Large language models encode clinical knowledge.

Large language models (LLMs) have demonstrated impressive capabilities, but the bar for clinical applications is high. Attempts to assess the clinical knowledge of models typically rely on automated evaluations based on limited benchmarks. Here, to address these limitations, we present MultiMedQA, a benchmark combining six existing medical question answering datasets spanning professional medicine, research and consumer queries and a new dataset of medical questions searched online, HealthSearchQA.

Cardiologists' Perspectives on BiDil and the Use of Race in Drug Prescribing.

Objectives: We explored cardiologists' attitudes and prescribing patterns specific to the use of generic isosorbide dinitrate and hydralazine hydrochloride, and the fixed-dose patented drug, BiDil.

Background: Since the Food and Drug Administration approved BiDil in 2005 with an indication for self-identified black patients, disagreement about the appropriateness of race-based drugs has intensified and led to calls for providers and researchers to abandon race-based delimitations. This paper reports empirical evidence of cardiologists' views on BiDil's race-based indication and their ongoing inertia with respect to the debate about BiDil.

Performance on Electronic Clinical Quality Measures in the Comprehensive Primary Care Initiative.

Electronic clinical quality measures (eCQMs) that capture data from electronic health records promise accurate and timely measurement, but their use has been limited in payment. The Comprehensive Primary Care initiative sponsored by the Centers for Medicare & Medicaid Services used eCQMs as part of a shared savings incentive. To assess performance, the authors developed benchmarks for 11 measures and compared performance of initiative and benchmark practices.

Behavioral Health and the Comprehensive Primary Care (CPC) Initiative: findings from the 2014 CPC behavioral health survey.

Background: Incorporating behavioral health care into patient centered medical homes is critical for improving patient health and care quality while reducing costs. Despite documented effectiveness of behavioral health integration (BHI) in primary care settings, implementation is limited outside of large health systems. We conducted a survey of BHI in primary care practices participating in the Comprehensive Primary Care (CPC) initiative, a four-year multi-payer initiative of the Centers for Medicare and Medicaid Services (CMS).

Uses and Limitations of Claims-based Performance Feedback Reports: Lessons From the Comprehensive Primary Care Initiative.

Background: Performance feedback is central to data-driven models of quality improvement, but the use of claims-based data for feedback has received little attention.

Purpose: To examine the challenges, uses, and limitations of quarterly Medicare claims-based performance feedback reports generated for practices participating in the Comprehensive Primary Care (CPC) initiative from 2012 to 2015.

Methods: Mixed methods study of nearly 500 CPC practices in seven regions, combining pilot testing; systematic monitoring; surveys; in-depth interviews; user feedback; and input from data feedback team.

Should the Affordable Care Act's preventive services coverage provision be used to widely disseminate whole genome sequencing to Americans?

I argue that the provision of the Patient Protection and Affordable Care Act (ACA) of 2010, which eliminates cost sharing for preventive services, should be utilized as a pathway for reimbursing whole genome sequencing (WGS) and making it widely available to most Americans. This act provides multiple routes for determining which preventive services receive this designation. Three of these routes should be considered as pathways for reimbursing WGS, including approval by the United States Preventive Services Task Force, inclusion in the guidelines of the American Academy of Pediatrics Bright Futures Project, and classification as a preventive service for women by the Institute of Medicine.

Toward better Alzheimer's research information sources for the public.

The National Plan to Address Alzheimer's Disease calls for a new relationship between researchers and members of the public. This relationship is one that provides research information to patients and allows patients to provide ideas to researchers. One way to describe it is a "bidirectional translational relationship.

A call to action for antimicrobial stewardship in the emergency department: approaches and strategies.

Antimicrobial resistance is a mounting public health concern. Emergency departments (EDs) represent a particularly important setting for addressing inappropriate antimicrobial prescribing practices, given the frequent use of antibiotics in this setting that sits at the interface of the community and the hospital. This article outlines the importance of antimicrobial stewardship in the ED setting and provides practical recommendations drawn from existing evidence for the application of various strategies and tools that could be implemented in the ED including advancement of clinical guidelines, clinical decision support systems, rapid diagnostics, and expansion of ED pharmacist programs.

Increasing the efficiency of medical research with dynamic research summaries for researchers and consumers.

Literature reviews are usually the first step in conducting medical research projects. They often lead to the creation of a useful research question. However, this initial step in medical research contains inefficiencies, which if removed, could speed up the research process and thereby enhance development of innovative health related products.

National culturally and linguistically appropriate services standards--mandates or not?

The U.S. Department of Health and Human Services' Office of Minority Health (OMH) promotes National Standards for Culturally and Linguistically Appropriate Services.

Associations between genetic variants in vitamin D metabolism and asthma characteristics in young African Americans: a pilot study.

Introduction: Low vitamin D levels have been associated with asthma severity in children. Young, urban African Americans (AAs) have high rates of hypovitaminosis D and asthma. Our objective was to determine associations between variants in vitamin D metabolism genes and asthma characteristics in a pilot study of young urban AAs.

Regional differences in awareness and attitudes regarding genetic testing for disease risk and ancestry.

Little is known about the lay public's awareness and attitudes concerning genetic testing and what factors influence their perspectives. The existing literature focuses mainly on ethnic and socioeconomic differences; however, here we focus on how awareness and attitudes regarding genetic testing differ by geographical regions in the US. We compared awareness and attitudes concerning genetic testing for disease risk and ancestry among 452 adults (41% Black and 67% female) in four major US cities, Norman, OK; Cincinnati, OH; Harlem, NY; and Washington, DC; prior to their participation in genetic ancestry testing.

Compulsory service programmes for recruiting health workers in remote and rural areas: do they work?

Compulsory service programmes have been used worldwide as a way to deploy and retain a professional health workforce within countries. Other names for these programmes include "obligatory", "mandatory", "required" and "requisite." All these different programme names refer to a country's law or policy that governs the mandatory deployment and retention of a heath worker in the underserved and/or rural areas of the country for a certain period of time.

Teaching health policy to residents--three-year experience with a multi-specialty curriculum.

Introduction: Most residents have limited education or exposure to health policy during residency.

Aims: We developed a course to (1) educate residents on health policy topics applicable to daily physician practice; (2) expose residents to health policy careers through visits with policy makers and analysts; (3) promote personal engagement in health policy.

Setting: Residents registered for a 3-week elective offered twice annually through the George Washington University Department of Health Policy.

Massachusetts et al. v Environmental Protection Agency: implications for public health policy and practice.

This installment of reviews the U.S. Supreme Court's April 2, 2007, decision in and considers its implications for public health policy and practice.

Genetic and social environment interactions and their impact on health policy.

Genetic and social factors are not as separate as once thought. Researchers within the social sciences are beginning to realize that genetics and the social environment interact synergistically to affect health behaviors and outcomes. This way of thinking is leading to new research models and is influencing the development of research initiatives.

The role of genetic and sociopolitical definitions of race in clinical trials.

Although the concept of race has been disputed for decades, race continues to be used as a variable in biomedical research. Public Law 103-43 calls on the National Institutes of Health to develop guidelines for defining "minority group" and "their subpopulations" for the purposes of ensuring that they are included in clinical trials. Current guidelines use census racial categories, even though these categories are labeled as not scientific by their creator, the Office of Management and Budget.