There’s been a lot of hype about personalised medicine and the potential of polygenic risk scores to help prevent disease. High risk individuals can be identified from genetic testing and targeted with prevention strategies. But how effective is communicating this risk to people?

New research by Luigi Russo and colleagues finds disclosing polygenic risk scores does not result in meaningful change to patient health behaviours or outcomes. Despite promising claims, current RCT data shows limited impact on preventive measures https://bit.ly/4oBzxsE

Scientific progress depends on more than discovery. This editorial, published in Considerations in Medicine, makes the case for recognising replication, transparency, and methodological rigour as essential components of impactful research. Read it here: https://bit.ly/4fOl7mu

Does disclosing polygenic risk scores change health outcomes? New research by Luigi Russo and colleagues summarises the evidence so far from all RCTs on the efficacy of communication of polygenic risk scores in changing health outcomes. https://bit.ly/3SnKPVa

A new review by Catrin Cox and colleagues discusses identifying and managing the coagulopathy of severe postpartum haemorrhage and reports on the new understanding of the haemostatic changes of postpartum haemorrhage Read the full review in BMJ Medicine: https://bit.ly/4amQQYo

Catrin Cox and colleagues examine new approaches in the haemostatic management of postpartum haemorrhage in this specialist review. https://bit.ly/4uyXHVU

Great thread on immortal time bias. Save the paper for your next journal club.

The proposed new rules on federal funding are another blow to 🇺🇸 science But they will also harm international collaborations, the lifeblood of science and health 🌐 Where is the US medical leadership and outrage? My new piece @bmj_latest www.bmj.com/content/393/...

Laura Shannon and colleagues examine the pathogenesis of pulmonary fibrosis and link the evolving mechanistic insights to current and emerging therapeutic strategies in this review. Read now in BMJ Medicine: https://bit.ly/3REaoRH

A new review by Laura Shannon and colleagues examines the pathogenesis of pulmonary fibrosis and links evolving mechanistic insights to current and emerging therapeutic strategies. Read now in BMJ Medicine: https://bit.ly/3REaoRH

Delphine Mitanchez and colleagues assesses whether procalcitonin-guided decision making can safely reduce the duration of antibiotic treatment in neonatal late onset sepsis in newborns Read the full study in BMJ Medicine: https://bit.ly/3PILP5q

Yan Xie and colleagues assess whether initiation of GLP-1 receptor agonists rather than sulfonylureas is associated with all cause acute pancreatitis and cause specific acute pancreatitis Read in BMJ Medicine: https://bit.ly/49iTWfB

Georgina Nakafero and colleagues examine incidence of fragility fracture, atypical femoral fracture & osteonecrosis of the jaw after bisphosphonate prescription. Read the full paper in BMJ Medicine: https://bit.ly/4uIFTIE

In this study, Marc Raynaud and colleagues validate the integrative Box (iBox) prediction system for kidney allograft failure in real world settings and clinical scenarios https://bit.ly/4v4Oghx

A new randomised control trial by Delphine Mitanchez and colleagues assesses whether procalcitonin-guided decision making can safely reduce the duration of antibiotic treatment in neonatal late onset sepsis Read the full study in BMJ Medicine: https://bit.ly/3RvkAf0

Paul van Amstel and colleagues and colleagues compare non-operative treatment strategy with appendectomy for children with simple appendicitis, looking at complications, quality of life, and cost-effectiveness. Read the full study in BMJ Medicine: https://bit.ly/49FrPY1

How can we safely reduce antibiotic exposure in newborns with late onset sepsis? Delphine Mitanchez and colleagues investigates if procalcitonin-guided decision-making can safely reduce the duration of antibiotic treatment for neonatal late onset sepsis. https://bit.ly/42BXRQZ

Can non-operative treatment safely help children avoid appendectomy? Paul van Amstel and colleagues compare a non-operative strategy with surgery for simple appendicitis, examining complications, quality of life, and cost savings after one year. https://bit.ly/4wCoSkK

The results from a new study by Marc Raynaud and colleagues highlight the versatility of the iBox system, a prediction model for long term risk of kidney allograft failure, and support its use for risk stratification in routine clinical practice https://bit.ly/4wofPUr

Yan Xie and colleagues assess whether initiation of GLP-1 receptor agonists rather than sulfonylureas is associated with all cause acute pancreatitis and cause specific acute pancreatitis in this nationwide cohort. https://bit.ly/3RpLpBe

Amira Mahmood and colleagues summarises the latest WHO treatment guidelines for pulmonary tuberculosis, including evidence to support agents and regimens, and emerging therapies. Read in BMJ Medicine: https://bit.ly/3ORCJ61

Research by Georgina Nakafero and colleagues examines incidence of fragility fracture, atypical femoral fracture & osteonecrosis of the jaw after bisphosphonate prescription. Read the full paper in BMJ Medicine: https://bit.ly/4uzkzoL

Yan Xie and colleagues assess whether initiation of GLP-1 receptor agonists rather than sulfonylureas is associated with all cause acute pancreatitis and cause specific acute pancreatitis in this nationwide cohort. https://bit.ly/4eQZbGG

Explore our Methods Primers Collection, where all resources in this area are conveniently organized for your reference https://bit.ly/45vZb9G

A new review by Amira Mahmood and colleagues summarises the latest consolidated WHO treatment guidelines for pulmonary tuberculosis including evidence to support agents and regimens, and emerging therapies. Read the full review in BMJ Medicine: https://bit.ly/4ugPFl0

Is there association between fragility fracture and interruption of bisphosphonate prescription? New research by Georgina Nakafero and colleagues examines incidence of fragility fracture, atypical femoral fracture & osteonecrosis of the jaw after bisphosphonate prescription. https://bit.ly/4eLCR1f

Vaccine cold chains are vital but prone to weaknesses that are particularly acute in sub-Saharan Africa. Gilbert Rukundo and colleagues examine how new advances and challenges in vaccine cold chains will affect readiness to control vaccine preventable disease LMICs in Africa https://bit.ly/4ckcvlw

Metabolic dysfunction associated steatotic liver disease (MASLD) is the new name for non-alcoholic fatty liver disease (NAFLD). A new specialist review in BMJ Medicine offers a guide to assessment of MASLD and discusses approved and emerging treatment options for MASLD. 🧵

Take a look at our open access specialist reviews, in one handy Collection for you to browse anytime https://bit.ly/3YpbpgB

Gilbert Rukundo and colleagues examine the vaccine cold chain in African low and middle income countries, and how new and emerging advances and challenges will affect readiness to control the burden of vaccine preventable disease on the continent https://bit.ly/3Q6TWbO

A new systematic review by @kdsweeney.bsky.social and colleagues identifies primary care and community based interventions for patients with multimorbidity involving depression or anxiety, to determine their effectiveness for improving patients’ health https://bit.ly/3Om7OhG

Yan Xie and colleagues examine glucagon-like peptide 1 receptor agonist discontinuation and risks of major adverse cardiovascular events in adults with type 2 diabetes https://bit.ly/4cyz4CY #CardiovascularHealth

Alan Wright and colleagues find that that lowering blood pressure early in pregnancy may reduce pre-eclampsia risk by up to 50%, but a large trial is needed to confirm the benefits, risks, and costs of this for clinical practice. https://bit.ly/4srHBfI #MaternalHealth

Tina Reinson and colleagues summarise current understandings in the pathogenesis, diagnosis, and management of metabolic dysfunction associated steatotic liver disease in adults in a new review. https://bit.ly/41HJJVA

A new study by Alan Wright and colleagues finds lowering blood pressure from early pregnancy may reduce preterm and term pre-eclampsia Read the full study in BMJ Medicine: https://bit.ly/4sfwDdh

New research by Yan Xie and colleagues found cardiovascular benefit of GLP-1RAs accumulated with continuous use, but even brief periods of discontinuations could progressively erode and ultimately reverse protection. Read the full paper in BMJ Medicine: https://bit.ly/3PpsINi

Jonathan Batty, Tamara del Toro, and Marlous Hall reflect on the results and potential limitations in Yan Xie and colleagues' research paper on the use of GLP-1 receptor agonists and their effectiveness in reducing major adverse cardiovascular events https://bit.ly/3NzRbio

Take a look at our open access specialist reviews, in one handy Collection for you to browse anytime https://bit.ly/3YpbpgB

Yan Xie and colleagues characterise patterns of use of glucagon-like peptide 1 receptor agonists and assess the associations between treatment scenarios and the risk of major adverse cardiovascular events in adults with type 2 diabetes https://bit.ly/4bIqT5m

Research by Kayleigh Mason and colleagues examines trends in the use of advice and guidance versus direct referral in NHS primary care from 2015 to 2023, raising questions about efficiency and equity in referral pathways. #HealthEquity https://bit.ly/4rSozPx

Interested in non-pharmacological interventions for fatigue in long term conditions? Joanna Leaviss and colleagues find interventions that support individuals to increase physical activity or that are based on cognitive behavioural approaches are effective in reducing fatigue https://bit.ly/47LPFAi

Immortal time bias in observational studies is common. A new BMJ Methods Primer from Harrison Hansford et al. explains what it is, and how to avoid it. 🧵https://bmjmedicine.bmj.com/content/5/1/e001280

In their new study, Joanna Leaviss and colleagues find that interventions focusing on physical activity and cognitive-behavioural approaches are effective in reducing fatigue in people with long-term medical conditions. Read the full study here: https://bit.ly/3PerFQ4

As eosinophilic oesophagitis prevalence continues to rise globally, Mark Mahon and colleagues explore recent advances in targeted treatments and diagnostics which are redefining long term care. https://bit.ly/4s4OBQk

A new review by Mark Mahon and colleagues explores developments in the diagnosis and management of eosinophilic oesophagitis, highlighting promising emerging minimally invasive tests for patients. Read the full article here: https://bit.ly/3P7Dt6A

Sara Pretorius and colleagues review UK guidelines for individual health conditions and propose improvements to guideline development processes to improve usability of guidelines for clinicians managing patients with multiple long term conditions https://bit.ly/4slFri8

Estimates of multimorbidity range from 15-43% of the adult population, and most people with one long term condition have more than one. How well do guidelines account for this? How often do they offer specific guidance on how to manage long term conditions that may be affected by comorbidities?🧵

Barbara Nicholl and colleagues reflect on how clinical guidelines largely focus on single diseases and are inadequate for the care required by people with multiple long-term conditions Read the full Editorial in BMJ Medicine: https://bit.ly/4tWorAy

How did you get on with our stats question? Was it too mean? Here are the answers🧵

In this study Sara Pretorius and colleagues evaluate how UK guidelines for individual health conditions account for coexisting conditions and propose changes to guideline development to improve care for people with multiple long term conditions https://bit.ly/4sczrYK