemedical training approaches offer a transformative solution for addressing diagnostic and infrastructure challenges in stroke care, particularly in resource-constrained healthcare settings. Comprehensive research is crucial to optimize these programs and enhance medical capabilities across diverse healthcare environments.

PMID:41239430 | DOI:10.1186/s42466-025-00448-2

BMC Med Educ. 2025 Nov 14;25(1):1604. doi: 10.1186/s12909-025-08009-6.

ABSTRACT

BACKGROUND: Physician Assistant/Associate (PA) students are facing increased impairment, adverse academic experiences, and impeded performance. Despite well-documented research demonstrating the multi-factorial wellness needs of many PA students nationally, the unnecessary challenges and continuance of harm persists. Such barriers have influenced student performance, stability, outcomes, and undesirable health events. Further, evidence suggests that student learner wellness is influenced by predisposing and mitigatable factors, which can be addressed proactively at the individual and program level. Early identification of well-being needs, risk factors, and modifiable action steps can enhance student success during the intensive educational journey of the PA student pre-clinical workforce. Therefore, examining, optimizing, and integrating longitudinal wellness practices across curricular design and program operations can have a lasting impact on learners, including as the future healthcare workforce (HCW). This scoping review aims to investigate wellness practices, alignment of their terminologies and implementations for PA students in the United States (U.S.) and evaluate health profession programs’ implications of the future HCW.

METHODS: The authors utilized a Joanna Briggs Institute (JBI) scoping review protocol and logic model to investigate the research query. Literature retrieval was led by the research librarian using keywords, Boolean operators, and database-specific terminology. Using a population, intervention, comparison, outcome, and setting (PICOS) framework and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) tools, studies were vetted through a phased eligibility screening process according to inclusion/exclusion criteria (PA students, wellness practices, occurred within the U.S., original research). Data extraction occurred systematically and involved categorization of terminology (constructs, positive/negative tone), wellness practices, and student impact and outcomes. Findings were mapped to best-fit wellness dimensions using the National Wellness Institute (NWI) competency-based model and to the PA Core Competencies. Thematic and directed content analysis was performed in sequence to determine culminative study results.

RESULTS: A total of 447 studies were retrieved from database searching (n = 439) and handsearching (n = 8). After initial screening and full-text review, 25 studies met inclusion criteria for a total of 9,628 PA student participants. Out of the 25 studies examined, 13/25 (52%) explored the didactic year, 3/25 (12%) examined the clinical year, 7/25 (28%) studied both, and 2/25 (8%) did not specify (Table 1). 28% (n = 7/25) of studies were anchored in evidence-based frameworks. Terminology, wellness practices, and implementation varied across the health professions programs. The ‘construct tone’ across studies used was nearly equivalent when examining positive (50.89%) versus negative (49.11%) terms related to ‘well-being,’ Three of 7 (42.86%) dimensions of wellness were most prevalent (EP, IM, and OA) (Fig. 2), whereas the remaining 4 of 7 (57.14%) dimensions (Ph, Sp, Soc, and OWB) had less representation (Table 2). Wellness practices were siloed or brief in nature as seen in 15/25 studies (60%), such as an isolated module or class session, and none of the studies (n = 0/25) addressed all the dimensions of wellness. Findings related to PA student positive/negative wellness experiences sourced directly from the included studies showed statistical significance (p < 0.0001 to p = 0.05), a predominance of moderate to strong correlations (r = -0.802, r = 0.762), and a range of effect sizes: odds ratios (1.04 to 2.09), Cohen’s d (0.09 to 0.38), and Pearson’s r (0.0 to 0.16).

CONCLUSIONS: Unified terminology, definitions, and implementation of wellness practices are necessary to optimize PA student success as future clinicians practicing medicine. Establishing and fostering practices that promote wellness habits, work-life balance, and modernization of antiquated health professions programs is an investment in the iterative growth toward long-term well-being, resilience, and success.

PMID:41239420 | DOI:10.1186/s12909-025-08009-6

J Health Popul Nutr. 2025 Nov 14;44(1):400. doi: 10.1186/s41043-025-01144-2.

ABSTRACT

BACKGROUND: Sarcopenia is a generalized skeletal muscle disease that significantly affects daily life and increases the risk of falls, fractures, and other related complications. Recent studies have shown that dietary adjustments can effectively prevent and delay the onset of sarcopenia.

METHODS: Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 were used in this investigation. We employed weighted multivariable logistic regression models to investigate the relationship of eight dietary factors with sarcopenia, and further explored these associations using weighted restricted cubic splines (RCS) and subgroup analyses.

RESULTS: A total of 8,221 participants were included in the study, of whom 715 were diagnosed with sarcopenia. In the weighted multivariable logistic regression model (Model 2), after adjusting for confounding factors, a significant negative association was observed between the intake of macronutrients and the incidence of sarcopenia: energy (OR 0.19, 95% CI 0.11-0.34), protein (OR 0.38, 95% CI 0.26-0.55), dietary fiber (OR 0.50, 95% CI 0.34-0.73), carbohydrates (OR 0.57, 95% CI 0.38-0.85), total sugars (OR 0.61, 95% CI 0.42-0.89), total fat (OR 0.60, 95% CI 0.41-0.88), total saturated fatty acids (OR 0.59, 95% CI 0.40-0.88), and total cholesterol (OR 0.51, 95% CI 0.35-0.77). A substantial linear negative link in the occurrence of sarcopenia and these eight dietary factors was found using RCS analysis. Subgroup analyses further confirmed the robustness of the relationship between macronutrients and sarcopenia.

CONCLUSIONS: Increasing the intake of dietary fiber, protein, energy and fat, while appropriately managing carbohydrate and cholesterol intake, may help reduce the risk of sarcopenia.

PMID:41239412 | DOI:10.1186/s41043-025-01144-2

BMC Surg. 2025 Nov 14;25(1):545. doi: 10.1186/s12893-025-03207-x.

ABSTRACT

OBJECTIVES: To compare outcomes of nasogastric (NGT) or nasoenteric tube decompression against no decompression in the non-operative management of adhesional small bowel obstruction (ASBO) using a systematic review and meta-analysis.

METHODS: Database searches up to February 2025 were conducted using Cochrane Library, EMBASE, MEDLINE and SCOPUS. Abstract screening and data extraction were performed by two independent reviewers. Patients aged 18 and above were included. Studies were excluded if they compared NGTs to long tube devices or if the primary aetiology of SBO was not adhesions. Quality appraisal was conducted using the Newcastle Ottawa Scale and meta-analysis was performed using RevMan Web Software.

RESULTS: Searches yielded 1442 studies, of which 4 met the inclusion criteria, comprising a total of 1219 patients undergoing non-operative management for ASBO. These were all retrospective cohort studies. Within these studies, a total of 732 patients had a nasogastric or nasoenteric tube inserted for ASBO while 487 patients were managed without one. NGT use had a non-significant trend toward increased operative intervention, with a pooled odds ratio of 2.58 (95% CI: 0.77 to 8.65; p = 0.09, I² = 82%). Three studies compared bowel resection rates; NGT use was not associated with a statistically significant increased risk of bowel resection (OR 2.31; 95% CI: 0.86-6.16; p = 0.10). All studies reported a longer length of hospital stay in the NGT group.

CONCLUSIONS: The available evidence is sparse, limited in design and quality, and marked by high heterogeneity, making it insufficient to draw a definitive conclusion regarding the role of NGTs in ASBO. High-quality evidence from a randomised controlled trial is needed to guide future practice.

TRIAL REGISTRATION: PROSPERO (CRD: CRD42021256098).

PMID:41239407 | DOI:10.1186/s12893-025-03207-x

BMC Psychol. 2025 Nov 14;13(1):1263. doi: 10.1186/s40359-025-03611-1.

ABSTRACT

BACKGROUND: Previous studies have shown that family relationships are closely related to internet gaming disorder (IGD) in adolescents. There are also neurological mechanisms that correlate spontaneous brain activity with adolescent family relationships and IGD. Therefore, this study explores the mediating role of spontaneous brain activity between family relationships and IGD in adolescents.

METHODS: This study used a cross-sectional design. It recruited 52 IGD adolescents as the IGD group and 51 normal adolescents as the healthy control (HC) group. The study included adolescents aged 12-18 years, with a male-to-female ratio of 45:7 in the IGD group and 41:10 in the HC group. The diagnosis of IGD was established based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria. The Young Internet Addiction Scale (YIAS) was used to assess the severity of internet addiction among adolescents, and the Chinese version of the Family Environment Scale (FES-CV) was used to evaluate family relationships. Resting-state functional MRI was utilized to assess adolescents’ spontaneous brain activity, specifically measuring the mean amplitude of low-frequency fluctuation (mALFF) and functional connectivity (FC). MRI data were collected using a Siemens Magnetom Prisma 3.0T MRI scanner. The specific scan sequence and parameters are as follows: BOLD sequence, repetition time (TR) = 1000 ms, echo time (TE) = 30 ms, flip angle = 70°, slice thickness = 2.2 mm, number of slices = 52, matrix size = 64 × 64, voxel size = 3 mm × 3 mm × 3 mm, scan duration = 360 s. The steps of data preprocessing included data format conversion, exclusion of time points, slice timing correction, head motion correction, spatial normalization, removal of linear drift, regression of covariates, band-pass filtering, and data cleaning. Statistical analysis was conducted using SPSS 22.0. Gaussian random field (GRF) correction was applied in the DPABI toolbox, with voxel-level p < 0.005 and cluster-level p < 0.05 indicating statistical significance. Pearson correlation was employed to analyze the relationships between various scales and between these scales and brain spontaneous activity. Mediation analysis was performed using the SPSS Process program.

RESULTS: (1) Compared to the HC group, the IGD group had significantly higher YIAS scores (t = 21.571, P < 0.05). For the FES-CV scores, the IGD group scored higher in conflict (t = 4.228, P < 0.05) and lower in cohesion (t=-3.768, P < 0.05), with statistically significant differences. (2) Pearson correlation analysis revealed a negative correlation between cohesion in family relationships and middle frontal gyrus (MFG) (r = – 0.443, p < 0.01), a negative correlation between cohesion and internet addiction (r = – 0.474, p < 0.01), and a positive correlation between internet addiction and MFG (r = 0.557, p < 0.01) in the IGD group. The MFG mediated the relationship between family relationships and internet addiction, with a mediation effect value of -0.183 (95% CI=-0.403 ~ -0.037), accounting for 38.77% of the total effect (-0.183/-0.472). (3) In the IGD group, the FC value from the MFG to the right insula was positively correlated with conflict in family relationships (r = 0.349, P < 0.05).

CONCLUSION: Family relationships are related to internet addiction in adolescents, and the MFG mediates this relationship. Additionally, the FC value from the MFG to the right insula in the IGD group is positively correlated with conflict. This suggests that the MFG may serve as a neurobiological marker through which family relationships influence IGD development in adolescents.

PMID:41239403 | DOI:10.1186/s40359-025-03611-1

J Am Acad Orthop Surg Glob Res Rev. 2025 Nov 12;9(11). doi: 10.5435/JAAOSGlobal-D-25-00319. eCollection 2025 Nov 1.

ABSTRACT

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is a common surgery, following which pain control medications are often prescribed. In recent years, efforts have been made to minimize opioids and other nonnarcotic medications as multimodal regimens evolve following such surgeries.

METHODS: Opioid-naïve ACL reconstruction patients were identified from the PearlDiver M165Ortho data set. Those with a history of substance abuse were excluded. Prescriptions of pain management medications were evaluated in the 90 days following surgery per 1000 ACL reconstructions and grouped into the following categories: opioids, benzodiazepines, NSAIDs, serotonin norepinephrine reuptake inhibitor/tricyclic antidepressant/antiepileptic, tramadol, gabapentinoid, and nonbenzodiazepine muscle relaxant.Trends for annual prescriptions and morphine milligram equivalents were defined. Multivariable analysis was performed to determine factors independently associated with narcotic prescriptions.

RESULTS: A total of 101,331 ACL reconstruction patients met study inclusion criteria. In the 90 days following surgery, opioid prescriptions decreased from 402.7 per 1,000 ACL reconstructions in 2010 to 153.5 in 2021 (-61.9%). Prescriptions of other pain management drugs on aggregate decreased from 298.0 in 2010 to 129.8 in 2021 (-56.4%). Among patients who received opioids in the 90 days postoperatively, morphine milligram equivalents prescribed per 1000 ACL reconstructions decreased from 277,941 in 2010 to 39,640 in 2021 (-85.7%).On multivariate analysis, the strongest predictors of postoperative opioid prescriptions were younger age (odds ratio [OR] 1.30 per decade decrease, P < 0.0001), male sex (relative to female, OR 1.39, P < 0.0001), patient comorbidity (per two-point decrease in Elixhauser Comorbidity Index, OR 1.25, P < 0.0001), and region of the country where surgery was performed (relative to west, Northeast OR 1.20, South OR 1.22, Midwest OR 1.41, P = 0.0006, P = 0.0026, P = 0.0002, respectively). Neither having the use of regional nerve blocks nor having multiple concomittent knee procedures affected postoperative opioid prescriptions.

CONCLUSION: Fewer prescriptions of both narcotic and nonnarcotic medications following ACL reconstruction had been written over the years from 2010 to 2021, likely in favor of nonprescription over-the-counter analgesics including NSAIDs and acetaminophen. There may be opportunities to further reduce opioid prescribing following ACL reconstruction, particularly among patients receiving regional nerve blocks or those undergoing isolated ACL reconstruction.

PMID:41237369 | DOI:10.5435/JAAOSGlobal-D-25-00319

JMIR Med Inform. 2025 Nov 14;13:e79307. doi: 10.2196/79307.

ABSTRACT

BACKGROUND: Missing data are a common challenge in electronic health record (EHR)-based prediction modeling. Traditional imputation methods may not suit prediction or machine learning models, and real-world use requires workflows that are implementable for both model development and real-time prediction.

OBJECTIVE: We evaluated methods for handling missing data when using EHR data to build clinical prediction models for patients admitted to the pediatric intensive care unit (PICU).

METHODS: Using EHR data containing missing values from an academic medical center PICU, we generated a synthetic complete dataset. From this, we created 300 datasets with missing data under varying mechanisms and proportions of missingness for the outcomes of (1) successful extubation (binary) and (2) blood pressure (continuous). We assessed strategies to address missing data including simple methods (eg, last observation carried forward [LOCF]), complex methods (eg, random forest multiple imputation), and native support for missing values in outcome prediction models.

RESULTS: Across 886 patients and 1220 intubation events, 18.2% of original data were missing. LOCF had the lowest imputation error, followed by random forest imputation (average mean squared error [MSE] improvement over mean imputation: 0.41 [range: 0.30, 0.50] and 0.33 [0.21, 0.43], respectively). LOCF generally outperformed other imputation methods across outcome metrics and models (mean improvement: 1.28% [range: -0.07%, 7.2%]). Imputation methods showed more performance variability for the binary outcome (balanced accuracy coefficient of variation: 0.042) than the continuous outcome (mean squared error coefficient of variation: 0.001).

CONCLUSIONS: Traditional imputation methods for inferential statistics, such as multiple imputation, may not be optimal for prediction models. The amount of missingness influenced performance more than the missingness mechanism. In datasets with frequent measurements, LOCF and native support for missing values in machine learning models offer reasonable performance for handling missingness at minimal computational cost in predictive analyses.

PMID:41237368 | DOI:10.2196/79307

JMIR Infodemiology. 2025 Nov 14;5:e74317. doi: 10.2196/74317.

ABSTRACT

BACKGROUND: A high prevalence of dry eye disease (DED) has intensified public health concerns in Taiwan. With the growing reliance on online resources for health information, platforms such as Google Trends (GT) provide a valuable method for capturing public interest. This approach also allows for the exploration of potential associations between public interest in DED and environmental parameters, which may further elucidate underlying factors contributing to the disease’s rising prevalence.

OBJECTIVE: This study aims to (1) analyze public interest in DED in Taiwan using GT data, (2) investigate correlations between search interest and environmental parameters, and (3) identify shifts in the focus of search over time.

METHODS: We analyzed GT data from December 2018 to July 2024, focusing on relative search volume (RSV) for DED across Taiwan and its 6 special municipalities. Temporal trends in RSV were assessed using spline regression models, and monthly variations were assessed using the Kruskal-Wallis test. The Spearman correlation analysis was used to evaluate the association between RSV and environmental parameters, while dynamic time warping analysis clarified the temporal alignment of RSV with these parameters. Rising search queries were analyzed to identify shifts in public interest over time. Furthermore, top Google search results for DED-related keywords were assessed for topic coverage, quality, and readability.

RESULTS: A significant rising trend in RSV for DED was observed over the study period in Taiwan (mean instantaneous derivative=0.445; P<.001) and across all 6 special municipalities. Environmental parameters such as methane (CH4), total hydrocarbons, and nonmethane hydrocarbons were identified as novel pollutants strongly correlated with RSV (P<.001), along with known pollutants such as nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), nitrogen oxides (NOx), and carbon monoxide (CO). Dynamic time warping analysis revealed the strongest temporal alignment was between RSV and hydrocarbons, including CH4 and total hydrocarbons, further emphasizing their potential role in influencing public interest. Assessment of web-based DED information of 80 websites revealed generally low quality (DISCERN score: mean 2.14, SD 0.40), and the average readability corresponded to a college reading level (grade: mean 21.1, SD 4.5). Rising search queries shifted from diagnostic and treatment methods before the COVID-19 pandemic to natural remedies during the COVID-19 lockdown and self-diagnosis and treatment options after the pandemic. Gaps were also identified between public interest and the availability of online information.

CONCLUSIONS: Public interest in DED has increased significantly in Taiwan from 2018 to 2024, with hydrocarbons identified as strongly associated environmental parameters. The shifts in related queries reflect changing public interest, accentuating the need for health care information that aligns with public interest and addresses gaps in available resources.

PMID:41237348 | DOI:10.2196/74317

JMIR Cardio. 2025 Nov 14;9:e79239. doi: 10.2196/79239.

ABSTRACT

BACKGROUND: The management of heart failure (HF) requires complex, data-driven decision-making. Although electronic health record (EHR) systems and clinical decision support (CDS) tools can streamline access to essential clinical information, it remains unclear which EHR elements and tools cardiologists and general medicine physicians prioritize when caring for patients with HF.

OBJECTIVE: This study aims to identify these elements and tools to improve the user interface design of future EHR applications.

METHODS: This study used a user-centered design research approach to understand physician workflows and decision-making needs in HF care. A cross-sectional online survey was administered to 302 physicians, comprising 150 cardiologists (including 15 HF specialists) and 152 general medicine physicians. Respondents reported their use of EHR variables (eg, medication lists, laboratory results, diagnostic tests, problem lists, clinical notes) for decision-making in HF care, as well as their time spent in the EHR before, during, and after patient visits along with their use of predictive models and patient-reported outcome questionnaire. Descriptive analyses, χ2 tests, and t tests were conducted to compare groups, with statistical significance set at P<.05.

RESULTS: A total of 302 health care providers participated in the survey, nearly evenly split between cardiologists (49.7%, 150/302) and general medicine physicians (50.3%, 152/302). Both groups consistently relied on medication lists, vital signs, laboratory results, diagnostic tests, problem lists, and clinical notes for HF decision-making. Cardiologists placed greater emphasis on diagnostic tests for inpatient HF care (mean [SD] overall frequency, 4.66 [0.50] vs 4.44 [0.64]; P=.012) and outpatient HF care (mean [SD] overall frequency, 4.67 [0.55] vs 4.35 [0.71], P<.001). In contrast, general medicine physicians relied more on problem lists for inpatient HF care (mean [SD] overall frequency, 4.63 [0.58] vs 4.43 [0.72], P=.034), with no significant difference in the outpatient setting (P>.05). Both groups underutilized standardized questionnaires and predictive models, with only 20.1% (29/144) of cardiologists and 4.5% (6/133) of general medicine physicians using standardized questionnaires (P<.001).

CONCLUSIONS: Both physician groups depend on medication lists, laboratory results, diagnostic tests, and problem lists. Cardiologists prioritize diagnostic tests, whereas general medicine physicians more often use problem lists. Low use of questionnaires and predictive models highlights the need for better integration of these tools. Future EHR design interface should tailor functionalities to accommodate these differing priorities and optimize HF care.

PMID:41237334 | DOI:10.2196/79239