JAMA network open
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This study assesses the role of telehealth in the delivery of care at the start of the COVID-19 pandemic. ⋯ This study of a large cohort of patients enrolled in US health plans documented patterns of care at the onset of COVID-19. The findings are relevant to policy makers, payers, and practitioners as they manage the use of telehealth during the pandemic and afterward.
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Adolescent access to firearms increases their risk of firearm injury. ⋯ In this study, many adolescents reported having ready access to loaded guns in their homes, even when all household firearms were locked. Many adolescents who reported having access to household firearms lived with parents who knew their children had access, but others lived with parents who did not know. These finding should inform prevention efforts aimed at reducing adolescent access to household firearms.
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Hypertensive disorders of pregnancy are a leading cause of maternal morbidity and mortality. The impact of applying recent guideline definitions for nonpregnant adults to pregnant women is unclear. ⋯ Using the lower diagnostic threshold for hypertension recommended in the 2017 ACC/AHA guideline increased the prevalence of chronic and gestational hypertension, markedly improved the appropriate identification of women who would go on to develop preeclampsia, and was associated with the identification of adverse fetal/neonatal risk.
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Risks for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care personnel (HCP) are unclear. ⋯ In this cross-sectional study of US HCP in 3 states, community exposures were associated with seropositivity to SARS-CoV-2, but workplace factors, including workplace role, environment, or contact with patients with known COVID-19, were not. These findings provide reassurance that current infection prevention practices in diverse health care settings are effective in preventing transmission of SARS-CoV-2 from patients to HCP.
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Postoperative complications can significantly impact perioperative care management and planning. ⋯ The ML models for predicting postoperative complications with model-agnostic interpretation offer opportunities for integrating risk predictions for clinical decision support. Such real-time clinical decision support can mitigate patient risks and help in anticipatory management for perioperative contingency planning.