Evaluating clinical guidelines for chronic disease management: Do they enable the personalization of care?

Objective: To described how general practitioners (GPs) personalize interventions for patients with chronic diseases and compare practice with the corresponding guidelines.

Study Design: Scoping review followed by a multicentre cross-sectional study in French general practices.

Methods: We identified elements of personalization described in guidelines related to diabetes, hypertension, dyslipidaemia, insomnia and depression.

High lifetime prevalence of regular nitrous oxide use in French medical students.

Although nitrous oxide (N₂O) is increasingly misused recreationally, its use and risks among medical students who have professional access to it are rarely explored. To investigate the recreational use of N₂O among medical students in Paris Region (France). This cross-sectional study used an online questionnaire distributed in 2022 through social networks, to all medical students (undergraduate student from the 2nd year of medical studies to residents until the end of the residency) from the six medical universities in Paris Region.

Identifying psychosocial and contextual markers considered by physicians to personalize care.

Background: The objective of the study was to identify the psychosocial and contextual markers considered by physicians to personalize care.

Methods: An online questionnaire with one open-ended question, asking physicians to describe clinical situations in which they personalized care, was used. Physicians were recruited from March 31, 2023, to August 10, 2023, from three hospitals, five university departments of general practice and six physician organizations in France.

Discordances in patients' and physicians' perspectives on which contextual factors should be accounted for during smoking cessation.

Background: Smoking cessation interventions requires attending to the circumstances and needs of individual patients. We aimed at highlighting the discordances between patients' and physicians' perspectives on contextual factors that should be considered during smoking cessation.

Methods: We identified 36 contextual factors identified that should be considered during smoking cessation using PubMed and interviewing general practitioners.

A methodological framework allows the identification of personomic markers to consider when designing personalized interventions.

Objectives: To develop a methodological framework to identify and prioritize personomic markers (e.g., psychosocial situation, beliefs…) to consider for personalizing interventions and to test in smoking cessation interventions.

Sustainable development in general practice.

Background: As health care accounts for 4-5% of global carbon emissions, many health organisations have called for implementing sustainable development actions in health care. However, sustainable development measures in general practice are rarely implemented by physicians. The aim of this study was to explore the practices of general practitioners (GPs) in terms of sustainable development to identify which actions are appropriate and achievable.

A classification of methods used to personalize participative interventions revealed inadequate reporting in trial protocols.

Objectives: The objective of the study was to develop a classification of methods used to personalize participative interventions in randomized controlled trials (RCTs).

Study Design And Setting: We conducted a systematic review including protocols of RCTs assessing participative interventions in PubMed and ClinicalTrials.gov between June 2018 and May 2019.

Impact of integrating objective structured clinical examination into academic student assessment: Large-scale experience in a French medical school.

Purpose: Objective structured clinical examinations (OSCE) evaluate clinical reasoning, communication skills, and interpersonal behavior during medical education. In France, clinical training has long relied on bedside clinical practice in academic hospitals. The need for a simulated teaching environment has recently emerged, due to the increasing number of students admitted to medical schools, and the necessity of objectively evaluating practical skills.

Diagnostic Agreement Between Telemedicine on Social Networks and Teledermatology Centers.

Purpose: With increasing delays in obtaining a dermatological consultation, general practitioners (GPs) are using social networks for telemedicine to obtain advice on dermatological images. The objective was to analyze diagnostic agreement between telemedicine on social networks (Twitter and MedPics) and standard teledermatology services (TDS).

Methods: This retrospective observational study included images published on Twitter and MedPics by GPs in 2016.

Comparison of mammography results from individual and organized screening for breast cancer.

Background: In France, the coexistence of individual screening (IS) and organized screening (OS) for breast cancer induces difficulties for primary care practitioners to position themselves. This study assessed whether the risk of having a mammography with a high risk of malignancy (BI-RADS 4 or 5) was different between patients aged from 50 to 74year performing it as part of an IS or of the OS.

Method: This cross-sectional multicenter study included women aged 50-74, with no personal history of breast cancer, performing mammography in radiology centers in Paris (France).

Patient-Physician Agreement in Reporting and Prioritizing Existing Chronic Conditions.

Purpose: In this study, we aimed to assess (1) the agreement between patient self-reports and general practitioner (GP) reports of the chronic conditions affecting the patients and (2) the agreement between patients and GPs on health priorities in a primary care setting.

Method: Patients were recruited in the Parisian area of France by a convenience sample of GPs; eligibility criteria required that the GP was the patient's listed primary care provider for at least 12 months. Participants were asked to report all the patient's current chronic conditions by using a previously developed list of 124 chronic conditions and write a list of up to 3 priority conditions.

Accuracy of clinical breast examination's abnormalities for breast cancer screening: cross-sectional study.

Objectives: The guidelines for breast cancer screening with clinical breast examination (CBE) are diverging CBE is recommended in France, whereas it is not recommended in the United States and Canada, given the lack of clear benefit and the risk of overmedication. To assess the accuracy of abnormalities found during CBE for in breast cancer screening.

Study Design: A cross-sectional study included women over 18 years with no history of breast cancer coming for a mammography at 3 ambulatory radiology practices in Paris.

Sleep Disturbance and Total Sleep Time in Persons Living with HIV: A Cross-Sectional Study.

Short and long sleep durations have been associated with inflammation and chronic diseases. To study the association between sleep duration/quality and HIV disease severity, a cross-sectional study was conducted in patients living with HIV (PLWHs) using self-administered questionnaires assessing total sleep time, insomnia (ICSD-3 criteria), and poor sleep quality (PSQI > 5). Multivariable logistic regression identified the factors associated with sleep disorders and with HIV features.

Bacterial resistance in urinary tract infections in patients with diabetes matched with patients without diabetes.

Background: With bacterial resistances having increased, patients with diabetes who are at higher risk of urinary tract infection (UTI) need to be studied. The study aim was to compare bacterial resistances to ofloxacin, cefixim, co-trimoxazole, nitrofurantoin and fosfomycin in UTI between patients with and without diabetes.

Methods: A cross-sectional study was conducted in ambulatory laboratories, including patients over 18 coming for urinalyses.