Journal of general internal medicine
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Creating clinical vignettes requires considerable effort. Recent developments in generative artificial intelligence (AI) for natural language processing have been remarkable and may allow for the easy and immediate creation of diverse clinical vignettes. ⋯ Overall, 97% of the clinical vignettes proved practically useful, based on confirmation and revision by Japanese medical physicians. Given the significant effort required by physicians to create vignettes without AI, using GPT is expected to greatly optimize this process.
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Use of the Patient Portal to Discuss Medications Among People with Dementia and Their Care Partners.
People with dementia (PWD) often use potentially inappropriate medications (PIM), exposing them to harm. Patient portals are a promising platform for delivering deprescribing educational interventions to reduce PIM use, yet little is known about how PWD and their care partners use patient portals to communicate with clinicians about medications. ⋯ PWD and their care partners frequently raise medication concerns in the portal, suggesting it is a promising platform for delivering deprescribing interventions for this population. Future research should identify characteristics of portal-based interventions that would best support deprescribing for PWD and develop pragmatic workflows.
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Nonverbal communication plays a pivotal role in the provision of effective patient care and has been associated with important patient health outcomes. Clinician posture, a nonverbal form of communication, may influence the patient experience and satisfaction. The relationship between clinician posture (i.e., standing or at the patient's eye level) and patient perceptions of clinician communication in the hospital-a setting with heightened power dynamics between patient and clinician-is currently unknown. ⋯ PROSPERO, CRD42020199817.
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Feedback on the diagnostic process has been proposed as a method of improving clinical reasoning and reducing diagnostic errors. Barriers to the delivery and receipt of feedback include time constraints and negative reactions. Given the shift toward asynchronous, digital communication, it is possible that electronic feedback ("e-feedback") could overcome these barriers. ⋯ E-feedback was well received by hospitalists. Their perspectives offer useful insights for enhancing electronic feedback interventions.
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In this study, we explore the barriers and facilitators to diabetes medication adherence and self-management for people with type 2 diabetes who have experienced homelessness. ⋯ Our findings highlight the structural vulnerabilities impacting people experiencing homelessness and identify inflection points of opportunity at structural and individual levels to strengthen diabetes medication adherence and self-management. This understanding can inform policy change and future tailored diabetes interventions.