Reviews & Analysis

QR4 is a new cardiovascular disease (CVD) risk score developed and evaluated in 16.9 million people that has better performance than other commonly used CVD risk scores. It includes nine new risk factors associated with increased risk of developing CVD (for example, a heart attack or stroke) over the next 10 years.

Food allergy treatment is undergoing a paradigm shift with new therapies emerging, including the recent FDA approval of omalizumab — but without evidence of disease modification and with uncertain quality-of-life improvement, it may not be a panacea for all.

AI models for tasks such as pathology and dermatology struggle to generalize to new patient groups or hospitals that they were not trained on; learning more robust features from unlabeled data could prevent overfitting to the training distribution and thereby increase fairness.

Causal machine learning methods could be used to predict treatment outcomes for subgroups and even individual patients; this Perspective outlines the potential benefits and limitations of the approach, offering practical guidance for appropriate clinical use.

Recent developments in bioengineering and organic chemistry have enabled targeting of the previously ‘undruggable’ KRAS; this review summarizes the successes, challenges and future of KRAS therapeutics in the clinic.

A small, prospective clinical study shows that ex vivo drug screening of pediatric cancer samples can identify effective therapeutic options. If validated, these findings could herald a new approach to precision medicine in this setting.

A large study of older adults in China points to physical and cognitive function — not age — as key predictors of heat-related mortality, highlighting the need for climate adaptation policies to prioritize accessibility across all age groups.

Most suspected cholera cases are not tested for Vibrio cholerae. Integrating systematic testing into cholera surveillance systems, even with imperfect rapid diagnostic tests, could yield large gains in efficiency and cost savings in the geographic targeting of mass oral cholera vaccination campaigns.

Evaluation of a clinical summarization method based on GPT-4 suggests that such models might reduce the documentation burden on clinicians — but prospective evaluation with high-priority tasks will be the true test of its potential.

The implementation of PCR tests of pooled saliva samples for universal screening of congenital cytomegalovirus infection was assessed in 15,805 neonates over 13 months. This extensive analysis revealed the high feasibility and empirical efficiency of the pooled testing approach, which had a clinically insignificant loss of sensitivity.

Clinical disease trajectories that describe neuropsychiatric symptoms were identified using natural language processing for 3,042 brain donors diagnosed with various neurodegenerative disorders. Trajectories revealed distinct temporal patterns that result in the identification of new clinical subtypes, and a subset of misdiagnosed donors.

Telehealth provision of medication abortion is safe and effective, but ensuring equitable access is challenging in the USA — and further compounded by an upcoming Supreme Court case.

Chronic pain is common, with more than one in five adult Americans reporting having pain daily or on most days. A multi-ancestry genomic analysis in 598,339 military veterans in the USA identifies 126 genetic variants associated with pain intensity, highlights shared genetic risk with substance use and psychiatric disorders, and reveals enrichment in GABAergic neurons as a key molecular contributor to experiencing pain.

Acute kidney injury affects one in five hospitalized patients and can lead to lasting kidney damage or death. We show that clonal hematopoiesis of indeterminate potential — a common age-related condition caused by blood cell mutations — increases the risk of acute kidney injury in multiple cohorts of human patients and in mouse models.

After many lean years, important progress has been made in updating the anti-tuberculosis drug armamentarium; a new drug that targets bacterial protein synthesis is one of several that could help transform the treatment of this neglected and deadly disease.

Self-care interventions have the potential to improve health coverage for women while offering greater agency and autonomy, but only if certain barriers—such as stigma and cost—can be overcome.

Primary fetal organoids are currently derived from tissue samples obtained at termination of pregnancy. We developed an approach that enables prenatal derivation of epithelial organoids from fetal fluids. Single-cell mapping of the human amniotic fluid content unveiled the presence of viable fetal epithelial progenitors of multiple tissues that can form fetal lung, kidney and intestinal organoids.

In a difference-in-differences analysis among Medicare beneficiaries in the USA, billion-dollar weather disasters were associated with higher rates of emergency department visits and deaths in the weeks after the disaster. Observed changes were more pronounced among counties that experienced the most loss and damage compared to all affected counties.

Patient-reported outcomes are invaluable tools, but may impose a burden on patients; this consensus statement provides a set of 19 recommendations to reduce respondent burden.

A new study shows the benefits of treating anxiety to prevent postnatal depression — and highlights the need for more pragmatic research to simplify treatment packages, address other comorbid symptoms, and deliver effective perinatal mental health care at scale.