Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.
1. Surgeon demonstrates social distancing during surgery, performs remote operation over 5G network
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A surgeon demonstrated how telesurgery could be successfully performed using robotic technology and a 5G network by operating on a cadaver patient from 15 km away. The low latency and high bandwidth of 5G allowed the surgeon to operate as if he were in the operating room with the patient. This was the first public demonstration of remote surgery over 5G. A brief research report is published in Annals of Internal Medicine.
The authors from Istituto Italiano di Tecnologia, Genoa, Italy presented a feasibility demonstration where robotic telemicrosurgery was performed on a cadaver patient's vocal chords with both sides of the system on wireless 5G networks. According to the authors, this demonstration showed the feasibility of remote surgery both in everyday and in emergency situations, such as those involving temporary field hospitals and the need for physical distancing between surgeons and patients (e.g. during COVID-19 pandemic, or after natural disasters). This type of surgery has the potential for large-scale adoption, revolutionizing healthcare and surgical treatments around the globe, the authors say.
Media contacts: For an embargoed PDF please contact Lauren Evans at email@example.com. To speak with the lead author, Leonardo de Mattos, MD, please contact Giuliano Greco at Giuliano.Greco@iit.it
2. Predicted albumin-creatinine ratio may be useful for CKD screening, staging, and prognosis
Albuminuria (presence of a type of protein in the urine), a marker of kidney disease, is associated with future risk for death, kidney failure, and cardiovascular events. Measurement of urine albumin-creatinine ratio (ACR) is the preferred method to assess albuminuria; however, many care providers check urine protein-creatinine ratio (PCR) or urine dipstick protein instead. Findings from an individual participant-based meta-analysis are published in Annals of Internal Medicine and enable conversion of PCR or urine dipstick protein to ACR for use in chronic kidney disease (CKD) screening, staging, and prognosis.
Researchers from the Chronic Kidney Disease Prognosis Consortium studied 919,383 adults with same-day measures of ACR and PCR or dipstick protein to develop equations for converting PCR and dipstick protein to urine ACR and to test their diagnostic accuracy in CKD screening and staging. They found that predicted ACR performed well in CKD screening and staging, as well as prognostically when used to predict the 2-year risk of kidney failure. These finding suggest that when ACR measurement is not available in health care or research settings, ACR estimating equations, such as those reported in this study, may enhance both research and clinical care.
Media contacts: For an embargoed PDF please contact Lauren Evans at firstname.lastname@example.org. The consortium leaders, Josef Coresh, MD, PhD or Morgan E. Grams, MD, PhD can be reached through Jonathan Eichberger at email@example.com.
3. USPSTF position paper details methods for developing recommendations to address social determinants of health
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The United States Preventive Services Task Force (Task Force) has tackled how they will develop primary-care based recommendations that address the social determinants of health (SDoH) that affect access and quality of health care. The Task Force position paper is published in Annals of Internal Medicine.
Social conditions that adversely influence health and wellbeing in the U.S. population are called SDoH. Some SDoH are modifiable and some are not. Public health interventions exist for improving modifiable SDoHs, such as food insecurity, transportation difficulties, and interpersonal safety. There is also a growing body of evidence on instruments and practices to screen for and intervene on SDoHs in clinical care settings. As such, the USPSTF is assessing the role of SDoHs in primary care prevention recommendations. Task Force members describe the mission of the USPSTF, highlight how SDoHs are currently incorporated into USPSTF recommendations for screening and prevention, and discuss a potential approach to address SDoHs in future recommendations.
Media contacts: For an embargoed PDF please contact Lauren Evans at firstname.lastname@example.org.
To speak with the lead author, Karina Davidson, PhD, please contact email@example.com.
Also in this issue:
Addressing Patient Bias Toward Health Care Workers: Recommendations for Medical Centers
Kimani Paul-Emile, JD, PhD; Jeffrey M. Critchfield, MD; Margaret Wheeler, MS, MD; Shalila de Bourmont, BS; Alicia Fernandez, MD
Restoring the Story and Creating a Valuable Clinical Note
Heather E. Gantzer, MD; Brian L. Block, MD; Lacy C. Hobgood, MD; and Janice Tufte
Ideas & Opinions