The health risks of generative AI-based wellness apps.

Artificial intelligence (AI)-enabled chatbots are increasingly being used to help people manage their mental health. Chatbots for mental health and particularly 'wellness' applications currently exist in a regulatory 'gray area'. Indeed, most generative AI-powered wellness apps will not be reviewed by health regulators.

Speaking Up and Taking Action: Psychological Safety and Joint Problem-Solving Orientation in Safety Improvement.

Healthcare organizations face stubborn challenges in ensuring patient safety and mitigating clinician turnover. This paper aims to advance theory and research on patient safety by elucidating how the role of psychological safety in patient safety can be enhanced with joint problem-solving orientation (JPS). We hypothesized and tested for an interaction between JPS and psychological safety in relation to safety improvement, leveraging longitudinal survey data from a sample of 14,943 patient-facing healthcare workers.

Going beyond the "self" in self-control: Interpersonal consequences of commitment strategies.

Commitment strategies are effective mechanisms individuals can use to overcome self-control problems. Across seven studies (and two supplemental studies), we explore the negative interpersonal consequences of commitment strategy choice and use. In Study 1, using an incentivized trust game, we demonstrate that individuals trust people who choose to use a commitment strategy less than those who choose to use willpower to achieve their goals.

Provider Perceptions of an Electronic Health Record Prostate Cancer Screening Tool.

Objectives:  We conducted a focus group to assess the attitudes of primary care physicians (PCPs) toward prostate-specific antigen (PSA)-screening algorithms, perceptions of using decision support tools, and features that would make such tools feasible to implement.

Methods:  A multidisciplinary team (primary care, urology, behavioral sciences, bioinformatics) developed the decision support tool that was presented to a focus group of 10 PCPs who also filled out a survey. Notes and audio-recorded transcripts were analyzed using Thematic Content Analysis.

A Provider-Facing Decision Support Tool for Prostate Cancer Screening in Primary Care: A Pilot Study.

Objectives:  Our objective was to pilot test an electronic health record-embedded decision support tool to facilitate prostate-specific antigen (PSA) screening discussions in the primary care setting.

Methods:  We pilot-tested a novel decision support tool that was used by 10 primary care physicians (PCPs) for 6 months, followed by a survey. The tool comprised (1) a risk-stratified algorithm, (2) a tool for facilitating shared decision-making (Simple Schema), (3) three best practice advisories (BPAs: <45, 45-75, and >75 years), and (4) a health maintenance module for scheduling automated reminders about PSA rescreening.

Enhancing Value and Well-Being: The Basket of Motivators Framework for Aligning Neurology Clinical Practices With Performance Outcomes.

Purpose Of Review: Physician burnout, which is prevalent in neurology, has accelerated in recent years. While multifactorial, a major contributing factor to burnout is a payment model that rewards volume over quality, leaving physicians overburdened and unfulfilled. The aim of this review was to investigate ways of reducing burnout while improving quality-based outcomes in a value-based health care model.

Tracing Digital Therapeutics Research Across Medical Specialties: Evidence from ClinicalTrials.gov.

Digital therapeutics (DTx), evidence-based software interventions for preventing, managing, or treating medical disorders, have rapidly evolved with healthcare's shift toward online, patient-centric solutions. This study scrutinizes DTx clinical trials from 2005 to 2022, analyzing their growth, funding, underlying medical specialties, and other R&D characteristics, using ClinicalTrials.gov data.

Variation in social media sensitivity across people and contexts.

Social media impacts people's wellbeing in different ways, but relatively little is known about why this is the case. Here we introduce the construct of "social media sensitivity" to understand how social media and wellbeing associations differ across people and the contexts in which these platforms are used. In a month-long large-scale intensive longitudinal study (total n = 1632; total number of observations = 120,599), we examined for whom and under which circumstances social media was associated with positive and negative changes in social and affective wellbeing.

Differences in Care Team Response to Patient Portal Messages by Patient Race and Ethnicity.

Importance: The COVID-19 pandemic was associated with substantial growth in patient portal messaging. Higher message volumes have largely persisted, reflecting a new normal. Prior work has documented lower message use by patients who belong to minoritized racial and ethnic groups, but research has not examined differences in care team response to messages.

Prospective Evaluation of the Cost of Performing Breast Imaging Examinations Using a Time-Driven Activity-Based Costing Method: A Single-Center Study.

Objective: Measuring the cost of performing breast imaging is difficult in healthcare systems. The purpose of our study was to evaluate this cost using time-driven activity-based costing (TDABC) and to evaluate cost drivers for different exams.

Methods: An IRB-approved, single-center prospective study was performed on 80 female patients presenting for breast screening, diagnostic or biopsy exams from July 2020 to April 2021.

The potential of generative AI for personalized persuasion at scale.

Matching the language or content of a message to the psychological profile of its recipient (known as "personalized persuasion") is widely considered to be one of the most effective messaging strategies. We demonstrate that the rapid advances in large language models (LLMs), like ChatGPT, could accelerate this influence by making personalized persuasion scalable. Across four studies (consisting of seven sub-studies; total N = 1788), we show that personalized messages crafted by ChatGPT exhibit significantly more influence than non-personalized messages.

"The Water in Which We Swim:" A Unique, Post-Clerkship Multidisciplinary Course.

Objective: To improve patient outcomes and promote health equity, medical students must be taught not only biomedicine, but also the social sciences to understand the larger contexts in which patients live and health care operates. Yet, most undergraduate medical education does not explicitly cover these topics in a required, longitudinal curriculum.

Methods: In January 2015 at Harvard Medical School, we created a two-part sequence (pre- and post-clerkship) of required, 4-week multidisciplinary courses-"Essentials of the Profession I and II"-to fill this gap.

Beyond the 510(k): The regulation of novel moderate-risk medical devices, intellectual property considerations, and innovation incentives in the FDA's De Novo pathway.

Moderate-risk medical devices constitute 99% of those that have been regulated by the U.S. Food and Drug Administration (FDA) since it gained authority to regulate medical technology nearly five decades ago.

Tepid Uptake of Digital Health Technologies in Clinical Trials by Pharmaceutical and Medical Device Firms.

Digital health technologies (DHTs) can enable more patient-centric therapeutic development by generating evidence that captures how patients feel and function, enabling decentralized trial designs that increase participant inclusivity and convenience, and collecting and structuring patient-generated data for regulators to use in approval decisions alongside traditional clinical outcomes. Although a growing body of evidence has documented increasing use of DHTs in clinical trials overall, the use of DHTs in clinical trials supporting medical product development is unclear; here, we quantify the use of DHTs in clinical trials sponsored by pharmaceutical and medical device firms. Despite interest from pharmaceutical and medical device manufacturers in DHTs, we find tepid uptake of DHTs in trials by these sponsor types over time.

Medicare price negotiation and pharmaceutical innovation following the Inflation Reduction Act.

The Inflation Reduction Act (IRA) requires Medicare to negotiate lower prices for some medicines with high Medicare spending. Using historical data from public and proprietary sources to apply the IRA's negotiation criteria retrospectively, we identify all drugs that met the eligibility criteria from 2012 to 2021 to classify drugs that would have had a negotiated price in effect in 2022 and to calculate associated decreases in industry revenues. Our results suggest that the IRA's reduction in overall industry revenue will be modest, will not affect most top-selling drugs and will not likely result in large-scale defunding of research and development.

Applying the principles for digital development to improve maternal and child health in the Peri-urban areas of Karachi, Pakistan.

Low- middle-income countries, including Pakistan, are facing significant obstacles in their efforts to achieve the global targets for maternal, newborn, and child health (MNCH) defined by the Sustainable Development Goals. Barriers at the individual, health system, and contextual levels undermine healthcare access for pregnant women and children, disproportionately affecting those in low-resource settings. To address these challenges in the high-mortality, peri-urban areas of Karachi, VITAL Pakistan Trust and Aga Khan University launched a digital health intervention (DHI) to stimulate demand for health services and streamline care management for health workers at the primary care level.

The effect of configural processing on mentalization.

Eight studies ( = 2,561) reveal that how we perceptually process a person's face affects our capacity to understand their mind. Studies 1A and B indicate this relationship functions via two separate pathways: (a) indirectly by increasing our sensitivity to the cues of a mind in a face and (b) directly by changing the way we relate to the mind behind the face. Six additional studies adopt perspective taking paradigms to provide further support for a direct effect of configural processing on mentalization.

Relational attributions for one's own resilience predict compassion for others.

Existing work on attribution theory distinguishes between external and internal attributions (i.e., "I overcame adversity due to luck" vs.

A simulation-based analysis of the impact of rhetorical citations in science.

Authors of scientific papers are usually encouraged to cite works that meaningfully influenced their research (substantive citations) and avoid citing works that had no meaningful influence (rhetorical citations). Rhetorical citations are assumed to degrade incentives for good work and benefit prominent papers and researchers. Here, we explore if rhetorical citations have some plausibly positive effects for science and disproportionately benefit the less prominent papers and researchers.

Subset scanning for multi-trait analysis using GWAS summary statistics.

Motivation: Multi-trait analysis has been shown to have greater statistical power than single-trait analysis. Most of the existing multi-trait analysis methods only work with a limited number of traits and usually prioritize high statistical power over identifying relevant traits, which heavily rely on domain knowledge.

Results: To handle diseases and traits with obscure etiology, we developed TraitScan, a powerful and fast algorithm that identifies potential pleiotropic traits from a moderate or large number of traits (e.

A multifaceted training tool to reduce weight bias among healthcare students: A randomized controlled trial.

Background: Weight bias toward people with obesity (PwO) is common in healthcare settings. Efforts to address weight bias in healthcare settings should begin during university studies. This study aimed to explore the effect of a multifaceted intervention on weight bias among undergraduate healthcare students.

Risk factors for COVID-19 in-hospital mortality in Argentina: A competing risk survival analysis.

COVID-19 poses dire threats for low and middle-income countries (LMICs). Yet, there remains limited rigorous evidence describing the characteristics and outcomes of hospitalized patients for LMICs, and often the evidence was based on small samples and/or unicentric. The objective of this study was to examine risk factors of COVID-19 mortality in Argentina, a hard-hit middle-income Latin American country.